Claims about whether or not infertility is a disease are sometimes invoked to defend or criticize the provision of state-funded treatment for infertility. In this paper, I suggest that this strategy is problematic. By exploring infertility through key approaches to disease in the philosophy of medicine, I show that there are deep theoretical disagreements regarding what subtypes of infertility qualify as diseases. Given that infertility's disease status remains unclear, one cannot uncontroversially justify or undermine its claim to medical treatment by (...) claiming that it is or is not a disease. Instead of focusing on disease status, a preferable strategy to approach the debate about state-funded treatment is to explicitly address the specific ethical considerations raised by infertility. I show how this alternative strategy can be supported by a recent theoretical framework in the philosophy of medicine, which avoids the problems associated with the concepts of health and disease. (shrink)

It is often claimed in parts of the psychiatric literature that neuroscientific research into the biological basis of mental disorder undermines dualism in the philosophy of mind. This paper shows that such a claim does not apply to all forms of dualism. Focusing on Kenneth Kendler’s discussion of the mind–body problem in biological psychiatry, I argue that such criticism of dualism often conflates the psychological and phenomenal concepts of the mental. Moreover, it fails to acknowledge that there are different varieties (...) of dualism, and so overlooks the important metaphysical insights of contemporary dualist philosophers. I argue that while the neuroscientific research underpinning biological psychiatry challenges the traditional dualism of René Descartes, it does not pose any problem for the more modern dualism of David Chalmers. It is possible to take seriously the scientific claims of biological psychiatry while holding that this latter form of dualism is true. This has implications for the positioning of the mind–body problem in psychiatry. While the “easy” problem of explaining psychological processes is relevant to the aims of biological psychiatry, psychiatrists need not worry about the “hard” problem of consciousness. (shrink)

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

Medical assistance in dying, which includes voluntary euthanasia and assisted suicide, is legally permissible in a number of jurisdictions, including the Netherlands, Belgium, Switzerland and Canada. Although medical assistance in dying is most commonly provided for suffering associated with terminal somatic illness, some jurisdictions have also offered it for severe and irremediable psychiatric illness. Meanwhile, recent work in the philosophy of psychiatry has led to a renewed understanding of psychiatric illness that emphasises the role of the relation between the person (...) and the external environment in the constitution of mental disorder. In this paper, I argue that this externalist approach to mental disorder highlights an ethical challenge to the practice of medical assistance in dying for psychiatric illness. At the level of the clinical assessment, externalism draws attention to potential social and environmental interventions that might have otherwise been overlooked by the standard approach to mental disorder, which may confound the judgement that there is no further reasonable alternative that could alleviate the person’s suffering. At the level of the wider society, externalism underscores how social prejudices and structural barriers that contribute to psychiatric illness constrain the affordances available to people and result in them seeking medical assistance in dying when they otherwise might not have had under better social conditions. (shrink)

In The Biopsychosocial Model of Health and Disease, Derek Bolton and Grant Gillett argue that a defensible updated version of the biopsychosocial model requires a metaphysically adequate account of disease causation that can accommodate biological, psychological, and social factors. This present paper offers a philosophical critique of their account of biopsychosocial causation. I argue that their account relies on claims about the normativity and the semantic content of biological information that are metaphysically contentious. Moreover, I suggest that these claims are (...) unnecessary for a defence of biopsychosocial causation, as the roles of multiple and diverse factors in disease causation can be readily accommodated by a more widely accepted and less metaphysically contentious account of causation. I then raise the more general concern that they are misdiagnosing the problem with the traditional version of the biopsychosocial model. The challenge when developing an explanatorily valuable version of the biopsychosocial model, I argue, is not so much providing an adequate account of biopsychosocial causation, but providing an adequate account of causal selection. Finally, I consider how this problem may be solved to arrive at a more explanatorily valuable and clinically useful version of the biopsychosocial model. (shrink)

In clinical medicine, a diagnosis can offer an explanation of a patient's symptoms by specifying the pathology that is causing them. Diagnoses in psychiatry are also sometimes presented in clinical texts as if they pick out pathological processes that cause sets of symptoms. However, current evidence suggests the possibility that many diagnostic categories in psychiatry are highly causally heterogeneous. For example, major depressive disorder may not be associated with a single type of underlying pathological process, but with a range of (...) different causal pathways, each involving complex interactions of various biological, psychological, and social factors. This paper explores the implications of causal heterogeneity for whether psychiatric diagnoses can be said to serve causal explanatory roles in clinical practice. I argue that while they may fall short of picking out a specific cause of the patient's symptoms, they can nonetheless supply different sorts of clinically relevant causal information. In particular, I suggest that some psychiatric diagnoses provide negative information that rules out certain causes, some provide approximate or disjunctive information about the range of possible causal processes, and some provide causal information about the relations between the symptoms themselves. (shrink)

Gender affirming hormone treatment is an important part of the care of trans adolescents which enables them to develop the secondary sexual characteristics congruent with their identified genders. There is an increasing amount of empirical evidence showing the benefits of gender affirming hormone treatment for psychological health and social well-being in this population. However, in several countries, access to gender affirming hormone treatment for trans adolescents has recently been severely restricted. While much of the opposition to gender affirming hormone treatment (...) for trans adolescents has in part been ideologically motivated, it also reflects a debate about whether there are harms that outweigh the benefits of the treatment. Accordingly, a systematic and comprehensive philosophical analysis of the ethics of gender affirming hormone treatment for trans adolescents is needed. Herein, I offer such an analysis that draws on the four principles of biomedical ethics by Tom Beauchamp and James Childress. Based on the considerations of beneficence, nonmaleficence, autonomy, and justice, I argue that the provision of access to gender affirming hormone treatment for consenting trans adolescents is ethically required and that the current restrictions to such treatment are ethically wrong. (shrink)

Diagnoses in medicine are often taken to serve as explanations of patients’ symptoms and signs. This article examines how they do so. I begin by arguing that although some instances of diagnostic explanation can be formulated as covering law arguments, they are explanatory neither in virtue of their argumentative structures nor in virtue of general regularities between diagnoses and clinical presentations. I then consider the theory that medical diagnoses explain symptoms and signs by identifying their actual causes in particular cases. (...) While I take this to be largely correct, I argue that for a diagnosis to function as a satisfactory causal explanation of a patient’s symptoms and signs, it also needs to be supplemented by understanding the mechanisms by which the identified cause produces the symptoms and signs. This mechanistic understanding comes not from the diagnosis itself, but rather from the theoretical framework within which the physician operates. (shrink)

Assisted reproduction using donor gametes is a procedure that allows those who are unable to produce their own gametes to achieve gestational parenthood. Where conception is achieved using donor sperm, the child lacks a genetic link to the intended father. Where it is achieved using a donor egg, the child lacks a genetic link to the intended mother. To address this lack of genetic kinship, some fertility clinics engage in the practice of matching the ethnicity of the gamete donor to (...) that of the recipient parent. The intended result is for the child to have the phenotypic characteristics of the recipient parents. This paper examines the philosophical and ethical problems raised by the policy of ethnic matching in gamete donation. I consider arguments for the provision of ethnic matching based on maximising physical resemblance and fostering ethnic identity development. I then consider an argument against ethnic matching based on the charge of racialism. I conclude that while the practice of ethnic matching in gamete donation could promote positive ethnic identity development in donor-conceived children from historically subjugated ethnic minorities, it also risks endorsing the problematic societal attitudes and assumptions regarding ethnicity that enabled such subjugation in the first place. (shrink)

This paper offers a philosophical analysis of the connection between mental disorder and suicide risk. In contemporary psychiatry, it is commonly suggested that this connection is a causal connection that has been established through empirical discovery. Herein, I examine the extent to which this claim can be sustained. I argue that the connection between mental disorder and increased suicide risk is not wholly causal but is partly conceptual. This in part relates to the way suicidality is built into the definitions (...) of some psychiatric diagnoses. It also relates to the broader normative assumption that suicidal behavior is by definition mentally disordered behavior. The above has significant epistemological implications, which I explore. I propose that the claim that suicide is connected with mental disorder cannot be justified solely by appealing to empirical evidence but also warrants a justification on conceptual and normative grounds. (shrink)

This paper examines the complex research landscape of contemporary suicidology from a philosophy of science perspective. I begin by unpacking the methods, concepts, and assumptions of some of the prominent approaches to studying suicide causation, including psychological autopsy studies, epidemiological studies, biological studies, and qualitative studies. I then analyze the different ways these approaches partition the causes of suicide, with particular emphasis on the ways they conceptualize the domain of mental disorder. I argue that these different ways of partitioning the (...) causal space and conceptualizing mental disorder result in incommensurabilities between the approaches. These incommensurabilities restrict the degrees to which the different approaches can be integrated, thus lending support to explanatory pluralism in the study of suicide causation. They also shed light on some of the philosophical underpinnings of the disagreement between mainstream suicidology and the emerging area of critical suicidology. (shrink)

Delusions and hallucinations present a challenge to traditional epistemology by allowing two people’s experiences of the world to be vastly different to each other. Traditional objective realism assumes that there is a mind-independent objective world of which people gain knowledge through experience. However, each person only has direct access to his or her own subjective experience of the world, and so neither can be certain that his or her experience represents an objective world more accurately than the other’s. This essay (...) proposes an intersubjective account of psychosis, which avoids this sceptical attack on objective certainty by considering reality not at the level of an objective mindindependent world, but at the level of peoples’ shared experiences. This intersubjective hypothesis is developed further, with reference to Husserl’s concept of multiple lifeworlds, into a relativistic account. The implication on the social role of psychiatry is also explored. (shrink)

Evolutionary psychiatry suggests that mental disorders can be explained in evolutionary terms (a) as failures of psychological mechanisms to produce the adaptive effects for which they were naturally selected, (b) as mismatches between naturally selected psychological mechanisms and contemporary environmental pressures, or (c) as naturally selected psychological mechanisms whose effects continue to be adaptive. In this paper, I present a philosophical critique of evolutionary psychiatry that draws on Subrena Smith’s matching problem for evolutionary psychology. For evolutionary psychiatry hypotheses to be (...) empirically supported, proponents of evolutionary psychiatry must demonstrate (1) that the contemporary psychological mechanisms involved in mental disorders resemble the psychological mechanisms of our evolutionary ancestors, (2) that the contemporary psychological mechanisms are phylogenetically descended from the ancestral psychological mechanisms, and (3) that the ancestral psychological mechanisms were naturally selected because their effects had adaptive benefits. However, for many mental disorders, evolutionary psychiatry lacks the methodological resources to demonstrate these conditions. Therefore, many evolutionary psychiatry hypotheses are empirically untestable and remain indefinitely underdetermined by data. (shrink)

In a recent paper, I argued that an externalist understanding of mental disorder from the philosophy of psychiatry presents an ethical challenge to the practice of medical assistance in dying (MAiD) for psychiatric illness, because it highlights the ways in which the suffering associated with psychiatric illness is sustained by features of the external environment wherein the person is embedded, including social barriers and injustices. In a response to my paper, Harry Hudson argues that addressing social inequality lacks relevance to (...) the immediate permissibility of psychiatric MAiD and that the issue of psychiatric MAiD should be informed by ‘pragmatic politics’ rather than by ‘obfuscatory philosophy’. Herein, I contend that Hudson’s response misconstrues my position and ascribes to me views I neither express nor endorse. My paper does not claim that psychiatric MAiD should be denied to people who are presently in intolerable distress. Rather, it suggests that the provision of psychiatric MAiD comes along with social responsibilities of the state to attend to the barriers and injustices that sustain and exacerbate psychiatric illness, as well as ethical responsibilities of clinicians to consider a wider range of presently available psychological and social interventions which may have been neglected under a traditional internalist approach. (shrink)

Illusionism is the view that conscious experience is some sort of introspective illusion. According to illusionism, there is no conscious experience, but it merely seems like there is conscious experience. This would suggest that much phenomenological enquiry, including work on phenomenological psychopathology, rests on a mistake. Some philosophers have argued that illusionism is obviously false, because seeming is itself an experiential state, and so necessarily presupposes the reality of conscious experience. In response, the illusionist could suggest that the relevant sort (...) of seeming here is not an experiential state, but is a cognitive state, such as a judgement or a belief, which is fully amenable to a physical or functionalist analysis. Herein, I argue that this response is unsuccessful and fails to undermine the reality of conscious experience. Nonetheless, the response does raise the problem of how a judgement or belief about the character of a conscious experience, even if it is true, can be justified if the conscious experience has no causal role in the formation of the judgement or belief. This is not a new problem, but is a reiteration of an old problem that is known in the philosophy of mind literature as the paradox of phenomenal judgement. I consider how the paradox of phenomenal judgement can be resolved and how the judgement or belief about conscious experience can be justified with appeal to the notion of acquaintance. (shrink)

In the political discourse regarding gender identity, the concept of biological sex has been weaponised by gender critical commentators to oppose gender affirmation for trans people. Recently, these commentators have appealed to an essentialist model of sex based on anisogamy, or relative gamete size, to argue that one’s sex is an immutable characteristic. I argue that the gender critical argument is unsound. The diverse purposes of sex classification and the complex variability of people’s sexual characteristics show that an essentialist model (...) is untenable. I then consider how a more adequate theoretical framework from the philosophy of biology can accommodate this complexity and capture how sex is classified in relevant contexts. Further implications of the framework are explored which concern the vagueness, polysemy, and mutability of sex. These undercut the gender critical argument and show that the appeal to biological sex fails to undermine gender affirmation for trans people. (shrink)

In the philosophical literature on consciousness and the mind-body problem, the conceivability argument against physicalism is usually taken to support a form of dualism between physicality and phenomenality. Usually, the discussion focuses on the qualitative character of experience, which is what the phenomenal feel of a given experience is like. By contrast, the subjective character of experience, or its individuation to a given first-person subject, tends to be set aside. The aim of this paper is to present a new and (...) more robust version of the conceivability argument for dualism that appeals to the subjective character of experience. Drawing on insights by philosophers in the phenomenological tradition, I conceptualise the first-person subjective character of experience as a transcendental condition of possibility for phenomenality that cannot be reduced to third-person facts about the physical world. Given this, the mind-body problem as it pertains to consciousness does not merely concern the inability of the set of physical facts about a brain state to capture the qualitative character of experience, but concerns the existential issue of why this brain state is accompanied by first-person subjectivity at all. This allows us to reconceive the conceivability argument in a way that presents a stronger case for dualism than the traditional version of the argument. (shrink)

This paper contributes to the debate in the philosophy of psychiatry regarding the relation between thought insertion in schizophrenia and the sense of selfhood. Some scholars have suggested that thought insertion presents a case where the sense of selfhood is lacking. Other scholars have disputed this by proposing that a form of minimal selfhood is a necessary feature of consciousness that is still present in thought insertion, albeit in a disturbed manner. Herein, I argue that the notion of minimal selfhood (...) that is used by these scholars is ambiguous between two meanings. The first is an ontological notion concerning the first-person individuation of consciousness. The second is a phenomenological notion concerning how a conscious experience is experienced as being given to the first-person subject. I argue that the former ontological notion is indeed a necessary feature of conscious experience, but the latter phenomenological notion is only a contingent feature. Therefore, even if it is possible that thought insertion presents a case where the feeling of first-person givenness is lacking or disturbed, the first-person individuation of consciousness remains present and undisturbed. As well as further clarifying the connection between consciousness and selfhood, this philosophical analysis reveals the extent to which schizophrenia can and cannot be said to comprise a disorder of selfhood. (shrink)

In contemporary philosophy of mind, the conceivability argument against physicalism is often used to support a form of dualism, which takes consciousness to be ontologically fundamental and distinct from physical matter. Recently, some proponents of the conceivability argument have also shown interest in panpsychism, which is the view that mentality is ubiquitous in the natural world. This paper examines the extent to which panpsychism can be sustained if the conceivability argument is taken seriously. I argue that panpsychism’s ubiquity claim permits (...) a strong reading or a weak reading. This presents a dilemma. On the one hand, the strong reading, which is typically characterised as a form of monism, is undermined by the conceivability argument. On the other hand, the weak reading, while compatible with the conceivability argument, turns out just to be a special case of dualism. I also show that the related position of panprotopsychism cannot provide a tenable monist position because it too cannot withstand the challenge of the conceivability argument. Therefore, if the conceivability argument is taken seriously, then we are committed to a dualist metaphysics, regardless of whether or not we accept the ubiquity claim. (shrink)

Diagnoses are central to the practice of medicine, where they serve a variety of functions for clinicians, patients, and society. They aid communication, explain symptoms, inform predictions, guide therapeutic interventions, legitimize sickness, and authorize access to resources. Insofar as psychiatry is a discipline whose practice is shaped by medical conventions, its diagnoses are sometimes presented as if they serve the same sorts of function as diagnoses in bodily medicine. However, there are philosophical problems that cast doubt on whether the functions (...) of psychiatric diagnoses can legitimately be considered to be equivalent to those of medical diagnoses. The aim of this chapter is to explicate some of these problems, particularly conceptual and epistemological problems pertaining to the roles of diagnoses as explanations. I begin with an overview of the various functions that medical diagnoses normally serve and suggest that many of these functions receive justificatory support from the explanatory roles of the diagnoses. I then present issues regarding the epistemic functions of psychiatric diagnoses and how these issues have featured in the arguments of prominent critics of psychiatry. (shrink)

This paper addresses a philosophical problem concerning the ontological status of age classification. For various purposes, people are commonly classified into categories such as “young adulthood”, “middle adulthood”, and “older adulthood”, which are defined chronologically. These age categories prima facie seem to qualify as natural kinds under a homeostatic property cluster account of natural kindhood, insofar as they capture certain biological, psychological, and social properties of people that tend to cluster together due to causal processes. However, this is challenged by (...) the observation that age categories are historically unstable. The properties that age categories are supposed to capture are affected by healthcare and cultural developments, such that people are staying biologically, psychologically, and socially young for longer. Furthermore, the act of classifying people into age categories can bring about changes in their behaviors, which in turn alter the biological, psychological, and social properties that the categories are supposed to capture. Accordingly, I propose that age categories are best understood as interactive kinds that are influenced in dynamic ways by looping effects. I consider some implications of these looping effects for our classificatory practices concerning age, including how different disciplines may need to review the ways they define and use age categories in their inductive inferences. (shrink)

In the Netherlands and Belgium, it is lawful for voluntary euthanasia to be offered on the grounds of psychiatric suffering. A recent case that has sparked much debate is that of Aurelia Brouwers, who was helped to die in the Netherlands on account of her suffering from borderline personality disorder. It is sometimes claimed that whether or not a mentally ill person’s wish to die is valid hinges on whether or not that wish is a symptom of the person’s mental (...) disorder. This article addresses the philosophical problems raised by this claim, with a specific focus on the diagnosis of borderline personality disorder. After considering descriptivist and causal conceptualizations of mental disorder, I argue that the current approach to borderline personality disorder in psychiatry precludes the possibility of dissociating the wish to die from the disorder. I then examine the implications of this analysis for the question of whether or not the request for voluntary euthanasia in the case of borderline personality disorder can be considered valid. Ultimately, I conclude that the inability to dissociate the wish to die from the disorder does not invalidate the wish in the case of borderline personality disorder. (shrink)

The necessity of origin suggests that a person’s identity is determined by the particular pair of gametes from which the person originated. An implication is that speculative scenarios concerning how we might otherwise have been had our gametic origins been different are dismissed as being metaphysically impossible. Given, however, that many of these speculations are intelligible and commonplace in the discourses of competent speakers, it is overhasty to dismiss them as mistakes. This paper offers a way of understanding these speculations (...) that does not commit them to incoherence but aims to make the best sense of what they are expressing. Using the philosophical framework of two‐dimensional semantics, it proposes that the speculative scenarios are best analysed as epistemic possibilities, rather than as metaphysical possibilities. It then explores some implications of this analysis for the ethical challenges associated with the non‐identity problem. (shrink)

It is widely assumed that there is value in the biological tie between parent and child. An implication of this is that adoption is often considered a less desirable alternative to procreation. This paper offers a philosophical defence of adoptive parenthood as a valuable and authentic form of parenthood. While previous defences have suggested that society’s valorisation of the biological tie is unjustified, I argue herein that the conception of the biological tie that features in the normative discourse on parenthood (...) is too narrowly genocentric. Against this genocentric conception, recent work in the philosophy of biology has emphasised the roles of joint determination, dynamic construction, and extended inheritance in development, which I suggest can substantiate a more inclusive conception of the biological tie. Accordingly, I propose that adoptive parents form a rich variety of biological ties with their children, some of which are as heritable and formative as genetic relatedness. (shrink)

Is psychopathy born or made? Contemporary psychopathy research shows that there is much wrong with this question. It is increasingly accepted that the development of psychopathy is dependent on multiple causal factors interacting with one another. However, there remains the major theoretical challenge of understanding the relations between these multiple causal factors in the developmental process. In this paper, I argue that the conventional picture of gene-environment interactionism does not offer an adequate account of psychopathy development. Instead, I propose that (...) a theoretical framework from the philosophy of biology, namely developmental systems theory, can facilitate a better understanding of psychopathy development that captures the contingent and dynamic relations between multiple causal factors. Some practical implications of a developmental systems theory approach to psychopathy are also explored. (shrink)

The notion that rape is an act of violence rather than sex is a central tenet in rape crisis support and education. A therapeutic benefit of this conceptualisation of rape is that it counters shame and guilt by affirming that the victim was not a complicit partner in an act of sex. However, this conceptualisation has recently been criticised for not capturing what makes rape an especially serious kind of wrong. This raises an apparent dilemma for rape crisis support. Recent (...) work in analytic moral philosophy on the nature of rape offers a way to resolve this dilemma. It is argued that rape is not sex, but is nonetheless sexual. This distinction allows for a charitable reformulation of the central tenet in rape crisis support, which can facilitate the dual therapeutic aims of countering the sense of shame and of recognising the especially serious kind of the harm suffered by the victim. (shrink)

This thesis is a philosophical examination of the explanatory roles of diagnoses in psychiatry. In medicine, diagnoses normally serve as causal explanations of patients’ symptoms. Given that psychiatry is a discipline whose practice is shaped by medical traditions, it is often implied that its diagnoses also serve such explanatory functions. This is evident in clinical texts that portray psychiatric diagnoses as referring to diseases that cause symptoms. However, there are problems which cast doubt on whether such portrayals are justified. I (...) address these problems and examine whether psychiatric diagnoses provide explanations of symptoms. The first problem is conceptual. In diagnostic manuals, psychiatric diagnoses are defined by their symptoms. This suggests that invoking them as explanations of the symptoms amounts to circularity. I argue that this can be resolved with an appropriate conceptual framework that captures the complex semantic values of diagnostic terms and their different uses in clinical discourse. I put forward such a framework based on two-dimensional semantics. The second problem is ontological. Empirical research suggests that diagnostic categories in psychiatry do not correspond to invariant causal types, but are associated with variable combinations of diverse causes that interact across biological, psychological, and social levels. Given this heterogeneity, I argue that psychiatric diagnoses fall short of paradigmatic cases of causal explanation, but that some can still provide other sorts of useful causal explanatory information. The original contribution of this thesis is the illumination of the conceptual relations between diagnoses and symptoms. This philosophical work is important, because it can be brought to valuable application in modifying psychiatric practice. (shrink)

Philosophers have relied on visual metaphors to analyse ideas and explain their theories at least since Plato. Descartes is famous for his system of axes, and Wittgenstein for his first design of truth table diagrams. Today, visualisation is a form of ‘computer-aided seeing’ information in data. Hence, information is the fundamental ‘currency’ exchanged through a visualisation pipeline. In this article, we examine the types of information that may occur at different stages of a general visualization pipeline. We do so from (...) a quantitative and a qualitative perspective. The quantitative analysis is developed on the basis of Shannon’s information theory. The qualitative analysis is developed on the basis of Floridi’s taxonomy in the philosophy of information. We then discuss in detail how the condition of the ‘data processing inequality’ can be broken in a visualisation pipeline. This theoretic finding underlines the usefulness and importance of visualisation in dealing with the increasing problem of data deluge. We show that the subject of visualisation should be studied using both qualitative and quantitative approaches, preferably in an interdisciplinary synergy between information theory and the philosophy of information. (shrink)

In this article, we explicate evidence-based nursing (EBN), critically appraise its framework and respond to nurses’ concern that EBN sidelines the caring elements of nursing practice. We use resources from care ethics, especially Vrinda Dalmiya’s work that considers care as crucial for both epistemology and ethics, to show how EBN is compatible with, and indeed can be enhanced by, the caring aspects of nursing practice. We demonstrate that caring can act as a bridge between ‘external’ evidence and the other pillars (...) of the EBN framework: clinical expertise; patient preferences and values. Drawing on an influential EBN handbook, section 1 presents the aims and features of EBN, including the normative principle that EBN should take place within a ‘context of caring’. We aim to understand this context and whether it can be neatly detached from the EBN framework, as the handbook seems to suggest. In section 2, we highlight the grounds for resistance to EBN from the nursing community, before mounting the argument that nursing practices can be understood fruitfully through feminist care ethics and/or virtue ethics lenses. In section 3, we deepen that analysis using Dalmiya’s concepts of care-knowing and care as a hybrid ethico-epistemic virtue, which are ideally suited to the complex practices of nursing. In section 4, we bring this rich understanding of care into conversation with EBN, showing that its framework cannot be adequately theorised without paying proper attention to care. Caring can be neither an innocuous background assumption of nor an afterthought to the EBN framework. (shrink)

Representing the kinetic state of a patient (posture, motion, and activity) during vital sign measurement is an important part of continuous monitoring applications, especially remote monitoring applications. In contextualized vital sign representation, the measurement result is presented in conjunction with salient measurement context metadata. We present an automated annotation system for vital sign measurements that uses ontologies from the Open Biomedical Ontology Foundry (OBO Foundry) to represent the patient’s kinetic state at the time of measurement. The annotation system is applied (...) to data generated by a wearable personal status monitoring (PSM) device. We demonstrate how annotated PSM data can be queried for contextualized vital signs as well as sensor algorithm configuration parameters. (shrink)

Is the societal-level of analysis sufficient today to understand the values of those in the global workforce? Or are individual-level analyses more appropriate for assessing the influence of values on ethical behaviors across country workforces? Using multi-level analyses for a 48-society sample, we test the utility of both the societal-level and individual-level dimensions of collectivism and individualism values for predicting ethical behaviors of business professionals. Our values-based behavioral analysis indicates that values at the individual-level make a more significant contribution to (...) explaining variance in ethical behaviors than do values at the societal-level. Implicitly, our findings question the soundness of using societal-level values measures. Implications for international business research are discussed. (shrink)

Does the Ship of Theseus present a genuine puzzle about persistence due to conflicting intuitions based on “continuity of form” and “continuity of matter” pulling in opposite directions? Philosophers are divided. Some claim that it presents a genuine puzzle but disagree over whether there is a solution. Others claim that there is no puzzle at all since the case has an obvious solution. To assess these proposals, we conducted a cross-cultural study involving nearly 3,000 people across twenty-two countries, speaking eighteen (...) different languages. Our results speak against the proposal that there is no puzzle at all and against the proposal that there is a puzzle but one that has no solution. Our results suggest that there are two criteria—“continuity of form” and “continuity of matter”— that constitute our concept of persistence and these two criteria receive different weightings in settling matters concerning persistence. (shrink)

Is the societal-level of analysis sufficient today to understand the values of those in the global workforce? Or are individual-level analyses more appropriate for assessing the influence of values on ethical behaviors across country workforces? Using multi-level analyses for a 48-society sample, we test the utility of both the societal-level and individual-level dimensions of collectivism and individualism values for predicting ethical behaviors of business professionals. Our values-based behavioral analysis indicates that values at the individual-level make a more significant contribution to (...) explaining variance in ethical behaviors than do values at the societal-level. Implicitly, our findings question the soundness of using societal-level values measures. Implications for international business research are discussed. (shrink)

Climate change and decarbonization raise complex justice questions that researchers and policymakers must address. The distributions of greenhouse gas emissions rights and mitigation efforts have dominated justice discourses within scenario research, an integrative element of the IPCC. However, the space of justice considerations is much larger. At present, there is no consistent approach to comprehensively incorporate and examine justice considerations. Here we propose a conceptual framework grounded in philosophical theory for this purpose. We apply this framework to climate mitigation scenarios (...) literature as proof of concept, enabling a more holistic and multidimensional investigation of justice. We identify areas of future research, including new metrics of service provisioning essential for human well-being. [Can be freely read by clicking the ReadCube link below.]. (shrink)

On the basis of PM2.5 data of the national air quality monitoring sites, local population data, and baseline all-cause mortality rate, PM2.5-related health economic benefits of the Air Improvement Action Plan implemented in Wuhan in 2013–2017 were investigated using health-impact and valuation functions. Annual avoided premature deaths driven by the average concentration of PM2.5 decrease were evaluated, and the economic benefits were computed by using the value of statistical life (VSL) method. Results showed that the number of avoided premature deaths (...) in Wuhan are 21,384 (95% confidence interval (CI): 15,004 to 27,255) during 2013–2017, due to the implementation of the Air Improvement Action Plan. According to the VSL method, the obtained economic benefits of Huangpi, Wuchang, Hongshan, Xinzhou, Jiang’an, Hanyang, Jiangxia, Qiaokou, Jianghan, Qingshan, Caidian, Dongxihu, and Hannan District were 8.55, 8.19, 8.04, 7.39, 5.78, 4.84, 4.37, 4.04, 3.90, 3.30, 2.87, 2.42, and 0.66 billion RMB (1 RMB = 0.1417 USD On 14 October 2019), respectively. These economic benefits added up to 64.35 billion RMB (95% CI: 45.15 to 82.02 billion RMB), accounting for 4.80% (95% CI: 3.37% to 6.12%) of the total GDP of Wuhan in 2017. Therefore, in the process of formulating a regional air quality improvement scheme, apart from establishing hierarchical emission-reduction standards and policies, policy makers should give integrated consideration to the relationship between regional economic development, environmental protection and residents’ health benefits. Furthermore, for improving air quality, air quality compensation mechanisms can be established on the basis of the status quo and trends of air quality, population distribution, and economic development factors. (shrink)

Nelson Goodman (1906-2007) approached the arts and other kinds of knowledge as forms of symbolism. His principal aim in philosophy was to advance understanding and remove confusions by verbal analysis and logical constructions. Goodman's philosophical theories encompass nominalism, constructivism and a version of radical relativism. In his Languages of Art, Goodman sets forth distinctions among the various art according to differences in the forms of symbols employed. He contributed as well to arts education and to philosophy of the museum. His (...) performance work, "Hockey Seen: A Nightmare in Three Periods and Sudden Death embodies his aesthetic theories. (shrink)

In written and spoken communications, metaphors are often used as an aid to help convey abstract or less tangible concepts. However, the benefits of using visual metaphors in visualization have so far been inconclusive. In this work, we report an empirical study to evaluate hypotheses that visual metaphors may aid memorization, visual search and concept comprehension. One major departure from previous metaphor-related experiments in the literature is that we make use of a dual-task methodology in our experiment. This design offers (...) an abstraction of typical situations where viewers do not have their full attention focused on visualization (e.g., in meetings and classes). The use of the secondary task introduces “divided attention”, and makes the effects of visual metaphors more observable. In addition, it also serves as additional masking in memory-based trials. The results of this study show that visual metaphors can help participants better remember the information depicted in visualization. On the other hand, visual metaphors can have a negative impact on the speed of visual search. The results also show a complex pattern as to the benefits of visual metaphors in helping participants grasp key concepts from visualization. (shrink)

This research explores the effects of globalization to the Malaysian architectural practice in the current situation. The research explores three issues, firstly what are the reasons local architects are taking projects locally (localization) only, and, secondly, what are the factors which motivate local architects to venture into international projects (termed as globalization). It also explores, thirdly, what are the factors which influence foreign architects coming to Malaysia to practice. Research was qualitative in nature using semi-structured interviews. The interviews were transcribed (...) and a thematic analysis was carried out. An online survey was conducted towards the end to a different group from the architecture fraternity to supplement the research and findings. Overall, the reasons uncovered for the first issue are the total lack of opportunities and insufficient capacity due to small practices. Reasons for the second issue are due to the more lucrative fees and the experience and technology transfer which are advancements to their practices. For the third issue, the factors were found to more personal reasons based rather than solely applying to practice. In summary, to go global or stay local is actually up to the individual preference of the architect and also the capacity of their practices. The findings can be used as a resource for architects and architectural students who are still deciding whether to globalize or localize their careers. As it currently the case, many architects are practicing in other countries to replicate architectural styles which may be more conducive to sustainable tourism, for example, hotel designs. (shrink)

Introduction: During the COVID-19 pandemic, adolescents have increasingly suffered from online problem behaviors and mental disorders. But little research has paid attention to the protective factors among adolescents. Therefore, the present study attempted to investigate the role of positive youth development (PYD) attributes in adolescents’ depression, internet gaming disorder (IGD) and cyberbullying/victimization (CBV). -/- Methods: A total of 995 Chinese adolescents (Mage = 15.97 years, SD = 0.77, 325 boys) from two public high schools in Hubei province were recruited to (...) participate in the three-wave longitudinal study over the span of 1 year during the pandemic (Time 1: November, 2020; Time 2: May, 2021; Time 3: November, 2021). -/- Results: T1 PYD attributes negatively predicted T2 depression and T3 online problematic behaviors. T2 depression positively predicted IGD at T3. T3 IGD significantly predicted greater involvement in T3 CBV, and vice versa. Moreover, depression and one online problem behavior mediated the relationships between PYD attributes and the other online problem behavior, separately and sequentially. (shrink)

Allelopathy is an important biological phenomenon in exotic plant invasions. Studies about this phenomenon can help us to understand how plant interactions influence plant colony and ecosystem functioning. Both alligator weed (Alternanthera philoxeroides, Ap) and crofton weed (Eupatorium adenophorum, Ea) are important destructive exotic species in China. Their allelopathic effects on native plant species are well documented. However, whether alligator weed and crofton weed antagonize each other regarding plant growth? There is largely unknown currently. Here we report that the leaf (...) extract from crofton weed possesses the negative effect on the growth of alligator weed. The results showed that root growth of alligator weed could be seriously inhibited by aqueous extract from crofton weed, exhibited as no root or a few roots if only. Consistent with the inhibition of root growth, we observed changes of physiological and biochemical parameters in treated alligator weed. The chlorophyll content, the root activity and the acetolactate synthase (ALS) activity were significantly decreased; while the rate of superoxide anion (O2-), the malondialdehyde (MDA) content, the peroxidase (POD) activity, and the shikimic acid content were remarkably increased in the treated alligator weed plants. These physiological analyzes suggested that the main allelopathic effects of crofton weed were mainly through affecting the integrity of cell membrane and the activity of the key enzymes. Further, these data also imply that one exotic species has the potential value to be used in bio-control of the other exotic species. (shrink)

Considering that the visual dimension of anatomy cannot be ignored and an anatomy education without the visual part will make a doctor imperfect in their profession, it may be seen that pictorial anatomy books written in previous periods are highly valuable. The purpose of this study is to investigate the spinal nerve anatomy included in the work titled Teşrihü’l-Ebdan min e’t-Tıb written in the XIVth century and compare the information at that period to the information of our time. The nervous (...) system was analyzed under a separate title in the book. Firstly, general information was provided about nerves, and then cranial and spinal nerves were described. The author stated in his work that there are two differences between humans and animals as feeling and movement. He stated that the center for feeling and movement is the brain and all nerves converge in the brain. Although there are insufficient or incorrect information in historical books of medicine, such books are highly valuable as they show the scientific progress. It is apparent that Mansur’s work titled Teşrihü’l-Ebdan min e’t-Tıb has a significant place in the history of anatomy, and its influence was reflected in the following periods. Despite the occasions of insufficient or incorrect information in the piece, we think it contributed to the historical development of anatomy. (shrink)

The objective of the paper is to implement and validate diagnosis in the medical field via refined neutrosophic fuzzy logic (RNFL). As such, we have proposed a Max-Min composition (MMC) method in RNFL. This method deals with the diagnosis under certain constraints like uncertainty and indeterminacy. Further, we have considered the diagnosis problems to validate the sensitivity analysis of the novel multi attribute decision-making technique. Finally, we gave the graphical representations and compared the obtained results with other existing measures in (...) refined neutrosophic fuzzy sets. (shrink)

I min artikel ”Att förstå – betraktelser utifrån en ny teori” (FT 31:4 Nov 2010) vill jag visa att det finns anledning att förtydliga förståelsebegreppet. Avsevärd möda har, historiskt sett, lagts ned på att definiera och bringa klarhet i begreppen kunskap och förklaring men förståelse, som når längre än vanlig kunskap, har förblivit ett otydligt begrepp. Teorin jag lägger fram i artikeln har som sin kärna en definition av förståelse. Denna utkristalliseras dels naturligt från vår vardagliga användning, dels från behovet (...) av att tydligt visa på vilket sätt förståelse är den djupaste formen av kunskap, av medveten insikt. Först när förståelsebegreppet utgör ett väl format verktyg kan kunskapsteorin nå sin fulla potential. Jag är tacksam gentemot Anders Tolland för att ha kritiskt granskat artikeln och för att han ger mig möjlighet att uttrycka teorin klarare. Tollands kritik berör främst oklarheter avseende innehållet i de abstraktioner som, tillsammans med jämförelser, är centrala element i teorin. Tolland bidrar också till förtydliganden, för vilka jag är mycket tacksam. Särskilt vill jag nämna påpekandena att förståelse dels kan relatera till vad något är, dels till varför det är på det sättet och att förståelse dels är en process, dels ett uppnått tillstånd. I det följande bemöter jag Tollands kritik och anser mig verkligen kunna visa att den framlagda teorin för förståelse är sammanhållen, tydlig och alls icke ”kontra-intuitiv” samt att den utgör ett viktigt, nytt kunskapsteoretiskt verktyg. (shrink)

我首先从哲学家(心理学家)路德维希·维特根斯坦的一些著名评论开始,因为平克与大多数人(由于我们进化的先天心理学的默认设置)分享了对心灵功能的某些偏见,以及因为维特根斯坦提供了独特而深刻的见解,了解语言 、思想和现实(他认为或多或少是共性)在其他地方所没有的。本卷只提到维特根斯坦,这是最不幸的,因为他是最聪明和原始的语言分析家。 在最后一章中,他用柏拉图洞穴的著名比喻,完美地概括了这本书,概述了头脑(语言、思想、故意心理)——盲目自私的产物,只是通过自动利他主义来缓和。携带我们基因副本的亲戚(包容性健身)——自动工作,但试图以 乐观的结局结束,给我们希望,我们仍然可以利用其巨大的能力进行合作,使世界成为一个体面的生活场所。 平克当然知道,但很少说,我们的心理被遗漏了比包括更多。在人类自然的窗口,被排除在外或给予最少的关注是数学和几何,音乐和声音,图像,事件和因果关系,本体论(类的东西或我们所知道的),大多数认识论(我们如 何知道),处置(相信,思考,判断,打算等)和行动,神经递质和内生,精神状态(如,萨托里和启蒙,大脑刺激和记录,脑损伤和行为的故意心理学的其余部分缺陷和障碍,游戏和运动,决策理论(包括博弈论和行为经济学 ),动物行为(很少语言,但10亿年的共同遗传学)。许多关于有意心理学领域的书籍已经写好了。本书中的数据是描述,而不是说明为什么我们的大脑这样做或它是如何做到的解释。我们怎么知道用各种方式使用句子(即, 知道它们的所有含义)？这是进化心理学,在更基本的水平运作——维特根斯坦最活跃的水平。人们对使用词语的背景关注甚少——这是维特根斯坦开创的舞台。 然而,这是一部经典作品,这些警告仍然值得一读。 那些希望从现代两个系统的观点来看为人类行为建立一个全面的最新框架的人,可以查阅我的书《路德维希的哲学、心理学、Min d和语言的逻辑结构》维特根斯坦和约翰·西尔的《第二部》(2019年)。那些对我更多的作品感兴趣的人可能会看到《会说话的猴子——一个末日星球上的哲学、心理学、科学、宗教和政治——文章和评论2006-20 19年第3次(2019年)和自杀乌托邦幻想21篇世纪4日 (2019) .