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

Over the past few decades, cognitive science has identified several forms of reasoning that make essential use of conceptual knowledge. Despite significant theoretical and empirical progress, there is still no unified framework for understanding how concepts are used in reasoning. This paper argues that the theory of conceptual spaces is capable of filling this gap. Our strategy is to demonstrate how various inference mechanisms which clearly rely on conceptual information—including similarity, typicality, and diagnosticity-based reasoning—can be modeled using (...) principles derived from conceptual spaces. Our first topic analyzes the role of expectations in inductive reasoning and their relation to the structure of our concepts. We examine the relationship between using generic expressions in natural language and common-sense reasoning as a second topic. We propose that the strength of a generic can be described by distances between properties and prototypes in conceptual spaces. Our third topic is category-based induction. We demonstrate that the theory of conceptual spaces can serve as a comprehensive model for this type of reasoning. The final topic is analogy. We review some proposals in this area, present a taxonomy of analogical relations, and show how to model them in terms of distances in conceptual spaces. We also briefly discuss the implications of the model for reasoning with concepts in artificial systems. (shrink)

Until now, philosophical debate about human embryonic stem cell (hESC) research has largely been limited to its ethical dimensions and implications. Although the importance and urgency of these ethical debates should not be underestimated, the almost undivided attention that mainstream and feminist philosophers have paid to the ethical dimensions of hESC research suggests that the only philosophically interesting questions and concerns about it are by and large ethical in nature. My argument goes some distance to challenge the assumption that ethical (...) considerations alone must be foregrounded in philosophical discussions about hESC research by introducing a critical stance on the epistemological and ontological assumptions that underlie and condition it. A central aim of the paper is to show how Foucault's insights into knowledge-power, taken in combination with Hacking's claims about styles of reasoning, can make these assumptions evident, as well as cast light on their potentially deleterious implications for disabled people. Arguing in this way also enables me to draw out constitutive effects of research on stem cells, that is, to indicate how the discursive practices surrounding research on stem cells, as well as the technology itself, contribute to the constitution of impairment. (shrink)

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

The observation that a crisis of confidence regarding Psychiatry exists is a notion shared even among psychiatrists themselves. Psychiatry has a checkered history and its alliance with the pharmaceutical industry, aka Big-Pharma, continues to reinforce a need for healthy skepticism. Why? Mainly, an over-reliance on the questionable expertise and authority afforded psychiatry as the specialists of mental health. I contend that the authority of psychiatry is misplaced and too often harmful. Since the criteria required to justify and satisfy psychiatric expertise (...) is not fully established as can be substantiated by compelling reasons to rethink its authority as a reliable profession in its current form. Psychiatric expertise is not particularly scientific and this is especially dangerous in a sector that prescribes mind-altering drugs. There are a number of identified criteria that would otherwise substantiate psychiatric expertise and whilst partially existent, are nonetheless deficient. These major yet deficient aspects of psychiatric practice concern diagnostic problems – reliability and verification of diagnoses and accurate testable validity of diagnoses - mainly due to an absence of identifiable underlying biomarkers ordinarily related to disease or biological conditions. Psychiatrists often fail to distinguish between reactive-depression (reaction to external event or circumstance) and endogenous-depression (biological) resulting, in part, from incorrectly distinguishing between conditions constitutive of ‘trait’ (endogenous) and of those of ‘state’ (e.g. reactive depression; adverse effects from medication, etc.). (shrink)

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

We offer a model of moral reform and regeneration that involves a wrong-doer making two movements: on the one hand, he identifies with himself as the one who did the act, while he also intentionally moves away from that self (or set of desires and intentions) and moves toward a transformed identity. We see this model at work in the formal practice of contrition and reform in Christian and Buddhist rites. This paper is part of a broader project we are (...) undertaking on the philosophy of forgiveness. (shrink)

This essay provides a medical theory that could clarify enigmas surrounding the historical Socrates. It offers textual evidence that Socrates had temporal lobe epilepsy and that its two types of seizure manifested as recurrent voices and peculiar behaviour, both of which were notorious hallmarks of Socrates. Common and immediate criticisms against the methodology of retrospective diagnosis are addressed first. Next, the diagnostic reasoning is presented in detail. The possibility of temporal lobe personality in Socrates is also considered. The (...) important implication of this theory is that one of the charges against Socrates, introducing new divinities, was a now well-known neurologic symptom. (shrink)

A RELATIVISTIC THEORY OF PHENOMENOLOCICAL CONSTITUTION: A SELF-REFERENTIAL, TRANSCENDENTAL APPROACH TO CONCEPTUAL PATHOLOGY. (Vol. I: French; Vol. II: English) -/- Steven James Bartlett -/- Doctoral dissertation director: Paul Ricoeur, Université de Paris Other doctoral committee members: Jean Ladrière and Alphonse de Waehlens, Université Catholique de Louvain Defended publically at the Université Catholique de Louvain, January, 1971. -/- Universite de Paris X (France), 1971. 797pp. -/- The principal objective of the work is to construct an analytically precise methodology which can serve (...) to identify, eliminate, and avoid a certain widespread _conceptual fault_ or _misconstruction_, called a "projective misconstruction" or "projection" by the author. It is argued that this variety of error in our thinking (i) infects a great number of our everyday, scientific, and philosophical concepts, claims, and theories, (ii) has largely been undetected, and (iii), when remedied, leads to a less controversial and more rigorous elucidation of the transcendental preconditions of human knowledge than has traditionally been possible. The dissertation identifies, perhaps for the first time, a _projective_ variety of self-referential inconsistency, and proposes an innovative, self-reflexive approach to transcendental argument in a logical and phenomenological context. The strength of the approach lies, it is claimed, in the fact that a rejection of the approach is possible only on pain of self-referential inconsistency. The argument is developed in the following stages: A general introduction identifies the central theme of the work, defines the scope of applicability of the results reached, and sketches the direction of the studies that follow. The preliminary discussion culminates in a recognition of the need for a _critique of impure reason_. The body of the work is divided into two parts: Section I seeks to develop a methodology, on a purely formal basis, which is, on the one hand, capable of being used to study the transcendental foundations of the special sciences, including its own proper transcendental foundation. On the other hand, the methodology proposed is intended as a diagnostic and therapeutic tool for dealing with _projective_ uses of concepts. The approach initiates an analysis of concepts from a perspective which views _knowledge as coordination_. Section I describes formal structures that possess the status of preconditions in such a coordinative account of knowledge. Special attention is given to the preconditions of _identifying reference_ to logical particulars. The first section attempts, then, to provide a self-referential, transcendental methodology which is essentially revisionary in that it is motivated by a concern for conceptual error-elimination. Phenomenology, considered in its unique capacity as a self-referential, transcendental discipline, is of special relevance to the study. Section II accordingly examines a group of concepts which come into question in connection with the central theme of _phenomenological constitution_. The "_de-projective methodology_" developed in Section I is applied to these concepts that have a foundational importance in transcendental phenomenology. A translation is, in effect, proposed from the language of consciousness to a language in which preconditions of referring are investigated. The result achieved is the elimination of self-defeating, projective concepts from a rigorous, phenomenological study of the constitutive foundations of science. The dissertation was presented in a two volume, double-language format for the convenience of French and English researchers. Each volume contains an analytical index. (shrink)

In this article I argue that characterizations of anger as a hostile emotion may be mistaken. My project is empirically informed and is partly descriptive, partly diagnostic. It is descriptive in that I am concerned with what anger is, and how it tends to manifest, rather than with what anger should be or how moral anger is manifested. The orthodox view on anger takes it to be, descriptively, an emotion that aims for retribution. This view fits well with anger (...) being a hostile emotion, as retribution is punitive. I will argue that a different view of anger deserves our attention. On this alternative view, anger aims for recognition of harms done, rather than for the punishment of those who have committed them. I argue that we have reason to favour a strong view that excludes retribution from anger’s main aims. In addition, I offer a diagnosis of the reasons that led the retributive view of anger to become, and remain, orthodoxy. This diagnosis provides indirect reason to give my descriptive proposal serious consideration, for it highlights that the orthodox view has dominated folk and philosophical conceptions of anger for reasons that do not speak in favour of the view’s veracity. The view that anger is a hostile emotion will therefore emerge as in need of serious scrutiny. (shrink)

In this paper I consider recent discussions within the representationalist theories of phenomenal consciousness, in particular, the discussions between first order representationalism (FOR) and higher order representationalism (HOR). I aim to show that either there is only a terminological dispute between them or, if the discussion is not simply terminological, then HOR is based on a misunderstanding of the phenomena that a theory of phenomenal consciousness should explain. First, I argue that we can defend first order representationalism from Carruthers' attacks (...) and ignore higher order thoughts in our account of phenomenal consciousness. Then I offer a diagnostic of Carruthers' misunderstanding. In the last section I consider further reasons to include mindreading abilities in an explanation of phenomenal consciousness. (shrink)

Everyone agrees that not all norms that govern belief and assertion are epistemic. But not enough attention has been paid to distinguishing epistemic norms from others. Norms in general differ from merely evaluative standards in virtue of the fact that it is fitting to hold subjects accountable for violating them, provided they lack an excuse. Different kinds of norm are most readily distinguished by their distinctive mode of accountability. My thesis is roughly that a norm is epistemic if and only (...) if its violation makes it fitting to reduce epistemic trust in the subject, even if there is no doubt about their sincerity, honesty, or other moral virtues. That is, violations of epistemic norms don’t merit resentment or other forms of blame, but rather deduction of credibility points in internal scorekeeping and related attitudinal and behavioral changes. As Fricker’s work on epistemic injustice shows, such distrust is undesirable from the point of view of an epistemic agent. Consequently, when one manifests epistemic distrust towards a subject in suitable circumstances, it amounts a way of holding her accountable. Since this form of accountability involves no opprobrium, there is good reason to think it is not linked to voluntary control in the same way as moral accountability. Finally, I make use of this account of what makes epistemic norms distinctive to point out some faulty diagnostics in debates about norms of assertion. My aim is not to defend any substantive view, however, but only to offer tools for identifying the right kind of evidence for epistemic norms. (shrink)

The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) was published in 2013 containing the following changes from the previous edition: gone are the subcategories ‘Autistic Disorder,’ ‘Asperger Syndrome’ and ‘PDD-NOS,’ replaced by the single diagnosis ‘Autism Spectrum Disorder,’ and there is a new category ‘Social Communication Disorder.’ In this paper I consider what kind of reasons would justify these changes if one were (a) a realist about autism, or (b) one were a constructivist. I (...) explore various analyses of autism in the research literature that portray it as essentially either a psychological, neurological or genetic phenomenon, and discuss these by reference to the diagnostic criteria and by analogy with the way we understand race and sex categories. I conclude that no realist reasons are available to justify the changes in the diagnostic criteria, and further, that the only way the changes could be justified is if one takes the position that the DSM categories are social constructs. I conclude by exploring what implications follow from this. (shrink)

In psychiatry some disorders of cognition are distinguished from instances of normal cognitive functioning and from other disorders in virtue of their surface features rather than in virtue of the underlying mechanisms responsible for their occurrence. Aetiological considerations often cannot play a significant classificatory and diagnostic role, because there is no sufficient knowledge or consensus about the causal history of many psychiatric disorders. Moreover, it is not always possible to uniquely identify a pathological behaviour as the symptom of a (...) certain disorder, as disorders that are likely to differ both in their causal histories and in their overall manifestations may give rise to very similar patterns of behaviour. -/- Consider delusions as an example. It wouldn’t be correct to define delusions as those beliefs people form as a result of a neurobiological deficit and a hypothesis-evaluation deficit (as some versions of the two-factor theory of delusions suggest), because for some delusions no neurobiological deficit may be found, and reasoning biases and motivational factors may be contributors to the formation of the delusion (e.g. McKay et al., 2005). Moreover, it would be a mistake to define delusions as symptoms of schizophrenia alone, because they occur also in other disorders, including dementia, amnesia, and delusional disorders. Thus, aetiological considerations may appear in the description and analysis of delusions, but do not feature prominently in their definition. -/- In this paper I argue that the surface features used as criteria for the classification and diagnosis of disorders of cognition are often epistemic in character. I shall offer two examples: confabulations and delusions are defined as beliefs or narratives that fail to meet standards of accuracy and justification. Although classifications and diagnoses based on features of people’s observable behaviour are necessary at these early stages of neuropsychiatric research, given the variety of conditions in which certain phenomena appear, I shall attempt to show that current epistemic accounts of confabulations and delusions have limitations. Epistemic criteria can guide both research and clinical practice, but fail to provide sufficient conditions for the identification of delusions and confabulations, and fail to demarcate pathological from non-pathological narratives or beliefs. -/- Another limitation of current epistemic accounts – which I shall not address here – is the excessive focus on epistemic faults of confabulations and delusions at the expense of their epistemically neutral or advantageous features (see Bortolotti and Cox, 2009). This may lead to a misconception of delusions and confabulations, and to an oversimplification in the assessment of the needs of people who require clinical treatment for their psychotic symptoms. (shrink)

The latest edition of the Diagnostic and Statistical Manual of Mental Disorders included the Social Communication Disorder as a new mental disorder characterized by deficits in pragmatic abilities. Although the introduction of SPCD in the psychiatry nosography depended on a variety of reasons—including bridging a nosological gap in the macro-category of Communication Disorders—in the last few years researchers have identified major issues in such revision. For instance, the symptomatology of SPCD is notably close to that of Autism Spectrum Disorder. (...) This opens up the possibility that individuals with very similar symptoms can be diagnosed differently and receive different clinical treatments and social support. The aim of this paper is to review recent debates on SPCD, particularly as regards its independence from ASD. In the first part, we outline the major aspects of the DSM-5 nosological revision involving ASD and SPCD. In the second part, we focus on the validity and reliability of SPCD. First, we analyze literature on three potential validators of SPCD, i.e., etiology, response to treatment, and measurability. Then, we turn to reliability issues connected with the introduction of the grandfather clause and the use of the concepts of spectrum and threshold in the definition of ASD. In the conclusion, we evaluate whether SPCD could play any role in contemporary psychiatry other than that of an independent mental disorder and discuss the role that non-epistemic factors could play in the delineation of the future psychiatry nosography. (shrink)

In this volume, leading philosophers of psychiatry examine psychiatric classification systems, including the Diagnostic and Statistical Manual of Mental Disorders, asking whether current systems are sufficient for effective diagnosis, treatment, and research. Doing so, they take up the question of whether mental disorders are natural kinds, grounded in something in the outside world. Psychiatric categories based on natural kinds should group phenomena in such a way that they are subject to the same type of causal explanations and respond similarly (...) to the same type of causal interventions. When these categories do not evince such groupings, there is reason to revise existing classifications. The contributors all question current psychiatric classifications systems and the assumptions on which they are based. They differ, however, as to why and to what extent the categories are inadequate and how to address the problem. Topics discussed include taxometric methods for identifying natural kinds, the error and bias inherent in DSM categories, and the complexities involved in classifying such specific mental disorders as "oppositional defiance disorder" and pathological gambling. -/- Contributors George Graham, Nick Haslam, Allan Horwitz, Harold Kincaid, Dominic Murphy, Jeffrey Poland, Nancy Nyquist Potter, Don Ross, Dan Stein, Jacqueline Sullivan, Serife Tekin, Peter Zachar. (shrink)

In view of the publication of the DSM-V researchers were asked to discuss the theoretical implications of the definition of mental disorders. The reasons for the use, in the DSM-III, of the term disorder instead of disease are considered. The analysis of these reasons clarifies the distinction between the general definition of disorder and its implicit, technical meaning which arises from concrete use in DSM disorders. The characteristics and limits of this technical meaning are discussed and contrasted to alternative definitions, (...) like Wakefield’s harmful/dysfunction analysis. It is shown that Wakefield’s analysis faces internal theoretical problems in addition to practical limits for its acceptance in the DSM-V. In particular, it is shown that: a) the term dysfunction is not purely factual but intrinsically normative/evaluative; b) it is difficult to clarify what dysfunctions are in the psychiatric context (the dysfunctional mechanism involved being unknown in most cases and the use of evolutionary theory being even more problematic); c) the use of conceptual analysis and commonsense intuition to define dysfunctions leaves unsatisfied empiricists; d) it is unlikely that the authors of the DSM-V will accept Wakefield’s suggestion to revise the diagnostic criteria of any single DSM disorder in accordance with his analysis, because this is an excessively extensive change and also because this would probably reduce DSM reliability. In conclusion, it is pointed up in which sense DSM mental disorders have to be conceived as constructs, and that this undermines the realistic search for a clear-cut demarcation criterion between what is disorder and what is not. (shrink)

In this paper I review how the notion of gender is understood in psychiatry, specifically in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). First, I examine the contraposition between sex and gender, and argue that it is still retained by DSM-5, even though with some caveats. Second, I claim that, even if genderqueer people are not pathologized and gender pluralism is the background assumption, some diagnostic criteria still conceal a residue of gender (...) dualism and essentialism. Third, I consider gender dysphoria, which is characterized by an incongruence between one’s experienced or expressed gender and one’s assigned gender; since this condition pertains to distress and disability, not to the incongruence per se, it does not pathologize transgender people. Still, I contend that it should be removed from DSM-5 for theoretical reasons. (shrink)

This is Vol. I in French. Vol. II in English is available separately from this website. -/- The principal objective of the work is to construct an analytically precise methodology which can serve to identify, eliminate, and avoid a certain widespread conceptual fault or misconstruction, called a "projective misconstruction" or "projection" by the author. -/- It is argued that this variety of error in our thinking (i) infects a great number of our everyday, scientific, and philosophical concepts, claims, and theories, (...) (ii) has largely been undetected, and (iii), when remedied, leads to a less controversial and more rigorous elucidation of the transcendental preconditions of human knowledge than has traditionally been possible. -/- The dissertation identifies, perhaps for the first time, a projective variety of self-referential inconsistency, and proposes an innovative, self-reflexive approach to transcendental argument in a logical and phenomenological context. The strength of the approach lies, it is claimed, in the fact that a rejection of the approach is possible only on pain of self-referential inconsistency. The argument is developed in the following stages: -/- A general introduction identifies the central theme of the work, defines the scope of applicability of the results reached, and sketches the direction of the studies that follow. The preliminary discussion culminates in a recognition of the need for a critique of impure reason. -/- The body of the work is divided into two parts: Section I seeks to develop a methodology, on a purely formal basis, which is, on the one hand, capable of being used to study the transcendental foundations of the special sciences, including its own proper transcendental foundation. On the other hand, the methodology proposed is intended as a diagnostic and therapeutic tool for dealing with projective uses of concepts. -/- The approach initiates an analysis of concepts from a perspective which views knowledge as coordination. Section I describes formal structures that possess the status of preconditions in such a coordinative account of knowledge. Special attention is given to the preconditions of identifying reference to logical particulars. The first section attempts, then, to provide a self-referential, transcendental methodology which is essentially revisionary in that it is motivated by a concern for conceptual error-elimination. -/- Phenomenology, considered in its unique capacity as a self-referential, transcendental discipline, is of special relevance to the study. Section II accordingly examines a group of concepts which come into question in connection with the central theme of phenomenological constitution. The "de-projective methodology" developed in Section I is applied to these concepts that have a foundational importance in transcendental phenomenology. A translation is, in effect, proposed from the language of consciousness to a language in which preconditions of referring are investigated. The result achieved is the elimination of self-defeating, projective concepts from a rigorous, phenomenological study of the constitutive foundations of science. -/- The dissertation was presented in a two volume, double-language format for the convenience of French and English researchers. Each volume contains an analytical index. (shrink)

Shirking, the act of avoiding the demands of one’s job, is generally seen as unethical. Drawing on empirical evidence from the sociology of work, I develop a normative conception of shirking as a form of worker resistance against illegitimate managerial power. In doing so, I present a new approach to the political theory of the firm, which is more adversarial and agent-centered than available alternatives. It is more adversarial as it recognizes the political value of counterproductive and disruptive behavior in (...) capitalist firms. It is more agent-centered because it theorizes the firm from the perspective of workers, asking what pro tanto reasons they have to shirk. I show that shirking under the structural domination of capitalism has diagnostic, agential, and epistemic values. The paper contributes to the wider methodological ambition to tailor political theorizing to the positionality of social actors, by shifting attention from the institutional design of the firm to the methods of worker resistance. (shrink)

In this paper I examine Habermas’ conception of the market in The Theory of Communicative Action (TCA). Habermas’ characterization of the market as norm-free has been controversial and I discuss three objections to it: the claims that it (1) conflates of action types, types of action coordination and spheres of action, (2) cannot account for the normative structure of the social organization of labour, and (3) that it makes impossible to make moral judgments about behaviour in the market. I conclude (...) that while some of these objections are unfounded, we have reason to revise Habermas’ substantive claims about the market. I also stress the importance of distinguishing between the TCA’s methodology and its time-diagnostic thrust. Next, I assess the colonization thesis through a case study of the commodification of higher education. I conclude that this thesis remains plausible, but that it needs to be supplemented with a theory of ideology. (shrink)

This paper aims for a more robust epistemological disjunctivism (ED) by offering on its behalf a new and better response to the ‘new evil genius’ problem. The first section articulates the ‘new evil genius challenge’ (NEG challenge) to ED, specifying its two components: the ‘first-order’ and ‘diagnostic’ problems for ED. The first-order problem challenges proponents of ED to offer some explanation of the intuition behind the thought that your radically deceived duplicate is no less justified than you are for (...) adopting her perceptual beliefs. In the second section, I argue that 'blamelessness' explanations are inadequate to the task and offer better explanations in their place—that of ‘trait-level virtue’ and ‘reasonability’. The diagnostic problem challenges proponents of ED to explain why it is that classical internalists disagree with them about how to interpret 'new evil genius' considerations. The proponent of ED owes some error theory. I tackle this problem in the third section, arguing that classical internalists overlook disjunctivist interpretations of new evil genius intuitions owing to a mistaken commitment to a ‘vindicatory’ explanation of perceptual knowledge. (shrink)

Plato’s Phaedrus, perhaps his most enigmatic and structurally convoluted dialogue, could easily be said to inaugurate a pointed critique of mass media that persists to the present day. Indeed, in certain corners of media theory, the origin myth of writing furnished in the Phaedrus (in which the Egyptian god Theuth presents writing as a gift to King Thamus) has in turn come to serve as a kind of origin myth for media theory: a primaeval pharmacopoeia of media effects. And yet, (...) this is an origin myth that can only underwrite not only its own non-originarity and non-truth, insofar as its very status as a written text ensures that it will never meet the criteria that it itself establishes for a reasoned account of things (logos). It remains perpetually orphaned, unable to defend itself, irrevocably cut off from its ‘father’, the speaking subject, and thus from the vitality of living discourse. But this paradox, I argue, is not a failing of the dialogue, but is a device intended to encourage the reader’s active involvement in the text’s status as medium. The Phaedrus is not just diagnostic, but therapeutic. (shrink)

Abstract: This working paper focuses on the question whether there is a therapeutic imperative that, in specific situations, would oblige us to perform genome editing at the germline level in the context of assisted reproduction. The answer to this central question is discussed primarily with reference to specific scenarios where preimplantation genetic diagnosis (PGD) does not represent an acceptable alternative to germline genome editing based on either medical, or ethical, or – from the perspective of the potential parents – moral (...) or religious grounds. This article deals with four different types of case constellations that result from these possible reasons against PGD as well as from the necessity or dispensability of a subsequent “control PGD.” These cases are discussed based on hypotheses concerning contextual factors and theoretical assumptions. In conclusion, we point out that if our assumptions are correct, there is probably no therapeutic imperative for genome editing at the germline level. We draw this rationale from the fact that germline interventions are likely not person-affecting. However, we caution the reader that our result is preliminary and needs to be more carefully examined in future work in light of the bioethical debate and potential objections. -/- // Abstract: Im Zentrum dieses Working Papers steht die Frage, ob es einen therapeutischen Imperativ geben kann, der uns, in bestimmten Situationen, verpflichten würde, eine Genomeditierung (genome editing) auf Keimbahnebene im Rahmen der assistierten Befruchtung vorzunehmen. Die Antwort auf diese zentrale Frage wird insbesondere mit Bezug auf Fälle diskutiert, in denen das Verfahren der Präimplantationsdiagnostik (PID) keine aus entweder medizinischen oder ethischen oder – aus Sicht der potentiellen Eltern – moralischen bzw. religiösen Gründen akzeptable Alternative zu einem Keimbahneingriff darstellt. Die möglichen Gründe gegen die PID sowie die Erforderlichkeit oder Verzichtbarkeit einer nachfolgenden «Kontroll-PID» ergeben vier verschiedene Fallkonstellationen, denen sich der Beitrag zuwendet. Auf Grundlage von Hypothesen zu kontextuellen Faktoren und theoretischen Annahmen diskutieren wir diese Fälle. Im Ergebnis verweisen wir darauf, dass es, wenn unsere Annahmen zutreffen, vermutlich keinen therapeutischen Imperativ zum genome editing auf Keimbahnebene gibt. Dies begründet sich daraus, dass der Keimbahneingriff vermutlich nicht als personenbezogen (person-affecting) zu bezeichnen ist. Wir weisen jedoch darauf hin, dass unser Ergebnis vorläufig ist und unter Berücksichtigung der bioethischen Debatte und möglicher Einwände genauer geprüft werden muss. -/- // Résumé: Ce Working Paper se concentre sur la question de l’existence d’un impératif thérapeutique qui, dans des situations spécifiques, nous obligerait à réaliser une édition du génome au niveau de la lignée germinale dans le cadre de la procréation assistée. Afin de répondre à cette question centrale nous développons quatre scénarios spécifiques dans lesquels le diagnostic préimplantatoire (DPI) ne représente pas une alternative acceptable à l’édition du génome germinal pour des raisons médicales, éthiques ou – du point de vue des futurs parents – morales ou religieuses. Cet article traite de quatre constellations différentes de cas résultant des raisons mises en avant pour s'opposer au DPI ainsi que de la nécessité ou de l’inutilité d’un ultérieur « DPI de contrôle » Ces cas sont discutés sur la base d’hypothèses portant sur les facteurs contextuels et sur les présupposés théoriques. En conclusion, nous soulignons que si nos hypothèses sont correctes, il n’y a probablement aucun impératif thérapeutique justifiant l’édition du génome au niveau de la lignée germinale. Nous arrivons à cette conclusion parce qu’une intervention au niveau de la lignée germinale n’est probablement pas susceptible d’affecter la personne. Cependant, nous mettons en garde le lecteur sur le fait que notre conclusion est préliminaire et qu’elle doit être examinée avec soin dans des futurs travaux instruits par le débat bioéthique et par les éventuelles objections. (shrink)

I develop a contractualist theory of just intelligence collection based on the collective moral responsibility to deliver security to a community and use the theory to justify certain kinds of signals interception. I also consider the rights of various intelligence targets like intelligence officers, service personnel, government employees, militants, and family members of all of these groups in order to consider how targets' waivers or forfeitures might create the moral space for just surveillance. Even people who are not doing anything (...) prejudicial to other states' security can be modeled as ceding rights against diagnostic collection--light touch collection limited to ascertaining if someone is likely an intelligence threat--as part of their duty to support just foreign institutions. Foreign intelligence officers could not perform the same job potential targets can reasonably demand their intelligence agencies perform on their behalf without this ceding of rights. More invasive forms of collection can only be justified if officers can reasonably model their citizens consenting to being the target of the same sort of collection by adversary states. (shrink)

In “The Zygote Argument is Invalid: Now What?” (2015), Kristin Mickelson published an objection to the Zygote Argument that she first presented in 2012 as workshop comments on a draft of Mele's "Manipulation, Moral Responsibility, and Bullet-Biting" (2013). Assuming that the phrase "determinism precludes free will" means something like determinism-related causal factors are what prevent people from acting freely when determinism is true, Mele's original Zygote Argument was invalid. At the workshop, Mickelson presented Mele with two options to address the (...) problem, a premise-preserving option and a conclusion-preserving option. That is, Mele could change the conclusion of the original argument to the negative, non-explanatory thesis entailed by its original two premises, or find a way to add premises that would support the positive, explanatory conclusion of the original argument (which, notably, is the conclusion that Pereboom supports using best-explanation reasoning in his Four-Case Argument). Mickelson used this as an opportunity to explain the key contribution that best-explanation reasoning makes to manipulation arguments -- and why the best variant of the manipulation argument might conclude that incompatibilism is FALSE. In response to Mickelson's objection, Mele changed the conclusion of the argument before "Manipulation, Moral Responsibility, and Bullet-Biting" went to print, choosing Mickelson's proposal to change its conclusion over the suggestion to change its premises. However, Mele failed to mention Mickelson's invalidity objection in print and that he changed the conclusion of his argument as a direct response to it; nor did Mele mention the costs that Mickelson outlined for the premise-preserving solution that he adopted or the benefits of a conclusion-preserving solution. At the same time, Mele began using the term 'incompatibilism' to pick out the negative, non-explanatory claim supported by the newly revised Zygote Argument--and also started to claim (without providing evidence) that those who use the term 'incompatibilism' to denote the explanatory claim deterministic causal factors *make it the case* that no one acts freely when determinism is true" is guilty of using the term in a nonstandard and nontraditional way that he had "never had any use for"--failing to mention that he clearly used the term in this explanatory sense in his 2005 critique of the Four-Case Argument, which is to be expected give that Derk Pereboom uses the explanatory definition (as do Kadri Vihvelin, Carolina Sartorio, and *most* other contributors to the free-will literature). In THIS reply essay, Mickelson responds to an attempt by Gabriel De Marco (FSU, advisor Alfred Mele) to defend the original Zygote Argument from Mickelson's 2012/2015 critique. Unfortunately, both of De Marco's proposed "solutions" are non-starters. The first is a non-starter because De Marco merely repeats the premise-preserving solution that Mickelson offered to Mele in 2012 and that Mele adopted in print in 2013. In other words, De Marco took credit for the premise-preserving solution to the invalidity objection that Mickelson developed (although he does *redescribe* Mickelson's solution in his own idiosyncratic jargon) and Mele had already adopted in print. De Marco's second solution is a non-starter because it is constituted by a patently invalid argument. Contrary to De Marco's proposal, it's not true that the conjunction of possibilism and incompossibilism deductively entails the positive, diagnostic claim that deterministic causal factors beyond one's control preclude (destroy, undermine, is antagonistically relevant to) free will when determinism is true. *My thanks to the editors of Philosophia for publishing this reply when PhilStudies would not. (shrink)

Popular two-factor accounts of thought insertion hold that this symptom of psychosis is caused by two elements working in tandem: an anomalous experience of some kind (the first factor) and a reasoning deficit or bias (the second factor). This chapter develops a very different alternative to explaining and treating thought insertion—one that views thought insertion as a form persecutory delusion. If this thesis is correct, clinical interventions for persecutory delusions may be successful for thought insertion as well. The chapter (...) begins by presenting several difficulties for two-factor accounts of thought insertion and for two-factor accounts of delusions more generally. It then discusses positive reasons for seeing thought insertion as a form of persecutory delusion. The positive case begins with reflection on first-person descriptions of thought insertion gleaned from online discussion forums. It continues by considering ways in which clinical diagnostic tools may create the appearance of deep differences between symptoms such as thought insertion and persecutory delusions where there are none. This case is bolstered by evidence for considerable variability in the content of delusions patients present with over time. Implications for the treatment of thought insertion are then considered. (shrink)

The purpose of the research is to develop a new methodological basis for identifying, analyzing and solving problems of international corporations export-import activities and to ground the directions for ensuring their business excellence. The approach originality provides introduction of a conceptual model that aims to eliminate the negative symptoms of international corporations export-import activities based on the results of comprehensive market research, effectiveness of export-import activities and calculation of the integrated indicator of business excellence. The leading corporations of Slovakia and (...) India in the production of bi-axially oriented polypropylene (BOPP) films were the primary basis for this study. The results of the research showed the need to implement a system of managerial innovation for reasoning the directions of ensuring international corporations business excellence. This is achieved because of using logically formalized methods and provides the improvement of organizational and structural interaction of management entities in the process of solving export-import activity problems. Important factors for ensuring business excellence are also the optimization of export and import costs, as well as an increase in export revenue for Slovak companies, and an increase in market share and cost optimization for Indian companies. The practical value of the obtained results is to develop a set of managerial innovations that can improve the efficiency of export-import activities and improve international corporations business. (shrink)

Background: Despite being often taken as the benchmark of quality for diagnostic and classificatory tools, 'validity' is admitted as a poorly worked out notion in psychiatric nosology. Objective: Here we aim at presenting a view that we believe to do better justice to the significance of the notion of validity, as well as at explaining away some misconceptions and inappropriate expectations regarding this attribute in the aforementioned context. Method: The notion of validity is addressed taking into account its role, (...) the framework according to which it should be assessed and the specific contents to which it refers within psychiatric nosology. Results and Conclusions: The notion of validity has an epistemological thrust and its foremost role is distinguishing correct reasoning and truth from what is irrational or false. From it follows not only that 'validity' always refers to elements of knowledge and rationality such as arguments, inferences and propositions, but also that the appropriate frameworks to assess 'validity' are logics and scientific methodology. When the validity of a psychiatric diagnostic category is at stake, the contents to which it refers are those relevantly related to the notion of 'diagnostic concept'. The consequences of our reading on the notion of 'validity' are discussed vis-à-vis the challenges faced by psychiatric nosology in order to have its diagnostic categories validated. (shrink)

The aim of this study was to obtain a baseline for clinical application of electroencephalography (EEG) in children and to evaluate the EEG findings in children with various acute and chronic central nervous system disorders and nonepileptic events. EEG records of 250 patients were studied in Neurophysiology Departments of Queen Rania Al-Abdullah Hospital for Children in Jordan. For each patient who had undergone EEG the following data were recorded: age, sex, source of referral (inpatient or outpatient department), reason for EEG, (...) diagnostic impressions, clinical presentation, the result of the EEG examinations and clinical correlation between the seizure type and EEG finding. Males (55%) were slightly outnumbered than females. The majority of cases were between 6-12 years. Total of 63.2% of all referrals for EEG were from outpatient clinics while inpatients accounted for 36.8% of referred cases, with Pediatric Neurology Department referrals being the highest (28.8%). Majority of diagnosis at referral were suspected epilepsy (80%) with epileptiform EEG abnormalities in 32%. Over all 64% the EEG records were normal, including all EEG records of children with syncope and headache. We conclude that there are many unnecessary routine EEG recordings in children. Investigation of epilepsy and acute encephalopathies appear to be the most valuable indications for routine pediatric EEG. EEG can be helpful in classification of seizures. Finding a way to reduce EEG requests is recommended. (shrink)

Not only defi ning the nature of schizophrenia, but even defi ning schizophrenia as a diagnostic entity is still a challenge for psychiatry. The current diagnostic systems and the related approach to psychopathology are of little aid to this purpose, and have inadvertently resulted in an impoverished clinical practice. There is substantial meaning underlying schizophrenic symptoms that would appear bizarre and senseless from the viewpoint of a purely descriptive method. Psychiatry needs to devise an approach that embraces the (...) complexity of the different perspectives of explanation and understanding of mental illness, examining the interplay of each element in the subjective experience. Symptoms such as delusion and hallucinations cannot merely be conceptualized as false judgment or lacking of external object, respectively, as they refl ect the fact that patients try to make sense of their different, globally altered experience of the self, of others and of the world. This line of reasoning builds on previous work in the phenomenological tradition postulating a disturbance in sensorimotor processes, which bond human beings with one another while remaining imperceptible to consciousness. This suggestion is consistent with a large body of research highlighting impairment in sensory processing in schizophrenia. Other authors underscored the importance of subtle alterations of functions other than sensorimotor processes, such as experiential anomalies of affectivity, cognition-perception and body-motor experience, alterations of self-awareness, and disturbances in reciprocal attunement leading to disconnection from a common register of meanings and loss of common sense. Heidegger refers to a human being as Being intrinsically selfrevelatory in the unity of physis and logos. He refers to the lived experience of being constantly in the everyday situation as being located, “thrown” into the world. The existence is always ‘in the world’, ‘near the things’ and ‘with the others’ for everybody, in the ways of ‘attunement’, ‘understanding’ and ‘discourse’, that are always together, in the unity of the Dasein. This conception of human existence may help understand the subjective experience of a schizophrenic patient and increase diagnostic accuracy and treatment adequacy. (shrink)

If we already had a periodic table of mental illness in hand, there would be less need for a book of this type. Although some psychiatrists do think of themselves as chemists, the analogy is without warrant. Not only does psychiatry lack an analogue of the periodic table, its principal tool -- the Diagnostic and Statistical Manual of Mental Disorders (DSM) -- is a contentious document. Even subsequent to the publication of DSM-III in 1980, which was intended to serve (...) as an operational guideline for clinical practice, it and its heirs (DSM-V was published in 2013) have often fueled rather than quelled controversy. Although beginning with that third major revision of DSM a concerted effort has been made to ensure greater consistency in diagnoses, psychiatry remains beset by concerns that it is insufficiently scientific, unduly influenced by the pharmaceutical industry, indecisive as to whether it should focus on the mind or the brain, incapable of distinguishing among types of diseases, inclined to expand illness criteria without adequate justification, overly reliant on subjective judgments, wont to conflate clinical and ethical judgments, and engaged in indiscriminate use of psychoactive drugs. These worries concerning its scientific and ethical status are among the reasons that psychiatry attracts the attention of philosophers. (shrink)

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

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

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

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

This is a discussion of the state of discussion on pragmatic reasons for belief.

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

Some sensory experiences are pleasant, some unpleasant. This is a truism. But understanding what makes these experiences pleasant and unpleasant is not an easy job. Various difficulties and puzzles arise as soon as we start theorizing. There are various philosophical theories on offer that seem to give different accounts for the positive or negative affective valences of sensory experiences. In this paper, we will look at the current state of art in the philosophy of mind, present the main contenders, critically (...) compare and contrast them. In particular, we want to examine how they handle the reason-giving power of affective states. We will look into two representationalist proposals (Evaluativism and Imperativism) and a functionalist proposal, and argue that, contrary to their own advertisements, the representationalist proposals don’t have good accounts of why and how sensory affect can motivate, rationalize, and justify subsequent behavior and intentional mental activity. We will show that our own functionalist proposal does a much better job in this regard, and that when the representationalist proposals are modified to do a better job, they fare better not because of their representationalist credentials but due to their functionalist ones. (shrink)

I defend the view that a reason for someone to do something is just a reason why she ought to do it. This simple view has been thought incompatible with the existence of reasons to do things that we may refrain from doing or even ought not to do. For it is widely assumed that there are reasons why we ought to do something only if we ought to do it. I present several counterexamples to this principle and reject some (...) ways of understanding "ought" so that the principle is compatible with my examples. I conclude with a hypothesis for when and why the principle should be expected to fail. (shrink)

This paper explores various subtleties in our ordinary thought and talk about normative reasons—subtleties which, if taken seriously, have various upshots, both substantive and methodological. I focus on two subtleties in particular. The first concerns the use of reason (in its normative sense) as both a count noun and as a mass noun, and the second concerns the context-sensitivity of normative reasons-claims. The more carefully we look at the language of reasons, I argue, the clearer its limitations and liabilities become. (...) The cumulative upshot is that although talk of reasons is intelligible and useful for the purposes of communication, we should be wary of placing much weight on it when engaging in substantive normative inquiry. By way of illustration, I consider some potential pitfalls of taking our talk of reasons too seriously, explaining how careful attention to the language of reasons undermines the main argument for moral particularism, Mark Schroeder’s recent defense of Humeanism about practical reasons, and the “reasons-first” program in metanormativity. (shrink)

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

Many philosophers have been attracted to the view that reasons are premises of good reasoning – that reasons to φ are premises of good reasoning towards φ-ing. However, while this reasoning view is indeed attractive, it faces a problem accommodating outweighed reasons. In this article, I argue that the standard solution to this problem is unsuccessful and propose an alternative, which draws on the idea that good patterns of reasoning can be defeasible. I conclude by drawing (...) out implications for the debate over pragmatic reasons for belief and other attitudes and for one influential form of reductionism about the normative. (shrink)

This article gives an overview of some recent debates about the relationship between reasons and rational requirements of coherence - e.g. the requirements to be consistent in our beliefs and intentions, and to intend what we take to be the necessary means to our ends.

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

What reasons do we have to use certain concepts and conceptions rather than others? Approaching that question in a methodologically humanistic rather than Platonic spirit, one might seek “reasons for concept use” in how well concepts serve the contingent human concerns of those who live by them. But appealing to the instrumentality of concepts in meeting our concerns invites the worry that this yields the wrong kind of reasons, especially if the relevant concerns are nonmoral ones. Drawing on Susan Wolf’s (...) work on the moral/nonmoral distinction and the neglected role of reasons of love, I argue that this worry is misplaced, and in fact overlooks some of our most important reasons to prefer certain concepts over others. Yet a lingering worry remains, namely that the value of concepts does not just lie in what they are good for. Drawing on another strand in Wolf’s work, I explore the question whether concepts can be valuable good-for-nothings, and show how this ultimately also underscores the importance of reasons of love as reasons for concept use. (shrink)

This chapter develops and defends an account of reason: to reason is to scrutinize one’s attitudes by consulting the perspectives of other persons. The principal attraction of this account is its ability to vindicate the unique of authority of reason. The chapter argues that this conception entails that reasoning is a robustly social endeavor—that it is, in the first instance, something we do with other people. It is further argued that such social endeavors presuppose mutual respect on the part (...) of those participating in them. The account therefore yields a form of Kantian constructivism: we have an unconditional duty of respect for persons because such a duty is implicit in the very nature of reasoning. -/- . (shrink)

This paper is a survey of the generalism-particularism debate and related issues concerning the relationship between normative reasons and moral principles.

Epistemic reasons are mental states. They are not propositions or non-mental facts. The discussion proceeds as follows. Section 1 introduces the topic. Section 2 gives two concrete examples of how our topic directly affects the internalism/externalism debate in normative epistemology. Section 3 responds to an argument against the view that reasons are mental states. Section 4 presents two problems for the view that reasons are propositions. Section 5 presents two problems for the view that reasons are non-mental facts. Section 6 (...) argues that reasons are mental states. Section 7 responds to objections. (shrink)