Deceased organ donation is widely considered as a case of easy rescue―that is, a case in which A may bestow considerable benefits on B while incurring negligent costs herself. Yet, the policy implications of this observation remain unclear. Drawing on Christopher H. Wellman’s samaritan account of political obligations, the paper develops a case for a so-called opt-out system, i.e., a scheme in which people are defaulted into being donors. The proposal’s key idea is that we may arrange people’s options in (...) specific ways for the sake of others. (shrink)

The Knowledge Norm of Assertion claims that it is proper to assert that p only if one knows that p. Though supported by a wide range of evidence, it appears to generate incorrect verdicts when applied to utterances of “I don't know.” Instead of being an objection to KNA, I argue that this linguistic data shows that “I don't know” does not standardly function as a literal assertion about one's epistemic status; rather, it is an indirect speech act that has (...) the primary illocutionary force of opting out of the speaker's conversational responsibilities. This explanation both reveals that the opt-out is an under-appreciated type of illocutionary act with a wide range of applications, and shows that the initial data in fact supports KNA over its rivals. (shrink)

In December 2015, Wales became the first country in the UK to move away from an opt-in system in organ procurement. The new legislation introduces the concept of deemed consent whereby a person who neither opt in nor opt out is deemed to have consented to donation. The data released by the National Health Service in July 2017 provide an excellent opportunity to assess this legislation in light of concerns that it would decrease procurement rates for living and deceased donation, (...) as well as sparking an increase in family refusals. None of these concerns have come to pass, with Wales experiencing more registered donors, fewer family refusals and more living donations. However, as the number of actual donors has dropped slightly from a high level, the situation must be monitored closely in the years to come. (shrink)

Objectives To increase postmortem organ donation rates, several countries are adopting an opt-out (presumed consent) policy, meaning that individuals are deemed donors unless they expressly refused so. Although opt-out countries tend to have higher donation rates, there is no conclusive evidence that this is caused by the policy itself. The main objective of this study is to better assess the direct impact of consent policy defaults per se on deceased organ recovery rates when considering the role of the family in (...) the decision-making process. This study does not take into account any indirect effects of defaults, such as potential psychological and behavioural effects on individuals and their relatives. -/- Design Based on previous work regarding consent policies, we created a conceptual model of the decision-making process for deceased organ recovery that included any scenario that could be directly influenced by opt-in or opt-out policies. We then applied this model to internationally published data of the consent process to determine how frequently policy defaults could apply. -/- Main outcome measures We measure the direct impact that opt-in and opt-out policies have per se on deceased organ recovery. -/- Results Our analysis shows that opt-in and opt-out have strictly identical outcomes in eight out of nine situations. They only differ when neither the deceased nor the family have expressed a preference and defaults therefore apply. The direct impact of consent policy defaults is typically circumscribed to a range of 0%–5% of all opportunities for organ recovery. Our study also shows that the intervention of the family improves organ retrieval under opt-in but hinders it under opt-out. -/- Conclusions This study may warn policy makers that, by emphasising the need to introduce presumed consent to increase organ recovery rates, they might be overestimating the influence of the default and underestimating the power granted to families. (shrink)

In this short comment on Just, Reasonable Multiculturalism, I concentrate on the permissible extent of interference by a liberal state in a community within that state when such interference aims to protect individuals within that community from it. He and I both value individuals and want them protected, of course. This shared value, however, leads us to different conclusions. On any liberal view, individuals must be allowed to act as they wish subject only to specific sorts of justified limitations. In (...) the mainstream approach that Cohen-Almagor accepts, these will include limitations necessary to not merely protect but also to promote autonomy. On my own view, by contrast, it is protection alone that justifies interference. I thus spell out Cohen-Almagor’s view about the need for interference with non-liberal groups within a liberal state and indicate my disagreement. (shrink)

As the debate over an English opt-out policy for organ procurement intensifies, assessing existing experiences becomes even more important. The Welsh introduction of opt-out legislation provides one important point of reference. With the introduction of deemed consent in December 2015, Wales became the first part of the UK to introduce an opt-out system in organ procurement. My article ‘Deemed consent: assessing the new opt-out approach to organ procurement in Wales’ conducted an early assessment of this.1 Taking its starting point in (...) important concerns often raised in discussion over opt-out legislation, it identified four key parameters to assess the effects. These are living donor rates, deceased donor rates, donor registrations and family refusals. My article compares these indicators before and after the enactment of the Welsh legislation employing a different-in-different design. In his reply to my article ‘Deemed consent: assessing the new opt-out approach to organ procurement in Wales’, Jordan Alexander Parsons offers two interesting critiques. The first pertains to the choice of indicators. Parsons prefer a narrower focus on the effect on deceased donor rates. The second pertains to the choice of data, Parsons preferring a time series of Wales to my different-in-different design. Parsons refers mainly to the official Welsh evaluation,2 a report I also cited in supplement to the NHS Activity Report data I employed. …. (shrink)

In this chapter, we provide an overview of the ethical considerations relevant to the use of nudges in organ donation policy. We do not defend a position on the permissibility of nudging in this context, but instead aim to clearly outline the strongest arguments on the different sides of this issue that have been presented in the English-language scholarly bioethics literature. We also highlight the questions that are in need of further investigation. In part 1, we briefly discuss nudging before (...) considering proposals to use nudges to increase the number of registered organ donors, including opt-out donor registration systems and the use of “nudge statements.” In part 2, we discuss the use of nudges to influence the decision-making of family members in circumstances where they have a veto over the donation of their loved one’s organs. (shrink)

Behavioral intervention techniques leveraging reactive responses have gained popularity as tools for promoting ethical behavior. Choice architects, for example, design and present default opt-out options to nudge individuals into accepting preselected choices deemed beneficial to both the decision-maker and society. Such interventions can also employ mild financial incentives or affective triggers including joy, fear, empathy, social pressure, and reputational rewards. We argue, however, that ethical competence is achieved via reflection, and that heavy reliance on reactive behavioral interventions can undermine the (...) development of ethical competence over the long term. Specifically, drawbacks may occur through motivational displacement, dependency, moral crowding out, loss of personal autonomy, and reactance. We introduce complementary cognitive boosting techniques designed to stimulate reflective cognition, as a more promising long-term strategy for instilling ethical behavior. One such approach is the Moral Self-Awareness (MSA) motivational construct, which incrementally leads agents to increasing levels of ethical reflection. We explain why ethical boosting approaches present more edifying and durable alternatives to reactive behavioral interventions and offer suggestions for social and organizational policy. (shrink)

An effective method to increase the number of potential cadaveric organ donors is to make people donors by default with the option to opt out. This non-coercive public policy tool to influence people’s choices is often justified on the basis of the as-judged-by-themselves principle: people are nudged into choosing what they themselves truly want. We review three often hypothesized reasons for why defaults work and argue that the as-judged-by-themselves principle may hold only in two of these cases. We specify further (...) conditions for when the principle can hold in these cases and show that whether those conditions are met is often unclear. We recommend ways to expand nationwide surveys to identify the actual reasons for why defaults work and discuss mandated choice policy as a viable solution to many arising conundrums. (shrink)

Is capitalism inherently predatory? Must there be winners and losers? Is public interest outdated and free-riding rational? Is consumer choice the same as self-determination? Must bargainers abandon the no-harm principle? Prisoners of Reason recalls that classical liberal capitalism exalted the no-harm principle. Although imperfect and exclusionary, modern liberalism recognized individual human dignity alongside individuals' responsibility to respect others. Neoliberalism, by contrast, views life as ceaseless struggle. Agents vie for scarce resources in antagonistic competition in which every individual seeks dominance. This (...) political theory is codified in non-cooperative game theory; the neoliberal citizen and consumer is the strategic rational actor. Rational choice justifies ends irrespective of means. Money becomes the medium of all value. Solidarity and good will are invalidated. Relationships are conducted on a quid pro quo basis. However, agents can freely opt out of this cynical race to the bottom by embracing a more expansive range of coherent action. (shrink)

This article first describes a dilemma for liberalism: On the one hand restricting their own options is an important means for groups of people to shape their lives. On the other hand, group members are typically divided over whether or not to accept option-restricting solutions or policies. Should we restrict the options of all members of a group even though some consent and some do not? This dilemma is particularly relevant to public health policy, which typically target groups of people (...) with no possibility for individuals to opt out. The article then goes on to propose and discuss a series of aggregation rules for individual into group consent. Consideration of a number of scenarios shows that such rules cannot be formulated only in terms of fractions of consenters and non-consenters, but must incorporate their motives and how much they stand to win or lose. This raises further questions, including what is the appropriate impact of altruistic consenters and non-consenters, what should be the impact of costs and benefits and whether these should be understood as gross or net. All these issues are dealt with in a liberal, anti-paternalistic spirit, in order to explore whether group consent can contribute to the justification of option-restricting public health policy. (shrink)

It is uncontroversial that something goes wrong with the blaming practices of hypocrites. However, it is more difficult to pinpoint exactly what is objectionable about their blaming practices. I contend that, just as epistemologists have recently done with blame, we can constructively treat hypocrisy as admitting of an epistemic species. This paper has two objectives: first, to identify the epistemic fault in epistemically hypocritical blame, and second, to explain why epistemically hypocritical blamers lose their standing to epistemically blame. I tackle (...) the first problem by appealing to an epistemic norm of consistency. I address the second by arguing that the epistemically hypocritical blamer commits to an opting-out of the set of shared epistemic standards that importantly underlies our standing to epistemically blame. I argue further that being epistemically hypocritical undermines a blamer’s standing even to judge epistemically blameworthy. (shrink)

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

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

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

MacKay and Robinson (2016) claim that some legal procedures that regulate organ donations (VAC, opt-in, opt-out) bypass people's rational capacities and thus are “potentially morally worse than MAC”, which only employs a very mild form of coercion. We provide a critique of their argumentation and defend the opposite thesis: MAC is potentially morally worse than the three other options.

Philosophers have had surprisingly little to say about the concept of a victim although it is presupposed by the extensive philosophical literature on rights. Proceeding in four stages, I seek to remedy this deficiency and to offer an alternative to the two current paradigms that eliminates the Othering of victims. First, I analyze two victim paradigms that emerged in the late 20th century along with the initial iteration of the international human rights regime – the pathetic victim paradigm and the (...) heroic victim paradigm. Holocaust victims are quintessential instances of the pathetic victim paradigm. They are marked by passivity and innocence in the face of overpowering force and unspeakable humanly inflicted suffering. Aung San Suu Kyi is an exemplar of the heroic victim paradigm – prisoners of conscience, in Amnesty International’s terms. Because heroic victims face off against the repressive power of the state to fight injustice, they are by no means passive, but they must be innocent of wrongdoing – that is, they must use nonviolent means of dissent – to qualify as heroic victims. Second, I problematize the asymmetrical conceptions of innocence that underwrite the two victim paradigms. Whereas the pathetic victim paradigm identifies innocence with passivity, the heroic victim paradigm countenances agentic victims and adverts to a universalist, absolutist stance on the limits of the legitimate use of state power to ascribe innocence to heroic victims. Both conceptions of innocence are out of keeping with well established social and legal practices regarding what constitutes coercive force and innocent victimhood. Consequently, there is reason to be skeptical of the two victim paradigms. Third, I identify two kinds of human rights violations and two categories of victims that AI defends despite their failure to fit the two paradigms – women trafficked into sex work and prisoners on death row. In many cases, women forced to do sex work are not innocent girls who are ignorant of the trafficking system and who helplessly fall prey to smugglers. They are desperately poor women who for that reason are willing to take enormous risks to try to relieve their own and often their families’ deprivation and suffering. Although these women act nonviolently for irreproachable reasons, they lack the public political agendas that characterize heroic victims. Unless non-fulfillment of subsistence rights is recognized as a form of overpowering force that inflicts severe, avoidable suffering, these women do not qualify as pathetic victims either. The victim paradigms pose an even greater obstacle to recognizing that the death penalty is a human rights violation and that death row prisoners are victims. Because a jury concluded that these individuals committed heinous, violent crimes, they are excluded by the heroic victim paradigm. Only if death row prisoners can be proven (usually through DNA evidence) not to have committed the crimes for which they were convicted can these individuals qualify as pathetic victims. In the absence of any reason to believe that they are innocent and especially if they are unrepentant, they are widely regarded as brutal victimizers of others who deserve no sympathy for, let along relief from, the suffering they “brought on themselves.” Finally, I confront the Othering of victims that results from the two victim paradigms, which leads many victims to eschew the label, thereby opting out of human right discourse. I propose revisions in the victim paradigms that eliminate the real-world exclusions they sponsor as well as the Othering of victims of human rights abuses. In particular, I endorse greater attention to what people and the institutions they create do to other people, and I favor a presumption that unnecessary and severe humanly inflicted suffering is a human rights violation. Moreover, I reject the innocence criterion embedded in the two paradigms and urge that it be replaced by a burdened agency criterion. These modifications better align the concept of a victim with a realistic understanding of human subjectivity and agency and allow for a more capacious understanding of who is a bearer of human rights and under what conditions right-holders become victims of rights violations. (shrink)

This article addresses the general ethical issues of accessing online personal data for research purposes. The authors discuss the practical aspects of online research with a specific case study that illustrates the ethical challenges encountered when accessing data from Kooth, an online youth web-counselling service. This paper firstly highlights the relevance of a process-based approach to ethics when accessing highly sensitive data and then discusses the ethical considerations and potential challenges regarding the accessing of public data from Digital Mental Health (...) services. It presents solutions that aim to protect young DMH service users as well as the DMH providers and researchers mining such data. Special consideration is given to service users’ expectations of what their data might be used for, as well as their perceptions of whether the data they post is public, private or open. We provide recommendations for planning and designing online research in an ethical manner that includes vulnerable young people as research participants. We emphasise the distinction between public, private and open data, which is crucial to comprehend the ethical challenges in accessing DMH data. Among our key recommendations, we foreground the need to consider a collaborative approach with the DMH providers while respecting service users’ control over personal data, and we propose the implementation of digital solutions embedded within the platform for explicit opt-out/opt-in recruitment strategies and ‘read more’ options. (shrink)

Smartphone technology is ubiquitous and subject to frequent complaints, both by reformers and the recalcitrant. The ubiquity of smartphone technology has led to many negative consequences, some of which may not be fully addressed by empirically oriented literature. One such consequence is a threat to a certain kind of autonomy. I argue that this threat justifies a form of Cynicism about smartphone technology, styled after ancient Cynicism. Cynicism is importantly different from its colloquialized, contemporary namesake (“cynicism”). While ancient Cynicism shares (...) the theme of opting out, in some sense, with contemporary cynicism, it is not a philosophy of withdrawn futility; in fact, the Cynic emphasis on embodiment may have an import on our lives in a time of smartphone ubiquity. Accordingly, I offer one Cynic value, autarkeia (self-sufficiency), which can be recruited to address the way that smartphone technology threatens our autonomy. (shrink)

Intensional evidence is any reason to accept a proposition that is not the truth values of the proposition accepted or, if it is a complex proposition, is not the truth values of its propositional contents. Extensional evidence is non-intensional evidence. Someone can accept a complex proposition, but deny its logical consequences when her acceptance is based on intensional evidence, while the logical consequences of the proposition presuppose the acceptance of extensional evidence, e.g., she can refuse the logical consequence of a (...) proposition she accepts because she doesn’t know what are the truth-values of its propositional contents. This tension motivates counterexamples to the negation of conditionals, the propositional analysis of conditionals, hypothetical syllogism, contraposition and or-to-if. It is argued that these counterexamples are non-starters because they rely on a mix of intensionally based premises and extensionally based conclusions. Instead, a genuine counterexample to classical argumentative forms should present circumstances where an intuitively true and extensionally based premise leads to an intuitively false conclusion that is also extensionally based. The other point is that evidentiary concerns about intensionally based beliefs should be constrained by the truth conditions of propositions presented by classical logic, which are nothing more than requirements of coherence in distributions of truth value. It is argued that this restriction also dissolves some known puzzles such as conditional stand-offs, the Adams pair, the opt-out property and the burglar’s puzzle. (shrink)

This is a study in thinking according to, but not withheld by, traditional methods from the branch of philosophy called Experiential Philosophy. Philosophers are interested in the topic of thought, if no one else. Yet, thinking is what we do sixteen hours a day. Or, as this study will show, thinking is what is done to us sixteen hours a day. What is thinking? Why is it? And, who is in charge here anyway? The following book will enter these questions (...) and make a serious attempt to keep deviations from target as small as possible. The thesis of this book is based on the recognition that thought is an activity in human beings that (1) proceeds in a fragmented way and that (2) basically cannot be halted. We cannot opt out of thinking. The conclusion is that this accounts for human suffering, lack of direction, and chaos in daily actions and decisions. This leads to the further conclusion that thinking is not something we do, it is something that is being done in us. (shrink)

The author brings out three interpretations of the relationship between neuroscience, philosophy and theology. Then he presents the character of neuroscience in contrast with biology and psycholo- gy. Critical consideration is given to different currents of neuroscience on the central theme of the relationship brain-mind, soul-body and the reductionism of body alone. He opts for the Thomistic view which holds that the spiritual soul is essentially linked to the body, making it the identity of the human person. Finally, he analyses (...) the relationship between neuroscience, philosophy and Christian Faith, concluding with some key meeting points between anthropology and neuroscience. (shrink)

Every year, hundreds of patients in England die whilst waiting for a kidney transplant, and this is evidence that the current system of altruistic-based donation is not sufficient to address the shortage of kidneys available for transplant. To address this problem, we propose a monopsony system whereby kidney donors can opt-in to receive financial compensation, whilst still preserving the right of individuals to donate without receiving any compensation. A monopsony system describes a market structure where there is only one ‘buyer’—in (...) this case the National Health Service. By doing so, several hundred lives could be saved each year in England, wait times for a kidney transplant could be significantly reduced, and it would lessen the burden on dialysis services. Furthermore, compensation would help alleviate the common disincentives to living kidney donation, such as its potential associated health and psychological costs, and it would also help to increase awareness of living kidney donation. The proposed system would also result in significant cost savings that could then be redirected towards preventing kidney disease and reducing health disparities. While concerns about exploitation, coercion, and the ‘crowding out’ of altruistic donors exist, we believe that careful implementation can mitigate these issues. Therefore, we recommend piloting financial compensation for living kidney donors at a transplant centre in England. (shrink)

This paper presents pretending as an enacted and fundamentally social activity. First, it demonstrates why we should think of pretense as inherently social. Then, it shows how that fact affects our theory in terms of what is needed in order to pretend. Standardly, pretense is seen as requiring a mechanism that allows one to bypass the “obvious” re- sponse to the environment in order to opt for a symbolic response; that mechanism is im- aginative and representational. This paper shows that (...) the Enactive Account of Pretense reconsiders the idea that one needs to respond to an absent environment when pretending, proposing instead that socially con- stituted perceptual affordances for play allow for non-obvious ways of responding to the present environment. The enactive account of pretense suggests that one need not posit special cognitive pretense mechanisms and mental scripts in order to account for pretend- ing, as available capacities for active perception and re-enactment of routines suffice. This paper concludes with suggestions for the kinds of cognitive skills that should be sought out to explain pretense. (shrink)

With the naturalist worldview having become widely accepted, the trend of naturalistic Buddhism has likewise become popular in both academic and religious circles. In this article, I preliminarily reflect on this naturalized approach to Buddhism in two main sections. In section 1, I point out that the Buddha rejects theistic beliefs that claim absolute power over our destiny, opting instead to encourage us to inquire intellectually and behave morally. The distinguishing characteristics of naturalism such as a humanistic approach, rational enquiry, (...) empirical observation, as well as a pragmatic and realistic outlook can all be seen in the Buddha’s teachings. In section 2, however, I advance arguments to show that while the Buddha is opposed to theistic doctrines, his views are not entirely in accordance with the presuppositions of naturalism. Firstly, the Buddha’s foremost concern is not purely intellectual in nature—the purpose of his teachings is to realize a soteriological goal through spiritual practice. Secondly, naturalism tends to subscribe to ‘self-being,’ while the Buddha holds all things to exist conditionally and impermanently. Because of the dependent nature of all things, it is not possible to discover their essence through reduction. Thirdly, naturalized philosophy would be a kind of belief-habit that follows from certain preconditioned assumptions. But the Buddha encourages us to re-examine our conceptual proliferation leading to biased views, as that ultimately leads to suffering. I conclude by proposing a broader naturalist outlook that would allow for a more inclusive conception of the natural world that would take the axiological dimension of human transcendence into account and increase an overall understanding of human potentiality. (shrink)

This article begins by distinguishing force and mood. Then it lays out desiderata on a successful account. It sketches as background the program of truth-theoretic semantics. Next, it surveys assimilation approaches and argues that they are inadequate. Then it shows how the fulfillment-conditional approach can be applied to imperatives, interrogatives, molecular sentences containing them, and quantification into mood markers. Next, it considers briefly the recent set of propositions approach to the semantics of interrogatives and exclamatives. Finally, it shows how to (...) integrate exclamatives and optatives into a framework similar to the fulfillment approach. (shrink)

This volume aims to develop a philosophical diagnostic of the present, focussing on contemporary technoscience. psychoanalysis submits contemporary technoscientific discourse to a symptomatic reading, analysing it with evenly-poised attention and from an oblique perspective. Psychoanalysis is not primarily interested in protons, genes or galaxies, but rather in the ways in which they are disclosed and discussed, focussing on the symptomatic terms, the metaphors and paradoxes at work in technoscientific discourse. This monograph presents a psychoanalytical assessment of technoscience. The first four (...) chapters provide a short introduction into the psychoanalysis of technoscience, its basic concepts and methods, as developed Sigmund Freud, Carl Gustav Jung, Gaston Bachelard and Jacques Lacan. In subsequent chapters, this approach is fleshed out with the help of case histories (palaeoanthropology, classical conditioning and virology). Psychoanalysis reveals that, rather than by disinterested curiosity, technoscience is driven by desire, resistance and the will to control. Moreover, the focus is on primal scenes, such as Dubois’ quixotic quest for the missing link and Pavlov’s discovery of the conditioned reflex. In addition, psychoanalysis opts for triangulation: understanding technoscientific research by comparing it to “different scenes”: to genres of the imagination, notably novels, so that, in this volume, the discovery of a Homo erectus skull by Dubois is compared to missing link novels by Jules Verne and Jack London (dating from the same period), Pavlov’s discovery of the conditioned reflex is compared with B.F. Skinner’s novel Walden Two and virology as a research field is considered through the lens of viral fiction. (shrink)

In this article, I show the role that the philosopher of cognitive science can cur-rently play in cognitive science research. I argue for the important, and not yet considered, role of the philosophy of cognitive science in cognitive science, that is, the importance of cooperation between philosophers of science with cogni-tive scientists in investigating the research methods and theoretical assump-tions of cognitive science. At the beginning of the paper I point out, how the philosopher of science, here, the philosopher of (...) cognitive science, can participate in interdisciplinary research. I am opting of the cooperation in investigating the so-called reflective problems. Then, I discuss four examples of issues important for the cognitive science, in which the competences possessed by the philosopher are useful. At the ending I point out wider landscape of possible cooperation of philosophers with cognitive scientists. (shrink)

This paper aims to contribute a design-focused perspective on the ‘alternative paradigm research’ discussion. To clarify the aspect of ‘design-focus’ that we wish to refer to, we will use the term ‘areas of design practice’ to cover those activities that focus on the conception and production of artefacts, in contrast to the activities of theorizing and writing histories. The literature on academic research in areas of design practice encompasses a board range of subjects and terminology -- it refers to the (...) creative and performing arts, the arts, design, etc., however what we take to be common in the literature is an interest in research involving the creation of original artefacts. In this paper, we cluster together the currently academicized, previously vocational areas. -/- We claim that researchers in different disciplines operate in different research paradigms owing to different worldviews. A worldview is determined by a set of foundational beliefs that are taken on faith, and a research paradigm is defined by axioms and assumptions that are a consequence of that worldview. For example, the scientific view of the world is that it exists independently from the individual and the individual’s thoughts about it; and it is possible to find out objective facts about the world by following certain procedures. This worldview conditions a research paradigm with an ontology of a real external world; that methodologically the data that is collected in procedurally appropriate ways will yield objective facts about that world; and that epistemologically the researcher stands in a disengaged relation to the world that is being investigated. The procedures that are regarded as appropriate within a particular research paradigm form the research models that are acceptable in that paradigm, and these research models determine what one should do in order to extend knowledge in a particular subject. Of course, the scientific worldview is not the only one, and this paper will contrast it to the design worldview as indicating the emergence of a unique research paradigm. -/- The relationship between a community’s worldview and the academic models that it adopts may be functional or dysfunctional. We claim that the relationship in the areas of design practice is often dysfunctional. This is because the academic model has not developed authentically in relation to its fundamental beliefs, but has done so in response to external forces for academicization. When pushed into the academy, areas of design practice did not possess their own academic models that were effectively linked to its worldview. We claim that, as a result, these areas simply co-opted research models from other disciplines. -/- The paper proposes a rationalistic approach for investigating the relationship between worldview and research paradigm -- between fundamental beliefs, theoretical concepts and methodology in research models. The rationalistic approach enables a critique, which reveals that there are indeed problematic issues with adopting academic models from other research paradigms in an uncritical way, and concludes that areas of design practice should be investigated as an example of a distinct worldview. (shrink)

The general topic of this paper is the ontological commitment to so-called "fictitious objects", that is, things and characters of fictional stories, like Sherlock Holmes and Pegasus. Discourse about fiction seems to entail an ontological commitment to fictitious entities, a commitment that is often deemed inconsistent with empirical facts. For instance, "Pegasus is a flying horse" seems to entail "There are flying horses" as well as "Pegasus exists" (according to some widely accepted logical principles). I discuss two solutions that have (...) been proposed in the literature. The first one amounts to rejecting sentences like "Pegasus is a flying horse" as false, at least if they are taken at face value. This solution is called the "story operator strategy". It consists in paraphrasing sentences like "Pegasus is a flying horse" by means of the expression "according to a story" such that they are interpreted as an elliptic formulation of, e.g., "According to a story, Pegasus is a flying horse". I spell out the difficulties of the story operator strategy and opt for a realist ontology of fiction. A novel interpretation of the story operator "according to a story" is given, which is not only consistent with but even sheds new light on such a realist ontology. In particular, it is shown how the story operator can be used as a tool to introduce the so-called "modes of predication distinction" (which is an essential ingredient of many realist ontologies of fiction) in a commonsensical way. (shrink)

In Philosophy, it is well known that of the total faculty population, the proportion of women is significantly lower than men. This disproportion is odd for a discipline within the humanities; these numbers seem more compatible with what is found in STEM (Science, Technology, Engineering, Mathematics) careers. These proportions are in turn a product of the low female presence that exists from the previous levels of academic training in philosophy. What happens in the case of the philosophy student body? For (...) example, the report presented by BeeBee and Saul (2011), on women in philosophy in the United Kingdom, in the period 2008 and 2009, points out that in the first degrees of academic training, in the bachelor's degree, women occupy 45% of the student population, in the master's degree 38% and in the doctorate 35%. Thus, "it is notable that there is a reduction in the proportion of women from the bachelor's degree to the doctorate [...]. This has as a consequence that at the professional level women holding positions as professors represent only 19%" (BeeBee & Saul, 2011, p. 11). Recently, Torres González (2018), based on European Union studies, points out that in Spain, with respect to gender disparity in students, "the data yield as a result masculinized studies, where, contrary to what happens in the branch of the humanities to which it [philosophy] belongs, males outnumber females by 28 percentage points" (2018, p. 328). This disparity is reflected in philosophy at the professional level, "the indicators of vertical segregation show a reinforced glass ceiling, which presents one of the worst data of hierarchical discrimination in the university: the percentage of female professors in philosophy is 12% compared to 21% of female professors in higher education" (Idem). Although it is a fact that there are fewer women than men studying philosophy and, therefore, fewer women than men working professionally in this discipline, we do not yet have possible explanations for this phenomenon of gender disparity in the student body in philosophy. In some cases, even if the number of women entering the philosophy degree program is already low, the number of women graduating is even lower, which indicates that there is attrition along the way; the initial numbers of women entering the program tend to decrease by the time they graduate. Thus we come to the question that is the subject of this paper: What causes female students to drop out of the philosophy program? In this article we answer this question from the philosophy of science and supported by local empirical data, so we do not give a complete or even less exhaustive answer. We review two explanatory models that purport to answer the question of why there are fewer women in philosophy, both formatively and professionally. These are the Different Voices Model (DVM) and the Perfect Storm Model (PSM); we opt for the latter and give reasons for it. Regarding the empirical aspect of our research, our source of statistical data belongs to the undergraduate program in philosophy at the Facultad de Estudios Superiores Acatlán-UNAM, Mexico (FES Acatlán), obtained in the framework of the SWIP-Analytic Mexico workshops. Our analysis of these data shows that even when female students have better GPAs than male students and take fewer subjects while enrolled, female students graduate less than male students in the FES Acatlan degree program. (shrink)

A significant portion of the secondary literature on Martin Heidegger’s Being and Time has focused on interpreting his formal conceptions of death and anxiety. Unlike these previous works, this essay will serve to fill a gap in the Heideggerian portrayal of death. Although he argues that Dasein is anxious about death at a fundamental level and that it proximally and for the most part covers up such anxiety, Heidegger does not provide ontic evidence in support of his claim, instead opting (...) to uncharacteristically take it as something self-evident. I attempt to supplement Heidegger’s framework by introducing Stephen Cave’s immortality narratives and the emerging field of Terror Management Theory as the aforementioned ontic evidence that rounds out Heidegger’s notion of death, before ultimately transitioning from Heidegger’s work into the larger philosophical discourse on death and demonstrating the potential joy that can manifest when one gains a lucid understanding of the ownness of their death and the narratives to which it gives rise. (shrink)

True Darwinian Ethics -/- Darwin’s model for the evolution of morality as presented in Descent of Man (1871) is shown to comprise three major stages that are here referred to as empathic premorality, tribal morality, and universalizing morality. Empathy, the key component of Darwin’s “social instincts” that started moral evolution, is here recognized as the principal cognitive device that conveys epistemic credibility to moral agency. The two constitutive elements of the tribal morality are conscience that Darwin conceived of as a (...) conflict between a lasting social motive and an immediate selfish impulse, and true altruism that evolved as a result of group (community) selection. Darwin’s genius recognized the uniqueness of group selection in human evolution as being dependent on mental faculties and speech that facilitated habit formation through praise and blame form other group members, with empathy as a gauge of others’ emotional reactions. Contrary to repeated claims, Darwin did not derive morality from reciprocity that he (and his contemporaries) considered to be “a low motive”, and adduced it only as a mechanism of habit formation. The universalizing morality was brought about by the increasing powers of intellect that led to respecting individual lives (rather than group interests only) and extending humane concerns beyond one’s group, ultimately to all sentient beings, which places Darwin among the spiritual fathers of modern humanitarianism. In terms of substantive ethics, Darwin’s views support moral individualism that requires to treat each subject according to his/her individual characteristics rather than any group membership. Darwin’s moral individualism and universalism have been elaborated by Peter Singer as the principle of equal consideration of interests and the expanding circle of ethics, respectively. Darwin’s model of moral evolution, which starts with intuitive but epistemically reliable moral agency and then allows for its rational improvement, provides a way out of the moral subjectivism of evolutionary ethics that reduces morality to an adaptation to social life. The primary or core morality that relies on empathy and implements reciprocity supports welfare (wellbeing) of a group and its members. Welfare (which has been defined by Darwin) is a basic “terminal” (ultimate) value that constitutes an objective, measurable fact. Since the primary morality supports welfare, it is objectively good, which justifies an ethical reasoning that such morality ought to be extended (with appropriate adjustments) to all sentient beings. Confusion over the status of morality is largely due to the lack of appreciation of its complexity: not only had its motivational apparatus (known as the moral agency) evolved by superposition of many emotional and pure cognitive mechanisms, but it has subsequently been co-opted to implement prudential, religious and possibly other norms that are accidental and sometimes contrary to its original social function. Those secondary morality norms are now enforced by the moral agency but lack moral objectivity and thus may support the perception of moral subjectivism and relativism. In short, true Darwinian ethics is based on the scientific axiology that recognizes evolutionary origins of all values, requires respecting all values that are experienced by each and every subject according to its individual characteristics, and calls for a critical assessment of each and every received morality. (shrink)

‘Torture porn’ films centre on themes of abduction, imprisonment and suffering. Within the subgenre, protagonists are typically placed under relentless surveillance by their captors. CCTV features in more than 45 contemporary torture-themed films (including Captivity, Hunger, and Torture Room). Security cameras signify a bridging point between the captors’ ability to observe and to control their prey. Founded on power-imbalance, torture porn’s prison-spaces are panoptical. Despite failing to encapsulate contemporary surveillance’s complexities (see Haggerty, 2011), the panopticon remains a dominant paradigm within (...) surveillance studies because it captures essential truths about the psychologies of self-governance and interdependency. This chapter will use torture porn’s panoptical spaces and captor-captive relationships as a springboard into examining those broader philosophical issues regarding selfhood. In the torture-space, cameras signify the control to which captives must submit. Since they are threatened with death, the surveillance dynamic appears to entirely subjugate these prisoners. However, the captive must undertake some agency in the oppression. Much of the captor’s implied threat is enacted by the captives, who brutalise one another to save themselves. The captor’s apparent omniscience is translated into omnipotence only because the captives forsake self-control – opting to engage in violent, contra-social behaviours – out of fear. Thus, it is implied that self-ownership is the bedrock of stable, interdependent sociality. To inspire horror, the opposite is depicted: fractured groups comprised of paranoid, self-invested individuals. By submitting to external pressure, these “weak” individuals empower their tormentor. Captives are not only encouraged to enact their own suppression, but also to internalise culpability for the suffering they undergo. Despite being threatened with erasure, torture porn’s protagonists are spotlighted in these films. Abductees dominate the screen-time, and their suffering drives the narrative forward. Torturers are often motivated solely by their victims’ agony. In many cases, torture is designed specifically for each hyper-individualised captive. These forms of emphasis imply that captives are the stimulus for their own victimisation. The captor’s exaggerated interest in the prisoners is perversely flattering: captives are implied to be worthy of the captor’s maniacal attention, which is reified by the CCTV cameras. In torture porn’s scenarios, it is not immediately clear who has greater control over the individual: the captor or the captive themselves. By dissecting how self-preservation, self-governance, and self-centredness manifest in torture porn, this chapter seeks to examine the dialectical qualities of liberty, interdependency and autonomy. (shrink)

I present a case for a rapprochement between aspects of rationalism and scientific realism, by way of a general framework employing modal epistemology and elements of 2-dimensional semantics (2DS). My overall argument strategy is meta-inductive: The bulk of this paper establishes a “base case,” i.e., a concretely constructive example by which I demonstrate this linkage. The base case or constructive example acts as the exemplar for generating, in a constructively ‘bottom-up’ fashion, a more generally rigorous case for rationalism-realism qua modal (...) epistemology. The exemple I choose in D. Chalmers’ (2002) modal rationalism and R. Giere’s (1985, 1988) constructive realism. I show by way of a thorough analysis how Giere’s claims concerning modal scope are characterized as instances of Chalmers’ modal rationalism, both weak and strong. In essence, as I demonstrate via Chalmers’ notions, ceteris paribus the constructive realist ultimately opts for a comparatively wider gate, characterized by modal reasoning, to lead from the rooms of conceivability qua thought experiments and models, to the pastures of metaphysical possibility. Chalmers likewise tries to erect such a wider gate, in his general conceivability-possibility theses. Anti-realists, on the other hand, see a narrower passage and my contention herein is that they suffer from modal myopia, which hopefully the ‘corrective vision’ of Chalmers’ modal rationalism can restore. In the introduction and concluding sections I sketch out suggestions of constructing ‘inductive steps’ from my base case, to generate more extensively general claims regarding realism qua rationalism. -/- . (shrink)

This dissertation aims to revive wave theory in the philosophy of sound. Wave theory identifies sounds with compression waves. Despite its wide acceptance in the scientific community as the default position, many philosophers have rejected wave theory and opted for different versions of distal theory instead. According to this current majority view, a sound has its stationary location at its source. I argue against this and other alternative philosophical theories of sound and develop wave theory into a more defensible form. (...) Philosophers of sound tend to emphasise how sounds are experienced to be in their arguments. Most often, it is assumed that that which appears to be a distally located bearer of auditory properties in an auditory experience is a sound. Chapter 1 argues that if this distal entity is the sound source instead, many of the existing theories of sound will be severely affected. Chapter 2 discusses auditory perception and criticises the common assumption that we hear non-sound entities in virtue of hearing sounds. I show that this assumption begs the question against certain theories of sound and that the contrary view that sound sources can be directly heard is more plausible. If sound sources can be directly heard, then features commonly attributed to sounds based on auditory experiences might rather be features of sound sources. I examine eight of such features in Chapter 3. Only four of them survive. Chapters 4 and 5 review the existing theories of sound. After a taxonomy of existing theories of sound, each theory is criticised one-by-one. Some of them are problematic precisely because they rely on the implausible assumption that that which appears to be distally located in an auditory experience is a sound rather than a sound source. Lastly, Chapter 6 focuses on wave theory. It begins with two positive arguments for wave theory in general, followed by my replies to two common objections in the literature. I then move on to develop my version of wave theory. There are two core aspects of my view. The first one is a metaphysics of compression waves; the second is an account of what it is to hear compression waves. After comparing my view with a similar theory, I demonstrate the explanatory power of my view in two steps. First, the eight commonly accepted features of sounds examined in Chapter 3 are revisited. It turns out that my view can accommodate all of them. Second, explanations for four special sound-related phenomena are offered at the end of the chapter. I conclude in the last chapter with the suggestion that, as a philosopher, the best way to defend wave theory is to offer a better understanding of auditory perception which explains how compression waves are experienced. (shrink)

This paper focuses on how building human potentialities in education can enhance learning competencies in students for the development of the self and the society. Human potential refers to a possibility human beings are capable of achieving. Montessori believes that the traditional system of education directs students to learn through memorization and recitation techniques and does not lay much emphasis on helping students to bring out their maximum potential. What goal can we attribute to education today? Our focus shall be (...) to answer the questions, what are the favorable conditions under which education can help to build human potentialities? Is Montessori’s view essential in enhancing creativity and building the necessary competencies of the learners in our society today? Education is a natural process carried out by the human individual. It is not what the teacher gives and is not acquired by listening to words but by experiences upon the environment. Montessori opts that education should help the learners develop confidence in their emerging abilities and offer them the opportunity to gain independence in daily tasks. The pedagogic significance of this work serves as a guide for the educational system in Africa and Cameroon in particular. It serves as a guide for curriculum developers and policy makers to bring out programs that will enhance the building of individual competencies for eventual development. Thus Montessori’s idea of education to build human potentialities is indispensible to our educational system today. (shrink)

In a Covid-19 world, everyone’s circumstances changed. Most of us are living and or working in quarantine or lockdown. There is evidence that lockdown itself can have serious negative psychological impact (Brooks et al., 2020). Nonetheless, strategies are being proposed which, arguably, mitigate these harms. Artmaking is one such strategy. As ‘art therapy’, it has been usefully deployed to address a wide range of mental health challenges including anxiety, depression, fatigue and post-traumatic stress (Regev & Cohen-Yatziv, 2018). Given that these (...) self-same impacts profile the mental health challenges identified in relation to pandemic isolation, art may be useful in mitigating mental health issues associated with lockdown. This paper does not address how the role art can play in the therapeutic mix for serious mental health disorders. More specifically it is focused on a narrower brief of ills – predominantly those associated with boredom and a loss of stimulation associated with the constrained circumstances of lockdown. The kind of ‘art therapy’ this paper has in mind is more accurately described as ‘art engagement’ as it concerns individuals actively engaging with art. Art engagement is taken as self-administered utilising the time-out imposed by lockdown as an opportunity to take stock and reset. I will argue that to be of optimal benefit to people in lockdown, the art engagement model should support art practices that are easily accessible to a wide range of people, and be broadly scoped regarding areas to explore. Finally, because the benefits flowing from art engagement are central to this quest, our art engagement model will need to be able to track how art enriches or impoverishes its practitioners. This paper will set up a framework for art engagement that provides an apt account of art practices suited to people in lockdown. I will examine how the resolution of two art puzzles point the way forward in developing an art engagement model. Adventitiously, understanding these puzzles will also prove useful for art making in constrained living arrangements. Managing the first of these puzzles requires a rejection of the notion that art can be determinately defined. Instead we opt for a model that privileges practices and products that enrich the lives of practitioners. The second puzzle assumes creativity relies to varying degrees on appropriation and so appropriation acts need to be included in the model. However, this comes at a cost. Appropriation disrupts any notion that art works are stable things situated forever in the realm of art. It will be shown that appropriation causes us to adopt a more expansive view about the fluidity of what counts as an artwork. This fluidity may take us into and out of the realm of what is traditionally thought of as ‘art’ entirely and leads us to abandon any dependency on art masters and art institutions in our artmaking quests. The paper will conclude by using the model described to outline three art engagement examples that demonstrate how sometimes ordinary everyday experiences can be enriched by taking an art-engaging stance even in the highly constrained environment of lockdown. (shrink)

Lately, there has been a lot of talk about the Ghettos, about wayward youths and Instagram rappers that glorify violence. In this piece, a Warsaw-based philosopher contributes to this discussion by examining the music of the ghetto and the culture of riots. Not in opposition to how bourgeois society usually frames such acts of discontent but rather as a reasonable democratic right that minorities are entitled to.

The phenomena of call-outs and call-ins are fiercely debated. Are they mere instances of virtue signaling? Or can they actually perform social justice work? This paper gains purchase on these questions by focusing on how language users negotiate norms in speech. The authors contend that norm-enacting speech not only makes a norm salient in a context but also creates conversational conditions that motivate adherence to that norm. Recognizing this allows us to define call-outs and call-ins: the act of calling-out brings (...) with it the presupposition that its target's behavior is norm-violating, whereas the act of calling-in simply presupposes its target's willingness to revise their belief. With these definitions at hand, we evaluate whether call-outs and call-ins are suitable tools for combating social injustice. (shrink)

According to the character condition, a person is morally responsible for an action A only if a character trait of hers non-accidentally motivates her performing A. But that condition is untenable according to the out of character objection because people can be morally responsible for acting out of character. We reassess this common objection. Of the seven accounts of acting out of character that we outline, only one is even a prima facie counterexample to the character condition. And it is (...) not obvious that people act out of character in that sense. We argue that whether the out of character objection succeeds ultimately depends on the unnoticed methodological commitment that cases that may not resemble human life provide good data for theorizing about moral responsibility. But even if such cases provide good data, the forcefulness of the objection is at least deflated given that its persuasive power is supposed to come from clear real-life cases. (shrink)

ABSTRACT:The distinction between what I call nonelective obligations and discretionary obligations, a distinction that focuses on one particular thread of the distinction between perfect and imperfect duties, helps us to identify the obligations that carry over from principals to agents. Clarity on this issue is necessary to identify the moral obligations within “shareholder primacy”, which conceives of managers as agents of shareholders. My main claim is that the principal-agent relation requires agents to fulfill nonelective obligations, but it does not always (...) require discharging discretionary obligations. I show that the requirement to fulfill nonelective obligations is more far-reaching than has been acknowledged by most defenders and critics of shareholder primacy. But I also show that managers are not bound by certain discretionary obligations like charity, showing that their moral obligations are more circumscribed than the obligations that apply to human beings in general. (shrink)

Contemporary philosophical and scienti .c discussions of mind developed from a 'proto-concept of mind ',a mythical,tradition- alistic,animistic and quasi-sensory theory about what it means to have a mind. It can be found in many di .erent cultures and has a semantic core corresponding to the folk-phenomenological notion of a 'soul '.It will be argued that this notion originates in accurate and truthful .rst-person reports about the experiential content of a special neurophenomenological state-class called 'out-of-body experiences '.They can be undergone by (...) every human being and seem to possess a culturally invariant cluster of functional and phenomenal core properties similar to the proto-concept of mind. The common causal factor in the emergence and development of the notion of the soul and the proto-concept of mind may consist in a yet to be determined set of properties realized by the human brain, underlying the cluster of phenomenal properties described in the relevant first-person reports. This hypothesis suggests that such a neurofunctional substrate ed human beings at different times, and in widely varying cultural contexts, to postulate the existence of a soul and to begin developing a theory of mind. (shrink)

This is a chapter of the planned monograph "Out of Nowhere: The Emergence of Spacetime in Quantum Theories of Gravity", co-authored by Nick Huggett and Christian Wüthrich and under contract with Oxford University Press. (More information at www<dot>beyondspacetime<dot>net.) This chapter investigates the meaning and significance of string theoretic dualities, arguing they reveal a surprising physical indeterminateness to spacetime.

Portmore wrote a good book, and I wrote a short thing about that book.

A defense of imprecise credences (and other imprecise doxastic attitudes).

We take up questions of passing/outing as they arise for those with queer femme identities. We argue that for persons with female-identified bodies and queer, feminine (‘femme’) gender identities, the possibilities above may not exist as distinct options: for example, what it means to ‘pass’ or ‘cover’ is not always distinguishable – conceptually or in practice – from living authentically and resisting heteronormative identification: i.e. the conditions of being ‘out’. In some ways, these conflations privilege queer femmes; in others, femmes (...) find themselves implicated in a political double bind. We contend that this example problematizes the very concepts of passing and outing, and the political and ethical demands that are taken to arise from them. We conclude by exploring what it means to live queer femme identity responsibly and what this means for the ethics of sexual identity more generally. (shrink)

Exercise-based rehabilitation forms a key part of the UK National Health Service patient-care pathway for cardiac rehabilitation (CR). Only around half of all eligible patients attend core CR, however, with social inequalities affecting participation. Few qualitative studies have explored in-depth the key factors influencing engagement with CR, specifically from a sociological theoretical, and ethnographic perspective. Utilising an ethnographic approach allowed us to get a sense of the embodied experiences of 10 participants attending or declining core CR, together with a further (...) seven family members/significant others. This provided in-depth appreciation of participants’ lifeworld contexts as key influences on CR participation. The article draws on these qualitative data and focuses on 1) participants’ initial thoughts about CR; and 2) navigating the field of CR, analysed via thematic analysis. We utilise a Bourdieusian theoretical perspective to theorise the findings, including salient socio-cultural factors influencing attendance/non-attendance and (non)adherence. The article findings highlight how perceptions of CR and the ability to navigate the field are strongly influenced by habitus and capital, and how personal biographies and socio-material conditions affect adherence to CR programmes. The study provides original insights into embodied experiences of exercise-based CR, and novel understandings of the reasons for drop-out/poor adherence, theorised from a Bourdieusian perspective. (shrink)

In addiction, apparently causally significant phenomena occur at a huge number of levels; addiction is affected by biomedical, neurological, pharmacological, clinical, social, and politico-legal factors, among many others. In such a complex, multifaceted field of inquiry, it seems very unlikely that all the many layers of explanation will prove amenable to any simple or straightforward, reductive analysis; if we are to unify the many different sciences of addiction while respecting their causal autonomy, then, what we are likely to need is (...) an integrative framework. In this paper, we propose the theory of “Externalist” or “4E” – for extended, embodied, embedded, and enactive – cognition, which focuses on the empirical and conceptual centrality of the wider extra-neural environment to cognitive and mental processes, as a candidate for such a framework. We begin in Section 2 by outlining how such a perspective might apply to psychiatry more generally, before turning to some of the ways it can illuminate addiction in particular: Section 3 points to a way of dissolving the classic dichotomy between the “choice model” and “disease model” in the addiction literature; Section 4 shows how 4E concepts can clarify the interplay between the addict’s brain and her environment; and Section 5 considers how these insights help to explain the success of some recovery strategies, and may help to inform the development of new ones. (shrink)