A lively topic of debate in decision theory over recent years concerns our understanding of the different risk attitudes exhibited by decision makers. There is ample evidence that risk-averse and risk-seeking behaviours are widespread, and a growing consensus that such behaviour is rationally permissible. In the context of clinical medicine, this matter is complicated by the fact that healthcare professionals must often make choices for the benefit of their patients, but the norms of rational choice are conventionally grounded in a (...) decision maker’s own desires, beliefs and actions. The presence of both doctor and patient raises the question of whose risk attitude matters for the choice at hand and what to do when these diverge. Must doctors make risky choices when treating risk-seeking patients? Ought they to be risk averse in general when choosing on behalf of others? In this paper, I will argue that healthcare professionals ought to adopt a deferential approach, whereby it is the risk attitude of the patient that matters in medical decision making. I will show how familiar arguments for widely held anti-paternalistic views about medicine can be straightforwardly extended to include not only patients’ evaluations of possible health states, but also their attitudes to risk. However, I will also show that this deferential view needs further refinement: patients’ higher-order attitudes towards their risk attitudes must be considered in order to avoid some counterexamples and to accommodate different views about what sort of attitudes risk attitudes actually are. (shrink)

Research on the capacity to understand others' minds has tended to focus on representations ofbeliefs,which are widely taken to be among the most central and basic theory of mind representations. Representations ofknowledge, by contrast, have received comparatively little attention and have often been understood as depending on prior representations of belief. After all, how could one represent someone as knowing something if one does not even represent them as believing it? Drawing on a wide range of methods across cognitive (...) science, we ask whether belief or knowledge is the more basic kind of representation. The evidence indicates that nonhuman primates attribute knowledge but not belief, that knowledge representations arise earlier in human development than belief representations, that the capacity to represent knowledge may remain intact in patient populations even when belief representation is disrupted, that knowledge (but not belief) attributions are likely automatic, and that explicit knowledge attributions are made more quickly than equivalent belief attributions. Critically, the theory of mind representations uncovered by these various methods exhibits a set of signature features clearly indicative of knowledge: they are not modality-specific, they are factive, they are not just true belief, and they allow for representations of egocentric ignorance. We argue that these signature features elucidate the primary function of knowledge representation: facilitating learning from others about the external world. This suggests a new way of understanding theory of mind – one that is focused on understanding others' minds in relation to the actual world, rather than independent from it. (shrink)

Last year saw the 20th anniversary edition of JECP, and in the introduction to the philosophy section of that landmark edition, we posed the question: apart from ethics, what is the role of philosophy ‘at the bedside’? The purpose of this question was not to downplay the significance of ethics to clinical practice. Rather, we raised it as part of a broader argument to the effect that ethical questions – about what we should do in any given situation – are (...) embedded within whole understandings of the situation, inseparable from our beliefs about what is the case, what it is that we feel we can claim to know, as well as the meaning we ascribe to different aspects of the situation or to our perception of it. Philosophy concerns fundamental questions: it is a discipline requiring us to examine the underlying assumptions we bring with us to our thinking about practical problems. Traditional academic philosophers divide their discipline into distinct areas that typically include logic: questions about meaning, truth and validity; ontology: questions about the nature of reality, what exists; epistemology: concerning knowledge; and ethics: how we should live and practice, the nature of value. Any credible attempt to analyse clinical reasoning will require us to think carefully about these types of question and the relationships between them, as they influence our thinking about specific situations and problems. So, the answers to the question we posed, about the role of philosophy at the bedside, are numerous and diverse, and that diversity is illustrated in the contributions to this thematic edition. (shrink)

This essay first introduces the moral sense theories of Francis Hutcheson, David Hume, and Adam Smith, and clarifies important differences between them. It then examines whether moral judgment based on the moral sense or moral sentiments varies according to one's metaphysical beliefs. For this, the essay mainly applies those theories to such issues as stem cell research, abortion, and active euthanasia. In all three theories, false religious beliefs can distort moral judgment. In Hutcheson's theory, answers to stem cell research, abortion, (...) and active euthanasia do not change according to the spectator's metaphysical beliefs. Yet answers to those issues can change according to the agent's metaphysical beliefs. Hume's theory cannot provide answers to stem cell research and abortion where the embryo or fetus is the receiver (the one affected by the agent's action) and to active euthanasia where the patient is unconscious. It may provide answers to abortion where the pregnant woman is the receiver and to active euthanasia where the patient is conscious. Yet the answers can vary depending on the woman's or the patient's metaphysical beliefs. Smith's theory can provide answers to stem cell research, abortion, and active euthanasia. But the answers can vary depending on the agent's metaphysical beliefs. These show that the moral sense or moral sentiments in those theories alone cannot identify appropriate morals. (shrink)

Clinical delusions have traditionally been characterized as beliefs in psychiatry. However, philosophers have recently engaged with the empirical literature and produced a number of objections to the so-called doxastic status of delusion, stemming mainly from the mismatch between the functional role of delusions and that expected of beliefs. In response to this, an appeal to dispositionalism about the nature of belief has been proposed to vindicate the doxastic status of delusion. In this paper, I first present the objections to (...) attributing beliefs to delusional patients and the application of dispositionalism in the attempt to vindicate doxasticism. I then assess this application and some responses to the objections to the doxastic characterization. Finally, I offer some conclusions about the limits of folk-psychological concepts in the characterization and explanation of complex psychological phenomena such as delusions. (shrink)

Just as sadness is not always a symptom of mood disorder, irrational beliefs are not always symptoms of illness. Pathological irrational beliefs are distinguished from non-pathological ones by considering whether their existence is best explained by assuming some underlying dysfunctions. The features from which to infer the pathological nature of irrational beliefs are: un-understandability of their progression; uniqueness; coexistence with other psycho-physiological disturbances and/or concurrent decreased levels of functioning; bizarreness of content; preceding organic diseases known to be associated with irrational (...) beliefs; treatment response to medical intervention, etc. Severe irrationality is sometimes caused by normal human motivation rather than by mental or physical dysfunction. Pure forms of self-deception may satisfy the diagnostic criteria of delusional disorder, but there may be no evidence that suggests that they are caused by illness. Although those with pathological delusions do not recognize their delusions as symptomatic of illness, differentiating pathological beliefs from normal irrational beliefs is vitally important: If a belief is pathological, psychiatrists must seriously consider treating the patient against her will. If it is not pathological, conversely, involuntary treatments are prohibited because they offend her basic autonomy. (shrink)

People suffering from severe monothematic delusions, such as Capgras, Fregoli, or Cotard patients, regularly assert extraordinary and unlikely things. For example, some say that their loved ones have been replaced by impostors. A popular view in philosophy and cognitive science is that such monothematic delusions aren't beliefs because they don't guide behaviour and affect in the way that beliefs do. Or, if they are beliefs, they are somehow anomalous, atypical, or marginal beliefs. We present evidence from five studies that folk (...) psychology unambiguously views monothematic delusions as stereotypical beliefs. This calls into question widespread assumptions in the professional literature about belief's stereotypical functional profile. We also show that folk psychology views delusional patients as holding contradictory beliefs. And we show that frequent assertion is a powerful cue to belief ascription, more powerful than even a robust and consistent track record of non-verbal behaviour. (shrink)

Conscientious objection in healthcare has come under heavy criticism on two grounds recently, particularly regarding abortion provision. First, critics claim conscientious objection involves a refusal to provide a legal and beneficial procedure requested by a patient, denying them access to healthcare. Second, they argue the exercise of conscientious objection is based on unverifiable personal beliefs. These characteristics, it is claimed, disqualify conscientious objection in healthcare. Here, we defend conscientious objection in the context of abortion provision. We show that abortion (...) has a dubitable claim to be medically beneficial, is rarely clinically indicated, and that conscientious objections should be accepted in these circumstances. We also show that reliance on personal beliefs is difficult to avoid if any form of objection is to be permitted, even if it is based on criteria such as the principles and values of the profession or the scope of professional practice. (shrink)

Hundreds of evaluative studies of psychotherapy still leave the issue of its effectiveness unsettled. The author argues that such studies have ignored the major determinant of therapeutic effectiveness, the role of a patient’s belief in the successful outcome in therapy. Psychiatrist Thomas Szasz, one of the foremost critics of psychiatry, wrote of this paper: "It is one of the best, if not the best, that I have read on this subject.” It makes little sense to claim that a (...) certain therapy is effective or ineffective in itself; rather, there is a relation of mutual interaction among three terms: a patient’s ability to learn in a psychological context, a therapist’s ability to teach, and the capacity of an approach to therapy to engender in the patient the necessary belief in its effectiveness. -/- The paper is followed by a 4-page 2014 Afterword. (shrink)

Delusions are deeply evidence-resistant. Patients with delusions are unmoved by evidence that is in direct conflict with the delusion, often responding to such evidence by offering obvious, and strange, confabulations. As a consequence, the standard view is that delusions are not evidence-responsive. This claim has been used as a key argumentative wedge in debates on the nature of delusions. Some have taken delusions to be beliefs and argued that this implies that belief is not constitutively evidence-responsive. Others hold fixed (...) the evidenceresponsiveness of belief and take this to show that delusions cannot be beliefs. Against this common assumption, I appeal to a large range of empirical evidence to argue that delusions are evidence-responsive in the sense that subjects have the capacity to respond to evidence on their delusion in rationally permissible ways. The extreme evidence-resistance of delusions is a consequence of powerful masking factors on these capacities, such as strange perceptual experiences, motivational factors, and cognitive biases. This view makes room for holding both that belief is constitutively evidence-responsive and that delusions are beliefs, and it has important implications for the study and treatment of delusions. (shrink)

Regarding the appropriateness of deception in clinical practice, two (apparently conflicting) claims are often emphasised. First, that ‘clinicians should not deceive their patients.’ Second, that deception is sometimes ‘in a patient’s best interest.’ Recently, Hardman has worked towards resolving this conflict by exploring ways in which deceptive and non-deceptive practices extend beyond consideration of patients’ beliefs. In short, some practices only seem deceptive because of the (common) assumption that non-deceptive care is solely aimed at fostering true beliefs. Non-deceptive care, (...) however, relates to patients’ non-doxastic attitudes in important ways as well. As such, Hardman suggests that by focusing on belief alone, we sometimes misidentify non-deceptive care as ‘deceptive’. Further, once we consider patients’ beliefs and non-doxastic attitudes, identifying cases of deception becomes more difficult than it may seem. In this essay, I argue that Hardman’s reasoning contains at least three serious flaws. First, his account of deception is underdeveloped, as it does not state whether deception must be intentional. The problem is that if intention is not required, absurd results follow. Alternatively, if intention is required, then identifying cases of deception will be much easier (in principle) than Hardman suggests. Second, Hardman mischaracterises the ‘inverse’ of deceptive care. Doing so leads to the mistaken conclusion that common conceptions of non-deceptive care are unjustifiably narrow. Third, Hardman fails to adequately separate questions about deception from questions about normativity. By addressing these issues, however, we can preserve some of Hardman’s most important insights, although in a much simpler, more principled way. (shrink)

Regarding the appropriateness of deception in clinical practice, two (apparently conflicting) claims are often emphasised. First, that ‘clinicians should not deceive their patients.’ Second, that deception is sometimes ‘in a patient’s best interest.’ Recently, Hardman has worked towards resolving this conflict by exploring ways in which deceptive and non-deceptive practices extend beyond consideration of patients’ beliefs. In short, some practices only seem deceptive because of the (common) assumption that non-deceptive care is solely aimed at fostering true beliefs. Non-deceptive care, (...) however, relates to patients’ non-doxastic attitudes in important ways as well. As such, Hardman suggests that by focusing on belief alone, we sometimes misidentify non-deceptive care as ‘deceptive’. Further, once we consider patients’ beliefs and non-doxastic attitudes, identifying cases of deception becomes more difficult than it may seem. In this essay, I argue that Hardman’s reasoning contains at least three serious flaws. First, his account of deception is underdeveloped, as it does not state whether deception must be intentional. The problem is that if intention is not required, absurd results follow. Alternatively, if intention is required, then identifying cases of deception will be much easier (in principle) than Hardman suggests. Second, Hardman mischaracterises the ‘inverse’ of deceptive care. Doing so leads to the mistaken conclusion that common conceptions of non-deceptive care are unjustifiably narrow. Third, Hardman fails to adequately separate questions about deception from questions about normativity. By addressing these issues, however, we can preserve some of Hardman’s most important insights, although in a much simpler, more principled way. (shrink)

Cases in which people are self-deceived seem to require that the person hold two contradictory beliefs, something which appears to be impossible or implausible. A phenomenon seen in some brain-damaged patients known as confabulation (roughly, an ongoing tendency to make false utterances without intent to deceive) can shed light on the problem of self-deception. The conflict is not actually between two beliefs, but between two representations, a 'conceptual' one and an 'analog' one. In addition, confabulation yields valuable clues about the (...) structure of normal human knowledge-gathering processes. [The hypothesis defended here is significantly altered and greatly expanded in my book Brain Fiction.]. (shrink)

This chapter connects the phenomenon of double bookkeeping to two critical debates in the philosophy of delusion: one from the analytic tradition and one from the phenomenological tradition. First, I will show how the failure of action guidance on the part of some delusions suggests an argument to the standard view that delusions are beliefs (doxasticism about delusion) and how its proponents have countered it by ascribing behavioral inertia to avolition, emotional disturbances, or a failure of the surrounding environment in (...) supporting the agent’s motivation to act. Second, I will show how the mismatch between the experience of double bookkeeping and that of having the usual propositional attitudes of folk psychology suggests another, more recalcitrant argument not only against doxasticism but against the very attempt to fit delusion into folk psychology. Third, I will show how phenomenologically inspired theories of delusion, such as the multiple realities hypothesis, bypass the debates above and focus on describing and understanding the disturbances in the structure of experience undergone by patients. I conclude that the philosophical discussions ensuing from an appreciation of double bookkeeping show some of the limitations of the analytic philosophical approach to delusion. (shrink)

The patient with Capgras’ syndrome claims that people very familiar to him have been replaced by impostors. I argue that this disorder is due to the destruction of a representation that the patient has of the mind of the familiar person. This creates the appearance of a familiar body and face, but without the familiar personality, beliefs, and thoughts. The posterior site of damage in Capgras’ is often reported to be the temporoparietal junction, an area that has a (...) role in the mindreading system, a connected system of cortical areas that allow us to attribute mental states to others. Just as the Capgras’ patient claims that that man is not his father, the patient with asomatognosia claims that his arm is not really his. A similar account applies here, in that a nearby brain area, the supramarginal gyrus, is damaged. This area works in concert with the temporoparietal junction and other areas to produce a large representation of a mind inside a body situated in an environment. Damage to the mind-representing part of this system (coupled with damage to executive processes in the prefrontal lobes) causes Capgras’ syndrome, whereas damage to the body-representing part of this system (also coupled with executive damage) causes asomatognosia. (shrink)

The traditional conception of self-deception takes it for an intrapersonal form of interpersonal deception. However, since the same subject is at the same time deceiver and deceived, this means attributing the agent a pair of contradictory beliefs. In the course of defending a deflationary conception of self-deception, Mele [1997] has challenged traditionalists to present convincing evidence that there are cases of self-deception in which what he calls the dual belief-requirement is satisfied. Levy [2009] has responded to this challenge affirming (...) that there is at least one real cases of self-deception that meets this requirement, namely, that of anosognosia. In this family of conditions, the patient apparently believes that there is nothing wrong with her while, at the same time, providing behavioral cues that indicate that the patient is somehow aware of his disease. If Levy is right, then traditionalism about self-deception could be vindicated, after having been widely abandoned due to its need to postulate exotic mental processes in order to make sense of the attribution of contradictory beliefs. In this paper, I assess whether Levy’s response to Mele’s challenge is successful by analyzing his interpretation of the empirical evidence to which he appeals. Finally, I attack the cogency of the underlying commitments about the nature of folk psychology to which one is required to defer in order to draw from conflicting evidence the attribution of contradictory beliefs. (shrink)

The article discusses the role and importance of storytelling in the context of creating and maintaining organisational culture in the healthcare sector. Medical institutions are constantly solving complex tasks related to the provision of high-quality medical care and interaction with patients and staff. In this regard, storytelling is an important tool, aimed at strengthening cultural values and adjusting goals. The study examines the nature of organisational culture, its main components and culture, its main components and the peculiarities of its formation (...) and maintenance in medical institutions. Organisational culture affects all aspects of business processes and is an important element of corporate identity, in particular in the healthcare sector. healthcare. The authors determine that storytelling as a communication tool has become an important part of business communication and management in recent decades part of business communication and management practice in recent decades. Storytelling can be used to form common values and create meaningful narratives that promote cultural change and support the organisational organisational identity of healthcare facilities. Stories in healthcare facilities reveal the specifics and uniqueness of the organisation, help to distinguish it from competitors from competitors and create a competitive advantage in the market. They form the organisation’s identity and the loyalty of employees and customers. Storytelling has an impact on on the organisational culture of a medical institution, promotes stability and highlights the unique character of the organisation character of the organisation; it allows to form values, beliefs and needs of of employees based on the institution’s mission. Storytelling is important for understanding medical discourse and the system of narratives in healthcare organisations. It supports or discredits official narratives or discredit them, depending on the perception of stakeholders. It is important that storytelling in healthcare facilities is accessible to all stakeholders and promote internal identification and loyalty to the institution. Thus, storytelling is an essential tool for building and maintaining organisational culture in healthcare facilities, helping to create a unique identity and competitive advantage. The article aims to stimulating discussion of the experience of using storytelling and further research of this important aspect of management in the healthcare sector. of healthcare enterprises. (shrink)

Patients in Quebec can legally obtain medical assistance in dying (MAID) if they are able to give informed consent, have a serious and incurable illness, are at the end of their lives and are in a situation of unbearable suffering. Since the Supreme Court of Canada’s 2015 Carter decision, access to MAID, under certain conditions, has become a constitutional right. Quebec physicians are now likely to receive requests for MAID from their patients. The Quebec and Canadian laws recognize a physician’s (...) right to conscientious objection, but this right is contested both in the medical ethics literature and in the public sphere. This paper presents the results of a qualitative study conducted with twenty Quebec physicians who did not integrate MAID into their medical practice, either because they were opposed to or deeply ambivalent about MAID. The interviews aimed to explore the reasons – religious and secular – for opposition to or ambivalence towards MAID. The secular reasons given by participants were grouped into four main categories: 1) the ends of medicine and professional identity, 2) the philosophy of palliative medicine and resource allocation in palliative care, 3) benevolent paternalism, the “good death”, and the interests of future selves, 4) the risk of a slippery slope and the protection of vulnerable people. (shrink)

The profound changes in personality, mood, and other features of the self that neural interventions can induce can be disconcerting to patients, their families, and caregivers. In the neuroethical debate, these concerns are often addressed in the context of possible threats to the narrative self. In this paper, I argue that it is necessary to consider a dimension of impacts on the narrative self which has so far been neglected: neural interventions can lead to a loss of meaning of actions, (...) feelings, beliefs, and other intentional elements of our self-narratives. To uphold the coherence of the self-narrative, the changes induced by neural interventions need to be accounted for through explanations in intentional or biochemical terms. However, only an explanation including intentional states delivers the content to directly ascribe personal meaning, i.e., subjective value to events. Neural interventions can deprive events of meaning because they may favor a predominantly biochemical account. A loss of meaning is not inherently negative but it can be problematic, particularly if events are affected one was not prepared or willing to have stripped of meaning. The paper further examines what it is about neural interventions that impacts meaning by analyzing different methods. To which degree the pull towards a biochemical view occurs depends on the characteristics of the neural intervention. By comparing Deep Brain Stimulation, Prozac, Ritalin, psychedelics, and psychotherapy, the paper identifies some main factors: the rate of change, the transparency of the causal chain, the involvement of the patient, and the presence of an acute phenomenological experience. (shrink)

Cognitive Behavioral Therapy has become the dominant form of psychotherapy in North America. The CBT model is theoretically based on the idea that all external and internal stimuli are filtered through meaning-making, consciously accessible cognitive schemas. The goal of CBT is to identify dysfunctional or maladaptive thoughts and beliefs, and replace them with more adaptive cognitive interpretations. While CBT is clearly effective as a treatment, there is good reason to be skeptical that its efficacy is due to the causal mechanisms (...) posited by the CBT model. This paper will argue that the specific cognitive schemas posited by the CBT model likely do not play a direct role in the development or treatment of psychological illness. Cognitive schemas, as identified in CBT interventions, are likely to be the result of patient confabulation and epistemically under-supported practitioner-based identification. CBT interventions appear to impose coherence on patients’ psychological states, rather than identifying and modifying preexistent causally efficacious core beliefs. (shrink)

Various psychopathologies of self-awareness, such as somatoparaphrenia and thought insertion in schizophrenia, might seem to threaten the viability of the higher-order thought (HOT) theory of consciousness since it requires a HOT about one’s own mental state to accompany every conscious state. The HOT theory of consciousness says that what makes a mental state a conscious mental state is that there is a HOT to the effect that “I am in mental state M.” I have argued in previous work that a (...) HOT theorist can adequately respond to this concern with respect to somatoparaphrenia and thought insertion. There is also Cotard syndrome which is a rare neuropsychiatric disorder in which people hold the delusional belief that they are dead, do not exist, or have lost their blood or internal organs. In this paper, I argue that HOT theory has nothing to fear from it either and can consistently account for what happens in such unusual cases. I analyze Cotard syndrome in light of my previous discussion of somatoparaphrenia and thought insertion, and argue that HOT theory can provide a somewhat analogous account without the worry of inconsistency. It is crucial to recognize that there are multiple “self-concepts” and levels of HOTs which can help to provide a more nuanced explanation. With regard to the connection between consciousness and self-consciousness, it is proposed that Cotard patients are indeed capable of having some “I-thoughts” about their bodies and mental states. (shrink)

According to the traditional Western concept of freedom, the ability to exercise free will depends on the availability of options and the possibility to consciously decide which one to choose. Since neuroscientific research increasingly shows the limits of what we in fact consciously control, it seems that our belief in free will and hence in personal autonomy is in trouble. -/- A closer look at the phenomenology of Obsessive-Compulsive Disorder (OCD) gives us reason to doubt the traditional concept of (...) freedom in terms of conscious control. Patients suffering from OCD experience themselves as unfree. The question is whether their lack of freedom is due to a lack of will power. Do they have too little conscious control over their thoughts and actions? Or could it be the opposite: are they exerting too much conscious control over their thoughts and actions? -/- In this chapter, we will argue that OCD patients testify to the general condition that exercising an increased conscious control over actions can in fact diminish the sense of agency rather than increase the experience of freedom. The experiences of these patients show that the traditional conception of freedom in terms of ‘free will’ has major shortcomings. There is an alternative, however, to be found in the work of Hannah Arendt. She advocates a conception of freedom as freedom in action. Combined with phenomenological insights on action, Arendt’s account of freedom helps us to get a more adequate understanding of the role of deliberation in the experience of freedom. We argue that the experience of freedom depends on the right balance between deliberate control and unreflective actions. (shrink)

We present counterexamples to the widespread assumption that Moorean sentences cannot be rationally asserted. We then explain why Moorean assertions of the sort we discuss do not incur the irrationality charge. Our argument involves an appeal to the dual-process theory of the mind and a contrast between the conditions for ascribing beliefs to oneself and the conditions for making assertions about independently existing states of affairs. We conclude by contrasting beliefs of the sort we discuss with the structurally similar but (...) rationally impermissible beliefs of certain psychiatric patients. (shrink)

Healthcare systems across the globe are struggling with increasing costs and worsening outcomes. This presents those responsible for overseeing healthcare with a challenge. Increasingly, policymakers, politicians, clinical entrepreneurs and computer and data scientists argue that a key part of the solution will be ‘Artificial Intelligence’ (AI) – particularly Machine Learning (ML). This argument stems not from the belief that all healthcare needs will soon be taken care of by “robot doctors.” Instead, it is an argument that rests on the (...) classic counterfactual definition of AI as an umbrella term for a range of techniques that can be used to make machines complete tasks in a way that would be considered intelligent were they to be completed by a human. Automation of this nature could offer great opportunities for the improvement of healthcare services and ultimately patients’ health by significantly improving human clinical capabilities in diagnosis, drug discovery, epidemiology, personalised medicine, and operational efficiency. However, if these AI solutions are to be embedded in clinical practice, then at least three issues need to be considered: the technical possibilities and limitations; the ethical, regulatory and legal framework; and the governance framework. In this article, we report on the results of a systematic analysis designed to provide a clear overview of the second of these elements: the ethical, regulatory and legal framework. We find that ethical issues arise at six levels of abstraction (individual, interpersonal, group, institutional, sectoral, and societal) and can be categorised as epistemic, normative, or overarching. We conclude by stressing how important it is that the ethical challenges raised by implementing AI in healthcare settings are tackled proactively rather than reactively and map the key considerations for policymakers to each of the ethical concerns highlighted. (shrink)

Delusions are unhinged hinge certainties. Delusions are defined as strongly anchored beliefs that do not change in the face of adverse evidence. The same goes for Wittgensteinian certainties. My paper refines the so-called framework views of delusion, presenting an argument that epistemically speaking, considering them to be certainties best accounts for delusions’ doxastic profile. Until now there has been little argument in favour of this position and the original proposals made too extreme predictions about the belief systems of delusional (...) patients. I show that my account fares better with the diverse objections that have been raised against older framework views of delusion (Campbell 2001, Gipps and Rhodes 2008). Finally, I examine what makes a harmless hinge into a pathological delusion. (shrink)

Hersey et al have outlined a proposed ethical framework for assessing abortion policies that locates the effect of government legislation between the provider and the patient, emphasising its influence on interactions between them. They claim that their framework offers an alternative to the personal moral claims that lie behind legislation restricting abortion access. However, they fail to observe that their own understanding of reproductive justice and the principles of medical ethics are similarly predicated on their individual moral beliefs. Consequently, (...) the conclusions obtained from their framework are also derived from their individual beliefs, and have no claim to being objective. (shrink)

There are numerous ways in which “the particular”—particular individuals, particular ideologies, values, beliefs, and perspectives—are sometimes overlooked, ignored, or even driven out of the healthcare profession. In many such cases, this is bad for patients, practitioners, and the profession. Hence, we should seek to find a place for the particular in health care. Specific topics that I examine in this essay include distribution of health care based on the particular needs of patients, the importance of protecting physicians’ right to conscientious (...) objection, the value in tolerating a plurality of moral and medical perspectives within the field, and more. Ultimately, as the imagery in the essay’s title suggests, I argue that if one cares about the “well-being” of the medical profession, then one should seek to avoid destroying the many diverse and particular entities that constitute it. (shrink)

It is widely believed to be permissible for a physician to discontinue any treatment upon the request of a competent patient. Many also believe it is never permissible for a physician to intentionally kill a patient. I argue that the prospect of deactivating a patient’s artificial heart presents us with a dilemma: either the first belief just mentioned is false or the second one is. Whichever horn of the dilemma we choose has significant implications for contemporary (...) medical ethics. (shrink)

In the article "What Sin Is: A Differential Analysis," Jesse Couenhoven delves into the definitions and categorizations of sin according to various Christian doctrines. The author critically examines traditional definitions, such as those provided by the Westminster Confession and catechisms, and argues that they fail to adequately distinguish between sin and evil, often conflating natural evils with sinful acts. Couenhoven also considers gray areas of ethical behavior, such as the actions of a schizophrenic who curses against God or the mistakes (...) made by medical residents that result in harm to patients, and questions whether these actions should be classified as sin. The primary question driving the article is how sin is differentiated from that which is "merely" evil. To address this, Couenhoven analyzes and evaluates three views of sin, testing their coherence with Christian beliefs and practices. The article aims to provide a more nuanced and sufficient understanding of sin within the Christian tradition, going beyond the necessary elements of the doctrine of sin to better identify and differentiate sin from evil. (shrink)

This (1982) essay sets out the claim that psychoanalysis is a cogent extension of the intuitive common sense psychology by which we naturally understand human action. In this psychology explanation proceeds by relating actions to the logically and causally cohering desires and beliefs of agents. As Freud showed, this kind of explanation is systematically deepened and extended by the explanation of dreams, the symptoms of mental disorder, and other related phenomena via the Freudian concept of wish fulfilment, which was later (...) extended to the more inclusive post-Freudian concept of phantasy. In this extension everyday actions, such as Freud's writing up his patient Irma's case history on the day before his dream of Irma's injection, are seen to be rooted in the same unconscious motives as are represented as fulfilled in dreams and symptoms -- e.g., in this case, by unconscious stirrings of deep guilt on the topic of injection, of which Freud was unaware until he analysed the dream. As this illustrates, the understanding of wishfulfilments and other formations of phantasy enables us fill out our account of agents and their actions by adding a stock of previously unacknowledged desires and modes of expression of desire. These are seen to cohere with, and also to deepen, our previous understanding: after understanding Freud's dream, we also have a deeper and firmer (and so more cogent) understanding of his behaviour on the previous day. In this way Freud effected an extension of our everyday mode of understanding that was cogent, cumulative, and radical, as illustrated further by examination of Freud's case history of the patient described as the Rat Man. (shrink)

Since the stone age humankind has created masterworks which possess a mysterious quality of solidity and grandeur or monumentality. A Paleolithic Venus and a still life by Cezanne both share this monumentality. Michelangelo likened monumentality to sculptural relief, Braque called monumentality 'space', and Hans Hoffman, himself one of the masters, called monumentality 'pictorial depth.' The masters agreed on the import of monumentality, but none of them left a clear explanation of it. In 1943 Earl Loran published his classic book on (...) Cezanne's pictorial structure but, as I demonstrate, his explanation was misleading. This book provide a clear explanation, as did an earlier book by Robert Casper. This book also traces some history of monumentality with reproductions. It also explains how some painters achieved monumentality and how a student can attempt it. Pictorial space is created in the tension between pairs of opposing planes. Opposing planes pull against each other, each containing the other, paradoxically, within the flat surface of the canvas. Sculpture also can be 'plastic': opposing masses pull against each other, each containing the other and creating tension in the space which lies between them. Painting has other aspects like subject matter, expression, style and technique but pictorial space does not depend on these. Monumentality moves us profoundly and apparently has done so since the Paleolith. Using patients' vignettes, I show that there are profound parallels between the structure of a monumental work of art and the structure of an evolving personality. In Winnicott's words, such a personality has 'depth ... an interior space to put beliefs in ... an inside ... a space where things can be held ... the capacity to accept paradox [to contain opposites] ... room and strength ... and originality and the acceptance of tradition as the basis for invention'. A monumental painting also meets this description. I argue that monumental art provides a visual portrait of an evolving personality just as myth, as Freud and Jung both showed, provides a narrative portrait of an evolving personality. An evolving personality is perhaps humankind's most important creation; an underlying purpose of both myth and art is to help us achieve it. I demonstrate in this book that monumental art represented the evolving personality since at least 35,000 BC. Thus to understand monumentality is to better understand the personality and its history. (shrink)

In this paper, we argue that providers who conscientiously refuse to provide legal and professionally accepted medical care are not always morally required to refer their patients to willing providers. Indeed, we will argue that refusing to refer is morally admirable in certain instances. In making the case, we show that belief in a sweeping moral duty to refer depends on an implicit assumption that the procedures sanctioned by legal and professional norms are ethically permissible. Focusing on examples of (...) female genital cutting, clitoridectomy and ‘normalizing’ surgery for children with intersex traits, we argue that this assumption is untenable and that providers are not morally required to refer when refusing to perform genuinely unethical procedures. The fact that acceptance of our thesis would force us to face the challenge of distinguishing between ethical and unethical medical practices is a virtue. This is the central task of medical ethics, and we must confront it rather than evade it. There are no data in this work. (shrink)

Shared decision-making involves health professionals and patients/clients working together to achieve true person-centred health care. However, this goal is infrequently realized, and most barriers are unknown. Discussion between philosophers, clinicians, and researchers can assist in confronting the epistemic and moral basis of health care, with benefits to all. The aim of this paper is to describe what shared decision-making is, discuss its necessary conditions, and develop a definition that can be used in practice to support excellence in maternity care. Discussion (...) between the authors, with backgrounds in philosophy, clinical maternity care, health care management, and maternity care research, assisted the team to confront established norms in maternity care and challenge the epistemic and moral basis of decision-making for caesarean section. The team concluded that shared decision-making must start in pregnancy and continue throughout labour and birth, with equality in discourse facilitated by the clinician. Clinicians have a duty of care for the adequacy of women's knowledge, which can only be fulfilled when relevant knowledge is offered freely and when personal beliefs and biases that may impinge on decision-making (defeaters) are disclosed. Informed consent is not shared decision-making. Key barriers include existing cultural norms of “the doctor knows best” and “patient acquiescence” that prevent defeaters being acknowledged and discussed and can lead to legal challenges, overuse of medical intervention and, in some areas, obstetric violence. Shared decision-making in maternity care can thus be defined as an enquiry by clinician and expectant woman aimed at deciding upon a course of care or none, which takes the form of a dialogue within which the clinician fulfils their duty of care to the client's knowledge by making available their complete knowledge (based on all types of evidence) and expertise, including an exposition of any relevant and recognized potential defeaters. Research to develop measurement tools is required. (shrink)

In this paper I consider the intuitive idea that God is fair and does not play favorites. This belief appears to be held by many theists. I will call it the Principle of Impartial Benevolence (PIB) and put it as follows: As much as possible, for all persons, God equally promotes the good and equally prevents the bad. I begin with the conviction that there is a prima facie tension between PIB and the disparity of human suffering. My aim (...) in what follows is to clarify this tension and show that it runs deep. More specifically, I will argue that PIB imposes stringent demands—including a patient-centered theodicy—on the sorts of reasons that would justify God in permitting suffering, and, that the historical disparity of suffering indicates that these demands are not met. I conclude that theists should disavow PIB or at least consider it sub judice. (shrink)

The few people familiar with the pseudo-Platonic dialogue Axiochus generally have a low opinion of it. It's easy to see why: the dialogue is a mish-mash of Platonic, Epicurean and Cynic arguments against the fear of death, seemingly tossed together with no regard whatsoever for their consistency. As Furley notes, the Axiochus appears to be horribly confused. Whereas in the Apology Socrates argues that death is either annihilation or a relocation of the soul, and is a blessing either way, "the (...) Socrates of the Axiochus wants to have it both ways": death is both annihilation and a release of the soul from the body into a better realm. This may be used to construct a valid argument for the conclusion that death is not evil, but at the expense of having a contradiction as one of its premises. But D. S. Hutchinson has recently proposed that these inconsistencies shouldn't surprise us if we view the Axiochus as "an unconventional version of a very conventional genre--the consolation letter." In this paper I expand on Hutchinson's brief suggestion and argue that the Axiochus can be rehabilitated by paying attention to its genre. Although the Axiochus does display many similarities to the consolation letter, the shift from letter to dialogue does--pace Hutchinson--significantly affect what's going on. Within the dialogue, Socrates behaves toward Axiochus in a way similar to the way the author of a consolation letter behaves towards the letter's reader: he is willing to use inconsistent arguments, borrowed from any source, in order to soothe the patient. However, in depicting this type of consolatory relationship between Socrates and Axiochus, the dialogue itself is not aiming at consoling its readers. Instead, it should be seen as displaying for the reader's consideration a certain type of consolatory argumentative practice. -/- Socrates notes that Axiochus is "very much in need of consolation" (365a), and he uses any means necessary to accomplish this task. Socrates exhibits many ways in which he is willing to sacrifice argumentative hygiene for the sake of therapeutic effectiveness. These include: -/- * Use of arguments with inconsistent premises, presented in propria persona. * Appeals to emotion * Tailoring arguments to the audience. * Presenting invalid arguments so as to induce unjustified but comforting beliefs. * Evasion. In these respects, I think that Socrates' argumentative practice is best compared to PH III 280-1, where Sextus Empiricus says that the skeptic will deliberately use logically weak arguments as long as they work. Dorothy Tarrant claims that what links the Socrates of the Axiochus to Socrates as he appears elsewhere in the Platonic corpus is his evident care for the welfare of his interlocutor's psyche. But this concern takes a quite different form in the Axiochus than it usually does. As with Sextus, psychic therapy in the Axiochus involves relief from pain. The primary difference between them is that Socrates, unlike Sextus, is not aiming at producing epochê in his patient. (shrink)

On 8th August 2019, Secretary of State for Health and Social Care, Matt Hancock, announced the creation of a £250 million NHS AI Lab. This significant investment is justified on the belief that transforming the UK’s National Health Service (NHS) into a more informationally mature and heterogeneous organisation, reliant on data-based and algorithmically-driven interactions, will offer significant benefit to patients, clinicians, and the overall system. These opportunities are realistic and should not be wasted. However, they may be missed (one (...) may recall the troubled Care.data programme) if the ethical challenges posed by this transformation are not carefully considered from the start, and then addressed thoroughly, systematically, and in a socially participatory way. To deal with this serious risk, the NHS AI Lab should create an Ethics Advisory Board and monitor, analyse, and address the normative and overarching ethical issues that arise at the individual, interpersonal, group, institutional and societal levels in AI for healthcare. (shrink)

In a recent paper, Gray, Knickman, and Wegner present three experiments which they take to show that people judge patients in a persistent vegetative state to have less mental capacity than the dead. They explain this result by claiming that people have implicit dualist or afterlife beliefs. This essay critically evaluates their experimental findings and their proposed explanation. We argue first that the experiments do not support the conclusion that people intuitively think PVS patients have less mentality than the dead. (...) And second, we provide an alternative explanation of our ascriptions of mentality to the dead and PVS patients, one which turns on Epicurean considerations about the nature of death. (shrink)

Health anxiety is, among other things, a response to a universal epistemological problem about whether changes in one’s body indicate serious illness, a problem that grows more challenging to the individual with age and with every advance in medical science, detection, and treatment. There is growing evidence that dysfunctional metacognitive beliefs – beliefs about thinking – are the driving factor, with dysfunctional substantive beliefs about the probability of illness a side‐effect, and that Metacognitive Therapy (MCT) is more effective than Cognitive (...) Behavioral Therapy (CBT). However, hypochondria is distinct from other forms of anxiety, I argue, in ways that make some reality‐checking techniques of CBT and MCT of limited usefulness. I propose a Re‐Calibration Technique (RCT) that complements these therapies by focusing on a metacognitive belief that has not been studied: the patient’s presumption of his own personal reliability in judging symptoms, an assumption exposed every time he disagrees with a doctor. I propose a technique whereby a patient keeps a long‐term register of every episode of alarm about symptoms and its resolution, possibly years later. When healthcare‐seeking impulses arise the patient then uses his own track record to re‐calibrate his confidence that medical attention is needed. The new technique allows one to improve self‐judgment about whether one has an illness or not by improving self‐knowledge of one’s own reliability. (shrink)

June 2022 A Revolutionary New Metaphysics, Based on Consciousness, and a Call to All Philosophers We are in a unique moment of our history unlike any previous moment ever. Virtually all human economies are based on the destruction of the Earth, and we are now at a place in our history where we can foresee if we continue on as we are, our own extinction. As I write, the planet is in deep trouble, heat, fires, great storms, and record flooding, (...) weather patterns drastic everywhere. Capitalism has been so successful in supplying us with an endless array of consumer items, that we have never noticed there is a cost. But there is a cost, the cost is the very life of the Earth herself, and now the day of reckoning is here. Days of reckoning are most often days of rath. But I am hoping that this is a day of major Awakening over the entire planet. We have caused a crisis so great for the Earth we can hardly get our minds around it. But I am proposing that deeply embedded in the crisis are ideas, about who and what the Earth is, Ourselves, and what we are here for. I am proposing that this is a call to all philosophy and philosophers to rethink ourselves from the ground up. The human race has never gotten the Earth right and now we must, for the Earth is the true foundation for civilization. We are in deep trouble with the Earth, and it owes to the fact that the great male thinkers never got the Earth right, they could never make the connection between the life of mind and the life of the Earth. I am proposing that deeply embedded in the crisis we are in are ideas. And that in fact the planet is in the grip of a false metaphysics, and scientific image of nature that really comes most recently from Descartes. His conviction that matter, and with it the Earth, are simply the weighable, the measurable the extended in space and time, utterly devoid of any inner life of mind thoughts or Consciousness. This view of matter and the Earth goes back to the very dawn of thought, Descartes is just its most recent and comprehensive version of things. This view of matter is really a false metaphysics that dominates most of the modern world and underpins the whole scientific image of nature itself. I am proposing this is a false metaphysics and offering a new version of things based on Consciousness. If there is a single idea fueling and driving the destruction of the planet, it is the conviction that the Earth is something without Consciousness. When you intend to ravage and savage the planet, turn it into consumer items to be converted into money in the bank, first pretend that all of the bright beings in the natural world are devoid of Consciousness, just “things” you do not have to have any conscious about destroying them. I am proposing that this term Consciousness, that has appeared as term and a problem for modern science, is the key to getting ourselves right with the Earth. I propose this new theory for science will ramify into every other disciplines as well, and the ways we think just about everything. This old paradigm based on a false theory of matter, has run its course, it has brought us to the brink of our own extinction. We need new ideas, and we need them now. You will find my recent work in the Scientific God Journal under the title: Consciousness as the Organizing Principle, and a very complete version of my arguments for this term Consciousness, along with radical reinterpretation of modern science itself, on the Galileo Commission site. It is a radical moment for all of the thinkers among us, take this as my small contribution to rethinking ourselves in new terms, based on my understanding that the true basis for the whole of Being, the Universe, the Cosmos, and with them Ourselves, is this term Consciousness. And unpack it. And I predict that with this term Consciousness every intractable human problem in both science and the modern world will go down like a line of dominos before it. And so, here are a few new ideas I would offer you. These are the times of the Reappearance of the Feminine, a great Awakening as of Springtime after a long dark and lonely Winter. We are leaving behind us an old civilization based on male dominance, fear lies and control, now in decay, disease, and death disintegrating all around us. We are moving into a whole new civilization based on Love and Truth. A new civilization requires new basic terms values and first principles. And so, I return to Descartes. 1. Just over 300 years ago a young man travelling with the army found himself stranded in a foreign town in a bare room lit by a candle with nothing to do but think. And in a couple of nights Descartes laid the entire thought foundations for modern science and most of the modern world. It isn’t clear that modern philosophers with their funding sources of grants, their graduate students, their reputation and all the perks and privileges of academia can do any better. Descartes claimed there are just two principles in the Universe, Matter and Mind. God was pure mind; human beings were mind and matter. And we are the only ones on the planet with mind. Everything else all of the bright array of beings who share the planet with us are simply matter. And matter? The weighable the measurable the extended in space and time utterly devoid of any inner life of thoughts, feelings, or Consciousness This classification was a boon for developing science. Scientists did not have to worry about any inner life in nature, ideas or Consciousness, they could just set about weighing and measuring, as they have until the present day. But it was a disaster for the Earth. Earth was once worshiped as a Goddess. With Descartes she became almost overnight “things.” Simply commodities and resources, an endless of supply of consumer items, to be turned into money in the bank. And now Descartes concept of matter is up for us. If there is a single idea that is enabling and driving the destruction of the Earth, it is the conviction that Earth is something without Consciousness. This whole scientific image of nature as something devoid of Consciousness is driving the destruction of the Earth, and driving us all insane, and it needs to change. Ever since Descartes formulated Dualism, scientists and philosophers have been trying to get rid of it. They have done this by attempting to make matter the fundamental term of reality, and to explain mind or Consciousness in terms of matter. And now, Consciousness has emerged as term and a problem for modern science. 2. The prevailing Universe picture has been mainly based on the belief that Consciousness appears only at the end of evolution in ourselves and some of the higher animals when matter attains “a certain state of complexity” and it is produced by neurons in the brain. But Consciousness is nothing real in itself, the neurons are doing the work, Consciousness is simply a byproduct of neural activity. As William James summed up this position, not his: Consciousness is to the brain as a shadow to the runner, it runs beside him but never influences his stride. And so, the great problem of neuroscience: How do neurons produce Consciousness? So far, no one has been able to say how. All we have is parallelism. Two processes are running in parallel a train of neural events and a train of Consciousness events. And so, which one is primary? The face of neuroscience and much of the modern world is that the neural events are what is really real, Consciousness is secondary. The conviction that Consciousness is something produced by neurons is so deeply held and has been so for so long, that it seems like an obvious fact. It is in fact an assumption and a theory, and it could all well be the other way around. The scientific image of nature as something devoid of Consciousness is now up for us. It has enabled the destruction of the Earth, and we are now at a unique place in our own evolution where we can foresee if we continue on as we are, our own extinction. And so, there are the best reasons for rethinking Descartes concepts of matter. Scientists and philosophers have been trying to escape dualism by making matter the fundamental term. And now, this has not worked. In a nutshell: The mind body problem, the “hard problem of Consciousness” ---how do neurons in the brain, atoms and molecules give rise to ideas thoughts and feelings and who what and where is the “I” who sees them? And then, the near-death experience. I remind you of the truth of the near-death experience. The body in the bed is brain dead eeg flat, but the patient, pure Consciousness is hovering at the ceiling watching the doctors work over the body below, able to read dials he could not have seen from the bed, sometimes able to events in the corridor beyond the room, all subsequently confirmed by the doctors. Evidence as good as it gets that the patient really was out of his body. And so, the patient is able to see without eyes, hear without ears and to think and remember without a brain. There is not a single scientific principle that can account for this. And I am proposing that the near-death experience is a threshold and a key for a much deeper understanding of the Universe. These three problems are so hard they cannot be solved by present scientific principles and therefore call all present principles and ways of thought into question. When your axioms cannot account for the data, it is time to drop them and find better fundamental terms. We have not been able to solve the problems of Consciousness with the assumption that matter is the most basic and fundamental term. And so, if Cartesian dualism is to be overcome at all, we need to try it the other way around. 3. We are in the position of Copernicus. Remember Copernicus? He was making his calculations on the assumption that the Earth was the center of the Universe until they became so unwieldy that he decided to try it all the other way around. To make the sun the center, the Earth revolving around it. And lo, all of his data fell neatly into place. I am proposing a whole new Universe picture. Evolution makes us continuous with every other being, Consciousness would not be in us if it were not in them also, and then, in the atoms and molecules and cells that make up living beings. I propose to make Consciousness the most basic term and see what follows. I am in fact, proposing a new Copernican Revolution, that Consciousness is the true basis for the Universe and the right fundamental term, for science itself all other disciplines as well, and the whole of the modern world. And I predict that every intractable problem in science or the modern world, will go down like a line of dominos before it. In a nutshell: Consciousness and not matter is “first and fundamental” in the Universe, it is there from the very “Beginning” everything has it and all of the true causalities, the explanatory principles belong to it. Not to matter. What then is matter? All matter is an Appearance of something much more real, Consciousness. All matter is an expression of Consciousness, even the least little bit of matter contains Consciousness, and is an expression of Consciousness. And so, we revise the scientific image of nature. Science at present is two termed, matter/energy. It needs to become three termed: Matter/energy/Consciousness, with the recognition that all of the basic principles, the true causalities of events, and of the Universe belong to Consciousness. And now physics. To accommodate this new Universe picture physics needs to alter just one term, energy. All energy contains Consciousness, that idea alone will change our world forever. The animals the trees the plants are just as conscious as we are, as is the Earth herself, a continuum of many forms of Consciousness of which our own is one. The Earth consists of interacting and intersecting forms of Consciousness, Consciousness within Consciousness within Consciousness within Consciousness. A remarkable work has just appeared entitled “Beyond Words What Animals Feel and Think.” Describing in detail how like ourselves all of the animals are. And the more we can see how like us everything else really is, the harder it will be for us to do them all in, in the interest of turning them into consumer items. And so, here is a new principle of understanding, that entails completely new forms of explanation, and a whole new Universe picture to be spelled out in terms of Consciousness and its various properties. This is a Universe that is aware awake and Enspirited throughout. And so, there is only one principle, not two. And so, how does Consciousness work? There is “no mind/body problem.” My Consciousness is aligning the Consciousness of neurons in the brain, that aligns the Consciousness of all other cells in the body, that aligns the Consciousness of molecules and atoms themselves. Mainly from the top down, but also interactive, and not reduction to the purely physical forces. 4. And so, here is a radical new Universe picture, and with it a new way to think about the Universe itself, the Earth, Ourselves, and Spirit. It requires a complete revision of both of the terms of modern science itself. The problem of the modern world owes in deep measure to Descartes concept of matter as something devoid of interior life. But he is only the most powerful and simple expression of a whole tradition of thought that predates him, that goes back to the very dawn of thought itself. It owes to the conviction of both Plato and Aristotle that the Earth was something devoid of reason, or mind, and therefore something to be held in complete contempt. We are emerging from a civilization based on contempt for the Earth, and down the road, it will become contempt for the body, sex, women, the Native people, and people of color everywhere. And so, this entire tradition is now up for us, it has brought us to the brink of our own extinction, and we need to get beyond it. I am proposing that this term Consciousness is the way out. The missing piece of the puzzle and the idea whose time has come. And it will enable us to move into a completely new civilization based on respect for the Earth, women, sex, people of color, that honors everyone and has a place for all. Revolutions in science occur when new data show up that cannot be accounted for by existing paradigms (Thomas Kuhns: The Structure of Scientific Revolutions). Consciousness, and all the properties and problems of Consciousness are just such data, and they compel a new scientific revolution. But we are a scientific age. A new Copernican revolution in science is such as revolution everywhere. And Consciousness is the key to getting every other reality at all levels and depths right as well. It will enable us finally to get the Earth right, get ourselves right with the Earth, and with one another. Archimedes: Give me a place to stand, and I will move the world. I am proposing a new synthesis among our fundamental terms in which this term Consciousness is the new lynchpin. And so, I return once more to Descartes. Descartes in the Mediations was a dualist, they were two realities interacting in the pineal gland mind and body. But Descartes age was high on “Cartesianisms,” on Descartes concept of matter. Animals were simply cleverly wired machines (Hobbes called them automata). Rumor had it that Descartes followers went about kicking dogs reasoning that their howls were not due to any feelings of pain, but simply the wiring of the machine. We have been doing this to the Earth ever since, and now the Earth is not going to stand for it any longer. It is time we all woke up. There is no matter in Descartes sense of it, or in Plato and Aristotle’s sense of it. This old concept of matter is embedded in all of the crisis and catastrophes---fires, drought, pandemics, over population, the disintegrating economies, our ways of life, capitalism and consumerism themselves. All matter is Enspirited, contains Consciousness, and is an expression of Consciousness. Now I tell you something about Descartes you may not know. In the Mediations was a dualist, there are minds and bodies. But by the end of his life, he knew the truth. Descartes guided his whole life by these vivid dreams, and toward the end of his life he had this dream: He saw the Universe as a giant machine and in the heart of the machine propelling the whole, was Consciousness. And so, out of the shades and shadows and into the light of day. Here is a renewed and a new science, a new cosmology. And with it, a revolutionary new metaphysics. The whole of the modern world is in the grip of a false metaphysics, based on Descartes theory of matter. Here is a new, and finally true metaphysics based on the single term, Consciousness. 5. And in all my works, I spell out this new metaphysics based on Consciousness, and what it means for how we think about virtually everything: The Universe, the Earth, Ourselves, and Spirit. Of who, what and where Spirit is, that we may connect with Spirit everywhere. There is only one term for the Universe, and not two, this single term Consciousness, that manifests itself in two modes: Consciousness in Form, Consciousness Formless. And so, here is a sketch of what this new term Consciousness really means. For four great aspects of the real, four new cornerstones for a whole new civilization on Earth, based on Love and Truth. A. For the Universe: New causalities, all matter is an expression of Consciousness, awake and aware, Enspirited throughout, which has a place for the causalities of love ideas intent plan and purpose, what Aristotle called final causality, that for the sake of which. And it has a place for subjectivity, the greatest mystery in the whole of the Universe, knowable only in ourselves, but there in everything else as well, bedrock in the chain of causalities. The buck stops here. Here are two very different Universe pictures. The Cartesian Universe consists of things, pushed, and pulled around by the physical forces that function blind. The true Universe consists of selves and not things. Selves at least in ourselves, are organized and focused about an I, an I am, or a sense of self in everything, ever other being dear to itself. Just one aspect of subjectivity. And so, it is Consciousness all the way down, and subjectivity all the way down. Science proceeds on the basis of the negligible of what it can leave out as unimportant. Subjectivity is the ultimate animating principle of the Universe. What Descartes really did was to strip from nature what is most essential about it, its animating principle Consciousness. And so, we come out of a long history of “clunk.” The great male thinkers have killed creation. First in concepts and now in the lived life. And so, after centuries of fruitless search, not all of it in vain, finally, and just in time the true basic principle for the Universe has shown up in virtually all disciplines, this term Consciousness. B. And so, the Earth: What does this term Consciousness really mean for the Earth? It means that all of the bright array of beings around us have Consciousness. And the more we can realize how like us they are, the harder it will be to do them all in. Is this what it really means to be “made in the image of Spirit?” To destroy ever other living being? The god of Genesis is a creator god who has created billions and billions of living forms. Man, taking himself to be made in the image of Spirit has destroyed virtually all of it. The Earth is not things, not commodities and resources, not an endless array of consumer goods. The Earth consists of conscious living spiritual beings like ourselves, who need to be honored and respected, nurtured and cared for, to be Loved. And if the human race can finally pull it off and bring Love here and start helping the Earth rather than destroying her, even our vast numbers now at 8 billion, may not matter. Deeply embedded in the modern world is a false cosmology based on the hitherto useful but ultimately false metaphysics of Descartes. In particular it owes to Descartes concepts of matter, and of the Earth, as something devoid of Consciousness. And now this concept is up for us. If there is a single idea enabling and driving the destruction of the planet, it is the conviction that the Earth is something devoid of Consciousness. And we all have a vested interest in keeping this false concept in place. When you intend to ravage and savage the Earth, to turn it into consumer items, and money in the bank, first pretend she has no Consciousness that way we need not have any conscious about it. We are in deep trouble with the planet. Virtually all human economies are based on the destruction of the Earth, and we are now at a place in our history where we can foresee if we continue on as we are, our own extinction. And so, here are a few new guiding principles for the planet, based on Consciousness. Consciousness has field properties. The Earth is Consciousness throughout, connected and interconnected throughout, intersecting and interacting fields of Consciousness of which our own is one. To harm one is to harm all. Only this understanding of the Earth can set our destructive technologies, and capitalism, their goals, and their limits. The real problem with capitalism, and with civilization itself is it has no true understanding of the Earth, all the exquisite networks and webworks that connect all beings with one another. Nor it is about to admit that the Earth is our “life support system,” reason gone insane in the modern world. We are destroying our life support system, capitalism is the full expression of the human death wish in the modern world, and it needs to change. And now, let the barriers between ourselves and all other beings go down. C. And so, Ourselves. This new Universe picture based on Consciousness opens into and has a place for new concepts of human identity. In particular, it has a place for reincarnation, a process whereby one Consciousness dons’ bodies again and again and lays them down. This is a process wholly impossible on materialistic theories. This new view of things puts a higher perspective on Freudian determinism, which is a partial knowing in a greater account. We are something more than the victims of genes drives and childhood. We are immortally eternal evolving spiritual beings who take on a cycle of earthly lives in order to achieve certain goals and abilities, and then, our earthly cycle complete, we depart the Earth plane for other areas of the Universe physical or purely spiritual, to continue our evolution elsewhere. The scientific evidence for reincarnation is increasing on all sides, see for example the work of Michael Newton, a mainstream scientist forced to confront the fact of reincarnation. A completely new reincarnational picture is now emerging everywhere. We choose our parents for abilities we could acquire through them. We all come here with reasons for being here, and we all have free will, an original property of Consciousness, and we work out our issues accordingly. We all come here with the same reason for being here. It is to experience the Earth plane and human society at all levels and depths, in every social role, every climate, both sexes male and female and in all races. We are all here to acquire a deep understanding of the Earth plane with all its challenges and all of its present problems. We are not here to devour and consume the Earth, but to honor her for the learning experience she makes available for us. And so, reincarnation is the great equalizer, the fundamental basis for any bill of rights. Many of the problems of the modern world owe to the fact that reincarnation has not been taught in the West. Reincarnation was the center piece of Jesus teachings. It was banned by a fourth century council that decided the populous could best be controlled through fear. They edited all mention of reincarnation from the scriptures, and inserted fear terms instead, a judgmental god, and so on. If reincarnation had been taught, there would have been no suppression of women, but the gift of both sexes would have been honored and developed. And there would have been no reason for contempt for people of color because who they are, we have been or will be. There is no reason to look down on anyone when we know that our own identity includes membership in theirs. The truth of reincarnation needs to be the foundation for getting ourselves right with the Earth, and with one another. D. And so, Spirit. This new Universe picture, based on Consciousness, has a place for Spirit as simply Infinite Consciousness. All universes all worlds are formed out of this Consciousness, divine and sacred throughout. And Spirit is everywhere in the Earth and can be connected everywhere. And the Native North American people had things right. Everything has its own Spirit, and without contradiction is also an expression of Spirit. And what I am really doing in terms of concepts of modern science is presenting the Native North American version of the Real. And this new Universe picture has a place for the essential insight of all religions almost smothered by church tradition: Love. Not an emotion but a great Oneness, that can be found everywhere, even in a busy city street. But especially in the Earth, that is levels and depths of Oneness everywhere. And so, for the first time in their long and bitter antagonistic history, science and religion now share a common base with this term Spirit, the lynchpin in a new conceptual framework. And I offer an interpretation of where we are in our history, this present moment of historical grace, and these tumultuous times in which we live, the return of the Goddess and the Divine Feminine, the Reappearance of the Feminine in history, the Advent of Women, this great Awakening, as of Springtime after a long dark Winter, the Awakening, the Second Coming. And so, stay tuned! (shrink)

Most mental disorders affect only a small segment of the population. On the reasonable assumption that minds or brains are prone to occasional malfunction, these disorders do not seem to pose distinctive explanatory problems. Depression, however, because it is so prevalent and costly, poses a conundrum that some try to explain by characterizing it as an adaptation—a trait that exists because it performed fitness-enhancing functions in ancestral populations. Heretofore, proposed evolutionary explanations of depression did not focus on thought processes; instead, (...) they emphasized that it facilitates navigation of adverse social circumstances or promotes immune response to infectious agents. According to a new hypothesis, the “analytical rumination hypothesis” (ARH), however, depression’s crucial adaptive trait is rumination—negative, intrusive thought. ARH holds that, (i) social dilemmas trigger depressed mood; (ii) depressed mood induces changes in body systems that facilitate ruminative analysis aimed at solving dilemmas; and, (iii) depressive rumination is a fitness-enhancing trait that was selected for in evolutionary time. Jointly, (i)~(iii) imply that we should not think of rumination as a disorder; instead, it is a trade-off, an eminently rational one. In the same way that fever solves a problem—coordination of the immune system in response to infection—so too does depressive rumination solve a problem, a social dilemma, albeit at the cost of inducing anhedonia and other maladies. But they argue that the cost is worthwhile, something that should be endured “until the problem is solved.” First, we argue that there are two distinct types of rumination, brooding and pondering; the former is associated with a disposition for depression, not the latter. But only the latter has the problem-solving capabilities that ARH requires. Second, recent brain imaging studies of depression reveal resting state hypoactivity in lateral regions and hyperactivity in paralimbic regions; this asymmetric pattern correlates with heightened levels of brooding, self-focused rumination. In other words, on the personal level, patients are trapped within self, isolated from the external world and suffused with negative affect; on the subpersonal level, this pattern is reflected by an asymmetric pattern of lateral vs. paralimbic resting state activity. Third, we proceed to conjecture that rational responses (e.g., pondering) to social dilemmas are those that strike a balance between internal and external considerations in the process of belief formation. Fourth, because the asymmetric resting state activity blocks those who suffer with depression from accessing and processing potentially positive stimuli from the external world, the capacity for rational, analytic response—hence, problem-solving—is constrained. Fifth, it follows that, although there might be conditions for which suffering should be endured rather than pharmacologically alleviated, depression is not one of those. Indeed, in view of the effects of the asymmetric resting state pattern, it is unlikely that depressive rumination would have been useful even for ancestral populations. (shrink)

Loss of personal identity in dementia can raise a number of ethical considerations, including the applicability of advance directives and the validity of patient preferences that seem incongruous with a previous history of values. In this chapter, we first endorse the self-concept view as the most appropriate approach to personal continuity in healthcare. We briefly describe two different types of dementia, Alzheimer’s dementia (AD) and behavioral-variant frontotemporal dementia (bv-FTD). We identify elements considered important for the continuation of a self-concept, (...) including continuation of memories, consistency in personality traits and personal preferences, and continued endorsement of certain moral tenets. We show that, depending on which element is considered most important for personal identity, continuity of a self-concept for individuals with distinct types of dementia will be affected and assessed differently. Utilizing a variety of empirical evidence, we argue that persistence of memory, personality traits, and preferences are not the most important for the maintenance of personal identity. Instead, as studies aimed to capture the folk-psychological view of personal continuity demonstrate, judgements about continuity depend primarily on the persistent commitment to widely shared moral beliefs. Because of that, we argue that individuals with bv-FTD are more likely to lose their sense of self than individuals whose dementia primarily affects memory, such as Alzheimer’s disease. We end the chapter by showing how the importance of moral beliefs for continuity of self can be used to provide guidance to health-care professionals when considering changes in preference by individuals with dementia. (shrink)

Ong, Caroline Whilst the reason and purpose of suffering may never be fully understood, there are ways of enduring, transcending and growing resilience to how it affects us. Our experience of suffering lies in the web of perceptions that involve our physical, spiritual and cosmological beliefs. Referencing Pain Seeking Understanding: Suffering, Medicine and Faith, edited by Margaret E. Mohrmann and Mark J. Hanson, this article gives a brief exploration of some propositions as to why an all-powerful, good God would allow (...) suffering to exist. From these various perspectives and using examples cited in the book, the article proposes that the healing art of medicine, honed through years of experience, knowledge and wisdom, can help individual patients endure and transcend suffering, and be whole once again. (shrink)

The paper focuses on the kind of expertise required by doctors in health communication and argues that such an expertise is twofold: both epistemological and communicative competences are necessary to achieve compliance with the patient. Firstly, we introduce the specific epistemic competences that deal with diagnosis and its problems. Secondly, we focus on the communicative competences and argue that an inappropriate strategy in communicating the reasons of diagnosis and therapy can make patient compliance unworkable. Finally, we focus on (...) the case of diabetes metaphor and propose the deliberate use of metaphors in health communication as an educational tool. On the one hand, metaphors might help doctors in explaining the disease in simpler terms and framing the experience of illness according to patient’s specific needs. On the other hand, metaphors might encourage a change in patient’s beliefs on their own experience of illness, and enable them to reach a shared decision making with doctors. (shrink)

The tendency to draw mind-brain dichotomies and evaluate mental disorders dualistically arises in both laypeople and mental health professionals, leads to biased judgments, and contributes to mental health stigmatization. This paper offers a theory identifying an underlying source of these evaluations in social practice. According to this theory, dualistic evaluations are rooted in two mechanisms by which we represent and evaluate the beliefs of others in folk psychology and theory of mind: the doxastic conception of mental disorders and doxastic voluntarism. (...) Tracing these origins contributes to our understanding of mental state representation in cognitive science and philosophy of psychiatry, the concept of belief in philosophy of mind, and may help improve patient experience and treatment in light of social stigmatization and bias toward mental illness. (shrink)

The idea that healthcare should become more person-centred is extremely influential. By using recent English policy developments as a case study, this article aims to critically analyse an important element of person-centred care, namely, the belief that to treat patients as persons is to think that care should be ‘co-produced’ by formal healthcare providers and patients together with unpaid carers and voluntary organizations. I draw on insights from political philosophy to highlight overlooked tensions between co-production and values like equality (...) and liberty. Regarding equality, I argue that co-production compounds both problems of gender inequality in the distribution of care labour and the challenges associated with securing equal access to care. Turning to liberty, I identify important commonalities between co-production and republicanism in political philosophy, given their shared insistence on common citizens’ civic virtue. Then, I use against co-production some liberal arguments against republicanism, to highlight a problem of over-demandingness. In bringing my argument to a close, however, I wish to caution against hastily rejecting co-production as a policy programme. (shrink)

Lately, more and more authors have asserted their belief that one of the criteria which, together with the medical ones, can and should be applied in the policy of selecting and/or prioritizing the patients in need for the allocation of medical resources with limited availability, is the principle of individual responsibility for illness. My intention in this study is to highlight some very serious obstacles looming against the attempt to apply this principle in the distribution of the medical services (...) with limited availability. Although there are numerous such obstacles, I shall only discuss five of them (the most important, in my opinion). These are: 1) the impossibility to establish with certainty whether a patient got ill due to his lifestyle; 2) the lack of a feasible and reliable method of establishing an individual’s responsibility for his lifestyle; 3) a patient’s right to privacy; 4) some moral requirements and principles and, last but not least, 5) the ethics of the medical profession. (shrink)

This paper explores the possibility of AI-based addendum therapy for borderline personality disorder, its potential advantages and limitations. Identity disturbance in this condition is strongly connected to self-narratives, which manifest excessive incoherence, causal gaps, dysfunctional beliefs, and diminished self-attributions of agency. Different types of therapy aim at boosting self-knowledge through self-narratives in BPD. The suggestion of this paper is that human-to-human therapy could be complemented by AI assistance holding out the promise of making patients' self-narratives more coherent through improving the (...) accuracy of their self-assessments, reflection on their emotions, and understanding their relationships with others. Theoretical and pragmatic arguments are presented in favour of this idea, and certain technical solutions are suggested to implement it. (shrink)

About death, grief, mourning, life after death and immortality. Why should we die like humans to survive as a species. -/- "No one wants to die. Even people who want to go to heaven don't want to die to get there. And yet death is the destination we all share. No one has ever escaped it. And that is as it should be, because Death is very likely the single best invention of Life. It is Life's change agent. It clears (...) out the old to make way for the new." (Steve Jobs) -/- CONTENTS: -/- Death - Philosophy of death - Religions - - Animism - - Atheism - - Buddhism - - Christianity - - Hinduism - - Islam - - Jainism - - Jehovah's Witnesses - - Judaism - - Latter-day Saints - - Spiritism - Symbolism - Personification of Death - - Notable personifications - - In mythologies - - - Hindu mythology - - - In Japan - - - Slavic paganism - - - Lithuanian paganism - - In the three monotheistic religions - - - Judaism - - - Christianity - - - In Mexico - - - Islam - Axiochos - - The characters of dialogue - - Dialogue - - Prologue - - Arguments - - Citations - Paradise - - Greco-Roman mythology - - Mesopotamian mythology and influences - - According to Judaism - - According to Christianity - - - According to Catholicism - - - According to Protestantism - - - According to the Church of Jesus Christ of Latter-day Saints - - According to Islam - - According to Hinduism - - According to modern spiritualities - - - According to the esoteric - Hell - - Mesopotamian origins - - According to Christianity - - - Names appearing in the biblical texts - - - Medieval artistic representations - - - Concepts according to Christian movements - - According to Judaism - - According to Islam - - According to Buddhism - - According to Hinduism - - According to modern esotericism - - - According to Aïvanhov - - - According to Allan Kardec - - Philosophy - - - Jewish Kabbalah - - - Sartre - - - Popular wisdom Funerals - The funeral ritual: a rite of passage - Prehistory - Ancient death customs - - The family bereavement - - Mummification - - Sarcophagi - - Funerals - - Ancient Greece - - Ancient Rome - - Celts, Germans and Scandinavians - Religious funeral rites - - Buddhism - - Judaism - Christianity - - Protestantism - - Islam - Funeral rites by continent - - In Africa - - In Europe - The contemporary era - Mourning (Grief) - - Steps - - - Death of a close - - Loss events without mourning value (white factors) - - Duration and manifestations - - Risks - - Colors - Graveyards (Cemeteries) - - First cemeteries - - Cemeteries today - Funerary art - Dolmens - - Types of dolmens - - Function - - Location - Passage graves - Cenotaphs - - Famous cenotaphs - Lanterns of the Dead Afterlife - History - Questions about death and immortality - Testimonials - - Spiritualistic experiences - - Popular literature on the afterlife - - "Memories" and reminiscences - - Early studies of the science of the 19th century and early 20th century - Types of scenarios - Some religious and philosophical concepts - - Afterlife in Buddhism - - Afterlife in Christianity - - According to Hinduism - - According to Islam - - According to Judaism - - According to Mormonism - - According to the ancient philosophies - - According to Spiritism - - According to Native American traditions - - According to Vedism - - According to Esotericism - In science - Near-death experiences - - Clinical death - - NDE frequency - - Effects of depth of NDE on survival - - Near-death experiences and shared-death experience - - - The first contemporary testimonials - - - Experience according to Moody - - - The concept of "shared death" - - - The NDE scales - - The study of Pim van Lommel - - Spiritual and patient point of view - - - Survivalists studies - - - The religious understanding of the phenomenon - - Scientific views - - - Physiological explanation - - - Psychological explanation - Reincarnation - - Religions - - - In Hinduism - - - In Jainism - - - In Buddhism - - - In Judaism - - - In Christianity - - - In Islam - - In contemporary times - - - Esotericism - - - Works of the psychiatrist Ian Stevenson - - - Radical increase in life expectancy and artificial reincarnation - - Criticism - - - Arthur Schopenhauer - - - Ramana Maharshi - - - Rene Guenon - - - Ananda Kentish Coomaraswamy - Metempsychosis - - Theories - - Ideas - Maschalismos Immortality - Immortality of the soul and religious traditions - - Buddhism - - Christianity - - Islam - - Mormonism - Contemporary perception of the immortality of the body - - Observation in the animal kingdom - - Perspectives for mankind - Immortality in science - - Alexis Carrel - - Jean Rostand - - Hayflick limit - - Étienne-Émile Baulieu and DHEA - - Aubrey de Grey - - Professor Skulachev - - Regenerative medicine - - Professor Christopher Jaeger - Eternal Return - - According to the Mesopotamians - - According to Heraclitus and the Stoics - Fountain of Youth - - History of myth and relatives myths - - - In Roman mythology, Germanic, Celtic and Irish - - - In the Middle-East - - - In Spain - - - In the Bible - - The fountain in art and literature - - Painting - - - Literature and cinema - - Persistent of the myth until today - Senescence - - Why do we age? - - Gene regulation - - Cellular senescence Undead - Ghoul - Lich - Mummy - Skeleton - Vampire - Zombie - Other legendary creatures - Creatures specific to a particular universe - Spiritism - - Point out - - Origins of spiritism - - - The traditions through the ages - - - Advent of Christianity in Europe - - - The survival of necromancy - - - The precursors - - - Relations of spiritualism to science - Mediumship - - History - - Skeptical point of view - - Favorable doctor's viewpoint - Ghosts - - Appearance - - Belief in ghosts - - Origin - - - Duality and return dead - - - Ancient roots - - Typology - - - Poltergeists - - - Revenants - - - Ghosts - - - Banshees - - - Apparitions of crisis - - - Phantasms of the living - - - Vision of his own double - - - Ghost armies - - - Ghosts of animals - - - Means of transport - - Science perspective - - - Hallucinations - - - Sleep paralysis - - - Induced ghosts - - - Aches and infrasounds - - - Magnetic fields - Vampires - - Characteristics - - - Vampire transformation - - - Identification - - - Faculties - - Protection against the vampires - - - Precautions at death and burial - - - Apotropaic objects and places - - Destruction of vampires - Zombie - - The concept - - Africa and voodoo - - - West Africa - - - South Africa - - - In Haiti (and the Caribbean) - - - Scientific research - - The "revenants" in the Western imaginary Death in art - Memento mori - - History - - - Antiquity - - - Christianity - - - Mexican syncretism - - Performing arts - - - In painting - - - In literature - - - In movies - - - In video games - - - In Japanese animation - - - In music - The iconography of Weighing of souls (Particular judgment) - - Origin - - Written sources - - Weighing in Romanesque art - - Weighing in Gothic art - - Weighing in the late Middle Ages: to a new iconography - - Weighing of souls or actions? - Poems - - Charlotte Brontë, “On the Death of Anne Brontë” - - Edgar Allan Poe, “Annabel Lee” - - Edna St. Vincent Millay, “And you as well must die” - - Emily Dickinson, “Because I could not stop for Death” - - Emily Dickinson, “If I Should Die” - - Lord Byron, “Epitaph to a Dog” - - Pablo Neruda, “Only Death” - - Stephen Crane, “God Lay Dead in Heaven” - - W. B. Yeats, “He Wishes His Beloved Were Dead” - - Rainer Maria Rilke, “Death” - Paintings - - The Three Dead Kings - - The Death of Nelson - - Beata Beatrix - Sculptures - - The Kiss of Death - - Background - - Imagery - - Angel of Grief - - Fallen Astronaut - Quotes References About the author - Nicolae Sfetcu - - By the same author - - Contact Publishing House - MultiMedia Publishing -/- DOI: 10.58679/TW44411. (shrink)

The article analyzes methodological and practical approaches of psychological counseling for adult clients. General psychological problems of this age group are generalized; the concept of restoration of balance between the image of the world and the image of the “I” of clients as the main internal mechanism of mental equilibrium is substantiated; the aspects of professional training of a psychologist to advisory practice with adults are considered. -/- The urgent problem of psychological counseling for adult clients is to help them (...) to solve such problems as negative behaviors, disadaptation, loss of the meaning of life, addictive behavior, depression, etc. Psychological help should be carried out in the direction of qualitative transformations of the image of the world and the image of “I”, which envisage the expansion of knowledge about the world, its positive emotional experience, the realism of ideological beliefs. The general trend in the development of the worldview is the lack of realism in the image of the world, which affects the formation of a false system of values, the development of distorted moral ideas, and as a consequence, problems of health, self-realization, professional adaptation, and behavior deviations. -/- The purpose of the article is to substantiate the methodology and methods of psychological counseling for clients of the adult age group. Specialization of practical activity of a psychologist with this age category requires special knowledge, skills, and skills from a specialist that qualitatively differ from the provision of psychological services to other age groups (children, adolescents, etc.). The success of solving the psychological problems of clients entirely depends on the introduction of the correct, in other words, “more objective”, realistic methodology of counseling. The task of the article is to describe specific aspects of advisory psychological counseling for adults. -/- Summarizing the issue of adult counseling, we note that this type of activity requires from a psychologist to continuously improve the theoretical knowledge and practical skills, as well as to rethink the life experience. The presence of only one of the components of this activity provokes unprofessionality – it often manifests as the behavior in the style of a teacher, a teacher of higher education, in which there is a somewhat superficial, authoritarian attitude to students. Consequently, effective counseling for adult clients is stimulated by professional introspection and qualification in order to avoid professional deviation. Therefore, it is advisable for a psychologist to gain experience with clients (patients) of the adult age group to practice in a counseling center under the guidance of a specialist, and if this is a medical institution – a doctor or therapist. (shrink)