The ‘multicultural clinical interaction’ presents itself as a dilemma for the mental health practitioner. Literature describes two problematic areas where this issues emerges - how to make an adequate distinction between religious rituals and the rituals that may be symptomatic of ‘obsessive compulsive disorder’ (OCD), and how to differentiate ‘normative’ religious or spiritual beliefs, behaviours, and experiences from ‘psychotic’ illnesses. When it comes to understanding service user’s ‘idioms of distress’, beliefs about how culture influences behaviour can create considerable confusion and (...) ‘normative uncertainty’ for mental health practitioners. In the absence of clear diagnostic and assessment criteria on distinguishing between ‘culture’ and ‘psychopathology’, practitioners have had to rely on their own intuition and seek out possible ‘strategies’ or ‘procedures’ from a contradictory and cross-disciplinary evidence base. Decontextualisation of service users’ experiences may result in the pathologisation of culturally ‘normative’ phenomenon, ‘category fallacy’ errors, and poor health care experiences and outcomes for service users. This paper situates this dilemma within a wider debate that has concerned both the biomedical and social sciences, namely, the unresolved question of ‘normality’ or ‘abnormality’. Indeed, issues that arise from dilemmas surrounding the question of ‘culture’ or ‘psychopathology’ are intimately tied to wider cultural ideas about what is considered ‘normal’. The disciplines of psychiatry, psychology, and medical anthropology have struggled to establish workable criteria against which to judge behaviour as ‘normal’, ‘abnormal’, or ‘pathological’. Three models for understanding mental ‘abnormality’ are evident in ‘transcultural psychiatry’ (what is now commonly known as ‘cultural psychiatry’), and these models have corresponded closely to the interpretive models used by anthropologists attempting to make sense of the apparent diversity of human societies. The three models of ‘absolutism’, ‘universalism’ and ‘cultural relativism’ have not only important consequences for the nature and conduct of research enquiry, but also have implications for how the dilemma of ‘culture’ or ‘psychopathology’ is attended to in clinical practice. (shrink)

We prove the following surprising property of Heyting's intuitionistic propositional calculus, IpC. Consider the collection of formulas, φ, built up from propositional variables (p,q,r,...) and falsity $(\perp)$ using conjunction $(\wedge)$ , disjunction (∨) and implication (→). Write $\vdash\phi$ to indicate that such a formula is intuitionistically valid. We show that for each variable p and formula φ there exists a formula Apφ (effectively computable from φ), containing only variables not equal to p which occur in φ, and such that for (...) all formulas ψ not involving $p, \vdash \psi \rightarrow A_p\phi$ if and only if $\vdash \psi \rightarrow \phi$ . Consequently quantification over propositional variables can be modelled in IpC, and there is an interpretation of the second order propositional calculus, IpC2, in IpC which restricts to the identity on first order propositions. An immediate corollary is the strengthening of the usual interpolation theorem for IpC to the statement that there are least and greatest interpolant formulas for any given pair of formulas. The result also has a number of interesting consequences for the algebraic counterpart of IpC, the theory of Heyting algebras. In particular we show that a model of IpC2 can be constructed whose algebra of truth-values is equal to any given Heyting algebra. (shrink)

The animalist says we are animals. This thesis is commonly understood as the universal generalization that all human persons are human animals. This article proposes an alternative: the thesis is a generic that admits of exceptions. We defend the resulting view, which we call ‘generic animalism’, and show its aptitude for diagnosing the limits of eight case-based objections to animalism.

Payoff dominance, a criterion for choosing between equilibrium points in games, is intuitively compelling, especially in matching games and other games of common interests, but it has not been justified from standard game-theoretic rationality assumptions. A psychological explanation of it is offered in terms of a form of reasoning that we call the Stackelberg heuristic in which players assume that their strategic thinking will be anticipated by their co-player(s). Two-person games are called Stackelberg-soluble if the players' strategies that maximize against (...) their co-players' best replies intersect in a Nash equilibrium. Proofs are given that every game of common interests is Stackelberg-soluble, that a Stackelberg solution is always a payoff-dominant outcome, and that in every game with multiple Nash equilibria a Stackelberg solution is a payoff-dominant equilibrium point. It is argued that the Stackelberg heuristic may be justified by evidentialist reasoning. (shrink)

Some incompatibilists about free will or moral responsibility and determinism would abandon their incompatibilism were they to learn that determinism is true. But is it reasonable to flip-flop in this way? In this article, we contend that it is and show what follows. The result is both a defense of a particular incompatibilist strategy and a general framework for assessing other cases of flip-flopping.

Materialists about human persons think that we are material through and through—wholly material beings. Those who endorse materialism more widely think that everything is material through and through. But what is it to be wholly material? In this article, I answer that question. I identify and defend a definition or analysis of ‘wholly material’.

The development of ethical guidelines and regulations regarding human subjects research has focused upon protection of vulnerable populations by relying on a limited typology of vulnerabilities. This results in several challenges: First, Institutional Review Boards struggle to interpret and apply the regulations because they are often vague and inconsistent. Second, applying the regulations to subjects who fit within multiple categories of vulnerability can lead to contradictions and the rejection of research that would be permissible if only one category were applicable. (...) Finally, some potential subjects have social and other context-based vulnerabilities that are not described in the federal regulations... (shrink)

Ancient Roman “technical memory” is not (as much of the modern specialist literature would have it) a generative technology of association. Rather it is (as a literal reading of the texts would suggest) a specialized tool for precise serial recall. Modern experimental evidence both confirms the fitness for the purpose of the technique and shows why that purpose is not trivial, as some have suggested. While the mechanism(s) by which the technique operates are not fully understood, a review of the (...) current literature suggests that it would have had the advantage over other mnemonic techniques by virtue of recruiting a variety of cognitive capacities. These likely include spatial/navigational mechanisms and possibly visual/imagery-based ones as well. Finally, small differences between the method as recorded in the ancient texts and similar methods that have been the subject of laboratory experiments are used to suggest possible directions for further experimentation. (shrink)

The interpretation of the dead donor rule (DDR) has been central to recent debates regarding normothermic regional perfusion with controlled donation after circulatory death (NRP-cDCD). Proponents...

The continental tradition in philosophy has gotten more "materialistic" over the last two hundred years. This has resulted from a combination of some very specific moves with regard to the epistemological parameters of understanding and the assertion that ideas may have material force in history. Therefore, the materialism within the continental tradition is not a materiality of being, but a materiality of understanding and action. Such an inquiry opens up space between the activities of sensation and the mental faculty of (...) cognition. 'I think, therefore I am,' is not an empirical statement, but a statement of cognition. It is assumed that this distinction is at the core of continental philosophy. Cognition is always interpretive. Experience is the start of cognition, but not its final product. Our cognitions cannot be separated from our experience of the physical, social, and cultural environment around us. The symbolic nature of language reinforces the interpretive nature of our thoughts and ideas. Our language is, therefore, always projecting an implicit image of the world. Language is, therefore, always political. The materiality of these cognitive world-views is manifested in two ways. First, in their formation. They are the products of sensual contact with the world. Second, in their effects. They move people. It is a picture of the world which serves to shape the content and character of human behavior. Whether we want to call these phantoms of the mind, world-view, ideas, thoughts, cognitions, or any other term, the dual character of their materiality is secure. This work examines the threads of materialist ideas running through the efforts of some major authors in the continental tradition in philosophy. A model of materialism is constructed in Chapter One and used to assess the materialist elements in works from Kant, Marx, Weber, Nietzsche, and contemporary poststructuralism. The work demonstrates the evolution of materialist thinking within the tradition and asserts an evolving and developing articulation of materialism in relation to the thoughts and activities of human beings." -- Publisher's description. (shrink)

Paul Krugman and others deny that bitcoin has legitimate uses. Critics like Krugman also fail to distinguish bitcoin from other cryptocurrencies. But once we isolate bitcoin from the rest of the field, we see how special, and how useful, it is. In this chapter, we explain why bitcoin is unique among cryptocurrencies as a credibly neutral monetary asset and why this is important. Its uniqueness doesn’t owe entirely to its age (as the oldest) or market ranking (as the most valuable). (...) As a credibly neutral monetary asset, bitcoin solves problems for those in less than ideal circumstances. And beyond bitcoin’s functionality, its origin and surrounding culture also help to explain why people trust bitcoin more than any other cryptocurrency to solve these problems. Nothing else comes close. This gap between bitcoin and everything else has implications for policy-making, journalism, and academic research. (shrink)

For good or for ill, we have animal bodies. Through them, we move around, eat and drink, and do many other things besides. We owe much – perhaps our very lives – to these ever-present animals. But how exactly do we relate to our animals? Are we parts of them, or they of us? Do we and these living animals co-inhere or constitute or coincide? Or what? Animalism answers that we are identical to them. There are many objections to animalism, (...) and a dizzying array of rival views. In this article, we do not propose to evaluate those objections and rivals. We will instead present a new argument for that view. The argument begins with the fact that we have emotions. (shrink)

In a recent article in this journal, Duijf claims to have proved that team reasoning can be viewed as a payoff transformation. His formalization mimics team reasoning but ignores its essential agency switch. The possibility of such a payoff transformation was never in doubt, does not imply that team reasoning can be viewed as a payoff transformation, and makes no sense in a game in which payoffs represent players’ utilities. A theorem is proved here that a simpler and more intuitive (...) payoff transformation can mimic any theory that predicts what strategies players will choose in a well-defined game. (shrink)

In this article, I focus on internal dimensions of moral responsibility. I argue that if such dimensions are real -- and it seems they are -- then moral responsibility is compatible with determinism.

Warrant is what fills the gap between mere true belief and knowledge. But a problem arises. Is there just one condition that satisfies this description? Suppose there isn’t: can anything interesting be said about warrant after all? Call this the uniqueness problem. In this paper, I solve the problem. I examine one plausible argument that there is no one condition filling the gap between mere true belief and knowledge. I then motivate and formulate revisions of the standard analysis of warrant. (...) Given these revisions, I argue that there is, after all, exactly one warrant condition. (shrink)

There is a new objection to the Consequence Argument for incompatibilism. I argue that the objection is more wide-ranging than originally thought. In particular: if it tells against the Consequence Argument, it tells against other arguments for incompatibilism too. I survey a few ways of dealing with this objection and show the costs of each. I then present an argument for incompatibilism that is immune to the objection and that enjoys other advantages.

Entangled by modernism -- Archaeological use of theories -- Object science -- Group formation, dissent, and change -- A method for analyzing cultural action -- Fragmenting the Bronze Age -- Contestation in the Hopewell.

Science and religious faith are two of the most important and influential forces in human life, yet there is widespread confusion about how, or indeed whether, they link together. This book describes this combination from the perspective of one who finds that they link together productively and creatively.

This paper focuses on the most common state policy responses to the opioid crisis, dividing them into six broad categories. Within each category we highlight the rationale behind the group of policies within it, discuss the details and support for individual policies, and explore the research base behind them. The objective is to better understand the most prevalent state responses to the opioid crisis.

Recent research in epidemiology has identified a number of factors beyond access to medical care that contribute to health disparities. Among the so-called socioeconomic determinants of health are income, education, and the distribution of social capital. One factor that has been overlooked in this discussion is the effect that stigmatization can have on health. In this paper, I identify two ways that social stigma can create health disparities: directly by impacting health-care seeking behaviour and indirectly through the internalization of negative (...) interpersonal judgments. I then argue that social arrangements that foster self-respect can reduce the impact of stigmatization on health disparities. I conclude by showing how John Rawls' conception of justice can be used to address the intersection of stigma, health, and self-respect, in contrast to critics of his position, who have seen him as excessively focused on the allocation of material goods. (shrink)

Despite increased calls for hospital ethics committees to serve as default decision-makers about life-sustaining treatment for unrepresented patients who lack decision-making capacity or a surrogate decision-maker and whose wishes regarding medical care are not known, little is known about how committees currently function in these cases. This was a retrospective cohort study of all ethics committee consultations involving decision-making about LST for unrepresented patients at a large academic hospital from 2007 to 2013. There were 310 ethics committee consultations, twenty-five of (...) which involved unrepresented patients. In thirteen cases, the ethics consultants evaluated a possible substitute decision-maker identified by social workers and/or case managers. In the remaining cases, the ethics consultants worked with the medical team to contact previous healthcare professionals to provide substituted judgement, found prior advance care planning documents, or identified the patient’s best interest as the decision-making standard. In the majority of cases, the final decision was to limit or withdraw LST or to change code status to Do Not Resuscitate/Do Not Intubate. Substitute decision-makers who had been evaluated through the ethics consultation process and who made the final decision alone were more likely to continue LST than cases in which physicians made the final decision. In our centre, the primary role of ethics consultants in decision-making for unrepresented patients is to identify appropriate decision-making standards. In the absence of other data suggesting that ethics committees, as currently constituted, are ready to serve as substitute decision-makers for unrepresented patients, caution is necessary before designating these committees as default decision-makers. (shrink)

We uncover a surprising discovery about the basis of thoughts. We begin by giving some plausible axioms about thoughts and their grounds. We then deduce a theorem, which has dramatic ramifications for the basis of all thoughts. The theorem implies that thoughts cannot come deterministically from any purely “thoughtless” states. We expect this result to be too dramatic for many philosophers. Hence, we proceed to investigate the prospect of giving up the axioms. We show that each axiom’s negation itself has (...) dramatic consequences that should be of interest to philosophers of mind. Our proof of the theorem provides a new guiderail for thinking about the nature and origin of thoughts. (shrink)

Making room for agency in a physical world is no easy task. Can it be done at all? In this article, I consider and reject an argument in the negative.

The main question of this study is whether God has a personality. We show what the question means, why it matters, and that good sense can be made of an affirmative answer to it. A God with personality — complete with particular, sometimes peculiar, and even seemingly unexplainable druthers — is not at war with maximal perfection, nor is the idea irredeemably anthropomorphic. And the hypothesis of divine personality is fruitful, with substantive consequences that span philosophical theology. But problems arise (...) here too, and new perspectives on inquiry itself. Our cosmos is blessed with weirdness aplenty. To come to know it is nothing less than to encounter a strange and untamed God. (shrink)

Many say that ontological disputes are defective because they are unimportant or without substance. In this paper, we defend ontological disputes from the charge, with a special focus on disputes over the existence of composite objects. Disputes over the existence of composite objects, we argue, have a number of substantive implications across a variety of topics in metaphysics, science, philosophical theology, philosophy of mind, and ethics. Since the disputes over the existence of composite objects have these substantive implications, they are (...) themselves substantive. (shrink)

In this paper, I will examine John Smeaton’s contribution to the vis viva controversy in Britain, focusing on how the hybridization of science, technology, and industry helped to establish vis viva, or mechanic power, as a measure of motive force. Smeaton, embodying the ‘hybrid expert’ who combined theoretical knowledge and practical knowhow, demonstrated that the notion of vis viva possessed a greater explanatory power than momentum, because it could be used to explain the difference in efficiency between overshot and undershot (...) waterwheels. Smeaton’s conclusions were correct since waterwheel efficiency was already measured in terms that were proportional to vis viva, not momentum, as a result of the industrial applications of waterwheel technology, which favored measuring efficiency by the product of mass and vertical displacement. Toward the end of the eighteenth century, the loss of motive force in the inelastic collision driving the undershot wheel began to be seen as equivalent to the expenditure of labor in the manufacture of commodities, further underlining how strictly scientific conclusions about motive force could have their origin in industrial practices. (shrink)

Among your closest associates is a certain human animal – a living, breathing, organism. You see it when you look in the mirror. When it is sick, you don't feel too well. Where it goes, you go. And, one thinks, where you go, it must follow. Indeed, you can make it move through sheer force of will. You bear, in short, an important and intimate relation to this, your animal. So too rest of us with our animals. Animalism says that (...) this relation is nothing short of identity. According to animalists, we do not only coincide with or constitute or inhabit or otherwise hang out with these close associates, our animals: we are them. In this article, I offer an opinionated take on what animalism might be and situate it against contemporary rivals. Then, I outline a simple case for animalism. Finally, I sketch non-standard routes for animalists to take in light of standard challenges. My goal in all of this is to open up some new avenues of animalist thinking. (shrink)

We develop a new puzzle concerning a material being's relationship to the smallest parts of the material world. In particular, we investigate how a being could be responsible for anything if its be...

In this commentary on Denis Noble’s “The Illusions of the Modern Synthesis,” I discuss three illusions he argues exist within the Modern Synthesis. These illusions have the common theme of attempting to identify the correct way of understanding and describing biological systems. I agree with much of Noble’s claims, but offer the language of developmental systems theory as a friendly tool for moving the project forward.

The main question of this short monograph is how the existence, supremacy, and uniqueness of an almighty and immaterial God bear on our own nature. It aims to uncover lessons about what we are by thinking about what God might be. A dominant theme is that Abrahamic monotheism is a surprisingly hospitable framework within which to defend and develop the view that we are wholly material beings. But the resulting materialism cannot be of any standard variety. It demands revisions and (...) twists on the usual views. We can indeed learn about ourselves by learning about God. One thing we learn is that, though we are indeed wholly material beings, we’re not nearly as ordinary as we might seem. (shrink)

Here is a question as intriguing as it is brief: what are we? The animalist’s answer is equal in brevity: we are animals. This stark formulation of the animalist slogan distances it from nearby claims—that we are essentially animals, for example, or that we have purely biological criteria of identity over time. Is the animalist slogan—unburdened by modal or criterial commitments—still interesting, though? Or has it lost its bite? In this article we address such questions by presenting a positive case (...) for the importance of animalism and applying that case to recent critiques. (shrink)

Systematic study of the intersection of ethics consultation services and solid organ transplants and recipients can identify and illustrate ethical issues that arise in the clinical care of these patients, including challenges beyond resource allocation. This was a single-centre, retrospective cohort study of all adult ethics consultations between January 1, 2007, and December 31, 2017, at a large academic medical centre in the north-eastern United States. Of the 880 ethics consultations, sixty (6.8 per cent ) involved solid organ transplant, thirty-nine (...) (65.0 per cent) for candidates and twenty-one (35.0 per cent ) for recipients. Ethics consultations were requested for 4.3 per cent of heart, 4.9 per cent of lung, 0.3 per cent of liver, and 0.3 per cent of kidney transplant recipients over the study period. Nurses were more likely to request ethics consultations for recipients than physicians (80.0 per cent vs 20.0 per cent, p = 0.006). The most common reason for consultation among transplant candidates was discussion about intensity of treatment or goals of care after the patient was not or was no longer a transplant candidate. The most common reason for ethics consultation among transplant recipients was disagreement between transplant providers and patients/families/non-transplant healthcare professionals over the appropriate intensity of treatment for recipients. Very few consultations involved questions about appropriate resource allocation. Ethics consultants involved in these cases most often navigated communication challenges between transplant and non-transplant healthcare professionals and patients and families. (shrink)

In this article, we identify three key design dimensions along which cryptocurrencies differ -- privacy, censorship-resistance, and consensus procedure. Each raises important normative issues. Our discussion uncovers new ways to approach the question of whether Bitcoin or other cryptocurrencies should be used as money, and new avenues for developing a positive answer to that question. A guiding theme is that progress here requires a mixed approach that integrates philosophical tools with the purely technical results of disciplines like computer science and (...) economics. Note: this article is the second entry within a two-part sequence on the Philosophy, Politics, and Economics of Cryptocurrency. (shrink)

Animalism is the view that we are animals: living, breathing, wholly material beings. Despite its considerable appeal, animalism has come under fire. Other philosophers have had much to say about objections to animalism that stem from reflection on personal identity over time. But one promising objection (the `Elimination Argument') has been overlooked. In this paper, I remedy this situation and examine the Elimination Argument in some detail. I contend that the Elimination Argument is both unsound and unmotivated.

Background: The bioethics literature contains speculation but little data about sociodemographic differences between patients for whom ethics committees (EC) are consulted for conflict about life-sustaining treatment (LST) and the broader hospital population that these committees serve. To provide an empirical context for this discussion, we examined differences in five sociodemographic factors between patients for whom an EC was consulted for conflict over LST and the general inpatient population, hypothesizing that nonwhite patients were most likely to be disproportionately represented. Methods: This (...) was a retrospective cohort study comparing self-reported race/ethnicity, household income, insurance status, primary language, and religious affiliation between patients involved in EC consultations for conflict over LST and the general adult inpatient population at a large academic hospital from January 1, 2007, through December 31, 2013. Results: There were 169 EC consultations involving conflict over LST and 243,197 adult inpatient admissions over the study period. On bivariate analysis, patients for whom the EC was consulted for conflict over LST were more likely to be nonwhite, low-income, and to speak a primary language other than English. They were not more likely to be underinsured or to report a religious affiliation. On multivariate analysis, patients for whom the EC was consulted for conflict over LST were more likely to be nonwhite (odds ratio [OR], 2.5; 95% confidence interval [CI], 1.7–3.7; p <.001). They were also more likely to be low income (OR, 1.8; 95% CI, 1.1–3.0; p =.02). They were not more likely to speak a primary language other than English (OR, 1.4; 95% CI, 0.9–2.1; p =.17). None of the assessed variables were associated with conflict over LST requiring additional meetings beyond the first EC consultation. Conclusions: Nonwhite and low-income status patients are disproportionately represented in EC committee consultation for conflict over LST compared to the general inpatient population. (shrink)