An important philosophical issue in the study of addiction is what difference the fact that a person is addicted makes to attributions of autonomy (and responsibility) to their drug-oriented behavior. In spite of accumulating evidence suggesting the role of emotional dysregulation in understanding addiction, it has received surprisingly little attention in the debate about this issue. I claim that, as a result, an important aspect of the autonomy impairment of many addicted individuals has been largely overlooked. A widely shared assumption (...) in the philosophical literature is that for addiction to impair a person’s autonomy it has to make them (in some sense) take drugs against their will. So-called “willing addicts” are therefore usually seen as exempted from the autonomy impairment believed to characterize “unwilling addicts”, the latter being those who ‘truly want’ to stop using drugs but find their attempts repeatedly derailed by failures of self-control. In this article, I argue that the association between addiction and emotional dysregulation shows why this assumption is false. Emotional dysregulation is not only consistent with the possibility that many addicts take drugs ‘willingly’, it supports the hypothesis that they use drugs because they truly want to. The article proposes an explanation for why emotional dysregulation should nevertheless be seen as an aspect of their loss of control and an important reason why they have impaired autonomy. I end by exploring some implications of this account for addict’s decision-making capacity when they are prescribed the drugs to which they are addicted. -/- . (shrink)

Recently clinicians have become more reliant on technologies such as artificial intelligence (AI) and machine learning (ML) for effective and accurate diagnosis and prognosis of diseases, especially mental health disorders. These remarks, however, apply primarily to Europe, the USA, China and other technologically developed nations. Africa is yet to leverage the potential applications of AI and ML within the medical space. Sub-Saharan African countries are currently disadvantaged economically and infrastructure-wise. Yet precisely, these circumstances create significant opportunities for the deployment of (...) medical AI, which has already been deployed in some places in the continent. However, while AI and ML have come with enormous promises in Africa, there are still challenges when it comes to successfully applying AI and ML designed elsewhere within the African context, especially in diagnosing mental health disorders. We argue, in this paper, that there ought not to be a homogeneous/generic design of AI and ML used in diagnosing mental health disorders. Our claim is grounded on the premise that mental health disorders cannot be diagnosed solely on ‘factual evidence’ but on both factual evidence and value-laden judgements of what constitutes mental health disorders in sub-Saharan Africa. For ML to play a successful role in diagnosing mental health disorders in sub-Saharan African medical spaces, with a precise focus on South Africa, we allude that it ought to understand what sub-Saharan Africans consider as mental health disorders, that is, the value-laden judgements of some conditions. (shrink)

This response to Kevin WildesÕs article in the previous issue of the Kennedy Institute of Ethics Journal addresses several major points of disagreement between Pellegrino and Wildes regarding the nature and scope of a philosophy of medicine, in particular how it is derived and by what method of philosophical enquiry it is best pursued.

Problems are raised with the global workspace hypothesis of consciousness, for example about exactly how global the workspace needs to be for consciousness to suddenly be present. Problems are also raised with Carruthers’s (2019) version that excludes conceptual (categorical or discrete) representations, and in which phenomenal consciousness can be reduced to physical processes, with instead a different levels of explanation approach to the relation between the brain and the mind advocated. A different theory of phenomenal consciousness is described, in which (...) there is a particular computational system involved in which Higher Order Syntactic Thoughts are used to perform credit assignment on first order thoughts of multiple step plans to correct them by manipulating symbols in a syntactic type of working memory. This provides a good evolutionary reason for the evolution of this kind of computational module, with which, it is proposed, phenomenal consciousness is associated. Some advantages of this HOST approach to phenomenal consciousness are then described with reference not only to the global workspace approach, but also to Higher Order Thought (HOT) theories. It is hypothesized that the HOST system which requires the ability to manipulate first order symbols in working memory might utilize parts of the prefrontal cortex implicated in working memory, and especially the left inferior frontal gyrus, which is involved in language and probably syntactical processing. Overall, the approach advocated is to identify the computations that are linked to consciousness, and to analyze the neural bases of those computations. (shrink)

Le passage du realisme des Recherches logiques de 1901 a l'idealisme des Idees de 1913 a ete le plus souvent tres mal compris a l'epoque et interprete a tort comme un reniement par Husserl de ses prises de position anterieures. La publication des Lecons sur le temps de 1905 et celle des Lecons sur l'espace de 1907 avaient deja montre qu'il ne s'etait agi la que de l'approfondissement de la meme problematique, celle des vecus intentionnels, mais qui ne pouvait plus (...) desormais rester en l'etat, parce que les problemes de constitution qu'elle traitait exigeraient l'emploi d'une methode rigoureuse. Ces Lecons sur la theorie de la signification de 1908 confirment cette certitude, puisqu'en reprenant de facon systematique l'etude du langage, Husserl y a ete conduit a donner a sa theorie de la reduction sa formulation la plus radicale, avec une opposition entre ce qui est phenologique du cote des apparitions et ce qui est phenomenologique du cote des apparaissants. (shrink)

Experimental psychologists in the learning tradition stress the importance of three of the authors' four key variables of experimental design. We review research investigating the roles played by these variables in studies of choice from our laboratory. Supporting the authors' claims, these studies show that the effects of these variables are not fixed and should not be taken for granted.

Game-theoretic rationality is not generally observed in human behavior. One important reason is that subjects do not perceive the tasks in the same way as the experimenters do. Moreover, the rich history of cooperation that participants bring into the laboratory affects the decisions they make.

We applaud Domjan et al. for providing an elegant account of Pavlovian feed-forward mechanisms in social behavior that eschews the pitfall of purposivism. However, they seem to imply that they have provided a complete account without provision for operant conditioning. We argue that operant conditioning plays a central role in social behavior, giving examples from fish and infant behavior.

Behavioral research suggests that rule-governed behavior should be less sensitive to environmental changes and thus more resistant to extinction (disconfirmation) than contingency-governed behavior. The opposite is implied in Davey's discussion of ontogenetic and phylogenetic contributions to fear development. The generality of the behavioral findings and their apparent inconsistency with the present article should be further explored with more sensitive research paradigms.

Heyman's target article makes a strong case for a behavioral approach to addiction, yet some important assumptions require justification, and promising behavioral alternatives to the author's melioration approach should be considered. In particular, the behavioral economic approach to addiction appears well developed and comprehensive. How does the melioration approach complement or improve on a behavioral economic account?

Emmanuel Levinas and Theodor Adorno are both post-Shoah philosophers who experienced refugeedom. In different contexts, both discuss the question of a linkage between language and soil, and ultimately show that the distinction between the native and the foreign is untenable. I suggest that Levinas’s evocation of linguistic soil illustrates his understanding of Jewishness as defined by a ceding of ground, thus showing that Levinas’s thought relies on a conception of ground in order to then reject it. Adorno, in evoking a (...) “language without soil,” argues for a conception of language that rejects organicism, seeing both loanwords and Jews as examples of difference without foreignness. (shrink)