In the conclusion to this multi-part article I first review the discussions carried out around the six essential questions in psychiatric diagnosis – the position taken by Allen Frances on each question, the commentaries on the respective question along with Frances’ responses to the commentaries, and my own view of the multiple discussions. In this review I emphasize that the core question is the first – what is the nature of psychiatric illness – and that in some manner all further (...) questions follow from the first. Following this review I attempt to move the discussion forward, addressing the first question from the perspectives of natural kind analysis and complexity analysis. This reflection leads toward a view of psychiatric disorders – and future nosologies – as far more complex and uncertain than we have imagined. (shrink)

In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role (...) of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM - whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part I of this article will take up the first two questions. With the first question, invited commentators express a range of opinion regarding the nature of psychiatric disorders, loosely divided into a realist position that the diagnostic categories represent real diseases that we can accurately name and know with our perceptual abilities, a middle, nominalist position that psychiatric disorders do exist in the real world but that our diagnostic categories are constructs that may or may not accurately represent the disorders out there, and finally a purely constructivist position that the diagnostic categories are simply constructs with no evidence of psychiatric disorders in the real world. The second question again offers a range of opinion as to how we should define a mental or psychiatric disorder, including the possibility that we should not try to formulate a definition. The general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances. (shrink)

The assessment of decision-making capacity in patients with brain injuries presents a range of clinical and legal challenges. Existing guidance on the conduct of such assessments is often generic; guidance specific to patients with brain injury is sparse and coarse-grained. We report on an interview-based study of decision-making capacity in patients suffering from acquired brain injury and organic personality disorder. We identify challenges associated with the assessment of DMC in this patient population, review three bodies of relevant research from cognitive (...) neuropsychology and neurophysiology, and draw on phenomenological analysis to identify three distinct abilities that play a role in decision-making, but which can be compromised in patients with organic personality disorder. We address the challenge of translating clinical findings into legally attestable results. (shrink)

In this chapter, it is argued that the Mind-Body Powers model of neural correlates of consciousness provides a metaphysical framework that yields the theoretical possibility of empirically detecting consciousness. Since the model is informed by an Aristotelian-Thomistic hylomorphic ontology rather than a physicalist ontology, it provides a philosophical foundation for the science of consciousness that is an alternative to physicalism. Our claim is not that the Mind-Body Powers model provides the only alternative, but rather that it provides a sufficient framework (...) for empirically detecting and scientifically studying consciousness. Elsewhere, the integrated information theory’s prediction about the neural correlate of being conscious has been used to illustrate how the Mind-Body Powers model grounds the possibility of empirically detecting consciousness (see M. Owen, 2021, ch. 8). The theory’s prediction was used as one plausible example of a hypothesis about the nature and location of the neural correlate that can be combined with the model. However, there is no settled conclusion about which neurobiological theory of consciousness accurately identifies the neural mechanisms corresponding to being conscious (NAS, 2021, p. 39; Sattin et al., 2021; Seth, 2017; Seth & Bayne, 2022). Therefore, this work will employ another plausible neurobiological prediction provided by the Temporal Circuit Hypothesis. The hypothesis is combined with the Mind-Body Powers model to demonstrate that empirically detecting consciousness is metaphysically plausible wholly apart from a physicalist framework. (shrink)

Polygenic risk scores (PRSs) have recently been used to inform reproductive decision-making in the context of embryonic screening. While this is yet to be widespread, it is contested and raises several challenges. This article provides an overview of some of the ethical considerations that arise with using PRSs for embryo screening and offers a series of regulatory considerations for jurisdictions that may wish to permit this in the future. These regulatory considerations cover possible regulators and regulatory tools, eligibility criteria, information (...) and education requirements and the need for ongoing refinement of the relevant technology, research and consultation. (shrink)

Psychological essentialism is the belief that some internal, unseen essence or force determines the common outward appearances and behaviors of category members. We investigated whether reasoning about transplants of bodily elements showed evidence of essentialist thinking. Both Americans and Indians endorsed the possibility of transplants conferring donors' personality, behavior, and luck on recipients, consistent with essentialism. Respondents also endorsed essentialist effects even when denying that transplants would change a recipient's category membership (e.g., predicting that a recipient of a pig's heart (...) would act more pig-like but denying that the recipient would become a pig). This finding runs counter to predictions from the strongest version of the “minimalist” position (Strevens,2000), an alternative to essentialism. Finally, studies asking about a broader range of donor-to-recipient transfers indicated that Indians essentialized more types of transfers than Americans, but neither sample essentialized monetary transfer. This suggests that results from bodily transplant conditions reflect genuine essentialism rather than broader magical thinking. (shrink)

In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role (...) of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM – whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part 1 of this article took up the first two questions. Part 2 took up the second two questions. Part 3 now deals with Questions 5 & 6. Question 5 confronts the issue of utility, whether the manual design of DSM-III and IV favors clinicians or researchers, and what that means for DSM-5. Our final question, Question 6, takes up a concluding issue, whether the acknowledged problems with the earlier DSMs warrants a significant overhaul of DSM-5 and future manuals. As in Parts 1 & 2 of this article, the general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances. (shrink)

In this article, we propose the Fair Priority Model for COVID-19 vaccine distribution, and emphasize three fundamental values we believe should be considered when distributing a COVID-19 vaccine among countries: Benefiting people and limiting harm, prioritizing the disadvantaged, and equal moral concern for all individuals. The Priority Model addresses these values by focusing on mitigating three types of harms caused by COVID-19: death and permanent organ damage, indirect health consequences, such as health care system strain and stress, as well as (...) economic destruction. It proposes proceeding in three phases: the first addresses premature death, the second long-term health issues and economic harms, and the third aims to contain viral transmission fully and restore pre-pandemic activity. -/- To those who may deem an ethical framework irrelevant because of the belief that many countries will pursue "vaccine nationalism," we argue such a framework still has broad relevance. Reasonable national partiality would permit countries to focus on vaccine distribution within their borders up until the rate of transmission is below 1, at which point there would not be sufficient vaccine-preventable harm to justify retaining a vaccine. When a government reaches the limit of national partiality, it should release vaccines for other countries. -/- We also argue against two other recent proposals. Distributing a vaccine proportional to a country's population mistakenly assumes that equality requires treating differently situated countries identically. Prioritizing countries according to the number of front-line health care workers, the proportion of the population over 65, and the number of people with comorbidities within each country may exacerbate disadvantage and end up giving the vaccine in large part to wealthy nations. (shrink)

In response to commentators, we argue that whether waiving patent rights will meaningfully improve access to COVID-19 vaccines for low income and middle-income countries (LMICs), particularly in the short term, is an empirical matter. We also reject preferentially allocating vaccines to countries that hosted trials because doing so unethically favours those with research infrastructure, rather than those facing the worst burdens from COVID-19.

The essays in this volume were written to celebrate the sixtieth birthday of G. E. L. Owen, who by his essays and seminars on ancient Greek philosophy has made a contribution to its study that is second to none.

Sietske A.L. van Till and Eline M. Bunnik (2024) have recently expressed a concern about science miscommunication regarding human brain organoids. They worry that the mereological fallacy is often being committed when the possibility of brain organoid psychological capacities such as consciousness and intelligence are considered, especially by bioethicists discussing the moral status of human brain organoids. Focusing specifically on one psychological capacity, namely consciousness, this article begins with a brief introduction to van Till and Bunnik’s concern about the mereological (...) fallacy as it relates to brain organoids. It is then shown that whether the mereological fallacy is being committed depends on commitments in philosophy of mind about how consciousness relates to the brain and its neural mechanisms. This is demonstrated by appealing to two different example views about the ontology of consciousness embraced by J.J.C. Smart’s type identity theory and a version of hylomorphism. The article ends with a discussion of how neurobiological theories of consciousness can be intertwined with ontological commitments about consciousness that have significant implications for HBOs. An awareness of this can yield a philosophically informed application of neurobiological theories to the topic of whether HBOs could be conscious. (shrink)

In this contribution we investigate the conceptual coherence of penal substitution and its moral validity. After assessing two opposing modern contributions, we turn to Reformed and medieval scholasticism. This scholastic manoeuvre sheds additional light on the analytic questions at issue. Following Owen and Scotus in their use of a relational analysis of guilt and its punishment, we argue that penal substitution is conceptually and morally coherent, albeit not univocally vis-à-vis ordinary punishment. Absent from the case of substitution is personal deservedness; (...) herein we follow Murphy. However, this leaves open the conceptual possibility of representative deservedness. (shrink)

In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role (...) of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM - whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part I of this article took up the first two questions. Part II will take up the second two questions. Question 3 deals with the question as to whether DSM-V should assume a conservative or assertive posture in making changes from DSM-IV. That question in turn breaks down into discussion of diagnoses that depend on, and aim toward, empirical, scientific validation, and diagnoses that are more value-laden and less amenable to scientific validation. Question 4 takes up the role of pragmatic consideration in a psychiatric nosology, whether the purely empirical considerations need to be tempered by considerations of practical consequence. As in Part 1 of this article, the general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances. (shrink)

After severe brain injury, one of the key challenges for medical doctors is to determine the patient’s prognosis. Who will do well? Who will not do well? Physicians need to know this, and families need to do this too, to address choices regarding the continuation of life supporting therapies. However, current prognostication methods are insufficient to provide a reliable prognosis. -/- Functional Magnetic Resonance Imaging (MRI) holds considerable promise for improving the accuracy of prognosis in acute brain injury patients. Nonetheless, (...) research on functional MRI in the intensive care unit context is ethically challenging. These studies raise several ethical issues that have not been addressed so far. In this article, Prof. Charles Weijer and his co-workers provide a framework for researchers and ethics committees to design and review these studies in an ethically sound way. (shrink)

Context The attitudes of medical professionals towards physician assisted dying have been widely discussed. Less explored is the level of agreement among physicians on the possibility of ‘rational suicide’—a considered suicide act made by a sound mind and a precondition of assisted dying legislation. Objective To assess attitudes towards rational suicide in a representative sample of senior doctors in England and Wales. Methods A postal survey was conducted of 1000 consultants and general practitioners randomly selected from a commercially available database. (...) The main outcome of interest was level of agreement with a statement about rational suicide. Results The corrected participation rate was 50%; 363 questionnaires were analysed. Overall 72% of doctors agreed with the possibility of rational suicide, 17% disagreed, and 11% were neutral. Doctors who identified themselves as being more religious were more likely to disagree. Some doctors who disagreed with legalisation of physician assisted suicide nevertheless agreed with the concept of rational suicide. Conclusions Most senior doctors in England and Wales feel that rational suicide is possible. There was no association with specialty. Strong religious belief was associated with disagreement, although levels of agreement were still high in people reporting the strongest religious belief. Most doctors who were opposed to physician assisted suicide believed that rational suicide was possible, suggesting that some medical opposition is best explained by other factors such as concerns of assessment and protection of vulnerable patients. (shrink)

This article examined the effects of body–object interaction (BOI) on semantic processing. BOI measures perceptions of the ease with which a human body can physically interact with a word's referent. In Experiment 1, BOI effects were examined in 2 semantic categorization tasks (SCT) in which participants decided if words are easily imageable. Responses were faster and more accurate for high BOI words (e.g., mask) than for low BOI words (e.g., ship). In Experiment 2, BOI effects were examined in a semantic (...) lexical decision task (SLDT), which taps both semantic feedback and semantic processing. The BOI effect was larger in the SLDT than in the SCT, suggesting that BOI facilitates both semantic feedback and semantic processing. The findings are consistent with the embodied cognition perspective (e.g.,, Perceptual Symbols Theory), which proposes that sensorimotor interactions with the environment are incorporated in semantic knowledge. (shrink)

Can dreams reveal insight into our cognitive abilities and aptitudes (i.e., “human intelligence”)? The relationship between dream production and trait-like cognitive abilities is the foundation of several long-standing theories on the neurocognitive and cognitive-psychological basis of dreaming. However, direct experimental evidence is sparse and remains contentious. On the other hand, recent research has provided compelling evidence demonstrating a link between dream content and new learning, suggesting that dreams reflect memory processing during sleep. It remains to be investigated whether the extent (...) of learning-related dream incorporation (i.e., the semantic similarity between waking experiences and dream content) is related to inter-individual differences in cognitive abilities. The relationship between pre–post sleep memory performance improvements and learning-related dream incorporation was investigated ( N = 24) to determine if this relationship could be explained by inter-individual differences in intellectual abilities (e.g., reasoning, short term memory (STM), and verbal abilities). The extent of dream incorporation using a novel and objective method of dream content analysis, employed a computational linguistic approach to measure the semantic relatedness between verbal reports describing the experience on a spatial (e.g., maze navigation) or a motor memory task (e.g., tennis simulator) with subsequent hypnagogic reverie dream reports and waking “daydream” reports, obtained during a daytime nap opportunity. Consistent with previous studies, the extent to which something new was learned was related ( r = 0.47) to how richly these novel experiences were incorporated into the content of dreams. This was significant for early (the first 4 dream reports) but not late dreams (the last 4 dream reports). Notably, here, we show for the first time that the extent of this incorporation for early dreams was related ( r = 0.41) to inter-individual differences in reasoning abilities. On the other hand, late dream incorporation was related ( r = 0.46) to inter-individual differences in verbal abilities. There was no relationship between performance improvements and intellectual abilities, and thus, inter-individual differences in cognitive abilities did not mediate the relationship between performance improvements and dream incorporation; suggesting a direct relationship between reasoning abilities and dream incorporation. This study provides the first evidence that learning-related dream production is related to inter-individual differences in cognitive abilities. (shrink)

Critique de la possibilité d'individus non-substantiels récurrents que G. E. L. Owen repère dans l'«Organon» d'Aristote. Soulevant le problème ontologique de l'un et du multiple, des entités particulières et des entités universelles chez Aristote, l'A. montre qu'un individu unique en nombre ne peut se reproduire périodiquement et que le statut modal des individus récurrents contredit la définition du sujet présent dans les «Catégories» . Conformément aux conditions de la ressemblance établies par Aristote dans les «Topiques», l'A. conclut à l'impossibilité d'individus (...) substantiels ou non-substantiels universels. (shrink)

Aristotle and the sea battle, by G. E. M. Anscombe.--Aristotle's different possibilities, by K. J. J. Hintikka.--On Aristotle's square of opposition, by M. Thompson.--Categories in Aristotle and in Kant, by J. C. Wilson.--Aristotle's Categories, chapters I-V: translation and notes, by J. L. Ackrill--Aristotle's theory of categories, by J. M. E. Moravcsik.--Essence and accident, by I. M. Copi.--Tithenai ta phainomena, by G. E. L. Owen.--Matter and predication in Aristotle, by J. Owens.--Problems in Metaphysics Z, chapter 13, by M. J. Woods.--The (...) meaning of agathon in the Ethics of Aristotle, by H. A. Prichard.--Agathon and eudaimonia in the Ethics of Aristotle, by J. L. Austin.--The final good in Aristotle's Ethics, by W. F. R. Hardie.--Aristotle on pleasure, by J. O. Urmson.--Bibliography (p. 335-41). (shrink)

Aristotle and the sea battle, by G. E. M. Anscombe.--Aristotle's different possibilities, by K. J. J. Hintikka.--On Aristotle's square of opposition, by M. Thompson.--Categories in Aristotle and in Kant, by J. C. Wilson.--Aristotle's Categories, chapters I-V: translation and notes, by J. L. Ackrill.--Aristotle's theory of categories, by J. M. E. Moravcsik.--Essence and accident, by I. M. Copi.--Tithenai ta phainomena, by G. E. L. Owen.--Matter and predication in Aristotle, by J. Owens.--Problems in Metaphysics Z, chapter 13, by M. J. Woods.--The (...) meaning of agathon in the Ethics of Aristotle, by H. A. Prichard.--Agathon and eudaimonia in the Ethics of Aristotle, by J. L. Austin.--The final good in Aristotle's Ethics, by W. F. R. Hardie.--Aristotle on pleasure, by J. O. Urmson.--Bibliography (p. 335-341). (shrink)

The Body–Object Interaction (BOI) variable measures how easily a human body can physically interact with a word's referent (Siakaluk, Pexman, Aguilera, Owen, & Sears, ). A facilitory BOI effect has been observed with adults in language tasks, with faster and more accurate responses for high BOI words (e.g., mask) than for low BOI words (e.g., ship; Wellsby, Siakaluk, Owen, & Pexman, ). We examined the development of this effect in children. Fifty children (aged 6–9 years) and a group of 21 (...) adults completed a word naming task with high and low BOI words. Younger children (aged 6–7 years) did not show a BOI effect, but older children (aged 8–9 years) showed a significant facilitory BOI effect, as did adults. Magnitude of children's BOI effect was related to age as well as reading skills. These results suggest that bodily experience (as measured by the BOI variable) begins to influence visual word recognition behavior by about 8 years of age. (shrink)

In Plato’s Parmenides 132a-133b, the widely known Third Man Paradox is stated, which has special interest for the history of logical reasoning. It is important for philosophers because it is often thought to be a devastating argument to Plato’s theory of Forms. Some philosophers have even viewed Aristotle’s theory of predication and the categories as inspired by reflection on it [Owen 1966]. For the historians of logic it is attractive, because of the phenomenon of self-reference that involves. Bocheński denies any (...) possibility of correct logical reasoning before Aristotle. In particular, he flatly declares of Plato that “correct logic we find none in his work” [1951, 15]. In this line, many papers have been written that call attention to the violation of a metalogical principle – the type rules – because of the Third Man Paradox. The problem of interpretation of the paradox raised many discussions, since the 50’s, and the literature devoted to this topic is today enormous. Nevertheless, many points in Plato’s reasoning remain obscure. Hitherto, it is commonly believed that the paradox was simply stated by Plato in his "Parmenides", but not actually solved. Even more, it is believed that it is hardly possible for Plato to have suggested a solution, because he confused the categories of substance and attribute. B. Russell has also argued that Plato violates in his arguments the restrictions imposed on language by the theory of logical types. This view is encouraged by the linguistic difficulties, which Plato has faced in his attempt to formulate an ontology of abstract entities, i.e. that in Greek language abstract and concrete terms are formally indistinguishable [Kneales 1984]. In this paper, we analyse the logical structure of the argument in an attempt to give a systematic consistent reconstruction of the text appealing to methods and concepts of modern logic and semantics. Already in 1954 G. Vlastos had noted in his seminal paper “The ‘Third Man’ Argument in the Parmenides” that “if any progress … is to be made at this juncture it must come from some advance in understanding the logical structure of the Argument”. Accordingly, our analysis is primarily focused on the line of logical reasoning, rather than the metaphysical underpinnings and philosophical implications of the paradox for Plato’s theory of Forms. We divide the Platonic text into three parts, presenting apparent thematic coherence: a) Formulation of the Third Man Paradox (132a-132b). The central issue of this part is a step-like generation of Forms that can continue ad infinitum. b) Discussion of the paradoxical situation (132b-c), by passing to the use of terminology echoing Eleatic philosophy. The concept of “thought” and the underlying semantics of Eleatic origin are central in this passage. c) Solution of the paradox (132d-133a). In our view, this part contains not only a resemblance regress, as most interpretators con-sider, but also the solution of the paradox by the introduction of a sound definition of the concept of “similarity”. We should note that the name ‘Third Man Paradox’ never occurs in Plato, who, strictly speaking, formulates a ‘Third Large Paradox’. The name ‘Third Man Paradox’ appears in the works of Aristotle and the commentators of the Peripatetic tradition. Later commentators have identified Aristotle’s Third Man with Plato’s Third Large Argument. In our paper, we also examine other testimonies about the Third Man Paradox found in the works of commentators in order to illuminate the logical structure of the argument. Although the vocabulary used in these versions is different, they do not affect its logical structure, but rather reveal different understandings by the ancient authors. These testimonies are divided into two main categories: those met in Neo-Platonic authors, notably in Proclus’ "Commentary on Plato’s Parmenides", and the versions of the Third Man Paradox found in texts of the Peripatetic tradition (Eudemus, Aristotle, Alexander). From our discussion, it becomes clear that the approaches to the paradox by the various scholars of antiquity are different, depending also on their participation in the one or the other campus of philosophical thought. We show that the Peripatetic authors are aware of the source of the paradox. However, the first scholar of antiquity who explicitly ascribes a solution to Plato seems to be Proclus. (shrink)