This paper defends a counterfactual account of explanation, according to which successful explanation requires tracing patterns of counterfactual dependence of a special sort, involving what I call active counterfactuals. Explanations having this feature must appeal to generalizations that are invariant--stable under certain sorts of changes. These ideas are illustrated by examples drawn from physics and econometrics.

Early intervention aims to identify children or families at risk of poor health, and take preventative measures at an early stage, when intervention is more likely to succeed. EI is concerned with the just distribution of “life chances,” so that all children are given fair opportunity to realize their potential and lead a good life; EI policy design, therefore, invokes ethical questions about the balance of responsibilities between the state, society, and individuals in addressing inequalities. We analyze a (...) corpus of EI policy guidance to investigate explicit and implicit ethical arguments about who should be held morally responsible for safeguarding child health and well-being. We examine the implications of these claims and explore what it would mean to put the proposed policies into practice. We conclude with some remarks about the useful role that philosophical analysis can play in EI policy development. (shrink)

When research concludes, post-trial access to the trial intervention or standard healthcare can be crucial for participants who are ill such as those in resource-poor countries with inadequate healthcare, British participants testing ‘last-chance drugs’ unavailable on the National Health Service and underinsured US participants. Yet, many researchers are unclear about their obligations regarding the post-trial period, and many research ethics committees do not know what to require of researchers. Consequences include participants who reasonably expect but lack PTA to the (...) trial intervention, unplanned financial liabilities for NHS Trusts forced to fund this, negative press and potential to undermine public trust.1–3,iOne reason for the lack of clarity is controversy over whether and when participants should have access, after the study, to the study intervention. At one extreme is the view that continued access should be ensured when the intervention has benefited the participant or when it has proven safe and effective for the participant population, irrespective of the cost and burden of ensuring continued access. At the other extreme is the view that continued access need never be provided so long as non-availability of the study intervention post-trial was adequately disclosed when participants were invited to participate.6 There is also disagreement about when poststudy access to the study intervention should be considered beneficial for participants. The spectrum ranges from the view that the intervention should be regarded as beneficial for a proposed use only after the …. (shrink)

Emotion-Focused Training for Emotion Coaching is based on Emotion-focused Therapy findings and was developed to help participants deepen their emotional skills. The goal was to examine the efficacy of a 12-week EFT-EC group program the level of emotion intelligence, self-compassion and self-criticism in a student population. A quasi-experiment with no control group was conducted with pre- and post-measurements using The Self-compassion scale, the Forms of Self-Criticising/attacking & Self-Reassuring Scale, and the Trait Emotional Intelligence Questionnaire – short form. The EFT-EC participants (...) were128 students. The EFT-EC intervention had a significant effect on self-criticism and self-control latent scores as reported at post-measurement. The structural equation model with latent variables was not an adequate fit for the rest of the subscales. These results are promising and suggest that interventions intended to enhance emotion skills can also reduce self-criticism even when not directly addressing it. (shrink)

Minors are generally considered incompetent to provide legally binding decisions regarding their health care, and parents or guardians are empowered to make those decisions on their behalf. Parental authority is not absolute, however, and when a parent acts contrary to the best interests of a child, the state may intervene. The best interests standard is the threshold most frequently employed in challenging a parent''s refusal to provide consent for a child''s medical care. In this paper, I will argue that the (...) best interest standard provides insufficient guidance for decision-making regarding children and does not reflect the actual standard used by medical providers and courts. Rather, I will suggest that the Harm Principle provides a more appropriate threshold for state intervention than the Best Interest standard. Finally, I will suggest a series of criteria that can be used in deciding whether the state should intervene in a parent''s decision to refuse medical care on behalf of a child. (shrink)

Non-reductive interventionist theories of causation and methodologies of causal reasoning embedded in that theoretical framework have become increasingly popular in recent years. This paper argues that one variant of an interventionist account of causation, viz. the one presented, for example, in Woodward (2003 ), is unsuited as a theoretical fundament of interventionist methodologies of causal reasoning, because it renders corresponding methodologies incapable of uncovering a causal structure in a finite number of steps. This finding runs counter to Woodward's own assessment (...) and to other recent studies which presume that Woodward's version of interventionism is effectively applicable to uncover causal structures, e.g. Campbell (2007 ) or Shapiro and Sober (2007 ). (shrink)

This paper explores the impacts of neurological intervention on selfhood with reference to recipients’ claims about changes to their self-understanding following Deep Brain Stimulation for treatment of Parkinson’s Disease. In the neuroethics literature, patients’ claims such as: “I don’t feel like myself anymore” and “I feel like a machine”, are often understood as expressing threats to identity. In this paper I argue that framing debates in terms of a possible threat to identity—whether for or against the proposition, is mistaken (...) and occludes what is ethically salient in changes from DBS. Rather, by adopting a relational narrative approach to identity and autonomy, I show that the ethically salient issue from DBS is impacts on autonomous agency—whether one’s actions and beliefs are one’s own, and how DBS may hinder, or foster, embodied, relational autonomy competences. This approach recognizes that if sufficiently significant, impacts on autonomy competences may pose a threat to one’s ability to contribute to the process of authoring one’s own life and so pose a threat to identity formation. I argue this approach resolves the confusion in the literature about whether and how DBS threatens identity and provides a complex picture of how DBS may affect selfhood by disrupting narrative identity formation and revision, distorting agency and/or undermining autonomy. (shrink)

Meek and Glymour use the graphical approach to causal modeling to argue that one and the same norm of rational choice can be used to deliver both causal-decision-theoretic verdicts and evidential-decision-theoretic verdicts. Specifically, they argue that if an agent maximizes conditional expected utility, then the agent will follow the causal decision theorist’s advice when she represents herself as intervening, and will follow the evidential decision theorist’s advice when she represents herself as not intervening. Since Meek and Glymour take no stand (...) on whether agents should represent themselves as intervening, they provide more general advice than standard causal decision theorists and evidential decision theorists. But I argue here that even Meek and Glymour’s advice is not sufficiently general. This is because their advice is not sensitive to the distinct ways in which agents can fail to intervene, and there are decision-making contexts in which agents can reasonably have non-extreme confidence that they are intervening. I then show that the most natural extension of Meek and Glymour’s framework fails, but offer a generalization of my “Interventionist Decision Theory” that does not suffer from the same problems. (shrink)

Stepping away from a normocentric understanding of autism goes beyond questioning the supposed lack of social motivation of autistic people. It evokes subversion of the prevalence of intellectual disability even in non-verbal autism. It also challenges the perceived purposelessness of some restricted interests and repetitive behaviors, and instead interprets them as legitimate exploratory and learning-associated manifestations.

Spillover occurs when one environmentally sustainable behaviour leads to another, often initiated by a behaviour change intervention. A number of studies have investigated positive and negative spillover effects, but empirical evidence is mixed, showing evidence for both positive and negative spillover effects, and lack of spillover altogether. Environmental identity has been identified as an influential factor for spillover effects. Building on identity process theory the current framework proposes that positive, negative, and a lack of spillover are determined by perceived (...) threat of initial behaviour and identity process mechanisms evaluating the behaviour. It is proposed, that an environmental behaviour change intervention may threaten one’s existing identities, leading to either (a) integration, (b) compartmentalisation, or (c) conflict between one’s environmental identity and non-environmental identities. Initial evidence for the proposed framework is based on a field intervention which included a meat reduction programme in a canteen of a medium size private sector company. Semi-structured interviews and an explorative visualisation method that aimed at assessing identity change were implemented with thirteen employees (i.e. intervention participants) before and after the intervention. The qualitative data was analysed by using thematic analysis via NVivo12. Results of the visualisation task and interview method provided initial evidence of direct and indirect positive contextual spillover effects, with comparatively less evidence a lack of spillover and a relative absence of reported negative spillover. This paper provides a novel theoretical approach, centred on identity process theory to enhance understanding of positive spillover, negative spillover, and the lack of spillover. (shrink)

This article outlines the emergence of ABA (Applied Behaviour Analysis) in the mid-20th century, and the current popularity of ABA in the anglophone world. I draw on the work of earlier historians to highlight the role of Ole Ivar Lovaas, the most influential practitioner of ABA. I argue that reception of his initial work was mainly positive, despite concerns regarding its efficacy and use of physical aversives. Lovaas’ work, however, was only cautiously accepted by medical practitioners until he published results (...) in 1987. Many accepted the results as validation of Lovaas’ research, though both his methods and broader understanding of autism had shifted considerably since his early work in the 1960s. The article analyses the controversies surrounding ABA since the early 1990s, considering in particular criticisms made by autistic people in the ‘neurodiversity movement’. As with earlier critics, some condemn the use of painful aversives, exemplified in the campaign against the use of shock therapy at the Judge Rotenberg Center. Unlike earlier, non-autistic critics, however, many in this movement reject the ideological goals of ABA, considering autism a harmless neurological difference rather than a pathology. They argue that eliminating benign autistic behaviour through ABA is impermissible, owing to the individual psychological harm and the wider societal impact. Finally, I compare the claims made by the neurodiversity movement with those made by similar 20th- and 21st-century social movements. (shrink)

The aim of this study is to describe how hermeneutic photography and one application of hermeneutic photography in particular, namely the photo-instrument, can be used as a health care intervention that fosters meaning (re-)construction of mental illness experiences. Studies into the ways how patients construct meaning in illness narratives indicate that aesthetic expressions of experiences may play an important role in meaning making and sharing. The study is part of a larger research project devoted to understanding the photostories that (...) result from groups of psychiatric patients using the photo-instrument. Within a focused ethnography approach we employed a qualitative design of a single case study. Text analysis of photostories was combined with observational data. Data were analyzed using hermeneutic theory. Participant observations were used for triangulation and complementarity. The interaction and collaboration between health care professionals and patients in the context of a photo group emerged as core concept that underlies the photo-instrument. The interaction triggered a reframing of meaning in the patient’s illness narrative that offered new perspectives on positive identity growth. The role of visualizing meaning in images was found to lend a dynamic power to the process and triggered a dialectic between real life circumstances and imagination played out in the context of situated action. The findings suggest that a positive reframing of meaning in illness narratives is facilitated by the photo-instrument. (shrink)

This article is a feminist intervention into the ways that disability is researched and represented in philosophy at present. Nevertheless, some of the claims that I make over the course of the article are also pertinent to the marginalization in philosophy of other areas of inquiry, including philosophy of race, feminist philosophy more broadly, indigenous philosophies, and LGBTQI philosophy. Although the discipline of philosophy largely continues to operate under the guise of neutrality, rationality, and objectivity, the institutionalized structure of (...) the discipline implicitly and explicitly promotes certain ontologies, epistemologies, and methodologies as bona fide philosophy, while casting the ontologies, epistemologies, and methodologies of marginalized philosophies as mere simulacra of allegedly fundamental ways of knowing and doing philosophy and thus rendering these marginalized philosophies more or less expendable. This article is designed to show that legitimized philosophical discourses are vital mechanisms in the problematization of disability. (shrink)

Criminologists have long acknowledged the link between a number of cognitive deficits, including low intelligence and impulsivity, and crime. A new wave of research has demonstrated that pharmacological intervention can restore or improve cognitive function, particularly executive function, and restore neural plasticity. Such restoration and improvement can allow for easier acquisition of new skills and as a result, presents significant possibilities for the criminal justice system. For example, studies have shown that supplements of Omega-3, a fatty acid commonly found (...) in food such as tuna, can decrease frequency of violent incidents in an incarcerated population. Research has also begun to explore the use of selective serotonin reuptake inhibitors to reduce impulsivity in some violent offenders. However, there are significant legal and ethical implications when moving from dietary supplements to prescription pharmaceuticals and medical devices for cognitive intervention. This paper will explore the legal and ethical issues surrounding the use of pharmacological intervention on prisoners as an effort to reduce crime and recidivism. (shrink)

The orthodox conception of human rights holds that human rights are moral rights possessed by all human beings simply in virtue of their humanity. In recent years, advocates of a 'political' conception of human rights have criticized this view on the grounds that it overlooks the distinctive political function performed by human rights. This article evaluates the arguments of two such critics, John Rawls and Joseph Raz, who characterize the political function of human rights as that of potential triggers for (...) intervention by one society against another. (shrink)

Recent years have seen growing interest in modifying interventionist accounts of causal explanation in order to characterise noncausal explanation. However, one surprising element of such accounts is that they have typically jettisoned the core feature of interventionism: interventions. Indeed, the prevailing opinion within the philosophy of science literature suggests that interventions exclusively demarcate causal relationships. This position is so prevalent that, until now, no one has even thought to name it. We call it “intervention puritanism” (I-puritanism, for short). In (...) this paper, we mount the first sustained defence of the idea that there are distinctively noncausal explanations which can be characterized in terms of possible interventions; a position we call “intervention liberalism” (I-liberalism, for short). While many have followed James Woodward (2003) in committing to I-puritanism, we trace support for I-liberalism back to the work of Jaegwon Kim (1974). Furthermore, we analyse two recent sources of scepticism regarding I-liberalism: debate surrounding mechanistic constitution; and attempts to provide a monistic account of explanation. We show that neither literature provides compelling reasons for adopting I-puritanism. Finally, we present a novel taxonomy of available positions upon the role of possible interventions in explanation: weak causal imperialism; strong causal imperialism; monist intervention puritanism; pluralist intervention puritanism; monist intervention liberalism; and finally, the specific position defended in this paper, pluralist intervention liberalism. (shrink)

Intervention studies with developmental samples are difficult to implement, in particular when targeting demographically diverse communities. Online studies have the potential to examine the efficacy of highly scalable interventions aimed at enhancing development, and to address some of the barriers faced by underrepresented communities for participating in developmental research. During the COVID-19 pandemic, we executed a fully remote randomized controlled trial language intervention with third and fourth grade students from diverse backgrounds across the United States. Using this as (...) a case study, we discuss both challenges and solutions to conducting an intensive online intervention through the various phases of the study, including recruitment, data collection, and fidelity of intervention implementation. We provide comprehensive suggestions and takeaways, and conclude by summarizing some important tradeoffs for researchers interested in carrying out such studies. (shrink)

Background: Previous systematic review indicated the prevalence of prenatal anxiety as 14–54%. Pregnant women are a high-risk population for COVID-19. However, the prevalence of anxiety symptoms and related factors is unknown in Chinese pregnant women during COVID-19 outbreak.Objective: To investigate the prevalence of anxiety symptoms and the related factors in Chinese pregnant women who were attending crisis intervention during the COVID-19 pandemic.Methods: The data of this cross-sectional study were collected in about 2 months. Data analysis was performed from April (...) to May 2020. Participants completed a set of questionnaires via the Wechat Mini-program before starting the online self-help crisis intervention for COVID-19 epidemic. A total of 2,120 Chinese pregnant women who were attending a self-help crisis intervention participated in this study. A survey was developed to address possible stress-related factors in pregnant women during the COVID-19 outbreak, including demographic, socioeconomic, and pregnancy-related factors, as well as COVID-19 related factors. Generalized Anxiety Disorder-7 scale and the 10-item perceived stress scale were, respectively, employed to measure anxiety and stress-related factors.Results: A total of 21.7% of pregnant women reported at least mild anxiety, and only 82 women reported moderate to severe anxiety. Factors associated with at least mild anxiety included living in Hubei province, nobody providing everyday life support, pelvic pain or vaginal bleeding, and higher perceived stress. Having relatives or neighbors with a diagnosis of COVID-19 was not associated with anxiety.Conclusions and Relevance: Our findings indicate that evaluation and intervention for maternal and infant health are necessary in pregnant women with anxiety during COVID-19 epidemic, especially those with higher perceived stress, less everyday life support, or vaginal bleeding. Interactions among these related medical, social and psychological factors need to be investigated in future studies. (shrink)

The overarching issue addressed in Catia Faria’s Animal Ethics in the Wild: Wild Animal Suffering and Intervention in Nature is ‘the problem of wild animal suffering in nature: Ought we to prevent,...

De Marco and colleagues claim that the standard account of invasiveness as commonly encountered ‘…does not capture all uses of the term in relation to medical interventions1 ’. This is open to challenge. Their first example is ‘non-invasive prenatal testing’. Because it involves puncturing the skin to obtain blood, De Marco et al take this as an example of how an incision or insertion is not sufficient to make an intervention invasive; here is a procedure that involves an incision, (...) but it is regarded as non-invasive. However, this ignores the context, and the term should really be understood in reference to the fetus. It is hard to believe healthcare professionals regard taking blood to measure, for example, ferritin levels as invasive but taking blood to look for fragments of fetal DNA as not. If anyone uses the term thinking it is not invasive to the mother, the solution would be to call it invasive, not redefine what is invasive. De Marco and colleagues’ second example is describing electroconvulsive therapy (ECT) as invasive. However, this is not borne out by their referenced papers. The first cited source is about non-invasive brain stimulation2 and only contains a single sentence about ECT. This sentence may suggest that their view is that ECT …. (shrink)

In Humanitarian Identity and the Political Sublime, Ashmita Khasnabish unites Amartya Sen's concept of pluralistic identity with Sri Aurobindo's philosophy of the "religion of human unity," where the European and Western philosophy of Enlightenment meets the East/India/Bengali intellectual and spiritual thought. The resulting neo-Enlightenment philosophy of identity incorporates Teresa Brennan's theory of the "transmission of affect" and the Relational Cultural Theory, culminating in a discussion of the postcolonial literary texts of Rushdie and Kincaid.

Introduced in 2007 by the Nuffield Council on Bioethics, the intervention ladder has become an influential tool in bioethics and public health policy for weighing the justification for interventions and for weighing considerations of intrusiveness and proportionality. However, while such considerations are critical, in its focus on these factors, the ladder overemphasises the role of personal responsibility and the importance of individual behaviour change in public health interventions. Through a study of vaccine hesitancy and vaccine mandates among healthcare workers, (...) this paper investigates how the ladder obscures systemic factors such as the social determinants of health. In overlooking these factors, potentially effective interventions are left off the table and the intervention ladder serves to divert attention away from key issues in public health. This paper, therefore, proposes a replacement for the intervention ladder—the intervention stairway. By broadening the intervention ladder to include systemic factors, the stairway ensures relevant interventions are not neglected merely due to the framing of the issue. Moreover, it more accurately captures factors influencing individual health as well as allocations of responsibility for improving these factors. (shrink)

In our experience, public health practitioners seeking to address a health problem often have just two very basic questions about the law: how can I use the law to create new interventions, or improve existing ones, to protect the public’s health; and will the law prevent me from successfully implementing certain interventions? In this way, the law is seen as either an opportunity for intervention to affect a public health problem, or an obstacle to enacting or implementing a desired (...) intervention.In addition, because some public health practitioners may not fully understand the intricacies of a given legal area, some possible obstacles to intervention may be either real or perceived. A real legal obstacle is not necessarily an insurmountable one, but it does have genuine legal force. A perceived obstacle has little, if any, true legal application to a given kind of intervention. (shrink)

The most common theoretical approaches to defining mental disorder are naturalism, normativism, and hybridism. Naturalism and normativism are often portrayed as diametrically opposed, with naturalism grounded in objective science and normativism grounded in social convention and values. Hybridism is seen as a way of combining the two. However, all three approaches share a common feature in that they conceive of mental disorders as deviations from norms. Naturalism concerns biological norms; normativism concerns social norms; and hybridism, both biological and social norms. (...) This raises the following two questions: (a) Are biological and social norms the only sorts of norms that are relevant to considerations of mental disorder? (b) Should addressing norm deviations continue to be a major focus of mental healthcare? This paper introduces several norms that are relevant to mental disorder beyond the biological and social. I argue that mental disorders often deviate from individual, well-being, and regulatory norms. I also consider approaches which question mental healthcare’s focus on addressing norm deviations in the first place, including the neurodiversity paradigm, social model of disability, and Mad discourse. Utilizing these critical approaches, I contend that whether mental health intervention is justified depends, in part, on the type of norm deviation being intervened upon. (shrink)

Observer intervention can be useful in preventing workplace harassment. This research extends the workplace harassment literature by using the Jones et al. ( 1984 ) stigma dimensions and related research (Summers et al., 2018 ; Weiner et al., 1988 ) to highlight differences and similarities between three forms of harassment (i.e., sexual, sexual orientation, religious) and their relations to observer intervention in workplace harassment incidents. Results from two studies reveal differences (controllability, stability, visibility) and similarities (disruptiveness, peril, bystander (...) efficacy, position authority) across forms of harassment in associations with observer intervention. Several differences across harassment of different religious subgroups (Atheists, Christians, Jews, Muslims) are also noted. We explore the implications of these findings and suggest future directions for research in the observer intervention and workplace harassment literature. (shrink)

Humanitarian intervention is a staple of current discussions about relations among states. Should powerful states interfere in the internal affairs of weaker ones, particularly those identified as failed states, in order to bring peace and stability when it is clear that the existing government can not do so? The concept is an old one, not a new one. European nations that engaged in overseas expansion generally justified their conquests on the grounds that they would seek to civilise and Christianise (...) the peoples whom they encountered. The most extensive discussion of the right ? or the responsibility ? of strong states to intervene on a humanitarian basis occurred among sixteenth- and seventeenth-century Spanish intellectuals who sought to justify the Spanish conquest of the Americas. The most famous of these figures was Francisco de Vitoria (1485?1546) whose De Indis outlined all of the arguments that could be raised for and against such intervention. His line of argument suggests that in the long run, intervention even with the best of intentions, may well lead to tragic consequences. It may even be hubris, the sin of those who would play God. (shrink)

Pediatric intervention principles help clinicians and health-care institutions determine appropriate responses when parents’ medical decisions place children at risk. Several intervention principles have been proposed and defended in the pediatric ethics literature. These principles may appear to provide conflicting guidance, but much of that conflict is superficial. First, seemingly different pediatric intervention principles sometimes converge on the same guidance. Second, these principles often aim to solve different problems in pediatrics or to operate in different background conditions. The (...) potential for convergence between intervention principles—or at least an absence of conflict between them—matters for both the theory and practice of pediatric ethics. This article builds on the recent work of a diverse group of pediatric ethicists tasked with identifying consensus guidelines for pediatric decision-making. (shrink)