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 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 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)

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)

It is argued that ideas and theories often evolve into preconceptions of our perceptions. Such evolution is implicit in Heidegger's notion of truths of alethia. The description of this process holds implications for the traditional givenness of humans for themselves in terms of the changabllity of absolute presuppositions. Among the implications are 1. the insufficiency of the historical mode for explaining changes in human self-perception; 2. the inadequacy of radical subjectivism and environmentalism; 3. a radical contingency and complexity to the (...) course of human conceptualization; and 4. the awareness that human efforts can influence alterations in preconceptions. The influence of modern brain theory is subject to these conditions. (shrink)

L B Daniels; Some Comments on ‘Value in Education’ by Johanna Burgess1, Journal of Philosophy of Education, Volume 8, Issue 2, 30 May 2006, Pages 237–250, https.

The morally responsible practice of clinical medicine depends on many factors, the integrity of clinical judgment chief among them. Responsible clinical judgment requires that it be deliberative. The disciplines of the humanities, all of which contribute to clinical ethics—as the papers that follow illustrate—teach that deliberative reasoning includes critical self-awareness and self-scrutiny. Critical appraisal proves essential to achieving both. The papers in the 2013 Clinical Ethics number of the Journal provide distinctive critical appraisals of clinical judgment: concepts of race; narrative; (...) stewardship; and the Rule of Rescue. By becoming commonplace, such critical appraisals of clinical judgment become essential to clinical ethics. (shrink)

This paper introduces the 2011 number of the Journal on Clinical Ethics. Philosophical critical appraisal is essential for the success of philosophical analysis and argument in clinical ethics. To clear away conceptual underbrush, papers in this Clinical Ethics number of the Journal address genetic engineering, conscience-based objections to forms of health care, placebos, and preventing exploitation of patients to be recruited to become research subjects.

In Virgil's third eclogue, the goatherd Menalcas responds to his challenger Damoetas by offering as his wager in their contest of song a pair of embossed cups,caelatum diuini opus Alcimedontis, decorated with a pattern of vine and ivy. In the middle of this design, he says, are two figures. One is the astronomer Conon, and the other—at this point Menalcas, afflicted with a sudden loss of memory, professes to have forgotten the name of the second figure, and breaks off into (...) a question :quis fuit alter, | descripsit radio totum qui gentibus orbem, | tempora quae messor, quae curuus arator haberet?Various candidates for the identity of this second astronomer have been suggested, one of the most favoured being Eudoxus of Cnidus, whosePhaenomenahad been versified by the Hellenistic poet Aratus. In 1930 it was proposed by Léon Herrmann that Menalcas in fact answers his own question in his reference tocuruUS ARAToratEcl.3.42: the solution to Virgil's riddle is already written into the question, in the form of the anagram ofAratusconcealed within these two words. Strictly speaking, Hermann notes only that ‘Aratorau v. 42 évoque le nom d’Aratos’; he and later exponents of the theory tend to ignore the preceding ‘-us’—but there seems no reason to exclude it if an allusion to the Greek poet is to be seen in the two following syllables. (shrink)

Anagrams and syllabic wordplay of the kind championed by Frederick Ahl in his Metaformations have not always been favourably received by scholars of Latin poetry; I would hesitate to propose the following instance, were it not for the fact that its occurrence seems peculiarly apposite to the context in which it appears. That Roman poets were prepared to use such techniques to enhance the presentation of an argument by exemplifying its operation at a verbal level is demonstrated by the famous (...) passage of Lucretius in which the poet seeks to illustrate the tendency of semina … ardoris to create fire in wood by the literal presence of elements from the word for ‘fires’ in that denoting wood. A similar conception may underlie the association insinuated by the love elegists between amor and mors, suggesting that death is somehow ‘written into’ love: so Propertius declares laus in amore mori, while Tibullus appears to point to the lurking presence of death in the pursuit of love in the lines interea, dum fata sinunt, iungamus amores: | iam ueniet tenebris Mors adoperta caput – so swift and unexpected is death's approach that it is already present in aMOReS in the preceding line. Ovid's awareness of the poetic potential of this kind of play is fully exhibited in his celebrated account of Echo and Narcissus in Metamorphoses 3, where the subject matter gives the poet ample scope to exploit the humorous and pathetic possibilities afforded by Echo's fragmented repetitions of the frustrated entreaties of her beloved. (shrink)

Au moment où il entreprend d'élaborer une preuve de l'existence de Dieu dont la force soit susceptible d'entraîner l'adhésion de tout esprit qui entend le sens des mots utilisés, s. Anselme veut faire appel à une notion de Dieu admise par tout le monde. Que signifie en effet ce mot Dieu, sinon, ce par rapport à quoi on ne saurait rien concevoir de plus parfait? La notion de Dieu et celle de la perfection la plus grande possible sont done, à (...) ses yeux, si intimement unies qu'on peut les employer l'une pour l'autre. Penser Dieu et penser 1'être le plus parfait possible, ce serait une seule et même chose. (shrink)

The papers in the 2010 “Clinical Ethics” number of the Journal of Medicine and Philosophy explore issues along La Frontera, the borders and boundaries of clinical ethics. The first three papers in this “Clinical Ethics” number of the Journal explore borders and boundaries drawn within clinical ethics, concerning the moral standing of complementary and alternative medicine, palliative sedation, and induced abortion and feticide. The fourth and fifth papers explore the borders and boundaries between research ethics and clinical ethics.

Recent work in the ontology of music suggests that we will avoid confusion if we distinguish between two kinds of question that are typically posed in music ontology. Thus, a distinction has been made between fundamental ontology and higher-order ontology. The former addresses questions about the basic metaphysical options from which ontologists choose. For instance, are musical works types, indicated types, classes of particulars, or some other kind of entity? Higher-order ontology addresses the question of what lies ‘at the centre’ (...) of a specific form of music, such as rock or jazz—or perhaps classical music. The argument of this essay is, first, that a close examination of the best efforts in two of these territories shows that they have the effect of pressing the music in each sphere into implausible Procrustean beds. Second, it is argued that the general question that higher-order ontologies pose, that is, ‘What work-kind is it that lies at the centre of a given kind of music, F?’ is a question based on a mistaken but seductive assumption, namely that the concept of the work of F has actual application. In fact, these concepts—upon which higher-order ontology depends—are mere artefacts of philosophy. The question is also addressed why the assumption is so seductive. Finally, the question finally is posed about what, if anything, is implied from the foregoing about the traditional ontology of classical music. (shrink)

Important features of the self-concept can be located outside of the individual and inside close or related others. The authors use this insight to reinterpret data previously said to support the empathy-altruism model of helping, which asserts that empathic concern for another results in selflessness and true altruism. That is, they argue that the conditions that lead to empathic concern also lead to a greater sense of self-other overlap, raising the possibility that helping under these conditions is not selfless but (...) is also directed toward the self. In 3 studies, the impact of empathic concern on willingness to help was eliminated when oneness--a measure of perceived self-other overlap--was considered. Path analyses revealed further that empathic concern increased helping only through its relation to perceived oneness, thereby throwing the empathy-altruism model into question. The authors suggest that empathic concern affects helping primarily as an emotional signal of oneness. (shrink)

Central concepts and consensus views in clinical ethics are marked by instability. The papers in this number of the Journal take up two such central concepts, quality of life and moral status, and two such consensus views, that germ-line gene transfer should not be undertaken for the purposes of enhancement of human traits and that the ethical obligation of physicians to treat HIV infected patients rests on consent of the physician. One outcome of these philosophical investigations is that these two (...) concepts and consensus views are less stable than one might have thought. I explore the possibility of generalizing this outcome in a reflection on clinical ethics as the management of instability and incompleteness, including the instability and incompleteness of clinical ethics itself. In the course of this reflection I liken clinical ethics to abstract expressionism in mid-twentieth century Western art. (shrink)

The Society of Jesus sprang from the devout faith of a sidelined soldier who traded in his weapons to form a militant order of Catholic Reformers sworn to serve the Papacy as missionary soldiers of Christ. Specialization in education led Jesuits to roles as theologians of the 16th Century, including as members of the School of Salamanca, whose Jesuit members mostly took pro-market positions on free enterprise. One learned Jesuit in particular deviated from his order’s default position of papal dirigisme (...) to become an enemy of the state. (shrink)

S'il est un point que les réflexions contemporaines sur le temps ont mis en relief et inscrit profondément dans notre conscience, c'est que l'avenir qu'on espère dépend directement du présent qu'on réalise. Telle est notre attitude en face du présent, telle elle sera inéluctablement en face de l'avenir; et donc l'avenir lui-même, puisque ce dernier n'est rien sinon un présent caché encore, au cœur d'un présent déjà actuel, et explicite. Il est en effet de l'essence même de notre condition humaine (...) d'avoir un présent structuré et comme stratifié. Certes on peut imaginer le présent comme un point sans épaisseur, comme la limite évanescente entre un segment de ligne qui marque le passé à jamais révolu, et l'avenir qui se meut vers nous pour basculer inexorablement vers le non-être en franchissant ce présent. Mais cette image, utile pour bien des tâches, ne correspond d'aucune manière à la réalité vivante de la conscience humaine et des activités qui lui sont propres. Nous sommes dans le présent ce que nous sommes et ce que, en un sens, nous croyons pouvoir dire que nous avons été. Une grande partie de ce que nous appelons le passé, notre passé personnel et sans doute notre passé spécifique, est présent, non seulement à titre de souvenir, pouvant être, ou non, évoqué, mais à titre de schéma dynamique modifiant notre être-au-monde, notre présente réaction au réel le plus réel, à la situation où nous avons à déployer notre activité. (shrink)

Virgil's fourth Eclogue is one of the most quoted, adapted and discussed works of classical literature. This study traces the fortunes of Eclogue 4 in the literature and art of the Italian Renaissance. It sheds new light on some of the most canonical works of Western art and literature, as well as introducing a large number of other, lesser-known items, some of which have not appeared in print since their original publication, while others are extant only in manuscript. Individual chapters (...) are devoted to the uses made of the fourth Eclogue in the political panegyric of Medici Florence, the Venetian Republic and the Renaissance papacy, and to religious appropriations of the Virgilian text in the genres of epic and pastoral poetry. The book also investigates the appearance of quotations from the poem in fifteenth- and sixteenth-century fresco cycles representing the prophetic Sibyls in Italian churches. (shrink)

Since the role of the Asian countries is increasing in the modern world, their philosophical traditions attract more and more attention. Due to this trend, a more complete panoramic view of the development of world philosophy as a whole is accessible, and it has become possible to understand that any constructions of the human mind that have arisen in a particular cultural field of experience cannot be regarded as exemplary and absolute. The researchers of Asian philosophies concentrate mostly on studying (...) the texts of individual thinkers. As a rule, they do not set themselves the task of examining these texts from the point of view of intercultural interactions and transformations of significant ideas and concepts in various cultural and historical contexts, defining the direction and mechanisms of cultural borrowing, as well as revealing new approaches and growth points. To achieve these goals, the research should focus at the problem of the self-determination and development of philosophy as a separate science in non-Western cultures, which are based on intellectual traditions with different origin than Greek and Judeo-Christian traditions. This article deals with the consideration of some topics that elucidate the features of the development of philosophical science in Japan, including the emergence of the concept of “philosophy” in this country, the definition of its subject, the formation of philosophical terminology, and various interpretations of what the term “Japanese philosophy” means. The author pays special attention to the characteristic of the main periods of progress of Japanese philosophical thought. In the conclusion, the author argues that the most important characteristic feature of the Japanese philosophy is its involvement in intercultural dialogue throughout its history. (shrink)