IntroductionThose in mental health-related consumer movements have made clear their demands for humane treatment and basic civil rights, an end to stigma and discrimination, and a chance to participate in their own recovery. But theorizing about the politics of recognition, 'recognition rights' and epistemic justice, suggests that they also have a stake in the broad cultural meanings associated with conceptions of mental health and illness.ResultsFirst person accounts of psychiatric diagnosis and mental health care (shown here to represent 'counter stories' to (...) the powerful 'master narrative' of biomedical psychiatry), offer indications about how experiences of mental disorder might be reframed and redefined as part of efforts to acknowledge and honor recognition rights and epistemic justice. However, the task of cultural semantics is one for the entire culture, not merely consumers. These new meanings must be negotiated. When they are not the result of negotiation, group-wrought definitions risk imposing a revision no less constraining than the mis-recognizing one it aims to replace. Contested realities make this a challenging task when it comes to cultural meanings about mental disorder. Examples from mental illness memoirs about two contested realities related to psychosis are examined here: the meaninglessness of symptoms, and the role of insight into illness. They show the magnitude of the challenge involved - for consumers, practitioners, and the general public - in the reconstruction of these new meanings and realities.ConclusionTo honor recognition rights and epistemic justice acknowledgement must be made of the heterogeneity of the effects of, and of responses to, psychiatric diagnosis and care, and the extent of the challenge of the reconstructive cultural semantics involved. (shrink)

My thanks to Professors Hawkins and Szmukler for their thoughtful commentaries; I am particularly glad to see these scholars' valuable expertise directed toward what raises pressing issues not only for psychiatry but for contemporary society.Prof. Hawkins reasons that the use of forced feeding with some anorexia is justified, while emphasizing that this will occur rarely. She and I are in agreement that a mere handful of cases may be affected by our debate, since anecdotal evidence from clinical settings as well (...) as the studies Hawkins cites suggest that forced feeding will often be contraindicated. Still, the matter can equally well be cast hypothetically, as I implied in my earlier discussion. If forced feeding... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Sigewiza’s CureJennifer H. Radden (bio)Keywordsbiopsychosocial model, Hildegard of Bingen, associationist presuppositions, causation, power of suggestionSuzanne Phillips and Monique Boivin provide us with a sympathetic and compelling account of how the various elements of Hildegard’s sophisticated amalgam of ritual, magic, religion, dietary and other medical remedies, caring, and community, formed a seamless cure for Sigewiza’s affliction. Whether Hildgard’s approach reflects an early instance of the biopsychosocial “model” is a separate (...) claim, and may be challenged. But that her ministrations somehow effected a cure in this case seems—if not without a doubt, then very likely.Descriptions of Sigewiza’s condition, with its “clumping together of blackness and steam” caused by a “constellation of humors,” echo those of other medieval writers speaking of the humoral disorder of melancholia—at that time an encompassing category for a range of symptoms and syndromes that would today be assigned as different mental disorders. In these descriptions a variety of explanations for mental illness are quite typically introduced, including biological, social, supernatural, dietary and astrological ones. Phillips and Boivin take care to point out that Hildegard was not offering her remedies as alternatives, but rather proposing them as at work jointly and in a range of causal directions, exhibiting mutual influence, and feedback loops. As these authors say, multiple explanations “were often held simultaneously... in reference to a specific case” (Phillips and Boivin 2007, XX). And the factors that might cause the system to move out of balance are many: food, emotions, the soul, the mind, actions, and spiritual forces. So although deeds may cause bodily changes and their psychological accompaniments, “problems in the diet might affect the humors which would then have psychological effects, which demons might... use as opportunities to cause further trouble in the spirit, mind, and body” (Phillips and Boivin 2007, 365).What first struck me about Hildegard’s description of these many distinct causes interacting in complex ways is its compatibility with the multi-causal accounts of depression (and other mental disorder) frequently proffered in our own time. Daily habits (e.g., diet, sleep and exercise regimes), genetic predispositions, including biological states of fragility, external events, experiences of loss, social roles, and cultural beliefs—not to mention spontaneous recovery, and placebo effects—are all regularly implicated in the onset and course of conditions such as depression.Still, the similarity to these modern causal accounts may be somewhat misleading and we must beware of overstating it. In favoring and pressing on Hildegard’s holistic understanding, moreover, Phillips and Boivin perhaps insufficiently emphasize significant dissimilarities between Hildegard’s and our contemporary accounts.It is the interaction between the various elements making up Sigewiza’s cure that is most noteworthy [End Page 373] in this account, as Phillips and Boivin recognize. Yet that relationship itself seems in some ways surprisingly problematic: difficult for us to make sense of, and profoundly unmodern. Granted, we think we see the way these approaches probably influenced how Sigewiza felt and responded; but it is not so clear how Hildegard saw things. Like a lot of thinking in medieval times, Hildegard’s account provides us with glimpses of an understanding of the world that today looks prescientific and in that respect, almost precausal. (So, to the extent that the biopsychosocial model is understood as a causal one, the case of Sigewiza may exemplify it only inexactly.)It is not merely the range and type of causes, including supernatural and astrological ones, in accounts such as Hildegard’s that distinguish it from today’s analyses. It is also the reliance of such accounts on what seems to be a different metaphysics, one of associations or qualities.Associationist presuppositions can be found in accounts of health and illness from before, during, and long after, Hildegard’s time. Three examples of this pervasive, but puzzling thinking serve to illustrate. The melancholiac’s perceived swarthiness and darkened skin color—regularly noted from the time of the Greek physicians and an established part of the medieval iconography in images of melancholy—were not, or not primarily, thought to be a causal result of the darkness of his bile, as one might suppose. Instead, this coloring seems... (shrink)

The use of list-learning paradigms to explore false memory has revealed several critical findings about the contributions of similarity and relatedness in memory phenomena more broadly. Characterizing the nature of “similarity and relatedness” can inform researchers about factors contributing to memory distortions and about the underlying associative and semantic networks that support veridical memory. Similarity can be defined in terms of semantic properties, lexical/associative properties, or structural properties. By manipulating the type of list and its relationship to a non-studied critical (...) item, we review the effects of these types of similarity on veridical and false memory. All forms of similarity reviewed here result in reliable error rates and the effects on veridical memory are variable. The results across a variety of paradigms and tests provide partial support for a number of theoretical explanations of false memory phenomena, but none of the theories readily account for all results. (shrink)

Although ethics consultation is offered as a clinical service in most hospitals in the United States, few valid and practical tools are available to evaluate, ensure, and improve ethics consultation quality. The quality of ethics consultation is important because poor quality ethics consultation can result in ethically inappropriate outcomes for patients, other stakeholders, or the health care system. To promote accountability for the quality of ethics consultation, we developed the Ethics Consultation Quality Assessment Tool. ECQAT enables raters to assess the (...) quality of ethics consultations based on the written record. Through rigorous development and preliminary testing, we identified key elements of a quality ethics consultation, established scoring criteria, developed training guidelines, and designed a holistic assessment process. This article describes the development of the ECQAT,.. (shrink)

Neurosurgery for psychiatric disorders, also sometimes referred to as psychosurgery, is rapidly evolving, with new techniques and indications being investigated actively. Many within the field have suggested that some form of guidelines or regulations are needed to help ensure that a promising field develops safely. Multiple countries have enacted specific laws regulating NPD. This article reviews NPD-specific laws drawn from North and South America, Asia and Europe, in order to identify the typical form and contents of these laws and to (...) set the groundwork for the design of an optimal regulation for the field. Key challenges for this design that are revealed by the review are how to define the scope of the law, what types of regulations are required, and how to approach international harmonization given the potential migration of researchers and patients. (shrink)

Do people morally deserve what they earn in the market? More specifically, can people legitimately claim to deserve what they earn in the market in a way that counts against redistributing those earnings? As most liberal political philosophers do, I argue that the answer is no. Unlike many of these philosophers, however, I do not focus on whether or not people can be deserving. Instead, I focus on the relationship between social institutions and moral desert, and advance two claims. First, (...) in the market, desert claims are undermined by the very nature of the market even if people can be deserving in general. Second, part of the intuition that motivates accounts of moral desert may be explained instead with reference to a principle of fairness that demands the fulfillment of people's legitimate expectations as to what they will receive, and this principle places much weaker restrictions on redistributive policies than do claims of moral desert. (shrink)

Internet-based health research is increasing, and often offers financial incentives but fraudulent behavior by participants can result. Specifically, eligible or ineligible individuals may enter the study multiple times and receive undeserved financial compensation. We review past experiences and approaches to this problem and propose several new strategies. Researchers can detect and prevent Internet research fraud in four broad ways: through the questionnaire/instrument ; through participants' non-questionnaire data and seeking external validation through computer information,, and 4) through study design. These approaches (...) each have pros and cons, and raise ethical, legal, and logistical questions, given that ethical tensions can emerge between preserving the integrity of research vs. protecting the privacy and confidentiality of study respondents. While past discussions concerning the ethics of online research have tended to focus on the participants' ability to trust the researchers, needs now arise to examine researchers' abilities to trust the participants. This analysis has several critical implications for future practice, policy, and research. (shrink)

Prediction‐based processes appear to play an important role in language. Few studies, however, have sought to test the relationship within individuals between prediction learning and natural language processing. This paper builds upon existing statistical learning work using a novel paradigm for studying the on‐line learning of predictive dependencies. Within this paradigm, a new “prediction task” is introduced that provides a sensitive index of individual differences for developing probabilistic sequential expectations. Across three interrelated experiments, the prediction task and results thereof are (...) used to bridge knowledge of the empirical relation between statistical learning and language within the context of nonadjacency processing. We first chart the trajectory for learning nonadjacencies, documenting individual differences in prediction learning. Subsequent simple recurrent network simulations then closely capture human performance patterns in the new paradigm. Finally, individual differences in prediction performances are shown to strongly correlate with participants’ sentence processing of complex, long‐distance dependencies in natural language. (shrink)

Recent, well-publicized scandals, involving unethical conduct have rekindled interest in academic misconduct. Prior studies of academic misconduct have focussed exclusively on situational factors (e.g., integrity culture, honor codes), demographic variables or personality constructs. We contend that it is important to also examine how␣these classes of variables interact to influence perceptions of and intentions relating to academic misconduct. In a sample of 217 business students, we examined how integrity culture interacts with Prudence and Adjustment to explain variance in estimated frequency of (...) cheating, suspicions of cheating, considering cheating and reporting cheating. Age, integrity culture, and personality variables were significantly related to different criteria. Overall, personality variables explained the most unique variance in academic misconduct, and Adjustment interacted with integrity culture, such that integrity culture had more influence on intentions to cheat for less well-adjusted individuals. Implications for practice are discussed and future research directions are offered. (shrink)

This book brings philosophical aesthetics into a broader cultural interest in the fine arts and draws together the classics of the history of aesthetics, the mid-twentieth century or "Analytic" aesthetics, and late-twentieth century or "Continental" post-structuralist "theory.".

We examine the reverse mathematics and computability theory of a form of Ramsey's theorem in which the linear n-tuples of a binary tree are colored.

As scholars integrate empirical approaches to ethical questions in healthcare, relational autonomy theory must inform research design and change practice. Qualitative approaches are well suited to issues where patient values play a central role, and they can be combined with relational autonomy theory to investigate the factors influencing autonomy-rich experiences. This paper draws upon my experience conducting bioethics research related to clinical trial decision-making to develop a systematic method for applying relational autonomy as a theoretical lens to qualitative health research. (...) The resultant practical guide utilizes Susan Sherwin’s theory of relational autonomy and presents an empirical method responsive to autonomy-relevant questions. (shrink)

The ability to judge accurately whether or not an action can be accomplished successfully is critical for selecting appropriate response options that enable adaptive behaviors. Such affordance judgments are thought to rely on the perceived fit between environmental properties and knowledge of one's current physical capabilities. Little, however, is currently known about the ability of individuals to judge their own affordances following a stroke, or about the underlying neural mechanisms involved. To address these issues, we employed a signal detection approach (...) to investigate the impact of left or right hemisphere injuries on judgments of whether a visual object was located within reach while remaining still. Regarding perceptual sensitivity and accuracy in judging reachability, there were no significant group differences between healthy controls, right brain damaged and left brain damaged stroke patients. However, while healthy controls and RBD patients demonstrated a negative response criterion and thus overestimated their reach capability, LBD patients' average response criterion converged to zero, indicating no judgment tendency. Critically, the LBD group's judgment tendency pattern is consistent with previous findings in this same sample on an affordance judgment task that required estimating whether the hand can fit through apertures. Lesion analysis suggests that this loss of judgment tendency may be associated with damage to the left insula, the left parietal and middle temporal lobe. Based on these results, we propose that damage to the left ventro-dorsal stream disrupts the retrieval and processing of a stable criterion, leading to stronger reliance on intact on-line body-perceptive processes computed within the preserved bilateral dorsal network. (shrink)

The social conservatism of evangelical and fundamentalist groups includes their support for premarital sexual restraint, husband leadership, and father involvement. The authors explore whether religious conservatism affects work–family outcomes of men using the National Survey of Families and Households, 1988 and 1993 waves. The authors hypothesize that men from conservative households will make earlier transitions to adulthood, work fewer hours, and earn less money. Moreover, the belief in strong paternal involvement should lead religiously conservative men to spend more time in (...) housework and child care. Results show that conservative religious affiliation does not hasten the transition to adulthood among men. Current religious conservatism results in lower wages but not reduced work hours, and religious affiliation does not affect housework or child care. (shrink)

While experience often affords important knowledge and insight that is difficult to garner through observation or testimony alone, it also has the potential to generate conflicts of interest and unrepresentative perspectives. We call this tension the paradox of experience. In this paper, we first outline appeals to experience made in debates about access to unproven medical products and disability bioethics, as examples of how experience claims arise in bioethics and some of the challenges raised by these claims. We then motivate (...) the idea that experience can be an asset by appealing to themes in feminist and moral epistemology, distinguishing between epistemic and justice-based appeals. Next, we explain the concern that experience may be a liability by appealing to empirical work on cognitive biases and theoretical work about the problem of partial representation. We conclude with preliminary recommendations for addressing the paradox and offer several questions for future discussion. (shrink)

Patients who experience difficulty making medical decisions are often referred to as “ambivalent.” However, the current lack of attention to the nuances between a cluster of phenomena that resemble...

Hastings Center Report, Volume 52, Issue 1, Page 42-50, January/February 2022.

Communicative Understandings of Women's Leadership Development: From Ceilings of Glass to Labyrinth Paths, edited by Elesha L. Ruminski and Annette M. Holba, weaves the disciplines of communication studies, leadership studies, and women's studies to offer theoretical and practical reflection about women's leadership development in academic, organizational, and political contexts. This work claims a space for women's leadership studies and acknowledges the paradigmatic shift from discussing women's leadership using the glass ceiling to what Eagly and Carli identify as the labyrinth of (...) leadership. (shrink)

Anthropologists now openly acknowledge that social anthropology can no longer fulfill its traditional aim of providing holistic, objective representations of people of "exotic" cultures. After Writing Culture asks what theoretical and practical role contemporary anthropology can play in our increasingly unpredictable and complex world. With fourteen articles written by well-known anthropologists, the work explores some of the directions in which contemporary anthropology is moving, following the questions raised by the "writing culture" debates of the 1980s. Some of the chapters cover: (...) the concept of caste in Indian society, Scottish ethnography, how dreams are culturally conceptualized, representations of the family, theme parks and the anthropologist in Japan, people's place in the landscape of Northern Australia, and representing the identity of the New Zealand Maori. (shrink)

Traditional approaches to measurement of violations of academic integrity may overestimate the magnitude and severity of cheating and confound panic with planned cheating. Differences in the severity and level of premeditation of academic integrity violations have largely been unexamined. Results of a study based on a combined sample of business students showed that students are more likely to commit minor cheating offenses and engage in panic-based cheating as compared to serious and planned cheating offenses. Results also indicated there is a (...) significant interaction between severity and type of cheating. We hypothesized serious and planned cheating offenses would be related to justifications and found the largest differences were between panic and planned. Finally, panic and minor cheating were associated with two self-control-related personality traits. Implications for cheating research are discussed. (shrink)

The classical utilitarian legacy of Jeremy Bentham, J. S. Mill, James Mill, and Henry Sidgwick has often been charged with both theoretical and practical complicity in the growth of British imperialism and the emerging racialist discourse of the nineteenth century. But there has been little scholarly work devoted to bringing together the conflicting interpretive perspectives on this legacy and its complex evolution with respect to orientalism and imperialism. This volume, with contributions by leading scholars in the field, represents the first (...) attempt to survey the full range of current scholarly controversy on how the classical utilitarians conceived of 'race' and the part it played in their ethical and political programs, particularly with respect to such issues as slavery and the governance of India. The book both advances our understanding of the history of utilitarianism and imperialism and promotes the scholarly debate, clarifying the major points at issue between those sympathetic to the utilitarian legacy and those critical of it. (shrink)

IntroductionClassifying the ethical issues in clinical ethics consultations is important to clinical practice and scholarship. We conducted a systematic review to characterize the typologies used to analyze clinical ethics consultations.MethodsWe identified empirical studies of clinical ethics consultation that reported types of ethical issues using PubMed. We screened these articles based on their titles and abstracts, and then by a review of their full text. We extracted study characteristics and typologies and coded the typologies.ResultsWe reviewed 428 articles; 30 of the articles (...) fulfilled our inclusion criteria. We identified 27 unique typologies. Each typology contained five to 47 categories (mean = 18). The most common categories were do-not-attempt-resuscitation orders (19 typologies, 70 percent), capacity (18 typologies, 67 percent), withholding (18 typologies, 67 percent), withdrawing (17 typologies, 63 percent), and surrogate or proxy (16 typologies, 59 percent). Only seven (26 percent) of the typologies contained all five of the most common categories. The typologies we used to characterize clinical ethics consultations exhibit significant heterogeneity and several conceptual limitations. A common typology is needed whose development may require multi-institutional collaboration and could be facilitated by professional organizations. (shrink)

This paper investigates potential motivations for late adopting U.S. companies to begin disclosing environmental liability amounts in their financial statements. Based on a review of 10-K reports filed from 1998 through 2012, inclusive, we identified 55 firms initiating environmental liability disclosure over the period, with all but three doing so by 2006. Focusing on the disclosers up through 2006, we argue that the companies may have used the disclosure as a tool of impression management to avoid potential stakeholder mis-estimation of (...) previously undisclosed liability exposures. We first compute tests to identify firms that may have begun the disclosure due to (1) materiality and (2) concerns of having proprietary costs imposed upon them due to changes in their environmental media coverage and environmental performance, and we find very few cases where these explanations might hold. For the remaining companies, we compared their newly disclosed liability amount, on average, with the mean level of environmental liability being disclosed by other firms in the year prior to the sample companies’ initiation, and find that it is significantly smaller, thus supporting our impression management argument. Finally, we find that overall level of environmental liability amounts was consistently decreasing over the time frame examined, suggesting that earlier adoption would have made more sense. However, it may also explain why almost no new firms began disclosing after the mid-2000s. (shrink)

Controversy persists over the ethics of compensating research participants and providing posttrial benefits to communities in developing countries. Little is known about residents' views on these subjects. In this study, interviews about compensation and posttrial benefits from a hypothetical HIV vaccine trial were conducted in Uganda’s Rakai District. Most respondents said researchers owed the community posttrial benefits and research compensation, but opinions differed as to what these should be. Debates about posttrial benefits and compensation rarely include residents' views like these, (...) but future ones should. (shrink)

We investigated how two cues to contrast—beat gesture and contrastive pitch accenting—affect comprehenders' cognitive load during processing of spoken referring expressions. In two visual‐world experiments, we orthogonally manipulated the presence of these cues and their felicity, or fit, with the local (sentence‐level) referential context in critical referring expressions while comprehenders' task‐evoked pupillary responses (TEPRs) were examined. In Experiment 1, beat gesture and contrastive accenting always matched the referential context of filler referring expressions and were therefore relatively felicitous on the global (...) (experiment) level, whereas in Experiment 2, beat gesture and contrastive accenting never fit the referential context of filler referring expressions and were therefore infelicitous on the global level. The results revealed that both beat gesture and contrastive accenting increased comprehenders' cognitive load. For beat gesture, this increase in cognitive load was driven by both local and global infelicity. For contrastive accenting, this increase in cognitive load was unaffected when cues were globally felicitous but exacerbated when cues were globally infelicitous. Together, these results suggest that comprehenders' cognitive resources are taxed by processing infelicitous use of beat gesture and contrastive accenting to convey contrast on both the local and global levels. (shrink)