ObjectiveStress can play a role in the onset and exacerbation of psoriasis. Psychological interventions to reduce stress have been shown to improve psychological and psoriasis-related outcomes. This pilot randomised study investigated the feasibility of a brief interaction with a Paro robot to reduce stress and improve skin parameters, after a stressor, in patients with psoriasis.MethodsAround 25 patients with psoriasis participated in a laboratory stress task, before being randomised to either interact with a Paro robot or sit quietly for 30 min. (...) Raman spectroscopy and trans-epidermal water loss were measured at baseline, after the stressor and after the intervention as indexes of acute skin changes. Psychological variables, including self-reported stress and affect, were also measured at the three time-points.ResultsNo statistically significant differences between the two conditions were found for any of the outcomes measured. However, effect sizes suggest significance could be possible with a larger sample size. Changes in the psychological and Raman spectroscopy outcomes across the experimental session were found, indicating the feasibility of the procedures.ConclusionThis pilot study showed that a brief interaction with a Paro robot was a feasible intervention for patients with psoriasis, but future trials should broaden the inclusion criteria to try to increase recruitment rates. Studying people who are highly stressed, depressed or who are stress-responders may increase the power of the intervention to show effects using a longer-term intervention. (shrink)

Causation The question, “What is causation?” may sound like a trivial question—it is as sure as common knowledge can ever be that some things cause another; that there are causes and they necessitate certain effects. We say that we know that what caused the president’s death was an assassin’s shot. But when asked why, we … Continue reading Causation →.

In this series of lectures, a distinguished group of international contributors from a variety of disciplines debate the current position of the recent achievements in engineering and computer science. (Technology & Industrial).

This paper takes issue with those commentators of Heidegger's philosophy whose point of entry into his thinking is the inherited prejudices of others. It demonstrates that if prior judgments are suspended, so that Heidegger's texts are permitted to speak for themselves, the truth of his `position', more a wege than a static motionless point, gradually and inexorably begins to emerge. I take Pope Benedict's first encyclical, Deus Caritas Est, to draw the theological contours of a truly post-modern ethic. I then (...) hold up Heidegger's philosophy, as this is characterized principally though not exclusively in his lecture Der Satz Der Identität, to consider possible symmetries. Finally I offer an answer to the question: does Heidegger's thought have ethical consequences? (shrink)

Philosophy of Medicine provides a fresh and comprehensive treatment of the topic. It offers a novel theory of the nature of medicine, and proposes a new attitude to medicine, aimed at improving the quality of debates between medical traditions and facilitating medicine's decolonization.

This chapter explores the idea that causal inference is warranted if and only if the mechanism underlying the inferred causal association is identified. This mechanistic stance is discernible in the epidemiological literature, and in the strategies adopted by epidemiologists seeking to establish causal hypotheses. But the exact opposite methodology is also discernible, the black box stance, which asserts that epidemiologists can and should make causal inferences on the basis of their evidence, without worrying about the mechanisms that might underlie their (...) hypotheses. I argue that the mechanistic stance is indeed a bad methodology for causal inference. However, I detach and defend a mechanistic interpretation of causal generalisations in epidemiology as existence claims about underlying mechanisms. (shrink)

This paper puts forward a general framework for thought about human information processing. It is intended to avoid some of the problems of pipeline or stage models of function. At the same time it avoids the snare of supposing a welter of indefinitely many separate processes. The approach is not particularly original, but rather represents the common elements or presuppositions in a number of modern theories. These presuppositions are not usually explicit, however, and making them so reduces the danger of (...) slipping back into earlier modes of thought.The key point is to distinguish between persisting representations and the processes that translate one representation into another. Various classes or groups of persisting representations can be distinguished by the experimental treatments that interfere with them. In particular, there now seem to be several kinds of short-term or temporary storage, different from each other as well as from longterm memory; the translating processes also have several different modes or kinds. A particularly important aspect of the current position is that a model of this general type no longer requires some external agent to direct and control long sequences of behaviour. (shrink)

In this series of lectures, a distinguished group of international contributors from a variety of disciplines debate the current position of the recent achievements in engineering and computer science. (Technology & Industrial).

In myrecent book I have sought to define a notion of stability and to argue that it is a useful notion for biomedical and especially epidemiological research (Broadbent 2013, 56–80). In this paper I seek to defend the notion of stability against two possible objections: that it fails to be epistemically significant, and that it amounts to nothing more than empirical adequacy. I argue that stability is epistemically significant because to know that a hypothesis is stable is to know (...) something about the world, even if not the truth of the hypothesis. I argue that knowledge of stability of a hypothesis is distinct from knowledge of its approximate truth. And I argue that asserting the stability of a hypothesis is distinct from asserting its empirical adequacy, because it allows that the hypothesis may still be implicated in empirically inadequate claims, entailing only that if the hypothesis is so implicated, it will not be revised soon. (shrink)

In the literature on health, naturalism and normativism are typically characterized as espousing and rejecting, respectively, the view that health is objective and value-free. This article points out that there are two distinct dimensions of disagreement, regarding objectivity and value-ladenness, and thus arranges naturalism and normativism as diagonal opposites on a two-by-two matrix of possible positions. One of the remaining quadrants is occupied by value-dependent realism, holding that health facts are value-laden and objective. The remaining quadrant, which holds that they (...) are non-objective but value-free, is unexplored. The article endorses a view in the latter quadrant, namely, the view that health is a secondary property. The article argues that a secondary property framework provides the resources to respond to the deepest objections to a broadly Boorsean account of natural function, and so preserves the spirit, though not the letter, of that account. Treating health as a secondary property permits a naturalistic explanation—specifically, an evolutionary explanation—of the health concept, in terms of the assistance such a concept might have provided to the survival and reproduction of those organisms that had it. This provides the explanation, missing from Boorse's account, for the fact that function is determined with reference to the contribution to the goals of survival and reproduction, relative to the age of the sex of the species, rather than some other equally natural goals or reference classes. _1_ Introduction _2_ Two Ways to Disagree about Health _3_ Secondary Properties _4_ Health as a Secondary Property _5_ Conclusion. (shrink)

Nineteenth-century medical advances were entwined with a conceptual innovation: the idea that many cases of disease which were previously thought to have diverse causes could be explained by the action of a single kind of cause, for example a certain bacterial or parasitic infestation. The focus of modern epidemiology, however, is on chronic non-communicable diseases, which frequently do not seem to be attributable to any single causal factor. This paper is an effort to resolve the resulting tension. The paper criticises (...) the monocausal model of disease, so successful in the nineteenth century. It also argues that a multifactorial model of disease can only be satisfactory if it amounts to more than a mere rejection of the monocausal model. A third alternative, the contrastive model, is proposed and defended on the grounds that it links the notions of disease and of general explanation, while avoiding the philosophical naiveties and practical difficulties of the monocausal model. (shrink)

This paper takes it as a premise that a distinction between matters of fact and of law is important in the causal inquiry. But it argues that separating factual and legal causation as different elements of liability is not the best way to implement the fact/law distinction. What counts as a cause-in-fact is partly a legal question; and certain liability-limiting doctrines under the umbrella of “legal causation” depend on the application of factual-causal concepts. The contrastive account of factual causation proposed (...) in this paper improves matters. This account more clearly distinguishes matters of fact from matters of law within the cause-in-fact inquiry. It also extends the scope of cause-in-fact to answer some questions currently answered by certain doctrines of legal causation—doctrines that, it is argued, are more naturally seen as applications of our ordinary causal concept than as noncausal liability-limiting devices. (shrink)

When is a cause of a cause of an effect also a cause of that effect? The right answer is either Sometimes or Always . In favour of Always , transitivity is considered by some to be necessary for distinguishing causes from redundant non-causal events. Moreover transitivity may be motivated by an interest in an unselective notion of causation, untroubled by principles of invidious discrimination. And causal relations appear to add up like transitive relations, so that the obtaining of the (...) overarching relation is not independent of the obtaining of the intermediaries. On the other hand, in favour of Sometimes , often we seem not to treat events that are very spatiotemporally remote from an effect as its causes, even when connected to the effect in question by a chain of counterfactual or chance-raising dependence. Moreover cases of double prevention provide counterexamples to causal transitivity even over short chains. According to the argument of this paper, causation is non-transitive. Transitizing causation provides no viable account of causal redundancy. An unselective approach to causation may motivate resisting the distance counterexamples to transitivity, but it does not help with double prevention, and even makes it more intractable. The strongest point in favour of transitivity is the adding up of causal relations, and this is the point that extant non-transitizing analyses have not adequately addressed. I propose a necessary condition on causation that explains the adding up phenomenon. In doing so it also provides a unifying explanation of distance and double prevention counterexamples to transitivity. (shrink)

According to the evolutionary sceptic, the fact that our cognitive faculties evolved radically undermines their reliability. A number of evolutionary epistemologists have sought to refute this kind of scepticism. This paper accepts the success of these attempts, yet argues that refuting the evolutionary sceptic is not enough to put any particular domain of beliefs – notably scientific beliefs, which include belief in Darwinian evolution – on a firm footing. The paper thus sets out to contribute to this positive justificatory project, (...) underdeveloped in the literature. In contrast to a ‘wholesale’ approach, attempting to secure justification for all of our beliefs on the grounds that our belief-forming mechanisms evolved to track truth, we propose a ‘piecemeal’ approach of assessing the reliability of particular belief-forming mechanisms in particular domains. This stands in contrast to the more familiar attempt to transfer warrant obtained for one domain to another by showing how one is somehow an extension of the other. We offer a naturalist reply to the charge of circularity by appealing to reliabilist work on the problem of induction, notably Peter Lipton's distinction between self-certifying and non-self-certifying inductive arguments. We show how, for scientific beliefs, a non-self-certifying argument might be made for the reliability of our cognitive faculties in that domain. We call this strategy Humean Bootstrapping. (shrink)

Commonly we distinguish the strike of a match, as a cause of the match lighting, from the presence of oxygen, as a mere condition. In this paper I propose an account of this phenomenon, which I call causal selection. I suggest some reasons for taking causal selection seriously, and indicate some shortcomings of the popular contrastive approach. Chief among these is the lack of an account of contrast choice. I propose that contrast choice is often just the counterfactual scenario in (...) which the effect does not occur: I suggest that if c causes e , then if e hadn't occurred, c wouldn't have occurred. I argue that this is a necessary condition on causation which causes meet but mere conditions fail. (shrink)

What is medicine? One obvious answer in the context of the contemporary clinical tradition is that medicine is the process of curing sick people. However, this “curative thesis” is not satisfactory, even when “cure” is defined generously and even when exceptions such as cosmetic surgery are set aside. Historian of medicine Roy Porter argues that the position of medicine in society has had, and still has, little to do with its ability to make people better. Moreover, the efficacy of medicine (...) for improving population health has been famously doubted by historians and epidemiologists. The curative thesis demands that we have mostly been stupid, duped, or staggeringly hopeful, given that medicine has not until recently offered more than a handful of effective cures. I suggest, in this article, that the core medical competence is neither to cure, nor to prevent, disease, but to understand and to predict it. I argue that this approach does a better job than the curative thesis at explaining why not all medicine is concerned with curative efforts and that it enjoys historical support from the ancient entanglement of prophecy and medicine and from the fact that medicine thrived for centuries with almost no effective cures and continues to thrive today in various forms that are mostly without curative efficacy. I suggest that this approach grounds a fairer approach to alternative, traditional, and other medical practices, as well as some fresh lessons for the development of mainstream medicine. (shrink)

This dissertation is a collection of three papers – “Knowing Oneself for Others,” “Stereotype Threat and the Value of Self-Knowledge,” and “Self-Knowledge, Epistemic Work, and Injustice” – in which I address the connections between self-knowledge production and social inequality. I explain, using a variety of contemporary political and cultural examples, that marginalized individuals are more likely to be required to know certain things about themselves than socially privileged individuals, especially about those aspects of their lives and identities which are essential (...) to their being marginalized. I argue that this should make us rethink our basic understanding of epistemic injustice, which is typically thought of as involving the prevention of marginalized individuals from producing knowledge. More specifically, in “Knowing Oneself for Others,” I introduce the notion of “compulsory self-disclosure,” a social phenomenon in which an individual is forced to reveal things about themselves, often in ways that further contribute to their oppression. “Stereotype Threat and the Value of Self-Knowledge” addresses how self-ignorance can actually be desirable for individuals facing stereotype threat, and I argue that treating stereotype threat as an epistemic injustice issue can actually harm rather than help individuals in certain cases. Finally, in “Self-Knowledge, Epistemic Work, and Injustice,” I assess the reasoning behind the assumption that marginalized people are self-ignorant; I argue that we need to appreciate the central role that epistemic work plays in self-knowledge production to understand why the standard assumption about marginalized self-ignorance is misguided. Ultimately, I would have us think of self-knowledge production as not just epistemic work but as work that is often emotionally difficult and even metaphysically transformative – coming to have self-knowledge in certain ways can quite literally change who you are. In light of this, the overarching aim of this work is to argue for there being an inextricable link between an individual’s knowledge of themselves and their social status, as well as to discourage readers from thinking of the production of self-knowledge as inherently desirable or as a wholly epistemic issue. (shrink)

AimsThe aim of this study was to assess the psychometric properties of the revised self-rated version of the Dysexecutive Questionnaire (DEX-R) within a non-clinical sample.MethodsThe study was hosted online, with 140 participants completing the DEX-R, GAD-2 and PHQ-2. Sixty participants also completed the FrSBe, with 99 additionally completing the DEX-R again 3 weeks later. Correlations with demographic factors and symptoms of anxiety and depression were conducted. Rasch and factor analysis were also used to explore underlying subconstructs.ResultsThe DEX-R correlated highly with (...) the FrSBe, indicating sound concurrent validity. Internal consistency, split-half reliability and test-retest reliability were excellent. Age and symptoms of depression and anxiety correlated with DEX-R scores, with older age associated with less dysexecutive problems. The Rasch analysis confirmed the multidimensionality of the rating scale, and a three-factor structure was found relating to activation-self-regulatory, cognitive and social-emotional processes. Frequencies of responses on DEX-R items varied, many were not fully endorsed indicating specific relevance of most but not all items to patients.ConclusionInterpretations of DEX-R ratings of dysexecutive problems should consider mood and individual variation. Systematic comparison of DEX-R responses between healthy and clinical groups could help identify a suitable cut off for dysexecutive symptoms. (shrink)

The counterfactual analysis of causation has focused on one particular counterfactual conditional, taking as its starting-point the suggestion that C causes E iff (C E). In this paper, some consequences are explored of reversing this counterfactual, and developing an account starting with the idea that C causes E iff (E C). This suggestion is discussed in relation to the problem of pre-emption. It is found that the 'reversed' counterfactual analysis can handle even the most difficult cases of pre-emption with only (...) minimal complications. The paper closes with a discussion of the wider philosophical implications of developing a reversed counterfactual analysis, especially concerning the differentiation of causes from causal conditions, causation by absences, and the extent to which causes suffice for their effects. (shrink)

Crossing the road within the traffic system is an example of an action human agents perform successfully day-to-day in complex systems. How do they perform such successful actions given that the behaviour of complex systems is often difficult to predict? The contemporary literature contains two contrasting approaches to the epistemology of complex systems: an analytic and a post-modern approach. We argue that neither approach adequately accounts for how successful action is possible in complex systems. Agents regularly perform successful actions without (...) obeying (explicit or implicit) algorithmic rules (as the analytic approach suggests) and without an existential leap to action (as the post-modern approach suggests). We offer an alternative: A common-sense pragmatist epistemology, one that focuses on the kind of actions making up most agents’ successful moment-to-moment actions in complex systems. Successful actions obtain when agents apply ceteris paribus rules-of-thumb during predictive and decisional practices while achieving some desired goal. (shrink)

I defend the normativity of meaning against recent objections by arguing for a new interpretation of the ‘ought’ relevant to meaning. Both critics and defenders of the normativity thesis have understood statements about how an expression ought to be used as either prescriptive or semantic. I propose an alternative view of the ‘ought’ as conveying the primitively normative attitudes speakers must adopt towards their uses if they are to use the expression with understanding.

We are pleased to once again present to the readers of Theoretical Medicine and Bioethics papers from the Philosophy of Medicine Roundtable. Previous issues have followed the 3rd and 4th Roundtables, and the current issue presents a selection from the more than 20 papers presented at the 5th Philosophy of Medicine Roundtable, which took place in New York, at Columbia University, in November 2013. Like its predecessors, held in Birmingham, AL, Rotterdam, and San Sebastian, this Roundtable attracted speakers from around (...) the world. It also featured keynote presentations from Rita Charon of Columbia University and Ross Upshur of the University of Toronto.It may seem somewhat odd to feature a special issue on philosophy of medicine in a journal that effectively has philosophy of medicine in its title. However, a review of the contents of this journal and similar ones, such as the Journal of Medicine and Philosophy, will quickly reveal such an issue’s purpose. The dominant content of these j .. (shrink)

Hannah Ginsborg presents fourteen essays which establish Kant's Critique of Judgment as a central contribution to the understanding of human cognition. The papers bring out the significance of Kant's philosophical notion of judgment, and use it to address interpretive issues in Kant's aesthetics, theory of knowledge, and philosophy of biology.

The correspondence between Hannah Arendt and Karl Jaspers begins in 1926, when the twenty-year-old Arendt studied philosophy with Jaspers in Heidelberg. It is interrupted by Arendt's emigration and Jasper's 'inner emigration' and resumes in the fall of 1945. From then until Jaspers's death in 1969, the initial teacher-student relationship develops into a close friendship. Three countries figure prominently in the correspondence: Germany, Israel, and the United States. Among the topics are Fascism, the atom bomb and the threat of global (...) destruction, German guilt for the Holocaust, Jewishness, the State of Israel, American politics and American universities, the Eichmann trial in Jerusalem. Arendt and Jaspers discuss people both famous and obscure. They gossip, joke complain, and argue. They commiserate with each other over the illnesses and infirmities of old age. And they converse about the world's great philosophers: Spinoza, Kant, Marx, Max Weber, Heidegger. Here is a fascinating dialogue between a woman and a man, a Jew and a German, a questioner and a visionary, both uncompromising in their examination of our troubled century. (shrink)

The view that exertion of effort determines praiseworthiness for an achievement is implicit in ‘no pain, no praise’-style objections to biomedical enhancement. On such views, if enhancements were t...

There is preliminary evidence, from case reports and investigational studies, to suggest that Deep Brain Stimulation could be used to treat some patients with Anorexia Nervosa. Although this research is at an early stage, the invasive nature of the intervention and the vulnerability of the potential patients are such that anticipatory ethical analysis is warranted. In this paper, we first show how different treatment mechanisms raise different philosophical and ethical questions. We distinguish three potential mechanisms alluded to in the neuroscientific (...) literature, relating to desire, control, and emotion, respectively. We explain why the precise nature of the mechanism has important implications for the patient’s autonomy and personal identity. In the second part of the paper, we consider practical dimensions of offering DBS to patients with AN in certain cases. We first discuss some limited circumstances where the mere offering of the intervention might be perceived as exerting a degree of coercive pressure that could serve to undermine the validity of the patient’s consent. Finally, we consider the implications of potential effects of DBS for the authenticity of the patient’s choice to continue using stimulation to ameliorate their condition. (shrink)

In this book she describes the perplexing crises which modern society faces as a result of the loss of meaning of the traditional key words of politics: justice ...

Discusses the nature of thought and volition, examines past philosophical theories, and clarifies the relation between will and freedom.

This article presents a model for regulating cognitive enhancement devices. Recently, it has become very easy for individuals to purchase devices which directly modulate brain function. For example, transcranial direct current stimulators are increasingly being produced and marketed online as devices for cognitive enhancement. Despite posing risks in a similar way to medical devices, devices that do not make any therapeutic claims do not have to meet anything more than basic product safety standards. We present the case for extending existing (...) medical device legislation to cover CEDs. Medical devices and CEDs operate by the same or similar mechanisms and pose the same or similar risks. This fact coupled with the arbitrariness of the line between treatment and enhancement count in favour of regulating these devices in the same way. In arguing for this regulatory model, the paper highlights potential challenges to its implementation, and suggests solutions. (shrink)