Much has been written over the years regarding the norms, values, and ideals of modern science—in a word, what is expected of science and scientists. Most frequently, however, attention has focused on the conduct expected of scientists (e.g., Merton’s norms) rather than on the specific content expected of their scientific contributions, and attention has also tended to focus on the current scene rather than on the events that produced it. So. a kind of two-fold gap exists in our understanding of (...) our scientific heritage. Why is this important? Because it turns out that the two general ideals that have shaped the content of modern science right from the start seem to contradict each other. Nonetheless, they both have enjoyed weighty reasons offered in their defense and they both have exerted strong holds through the centuries on scientists and nonscientists alike, and still exert these holds. And the tradition has not offered any satisfying resolution. So, it is high time we deal with this situation. At least, that is what I attempt to do in this paper. (shrink)

What drives someone to commit an act of terrible violence? Drawing from her thirty years' experience in working with people who have committed serious offenses, Dr. Gwen Adshead provides fresh and surprising insights into violence and the mind. Through a collaboration with coauthor Eileen Horne, Dr. Adshead brings her extraordinary career to life in a series of unflinching portraits. In eleven vivid narratives based on decades of providing therapy to people in prisons and secure hospitals, an internationally renowned (...) forensic psychiatrist and psychotherapist demonstrates the remarkable human capacity for radical empathy, change, and redemption. Based on 30 years of experience working in prisons and secure psychiatric hospitals with people convicted of serious violent offenses, internationally renowned forensic psychiatrist Dr. Gwen Adshead presents an account of mental illness and the nature of evil in this compelling series of stories. (shrink)

Explores sociocultural influences on the construction of traditional aesthetic theories and judgments.

This study investigated effects of codes of ethics on perceptions of ethical behavior. Respondents from companies with codes of ethics (n = 465) rated role set members (top management, supervisors, peers, subordinates, self) as more ethical and felt more encouraged and supported for ethical behavior than respondents from companies without codes (n = 301). Key aspects of the organizational climate, such as supportiveness for ethical behavior, freedom to act ethically, and satisfaction with the outcome of ethical problems were impacted by (...) the presence of an ethics code. The mere presence of a code of ethics appears to have a positive impact on perceptions of ethical behavior in organizations, even when respondents cannot recall specific content of the code. (shrink)

Szasz argues that the threat of harm to self or others cannot be understood as a symptom of mental illness, and that there is an irresolvable tension between the traditional medical ethical duty to heal, and any notion of a medical duty to protect the public.1 I think these are two distinct arguments which could each be the subject of extended analysis, and this commentary is of necessity limited.Professor Szasz has consistently raised concerns about the political abuse of psychiatry as (...) a way of controlling dissidence. Many of his arguments remain as cogent and unanswered as when they were first put 30 years ago. But as sympathetic as I am to some of his criticisms, it seems to me that many are too sweeping; especially the first claim that there is no such thing as mental illness, but only persons whose expressed intentions involve taking a stance which is contrary to certain social rules.I do not propose here to discuss the so called “hard” problem of consciousness—that is, exactly how brain states give rise to intentional psychological experience, or indeed, the extent to which “brain” and “mental” can be used synonymously. If we accept that mental states give rise to intentions, then different mental states will give rise to different intentions, and there is no reason not to think that there might be abnormal mental states that might give rise to abnormal intentions. The question then is what we mean by the word “abnormal”. Clearly it is possible for abnormal to be defined as “socially inappropriate”, which is Szasz’s concern. In that case, political and social dissidence is then turned into a symptom by the language of medicine, and thus becomes not a social matter, but an individual’s personal problem.But “abnormal” could be defined with reference …. (shrink)

Freely given informed consent to participation is the ethical cornerstone of research in health care. However, in mental health settings, there are many patients who lack the capacity to give such consent to participate in research. There is an abundance of guidance now available on how researchers might think about this issue and the Royal College of Psychiatrists has also recently reviewed its guidance to members about the ethics of research. In this piece, I will discuss some of the issues (...) that were raised during the revision process, and add some reflections of my own. (shrink)

Crisis demands -- Crisis narratives -- Crisis: refrain!

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 10.2 (2003) 185-187 [Access article in PDF] Measuring Moral Identities:Psychopaths and Responsibility Gwen Adshead Doctor Ciocchetti examines the responsibility of psychopaths as a function of psychological capacities operating within relationships. He then argues against the punishment of psychopaths. I have some sympathy with both views, but perhaps argued in different ways, and from different standpoints, based on my clinical experience.Doctor Ciocchetti's offers an unusual (...) account of responsibility as a concept that involves at least two people, and perhaps many more than two; and this I would entirely support. In this sense, responsibility is a transitive and dynamic process that involves not only the personal sense of ownership of an action or thought, but also the attribution of responsibility by others. Moral, when applied to intentions, seems to me to suggest that they are intentions that involve another person and that they are held by an active agent who can make choices about those intentions. Responsibility implies not only causal responsibility, but also that the actor owns his own intentions about his behaviors toward others.Responsibility, either as experienced by the actor or attributed by others, is a type of moral judgment; an exercise in moral reasoning. Following Gilligan (1987), I am persuaded that moral reasoning, or the discourse of ought-and-should is relational in nature and must be seen in the context of relationships. I think much of the early work on moral reasoning in offenders is flawed because it assumes that moral reasoning was a capacity like serum bilirubin: normally distributed out there in the population, and able to be measured by an objective observer, in a process independent of the findings. Unsurprisingly, these studies found either that offenders had immature moral reasoning capacities (which we might have guessed already), or they had normal moral reasoning capacity, which was disturbing and puzzling.What we want to understand is how people come to let themselves do horrible things to others. Cioccchetti argues that psychopaths can do these things because they lack the affective capacities needed to respond to others' distress. Ordinary people care about harm to others (including the physical self/body and sentient animals) and demand explanations for the deliberate infliction of suffering on others. It is not only the lack of participant attitudes in the psychopath that bother us; it is our own responses, expressive of our participant attitudes, that tell us something about what this person is, and what is wrong. In my view, this is what punishment is all about for us, the larger social group [End Page 185] forced to respond to the distressing and disturbing actions of others.As Ciocchetti suggests, it is the perceived guilt of the offender that justifies the punishment; it is also the experienced distress of those affected that drives the need for punishment. The distress is part of the relationship between the victim and the offender; the victim is often just as active as the offender.The issue becomes most clear in relation to capital punishment and its supporters, especially those who wish not only to view executions, but also to broadcast them. In considering this, there are two useful sources of information: first, studies of the reactions of those who witness executions, and second, studies of the impact of murder on those related to the murder victim, so-called secondary victims. In those states that have capital punishment in the United States, it is often the secondary victims who witness the execution. They often have testified to the appalling impact of the offender's crime on them; most states give them a right to be present at the execution, even if they do not exercise it. It is hard not to think that it is the enormity of the feelings caused by the offender's wrongdoing that the death sentence is designed to address; the death of the offender changes the relationship between victim and offender, as much as the death of the original victim changes the relationship with their relatives. One might then wonder about the impact of his or her execution on the relatives... (shrink)

This study investigated effects of codes of ethics on perceptions of ethical behavior. Respondents from companies with codes of ethics (n = 465) rated role set members (top management, supervisors, peers, subordinates, self) as more ethical and felt more encouraged and supported for ethical behavior than respondents from companies without codes (n = 301). Key aspects of the organizational climate, such as supportiveness for ethical behavior, freedom to act ethically, and satisfaction with the outcome of ethical problems were impacted by (...) the presence of an ethics code. The mere presence of a code of ethics appears to have a positive impact on perceptions of ethical behavior in organizations, even when respondents cannot recall specific content of the code. (shrink)

Feminism, poststructuralism, postcolonialism, and Marxism, among other critical approaches, have undermined traditional notions of aesthetics in recent decades. But questions of aesthetic judgment and pleasure persist, and many critics now seek a "return to aesthetics" or a "return to beauty." Janet Wolff advances a "postcritical" aesthetics grounded in shared values that are negotiated in the context of community. She relates this approach to contemporary debates about a committed politics similarly founded on the abandonment of certainty. Neither universalist nor relativist, (...) the "aesthetics of uncertainty" provides a discourse on beauty that contemporary critics can engage with and offers a basis for judgment that is committed to assigning value to works of art. Wolff explores her position through a range of topics: the question of beauty in relation to feminist critique; the problematic status of twentieth-century English art, visual representations of the Holocaust, Jewish identity as portrayed by the artist R. B. Kitaj, refugee artists and modernism in 1940s Britain, and the nature and appeal of imagistic thinking in sociology. She addresses the desire for certainty and the timeliness of doubt and concludes with a meditation on the intersection of aesthetics and ethics, arguing that ethical issues are very much implicated in aesthetic discourse. (shrink)

This new book integrates material drawn from a variety of sources – feminist theory, cultural and literary analysis, sociology and art history – in an original discussion of women′s relationship to modern and post–modern culture. The essays in the book challenge the continuing separation of sociological from textual analysis in cultural (and feminist) theory and enquiry. They address critically the question of women′s writing, exploring the idea that women may begin to define their own lives and construct their identities in (...) a patriarchal culture through the very process of writing. They also present a cogent defence of a feminist cultural politics, including a politics of the body. (shrink)

In 1978, as the protests against the Shah of Iran reached their zenith, philosopher Michel Foucault was working as a special correspondent for _Corriere della Sera_ and _le Nouvel Observateur_. During his little-known stint as a journalist, Foucault traveled to Iran, met with leaders like Ayatollah Khomeini, and wrote a series of articles on the revolution. _Foucault and the Iranian Revolution _is the first book-length analysis of these essays on Iran, the majority of which have never before appeared in English. (...) Accompanying the analysis are annotated translations of the Iran writings in their entirety and the at times blistering responses from such contemporaneous critics as Middle East scholar Maxime Rodinson as well as comments on the revolution by feminist philosopher Simone de Beauvoir. In this important and controversial account, Janet Afary and Kevin B. Anderson illuminate Foucault's support of the Islamist movement. They also show how Foucault's experiences in Iran contributed to a turning point in his thought, influencing his ideas on the Enlightenment, homosexuality, and his search for political spirituality. _Foucault and the Iranian Revolution_ informs current discussion on the divisions that have reemerged among Western intellectuals over the response to radical Islamism after September 11. Foucault's provocative writings are thus essential for understanding the history and the future of the West's relationship with Iran and, more generally, to political Islam. In their examination of these journalistic pieces, Afary and Anderson offer a surprising glimpse into the mind of a celebrated thinker. (shrink)

If business requires ethical solutions that are viable in the liminal landscape between concepts and corporate office, then business ethics and corporate social responsibility should offer tools that can survive the trek, that flourish in this well-traveled, but often unarticulated, environment. Indeed, feminist ethics produces, accesses, and engages such tools. However, work in BE and CSR consistently conflates feminist ethics and feminine ethics and care ethics. I offer clarification and invoke the analytic power of three feminist ethicists 'in action' whose (...) investigations into the "grey zones" of harms; identity and representational conventions; and "asymmetrical reciprocity" harmonize with business ethics' requirements. (shrink)

Self-injury is a perilous and increasingly common behavior that is particularly prevalent among youth. Nonetheless, there is a deep-rooted public stigma towards people who self-injure. Consequently, people who engage in self-injury are reluctant to seek professional help or disclose their experiences to others. This article aims to combat stigma and promote help-seeking behavior by debunking the common myths surrounding self-injury in the Malaysian context. Specifically, this article aims to serve as an eye-opener for Malaysian counselors and other mental health professionals (...) to improve their multicultural knowledge, skills, and attitudes when working with those who self-injure. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 9.1 (2002) 15-18 [Access article in PDF] Through a Glass, Darkly:Commentary on Ward Gwen Adshead Keywords: psychopathy, moral reasoning. Now we see, as through a glass darkly.... (St Paul's first letter to the Corinthians, Chapter 13) JIM DID AN EVIL THING. He deliberately caused another person's suffering in a way that was humiliating, cruel, and persistent. He very nearly killed another man. He knew (...) what he was doing; he knew it was wrong, but somehow, that did not matter to him. After he was caught, he came to a forensic psychiatric facility where he was offered therapy. (What the purpose of therapy is could be the subject of a paper in its own right, although I will say a little more about this at the end of the paper). Several years on, Jim has had many thoughts about his behavior. First, he has no doubt that he was responsible insofar as he chose to do what he did, and he feels guilty on that count. Second, he is also aware that he had consciously carried out such acts many times in his mind before, but had not previously acted out his fantasy; and that therefore the process of crossing the line between fantasy and reality is a crucial one for him to think about further. This metaphor of a line that has to be crossed from one place to another suggests two worlds: one of internal reality and the other of external reality. Jim used the metaphor thus: "I came up to the line, but I drew back." He also said of this moment (when he nearly killed his first victim): "I said to myself... 'This is mad... I can't justify this.'... " I have emphasized these words of Jim's because I want to use his experience to explore some of the arguments raised in David Ward's most interesting paper. I found much to agree with, and some claims that sat less easily. I should say that the context of my response is my work as a psychotherapist with mentally disordered offenders in Broadmoor Hospital, and also a current research project with Jonathan Glover and Christine Brown on moral reasoning in antisocial men. Kant and Won't I have no doubt that most if not all of the men (and women) that I work with do operate according to universalizable principles. As the author suggests, however, these principles are incoherent and contain what Cleckley (1976) called a type of agnosia, or distorted vision. It seems to me that Kant's two forms of principle are really two different levels of intention or choice-making process. Kant's hypothetical level of intention is very much about making choices in the external world: I experience the world as cold, I want to be warm because I need to be warm, I will do what I need to do to make that need happen for me. It is not universalizable because [End Page 15] others may not feel the cold as I do. Notice that this level of intention may be very closely linked to the next level, which Kant calls categorical: I would like the world to be such that everyone who is needy will get their needs met, and I would like to be the sort of person who makes that happen. The categorical level of intention is Kant's take on the Golden Rule: that you should want everyone to be treated as you yourself would wish to be treated. It is an intentional process that is interpersonal, which implies a second order of thinking—thinking about one's thoughts and wishes, and thinking about the sort of person one would wish to be in relation to others.At this point, I think it may be helpful to bring in the other aspect of Kant's vision of moral intentions, which is the injunction to treat others as ends in themselves and not merely as means to ends. Thus every individual is a unique person or self, who claims respect as a person and not... (shrink)

This core adoptable text provides a comprehensive overview of the challenges facing organisations as they pursue global business activities. Ethics in business has grown to be of increasing importance in the world of today, as companies have been placed in the moral spotlight by shareholders, consumers, employees and governments. The growing complexities of the global economy demand a broader and a deeper view of business ethics than that offered by current management approaches that focus on reforming corporate behaviour. Business Ethics (...) places business ethics in a richer contextual setting, focusing on the challenges that businesses must now confront, and exploring how these issues can be met by a rethinking of business models, goals and strategies. Business Ethics is the ideal textbook for students taking business ethics modules at undergraduate, postgraduate and MBA levels. (shrink)

Foreword by Robert H. Bork -- Culture wars -- A distorted understanding of rights -- The right to privacy -- Griswold and contraception -- Roe and abortion -- Assisted suicide and homosexuality -- Political connections and natural consequences.

Understanding science requires appreciating the values it presupposes and its social context. Both the values that scientists hold and their social context can affect scientific communication. Philosophers of science have recently begun studying scientific communication, especially as it relates to public policy. Some have proposed “guiding principles for communicating scientific findings” to promote trust and objectivity. This paper contributes to this line of research in a novel way using behavioural experimentation. We report results from three experiments testing judgments about the (...) trustworthiness, competence and objectivity of scientists. More specifically, we tested whether such judgments are affected by three factors: consulting or not consulting nonscientists, conducting research under a restrictive or non-restrictive governmental communication policy, and the source of a lab’s funding (i.e., government funding, private funding, or a combination of the two). We found that each of these factors affects ordinary judgments of trustworthiness, competence and objectivity. These findings support several recommendations that could help improve scientific communication and communication policies. (shrink)

This paper proposes communities of practice (CoP) as a process to build moral resilience in healthcare settings. We introduce the starting point of moral distress that arises from ethical challenges when actions of the healthcare professional are constrained. We examine how situations such as the current COVID-19 pandemic can exponentially increase moral distress in healthcare professionals. Then, we explore how moral resilience can help cope with moral distress. We propose the term collective moral resilience to capture the shared capacity arising (...) from mutual engagement and dialogue in group settings, towards responding to individual moral distress and towards building an ethical practice environment. Finally, we look at CoPs in healthcare and explore how these group experiences can be used to build collective moral resilience. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Commentary on“Psychopathy, Other-Regarding Moral Beliefs, and Responsibility”Gwen Adshead (bio)AbstractIn this commentary, I address two points raised by Fields: the origin of other-regarding beliefs, and the management of psychopaths, if they are not criminally responsible (as Fields suggests). I argue that the capacity to form affective bonds is necessary in order to hold other-regarding beliefs, and that a psychological developmental perspective may be helpful in understanding the moral understanding (...) of the psychopath. In response to Fields’s view that psychopaths should receive “treatment,” I suggest that most forensic psychiatrists do not agree.Keywordspersonality disorder, empathy, development, remorse, attachment theoryInsufficient attention has been paid to the problem posed by so-called “psychopaths.” Lloyd Fields’s paper is therefore welcome. Here I shall focus on two issues: the nature and acquisition of other-regarding beliefs, and the implications for managing those who do not have them.Fields argues that there is a subgroup of psychopaths, unable to form “other-regarding beliefs”; that such beliefs provide a motivation for acting in a particular way, and result in a “[disposition] to experience certain emotions and to have certain attitudes.”But it is arguable that the disposition to experience certain emotions and have certain attitudes towards others could be critical to acquiring the capacity to have other-regarding beliefs. If one asks what stops people from hurting others, a common answer is that it makes people feel bad. To quote Mencius (Legge, 1960): “All men have a mind which cannot bear to see the suffering of others.”The question then is, how does anyone acquire a notion of “the other,” such that failing to endorse other-regarding principles/beliefs has an adverse effect on the subject?Mencius’ “mind” implied “reciprocity,” and involved four components:i. The recognition of another’s distressii. Being moved by that distress (empathy)iii. Wishing to reduce that distress (sympathy)iv. Altruism (the sense of obligation to reduce distress, and guilt if one fails).By these criteria, (iv) resembles Fields’s “other-regarding” belief, in that the sense of obligation provides a reason for acting. I would argue that (iv) is a virtue, which requires (i), (ii) and (iii) as capacities—not necessarily separate, but different aspects of a broader “affective” capacity. It is this affective capacity which is arguably lacking in the psychopath.Some of these capacities have already been discussed in the literature of psychopathy. It is the [End Page 279] failure to recognize another’s distress which Cleckley describes in many of his cases (Cleckley 1964), and which he describes as a type of “agnosia.” This term implies some neuropathological deficit, and there is some evidence for such deficits in psychopaths, mainly in the autonomic nervous system. Blair (1995) has also suggested that psychopaths lack a (postulated) violence inhibitory mechanism (VIM).It could be argued, however, that such neuropathological hypotheses lead to circular arguments about psychopathy, as described by Barbara Wootton 1(Wootton 1959). A more fruitful account is offered by theories (such as attachment theory) which offer a developmental account which includes both psychological and neuropathological perspectives. Described and developed by Bowlby (1969), attachment theory draws on experimental work with non-human primates and emphasises the importance of relationships with significant others in infancy for the development of later social relationships (Harlow 1975; Ruppenthal et al 1976). Such attachment relationships are also important for the development of cortical neural networks, and the modulation of stress, which can itself be neurotoxic (Sapolsky 1994).How could attachment theory be relevant to acquiring an affective capacity? The earliest work on attachment behaviors showed that monkeys failing to make early attachments behaved recklessly with other monkeys, and could not make relationships (for example, to mate). Of particular relevance was the finding that such monkeys launched suicidal attacks on monkeys higher in the hierarchy; not dissimilar to those “self-defeating” behaviors which Cleckley described in human psychopaths.So much for possibly psychopathic monkeys; do humans with failed attachments lack affective capacity? There is evidence that substantial proportions of “psychopaths” have histories of failed attachments in childhood. The more severe the failure, the more severe the disturbance in adulthood, which might explain why there... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Vice and ViciousnessGwen Adshead (bio)Keywordspsychiatric diagnosis, antisocial behaviorI am Grateful to Professor Sadler for such a clear and helpful account of how human misconduct (or vice) has been confounded diagnostically with human disease (as defined by the Diagnostic and Statistical Manual of Mental Disorders [DSM] classificatory system); and even more grateful for the chance to offer comment. Professor Sadler’s paper raises questions about the DSM enterprise as a (...) whole; and this is a field in which I have no particular experience to offer for additional discussion. But his other main point is that psychiatrists are constantly invited to distinguish between vice and disease, and he gives three examples, one of which is a clinical case from my own research. I entirely agree with him that this is a good example, and in this commentary, I will explain why.The argument is about how to distinguish between human behaviors that reflect chosen deviance from prosocial norms and behaviors that reflect a diseased state of mind. Arguments are both legal and political: Aristotle, in the Nichomachean Ethics sets out conditions in which a man should not be blamed for his behaviors, and to some extent these conditions still hold good in the criminal court; ignorance of the meaning of one’s actions, or being forced to act under duress, are good legal defenses. Politically, as Professor Sadler makes clear, the arguments were set out first by Foucault and then Szasz; it is possible for the state to use medical discourse to turn what might be a legitimate social grievance into individual pathology—the ultimate ad hominem argument.These arguments have not gone away, despite the best efforts of a materialist wing of neuropsychiatry, aided and abetted by pharmaceutical companies, who have a great interest in reductionist arguments in the biosciences. This is particularly so in relation to antisocial behaviors, especially crime. I want to focus on one particular type of antisocial behaviors, namely, the wish to hurt another person. I focus on this because it is my clinical bread and butter: My work as a forensic psychiatrist and psychotherapist requires me to try and understand how and why people want to hurt others. But I think it also makes sense to focus on this because it is the most problematic wish socially and demands understanding. All three of Professor Sadler’s examples involve hurt and harm to others, and it is noteworthy that neuroreductionist or medicalized explanations are rarely sought for theft or tax evasion. This must be in part because socially we think it is normal to try and profit yourself, even illegally, if you can get away with it. (I actually think that such behavior is not all that normal, but that is an argument for another day).Let us take the clinical example from my own work, cited by Professor Sadler. It is an example of what is called in the DSM “Factitious Disorder by Proxy” (FDP), although it also has an unhelpful eponym of “Munchausen’s Syndrome by Proxy.” As a practicing forensic psychiatrist, it is one of the best examples I know of what has been crudely dichotomized as a “mad or bad?” debate. A [End Page 23] mother quite deliberately makes her child ill, and then presents the child to medical services as in need of hospital treatment. In the case I described with Dr. Bluglass, the mother smothered her baby girl and then presented her as having “breathing difficulties” (which was, of course, quite true in one sense). There are two examples of vice here: deliberately hurting your child and lying to others about it; the lies also have the indirect result of potentially causing more harm to the baby. Harming your child, and then lying about it, in a not-for-profit way, are criteria for FDP.Quite how these actions ever made it into the DSM is puzzling, when they are quite straightforwardly antisocial. If a man in the street were to smother another man to the point of asphyxia, and then lie about it, we might well ask many questions about why he had done it, but we would not say that no offence had occurred. We... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:What’s His Story?Gwen Adshead (bio)Keywordsnarrative, violence, identityIn this commentary, I discuss three issues raised by Cartwright: whether and to what extent explanations from the past can adequately explain or excuse present actions, the nature of moral identity, and the notion of the moral community.I have often thought that psychiatrists and psychotherapists working with offenders have to be like writers of detective fiction. To make the story convincing, the (...) writer of detective fiction has to convey to the reader an understanding of the killer's motives. The successful writer enables the reader to appreciate the killer's reasons for killing; and these reasons offer to readers a tantalizing glimpse of what it might actually be like to be a violent and dangerous person; or more particularly, one who acts on their cruel and violent thoughts.Psychiatrists want to understand the reasons for their patient's violence, for several reasons (which probably include the voyeuristic pleasure that all humans seem to have at other people's disasters). However, the main reason is to do with prevention of future harm; if we understand the reasons that this happened, then we can take steps to make sure that it does not happen again. This view has been called the just world theory (Janoff Bulman 1989), which implies a world of predictable causes and reasons, where disasters occur because of an identifiable fault or omission that can be rectified with good result. The payoff of this view is that it gives the believer a sense of control, which after a disaster is important for maintaining confidence and self-esteem.The problem with this theory is that it presupposes that the world of human actions is essentially rational, and that people do things for reasons that make sense to them. However, much human cruelty has an irrational and unreasonable aspect to it; one that literally makes no sense. Cartwright's paper begins with a narrative about real people doing really dreadful things for no reasons that would ever satisfy the average detective story reader. Forensic mental health work is full of histories that are actually much stranger than any detective fiction.But it seems that humans are not happy with stories that do not make sense, even if senselessness is part of the natural world around them. As Cartwright indicates (see p. 150), when we hear about people like Robert Harris, we immediately move the field of inquiry from "Why did he do that?" to "Why is he like that?" With the rise of developmental psychology over the last 150 years, it has become natural to look at people's histories to see if this explains the person's present identity. In this sense, therefore, we seem to be natural Aristotelians, assuming that a man's character is revealed by his current actions: we also seem to be assuming that a man's character is an expression of past actions and events. [End Page 157]His-Story: Explaining the PresentIs this in fact the case? To what extent is it true that our identities are shaped by our past experiences? Even if this were the case, shaping is not the same as determining. There has always been a risk that developmental psychology will take up a similar position to genetics, with regard to explaining behavior; namely, that there are those who will try to argue that the presence of this, that, or the other gene, or this, that, or the other experience, both determines and "explains" the behavior. The moral point here is that when it comes to violent and antisocial behaviors, a person's past history is said to simultaneously explain the behavior, determine the behavior, and excuse it, by implying that the actor had no choice about what he did, given his past. This has been taken to an extreme in the US criminal courts, with what Dershowitz (1994) has called "the abuse excuse" (used most notably in the trial of the Menendez brothers, who killed their parents and claimed at the trial that their parents had abused them).Trials are about evidence, and it is worth considering the evidence about the effect of early childhood adversity... (shrink)

One approach to the analysis of ethical dilemmas in medical practice uses the “four principles plus scope” approach. These principles are: respect for autonomy, beneficence, non-maleficence and justice, along with concern for their scope of application. However, conflicts between the different principles are commonplace in psychiatric practice, especially in forensic psychiatry, where duties to patients often conflict with duties to third parties such as the public. This article seeks to highlight some of the specific ethical dilemmas encountered in forensic psychiatry: (...) the excessive use of segregation for the protection of others, the ethics of using mechanical restraint when clinically beneficial and the use of physical treatment without consent. We argue that justice, as a principle, should be paramount in forensic psychiatry, and that there is a need for a more specific code of ethics to cover specialised areas of medicine like forensic psychiatry. This code should specify that in cases of conflict between different principles, justice should gain precedence over the other principles. (shrink)

The goal of this paper is to propose a relational turn in healthcare professionalism, to improve the responsiveness of both healthcare professionals and organizations towards care of patients, but also professionals. To this end, it is important to stress the way in which difficult situations and vulnerability faced by professionals can have an impact on their performance of work. This article pursue two objectives. First, I focus on understanding and making visible shared vulnerability that arises in clinical settings from a (...) triple perspective: patient and family, health professionals, and institutions. Second, to address this challenge for professionalism, in this paper I articulate the term "relational centered-patient professionalism", which has two main axes. The relational approach means taking into account how the relationships among professionals, patients and institutions determine the constitution and evolution of those professional values. The focus on patient centered care is indispensable, because it is the ultimate goal pursued by the development of these professional values, and must always be at the center. (shrink)

"This stunning work is without question a major contribution to Cartesian studies, to the field of early modern philosophy, and to general epistemology- ...

A feminist primer for philosophers of science -- The legacy of twentieth century philosophy of science -- What feminist science studies can offer -- Challenges from every direction -- The prospects of twenty-first century philosophy of science.

Recent research on the cognitive abilities and emotional capacities of animals has fueled the animal rights movement and renewed debate over the differences between human and non-human animals. This debate has not been central to sociology, although George Herbert Mead drew a very hard line between humans and animals by asserting that the latter were not capable of symbolic interaction. Sociologists are now beginning to question this assumption, and this article falls within this new line of research. We begin by (...) presenting alternative interpretations of symbolic interaction that allow for the possibility of such activity in non-human animals. We review recent research on symbolic interaction between humans and dogs, and we present our own research findings on human-feline interaction. We conclude that there is growing evidence that symbolic interaction is widely distributed throughout the animal kingdom, and that it enables animals to survive more effectively in a wide variety of environments. (shrink)

This volume continues the story of European political theorising by focusing on medieval and Renaissance thinkers. It includes extensive discussion of the practices that underpinned medieval political theories and which continued to play crucial roles in the eventual development of early-modern political institutions and debates. The author strikes a balance between trying to understand the philosophical cogency of medieval and Renaissance arguments on the one hand, elucidating why historically-suited medieval and Renaissance thinkers thought the ways they did about politics; and (...) why we often think otherwise. (shrink)