Are conspiracy theory beliefs pathological? That depends on what is meant by "pathological." This paper begins by unpacking that ill-defined and value-laden term before making the case that widespread conspiracy theory belief should not be conceptualized through the “othering’ perspective of individual psychopathology. In doing so, it adopts a phenomenological perspective to argue that conspiracy theory beliefs can be reliably distinguished from paranoid delusions based on falsity, belief conviction, idiosyncrasy, and self-referentiality. A socio-epistemic model is then presented that characterizes the (...) broader phenomenon of conspiracy theory belief as a product of a sick society plagued by epistemic mistrust and vulnerability to misinformation that is ubiquitous in today’s post-truth world. Finally, it is proposed that for individuals, the harmfulness of conspiracy theory belief is less related to belief content as it is to belief conviction and degree of self-relevant consequentiality. Staging conspiracy theory belief in terms of ideological commitment offers a conceptual framework to estimate behavioral risks and test hypotheses about the effectiveness of interventions along a continuum of belief conviction and associated socio-epistemic dynamics. Interventions should target not only individuals, but the dysfunctional social conditions that give rise to the pervasive and enduring phenomenon of conspiracy theory belief. (shrink)

In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role (...) of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM – whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part 1 of this article took up the first two questions. Part 2 took up the second two questions. Part 3 now deals with Questions 5 & 6. Question 5 confronts the issue of utility, whether the manual design of DSM-III and IV favors clinicians or researchers, and what that means for DSM-5. Our final question, Question 6, takes up a concluding issue, whether the acknowledged problems with the earlier DSMs warrants a significant overhaul of DSM-5 and future manuals. As in Parts 1 & 2 of this article, the general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances. (shrink)

In the conclusion to this multi-part article I first review the discussions carried out around the six essential questions in psychiatric diagnosis – the position taken by Allen Frances on each question, the commentaries on the respective question along with Frances’ responses to the commentaries, and my own view of the multiple discussions. In this review I emphasize that the core question is the first – what is the nature of psychiatric illness – and that in some manner all further (...) questions follow from the first. Following this review I attempt to move the discussion forward, addressing the first question from the perspectives of natural kind analysis and complexity analysis. This reflection leads toward a view of psychiatric disorders – and future nosologies – as far more complex and uncertain than we have imagined. (shrink)

In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role (...) of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM - whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part I of this article will take up the first two questions. With the first question, invited commentators express a range of opinion regarding the nature of psychiatric disorders, loosely divided into a realist position that the diagnostic categories represent real diseases that we can accurately name and know with our perceptual abilities, a middle, nominalist position that psychiatric disorders do exist in the real world but that our diagnostic categories are constructs that may or may not accurately represent the disorders out there, and finally a purely constructivist position that the diagnostic categories are simply constructs with no evidence of psychiatric disorders in the real world. The second question again offers a range of opinion as to how we should define a mental or psychiatric disorder, including the possibility that we should not try to formulate a definition. The general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances. (shrink)

In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role (...) of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM - whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part I of this article took up the first two questions. Part II will take up the second two questions. Question 3 deals with the question as to whether DSM-V should assume a conservative or assertive posture in making changes from DSM-IV. That question in turn breaks down into discussion of diagnoses that depend on, and aim toward, empirical, scientific validation, and diagnoses that are more value-laden and less amenable to scientific validation. Question 4 takes up the role of pragmatic consideration in a psychiatric nosology, whether the purely empirical considerations need to be tempered by considerations of practical consequence. As in Part 1 of this article, the general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances. (shrink)

This volume has 41 chapters written to honor the 100th birthday of Mario Bunge. It celebrates the work of this influential Argentine/Canadian physicist and philosopher. Contributions show the value of Bunge’s science-informed philosophy and his systematic approach to philosophical problems. The chapters explore the exceptionally wide spectrum of Bunge’s contributions to: metaphysics, methodology and philosophy of science, philosophy of mathematics, philosophy of physics, philosophy of psychology, philosophy of social science, philosophy of biology, philosophy of technology, moral philosophy, social and political (...) philosophy, medical philosophy, and education. The contributors include scholars from 16 countries. Bunge combines ontological realism with epistemological fallibilism. He believes that science provides the best and most warranted knowledge of the natural and social world, and that such knowledge is the only sound basis for moral decision making and social and political reform. Bunge argues for the unity of knowledge. In his eyes, science and philosophy constitute a fruitful and necessary partnership. Readers will discover the wisdom of this approach and will gain insight into the utility of cross-disciplinary scholarship. This anthology will appeal to researchers, students, and teachers in philosophy of science, social science, and liberal education programmes. 1. Introduction Section I. An Academic Vocation Section II. Philosophy Section III. Physics and Philosophy of Physics Section IV. Cognitive Science and Philosophy of Mind Section V. Sociology and Social Theory Section VI. Ethics and Political Philosophy Section VII. Biology and Philosophy of Biology Section VIII. Mathematics Section IX. Education Section X. Varia Section XI. Bibliography. (shrink)

Written by a contemporary of Marx and one of the most influential subversive critics of modern European society, this work (1840) has become a classic of political thought through its critique of private property as the essential institution of Western culture as well as the root of its problems.

En cent ans, le mouvement évangélique a rallié à sa cause plus d’un quart des chrétiens dans le monde entier. Pour comprendre les mécanismes d’une trans-nationalisation religieuse de telle envergure, l’article suit la trame du pentecôtisme à travers quelques moments et lieux considérés comme des tournants décisifs dans son évolution. L’objectif est d’éclairer l’émergence de son esprit de réveil et, en parallèle, de cette fameuse «compétence caméléon» qui conduit le mouvement évangélique, dans ses variantes les plus récentes, à une conception (...) plus utilitariste de la foi. (shrink)

It is widely assumed that disability is typically a bad thing for those who are disabled. Our purpose in this essay is to critique this view and defend a more nuanced picture of the relationship between disability and well-being. We first examine four interpretations of the above view and argue that it is false on each interpretation. We then ask whether disability is thereby a neutral trait. Our view is that most disabilities are neutral in one sense, though we cannot (...) make simple generalizations about disability's relationship to well-being in other important senses. After defending this view, we discuss its practical implications for selective abortion for disability, nondisabled people's interactions with disabled people, and the use of QALYs in health policy. (shrink)

Raynal and his collaborator, Diderot, offer views on the history and nature of the British Constitution in various parts of their encyclopedic account of Western expansion, The History of the Two Indies (1770, revised versions 1780 and 1784). These opinions are analysed in comparison with the judgments of Montesquieu, Voltaire, Hume, Bolingbroke, De Lolme and others. The evolution of Raynal's ideas on the subject is discussed in the light of his earlier anglophobic History of the Parliament of England (1748) and (...) the mutually contrasting French historians he used for that work, the Jesuit Pierre-Joseph d'Orleans and the Huguenot Paul de Rapin-Thoyras. Raynal's conversion to a liberal admiration for British institutions is seen both in the context of the American Revolution and his relationship with Diderot. His insistence on a historical approach clashes with Diderot's more radical and philosophical rhetoric, and the stress between their attitudes becomes apparent in the compromises they attain. Notable among their conclusions are the rejection of English appeals to antiquity, and the fortuitous development of liberty through a series of well defined stages. (shrink)

This article revises received wisdom about the Durkheimian school of sociology and its relationship to Marxism by analyzing the work of Célestin Bouglé, one of the most influential and least examined sociologists of the Durkheimian tradition. Like other better-known Durkheimians of his generation such as Marcel Mauss and Maurice Halbwachs, Bouglé engaged Durkheimian sociology with Marxian and other German traditions of social thought. In the process he also paid an important debt to the French socialists that Marx and so many (...) French Marxists have denigrated as ‘utopian’, especially Saint-Simon, Pierre-Joseph Proudhon and Charles Fourier. In fact, the concerns of Bouglé’s political sociology and Durkheimian sociology more generally are indissociable from the politics of Third Republic France. (shrink)

Waiting time is widely used in health and social policy to make resource allocation decisions, yet no general account of the moral significance of waiting time exists. We provide such an account. We argue that waiting time is not intrinsically morally significant, and that the first person in a queue for a resource does not ipso facto have a right to receive that resource first. However, waiting time can and sometimes should play a role in justifying allocation decisions. First, there (...) is a duty of fairness prohibiting line-cutting where a sufficiently just queue exists. Second, waiting time has several morally attractive features that can justify its incorporation into allocation schemes. Where candidates are in relevantly similar circumstances, allocating by waiting time is relatively efficient, maximizes distribution equality relative to other Pareto efficient distributions, and treats candidates fairly. The claim that allocation using waiting time is fair is controversial. Some have claimed that formal lotteries are a fairer way to select among equal beneficiaries. We argue that lotteries are no fairer than allocation based on waiting time when it is equiprobable how a prospective queue will be ordered. In practice, lotteries share many of the disadvantages of queues; which is fairer will depend on contingent features of the allocation scenario. The upshot is that first-come, first-served is in fact a just way to allocate resources in many of the cases where it seems pre-theoretically compelling, and waiting time has unique normative properties which frequently justify its incorporation into resource allocation schemes. (shrink)

One widely used method for allocating health care resources involves the use of cost-effectiveness analysis (CEA) to rank treatments in terms of quality-adjusted life-years (QALYs) gained. CEA has been criticized for discriminating against people with disabilities by valuing their lives less than those of non-disabled people. Avoiding discrimination seems to lead to the ’QALY trap’: we cannot value saving lives equally and still value raising quality of life. This paper reviews existing responses to the QALY trap and argues that all (...) are problematic. Instead, we argue that adopting a moderate form of prioritarianism avoids the QALY trap and disability discrimination. (shrink)

Post-abortion care research is increasingly being conducted in low- and middle-income countries to help reduce the high burden of unsafe abortion. This study aims to help address the evidence gap about ethical challenges that researchers in LMICs face when carrying out PAC research with adolescents. Employing an explorative qualitative approach, the study identified several ethics challenges encountered by PAC researchers in Zambia, including those associated with seeking ethics and regulatory approvals at institutional and national levels. Persistent stigma around abortion and (...) community perceptions that PAC studies encourage adolescents to seek abortion affected adolescents’ right to exercise their autonomy and to make decisions as well as exposed adolescents to social stigmatization risks. Challenges with recruitment was reported to result in abandoning of studies, thereby undermining development of PAC services that are more responsive to adolescent needs. Training needs identified included knowledge of best practices for conducting and disseminating PAC research. Strategies for addressing the ethical challenges included trust building and using less value-laden terminology when seeking permission and consent. It is essential to the future of PAC research in Zambia and globally that these important challenges be addressed through the development of comprehensive ethics guidance. (shrink)

The COVID-19 pandemic that struck New York City in the spring of 2020 was a natural experiment for the clinical ethics services of NewYork-Presbyterian (NYP). Two distinct teams at NYP’s flagship academic medical centers—at NYP/ Columbia University Medical Center (Columbia) and NYP/ Weill Cornell Medical Center (Weill Cornell)—were faced with the same pandemic and operated under the same institutional rules. Each campus used time as an heuristic to analyze our collective response. The Columbia team compares consults during the pandemic with (...) the same period during the year prior. The Weill Cornell service describes the phases of the pandemic to depict its temporal evolution and subsequent ethical challenges. Both sites report that the predominant ethical challenges centered around end-of-life decision making, setting goals of care, and medical futility, all complicated by resource allocation questions and the ambiguity of state law under crisis standards of care. The Columbia campus saw a statistically significant increase in ethics consultations provided to Hispanic patients, perhaps reflective of the disproportionate burden of COVID-19 suffered by this demographic. While Weill Cornell and Columbia saw a surge in clinical ethics consultations, the two services assumed a more expansive role than one normally played in institutional life. Serving as intermediaries between frontline clinicians and senior hospital administrators, consultants provided critical intelligence to hospital leadership about the evolution of the pandemic, disseminated information to clinicians, and attended to the moral distress of colleagues who were asked to provide care under truly extraordinary circumstances. The COVID-19 surge in New York City revealed latent capabilities in ethics consultation that may prove useful to the broader clinical ethics community as it responds to the current pandemic and reconceptualizes its potential for future service. (shrink)

It is commonly thought that disability is a harm or “bad difference” because having a disability restricts valuable options in life. In his recent essay “Disability, Options and Well-Being,” Thomas Crawley offers a novel defense of this style of reasoning and argues that we and like-minded critics of this brand of argument are guilty of an inconsistency. Our aim in this article is to explain why our view avoids inconsistency, to challenge Crawley's positive defense of the Options Argument, and to (...) suggest that this general line of reasoning employs a double standard. (shrink)

Signal transduction pathways constructed around a core module of three consecutive protein kinases, the most distal being a member of the extracellular signal‐regulated kinase (ERK) family, are ubiquitous among eukaryotes. Recent work has defined two cascades activated preferentially by the inflammatory cytokines TNF‐α and IL‐1‐β, as well as by a wide variety of cellular stresses such as UV and ionizing radiation, hyperosmolarity, heat stress, oxidative stress, etc. One pathway converges on the ERK subfamily known as the ‘stress activated’ protein kinases (...) (SAPKs, also termed Jun N‐terminal kinases, JNKs), whereas the second pathway recruits the p38 kinases. Upstream inputs are diverse, and include small GTPases (primarily Rac and Cdc42; secondarily Ras) acting through mammalian homologs of the yeast Ste20 kinase, other kinase subfamilies (e.g. GC kinase) and ceramide, a putative second messenger for certain TNF‐α actions. These two cascades signal cell cycle delay, cellular repair or apoptosis in most cells, as well as activation of immune and reticuloendothelial cells. (shrink)

Two experiments investigated the impact of affect on the working self-concept. Following an affect induction, participants completed the Twenty Statements Test (TST) to assess their working self-concepts. Participants in predominantly happy and angry states used more abstract statements to describe themselves than did participants in predominantly sad and fearful states. Evaluations of the statements that participants generated (Experiment 2) demonstrate that these effects are not the result of (1) participants describing positively and negatively valenced information at different levels of abstraction, (...) or (2) valence-based affective priming. Further, half of the participants in Experiment 2 were led to attribute their affect to the manipulation prior to completing the TST. This manipulation eliminated the influence of affect on the working self-concept. Taken together, these results are consistent with theory and research on the informative functions of affect. (shrink)

The spring, summer, and fall 2006 editions of Critical Inquiry hosted a heated exchange between Ernesto Laclau and Slavoj Žižek regarding the proper definition of the Lacanian Real. Žižek claims "the Real is the inexorable abstract spectral logic of capital that determines what goes on in social reality". In response, Laclau states that Žižek's "spectral logic of capital" is a gross distortion of Lacanian theory: "The Real is not a specifiable object endowed with laws of movement on its own but, (...) on the contrary, something that only exists and shows itself through its disruptive effects within the Symbolic". Laclau's formulation of the Real, however, forecloses the possibility of... (shrink)

This volume brings together some of the most distinguished thinkers in the field of theology to consider the question of the meaning of life in the various global religions.

Pavlovian cues predict the occurrence of motivationally salient outcomes, thus serving as an important trigger of approach and avoidance behavior. The amygdala is a key substrate of Pavlovian conditioning, and the nature of its contribution varies by the motivational valence of unconditioned stimuli. The literature on aversive Pavlovian learning supports a serial-processing model of amygdalar function, while appetitive studies suggest that Pavlovian associations are processed through parallel circuits in the amygdala. It is proposed that serial and parallel forms of information (...) processing can be attributed to differential recruitment of amygdalar nuclei, with emphasis placed on the lateral amygdala. (shrink)

Advancements in novel neurotechnologies, such as brain computer interfaces and neuromodulatory devices such as deep brain stimulators, will have profound implications for society and human rights. While these technologies are improving the diagnosis and treatment of mental and neurological diseases, they can also alter individual agency and estrange those using neurotechnologies from their sense of self, challenging basic notions of what it means to be human. As an international coalition of interdisciplinary scholars and practitioners, we examine these challenges and make (...) recommendations to mitigate negative consequences that could arise from the unregulated development or application of novel neurotechnologies. We explore potential ethical challenges in four key areas: identity and agency, privacy, bias, and enhancement. To address them, we propose democratic and inclusive summits to establish globally-coordinated ethical and societal guidelines for neurotechnology development and application, new measures, including “Neurorights,” for data privacy, security, and consent to empower neurotechnology users’ control over their data, new methods of identifying and preventing bias, and the adoption of public guidelines for safe and equitable distribution of neurotechnological devices. (shrink)

This paper examines the seasonality of induced abortion in North Carolina between 1980 and 1993. Distinct seasonal patterns are found, with a peak in February and a valley in September. These patterns correspond to the implicit seasonality of conceptions associated with the seasonality of birth pattern. One notable difference from the general pattern is among unmarried women aged 18 and younger. They have the February peak and an additional peak in August that may be associated with the summer vacation from (...) school. (shrink)