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)

Supplying a logically–valid argument for the existence of God can be done quite easily, e.g.

Democracy and the state are two political notions that have come under considerable duress in late modernity. This paper considers a prominent critic of both, Sheldon Wolin. The paper examines three elements that figure in Wolin's analyses of democracy and the modern state in a central way: community, memory, and the culture of history. A theorisation of these elements can illuminate what is at stake in the articulation of political conceptions that yield communal forms through the constitution of political space. (...) Wolin's analyses of democracy, the state, and modern power can be of help, first, in elucidating the political valences of the three elements themselves; second, in specifying relationships of mutuality among them; and third, in theorising what is at issue in the transposition of these elements from the domestic sphere to the international. The paper speaks mainly to the first and second concerns. A path is explored for thinking what is at stake in the third, namely, locating in and then transposing from the domestic sphere a ‘we’ which does not enjoy a precise ontology, but which is nonetheless capable of giving collaborative efforts in world-political spheres another political ground. (shrink)

Supplying a logically–valid argument for the existence of God can be done quite easily, e.g.

Examines the underlying assumptions and associated concepts of how we determine whether or not a person is capable of making moral judgements.

‘The political’ is much talked about today, but its invocation in international political theory is all but entirely dismissed. Yet, moral-ethical articulations do impact theorizing about international life, albeit in a most peculiar and often concealed fashion. In this paper I investigate the modernity of sovereignty in political and international theory and explain why invocations of the moral-ethical are so forcefully liquidated from international relations theory. I examine the constitutive effects of the sovereignty imperative and explain how modern notions of (...) ethics, politics and community are delimited by the need to effect what can be made to count as the pre-political ground of will-formation. A peculiar modernist strategy delimits the imagination of the politically possible in international life. I argue that critique must attend and not dispense with a fundamental paradoxicality (which is transfigured as modernity’s very metaphysical embodiment) that structures a distinctively modern manner of reflecting on ethics and community. The paradoxicality is sovereignty. It is accommodated by a liberal politics that works to conceal a restive anxiety of the modern ‘condition’. This anxiety is in turn productive of a politics with which we must grapple as we elaborate governance in global life. (shrink)

In the United States of America, the years from 1880 to 1915 were a period of rapid urbanization, combined in some areas with intense industrialization. This paper explores the creation in cities of the new industrial heartland of new institutions of higher learning. The case studies chosen illustrate varying responses to local needs for scientific and technical expertise, and illuminate how new concepts of higher education in the United States helped to shape the emergent connection between science and industry.

The Handbook of the Study of Play brings together, in two volumes, thinkers whose diverse interests at the leading edge of scholarship and practice define the current field. Because play is an activity that humans have shared across time, place, and culture, and in their personal developmental timelines - and because this behavior stretches deep into the evolutionary past - no single discipline can lay claim to exclusive rights to study the subject. Thus, this handbook features the thinking of evolutionary (...) psychologists; ethologists and biologists; neuroscientists; developmental psychologists; psychotherapists and play therapists; historians; sociologists and anthropologists; cultural psychologists; philosophers; theorists of music, performance, and dance; specialists in learning and language acquisition; and playground designers. Together, but out of their varied understandings, the incisive contributions to The Handbook of the Study of Play take on vital questions of educational policy, literacy, fitness, the role of play in brain development, spotaneity and pleasure, well-being and happiness, fairness, and the fuller realization of the self. These volumes also comprise an intellectual history, offering retrospective looks at the great thinkers who have made possible the modern study of play. -- from back cover. (shrink)

Physicians generally recommend that patients resuscitated with naloxone after opioid overdose stay in the emergency department for a period of observation in order to prevent harm from delayed sequelae of opioid toxicity. Patients frequently refuse this period of observation despiteenefit to risk. Healthcare providers are thus confronted with the challenge of how best to protect the patient’s interests while also respecting autonomy, including assessing whether the patient is making an autonomous choice to refuse care. Previous studies have shown that physicians (...) have widely divergent approaches to navigating these conflicts. This paper reviews what is known about the effects of opioid use disorder on decision-making, and argues that some subset of these refusals are non-autonomous choices, even when patients appear to have decision making capacity. This conclusion has several implications for how physicians assess and respond to patients refusing medical recommendations after naloxone resuscitation. (shrink)

Traditional engineering courses typically approach teaching and problem solving by focusing on the physical dimensions of those problems without consideration of dynamic social and ethical dimensions. As such, projects can fail to consider human rights, community questions and concerns, broader impacts upon society, or otherwise result in inequitable outcomes. And, despite the fact that students in engineering receive training on the Professional Code of Ethics for Engineers, to which they are expected to adhere in practice, many students are unable to (...) recognize and analyze real-life ethical challenges as they arise. Indeed, research has found that students are typically less engaged with ethics—defined as the sensitivity and judgment of microethics and macroethics, sensitivity to diversity, and interest in promoting organizational ethical culture—at the end of their engineering studies than they were at the beginning. As such, many studies have focused on developing and improving the curriculum surrounding ethics through, for instance, exposing students to ethics case studies. However, such ethics courses often present a narrow and simplified view of ethics that students may struggle to integrate with their broader experience as engineers. Thus, there is a critical need to unpack the complexity of ethical behavior amongst engineering students in order to determine how to better foster ethical judgment and behavior. Promoting ethical behavior among engineering students and developing a culture of ethical behavior within institutions have become goals of many engineering programs. Towards this goal, we would like to present an overview of the current scholarship of engineering ethics and propose a theoretical framework of ethical behavior using a review of articles related to engineering ethics from 1997-2020. The review engages in theories across disciplines including philosophy, education, and psychology. In this work-in-progress paper, we present a subset of initial results based on a review of the first 50 articles out of the systematically selected 409 articles from Springer, Engineering Village, and EBSCO-Education Full Text. Preliminary results identify two major kinds of drivers of ethical behavior, namely individual level ethical behavior drivers and institutional drivers. Our preliminary results indicate that a sensitivity to both microethics and macroethics as well as the implicit and explicit understanding of ethics are essential in promoting ethical behavior amongst students. Furthermore, while drivers of ethical behavior at the individual level is important, one should not ignore the roles of the drivers of ethical behavior at the institutional level in promoting a collective ethical culture within organizations. The review also points to a need to focus on increasing students’ macroethical sensitivity to topics such as sustainability and protection of human rights. This research thus addresses the need, driven by existing scholarship, 2 to identify a conceptual framework for explaining how ethical judgment and behavior in engineering can be further promoted. (shrink)

Engineering ethics can be divided into three spheres, namely the technical, the professional, and the social. Ideally, engineering students should engage with all three spheres of ethics, but the literature suggests that this might not be the case. How do engineering students engage with the three spheres of engineering ethics during a global pandemic? The COVID-19 pandemic represents a dramatic and ongoing real-world challenge affecting many students personally. This research explores the extent to which engineering students engage with each sphere (...) of engineering ethics by examining how engineering students understand their roles in addressing the pandemic and its implications. We conducted a survey with undergraduate engineering students (n = 410) at a university in the Midwest. Qualitative analysis suggests that there was low engagement with both social ethics and professional ethics among respondents, while there was higher engagement with technical ethics. Quantitative analysis suggests that non-conservative engineering students from less wealthy families in our study show higher engagement with technical ethics as compared to conservative engineering students from less wealthy families. Non-conservative engineering students from wealthy families, however, show similar engagement with technical ethics as compared to conservative engineering students from wealthy families. In addition, engineering students from both wealthy and less wealthy families show higher engagement with technical ethics if they reside in urban areas as compared to engineering students from both wealthy and less wealthy families in non-urban areas. In addition, the difference in terms of engagement with technical ethics between non-urban engineering students from less wealthy families and urban engineering students from less wealthy families is larger than the difference in terms of engagement with technical ethics between non-urban engineering students from wealthy families and urban engineering students from wealthy families. Further investigation will be needed to explain these findings. However, qualitative results confirm that, despite the potential for the pandemic to encourage engagement with all three spheres of ethics, there continues to be low engagement with ethics beyond the technical level. (shrink)

Although informed consent is important in clinical research, questions persist regarding when it is necessary, what it requires, and how it should be obtained. The standard view in research ethics is that the function of informed consent is to respect individual autonomy. However, consent processes are multidimensional and serve other ethical functions as well. These functions deserve particular attention when barriers to consent exist. We argue that consent serves seven ethically important and conceptually distinct functions. The first four functions pertain (...) principally to individual participants: (1) providing transparency; (2) allowing control and authorization; (3) promoting concordance with participants' values; and (4) protecting and promoting welfare interests. Three other functions are systemic or policy focused: (5) promoting trust; (6) satisfying regulatory requirements; and (7) promoting integrity in research. Reframing consent around these functions can guide approaches to consent that are context sensitive and that maximize achievable goals. (shrink)

This article presents the results of a study that investigated the roles that religiosity and ones money ethic play in determining consumer attitudes/beliefs in various situations regarding questionable consumer practices. One dimension of religiosity – intrinsic religiousness – was studied. Four separate dimensions of a money ethic scale were initially examined, but only one was used in the final analyses. Results indicated that both intrinsic religiousness and one’s money ethic were significant determinants of most types of consumer ethical beliefs.

This article presents the results of a study that investigated the role that religiosity plays in determining consumer attitudes/beliefs regarding various questionable consumer practices. Additionally, other personal factors were examined including idealism, relativism, consumer alienation and selected demographics such as income and age. All of these constructs were examined as antecedents of consumer ethical beliefs. The results of a post hoc analysis indicated that religiosity was a significant determinate of both idealism and relativism, and since idealism and relativism determine consumer (...) ethical beliefs, religiosity is a significant indirect determinate of consumer ethical beliefs. (shrink)

This article presents the results of an exploratory study that investigated the role that religiosity plays in determining consumer attitudes/beliefs in various situations regarding questionable consumer practices. Two dimensions of religiosity – intrinsic and extrinsic religiousness – were studied. Results indicated that an intrinsic religiousness was a significant determinant of consumer ethical beliefs, but extrinsic religiousness was not related to those beliefs.

This article presents the results of a study that investigated the roles that one's money ethic, religiosity and attitude toward business play in determining consumer attitudes/beliefs in various situations regarding questionable consumer practices. Two dimensions of religiosity - intrinsic and extrinsic religiousness - were studied. A global scale of money ethic was examined, as was a global measure of attitude toward business. Results indicate that both types of religiosity as well as one's money ethic and attitude toward business were significant (...) determinants of at least some types of consumer ethical beliefs. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Clinicians’ “Folk” Taxonomies and the DSM: Pick Your PoisonG. Scott Waterman (bio)Keywordsnosology, classification, diagnosis, psychopathologyWith attention turning to the process of formulating the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V; e.g., Kendler et al. 2008), the study by Flanagan and Blashfield (2007) of the similarities and differences between clinicians’ “folk” taxonomies and psychiatry’s official one is timely, and its lessons are in need (...) of analysis. In this commentary I first address questions raised by the existence of multiple de facto taxonomies, and by the characteristics of those taxonomies themselves, before focusing attention on the DSM diagnostic system and its attributes that make acceptance by its constituencies far less than complete. Although the aim of Flanagan’s and Blashfield’s study is explicitly descriptive rather than normative, it provides an important opportunity to examine the extent to which our taxonomies serve the purposes for which they were constructed—whether by experts or by clinicians.There are certainly reasons to expect significant deviations between clinicians’ everyday taxonomies and the official one. Perhaps the most glaring reason is the fact that—even if it were desirable—no one can be familiar with the enormous number of categories codified by the DSM. On the other hand, the remarkable hegemony of the DSM—in the education and training of physicians and clinical psychologists, in clinical communication, and in the ubiquitous administrative functions of billing and coding—makes such deviations at least somewhat surprising and in need of scrutiny and explanation. The first question, however, is whether one should be concerned by the existence (surprising or otherwise) of multiple taxonomies. Flanagan and Blashfield make the compelling case that, given the high rate at which Americans seek clinical attention for psychiatric problems, the stakes are commensurately high for our efforts at categorizing those problems in valid and useful ways. And the extent to which a gulf exists between the way psychiatry and clinical psychology are written about and taught on the one hand, and conceptualized and practiced by clinicians on the other, invites a multitude of problems—among which cynicism about our disciplines may be one of the most pernicious.At least as important as their finding of only moderate correlations between clinicians’ taxonomies [End Page 271] and that of the DSM are the characteristics of clinicians’ diagnostic systems themselves. One potentially major artifact of their methodology, however, must be borne in mind: the instruction to the clinicians in their study to “[p]ut together the diagnoses that have similar treatments…” (emphasis mine). Although they cite previous work (Flanagan and Blashfield 2006) in defense of the proposition that such instruction did not unduly influence their findings, it was certainly an avoidable potential problem, which itself likely reflects the history of our clinical disciplines in which the treatment cart frequently pulled the diagnosis horse. It is, therefore, not unlikely that clinicians’ taxonomies might emphasize treatment considerations even if they had not been directed to do so. The fallacious reasoning behind such intuitively appealing practice, however, must be exposed. The implicit assumption that treatment response is a proxy for other important characteristics of illnesses is predicated on the false proposition that our treatments exert their effects via similar mechanisms across the various indications for their uses, thus allowing us to infer from such responses that what was awry in the first place among the conditions for which a given treatment is effective must be closely related. Categorizing mania and trigeminal neuralgia together by virtue of their shared responses to anticonvulsant therapy, or considering autoimmune platelet deficiencies to be closely related to abdominal trauma due to the fact that each sometimes requires splenectomy, are examples of the potential results of acting on that false premise.Another parameter on which the clinicians in the current study based their nosologies—most explicitly by the “dimensional experts”—is the “environmental” versus “biological” one. Given that a coherent dichotomy would either distinguish environmental from genetic etiological factors, or would contrast psychological (i.e., subjective or first-person) from biological (i.e., objective or third-person) manifestations of illness, a taxonomy one of whose axes purports to represent an environmental/biological continuum cannot... (shrink)

Psychiatry's relation to the rest of medicine is ambivalent. Its legitimacy as a specialty is often conceived as being closely linked to its fidelity to the fundamental paradigms of medicine, especially the centrality of diagnosis and the association of diagnosis with treatment indications. However, as Gagné-Julien notes, a major impetus behind the quest for a solution to the demarcation problem in psychiatry is "growing concerns regarding over-medicalization". Although it could appear that these two considerations point in opposite directions, both arguably (...) would be served by what Gagné-Julien labels "a satisfying definition" of mental disorder. Such a... (shrink)

When we sit down to write an article that we plan to submit for publication, it is usually because we have completed some piece of empirical or conceptual work that has led us to conclusions we wish to share with our scholarly communities. In this instance, though, my essay under discussion was itself the means by which I sought to draw some conclusions about my recent experiences. Contrary to my initial plans—and my custom—I began writing without a clear idea of (...) where I would wind up. The commentaries, taken as a whole, affirm that my ambivalence about the topic at hand—fully revealed to me while formulating the article—came through, albeit in different ways to different commentators. And... (shrink)

This study examined the effect of various antecedent variables on marketers’ perceptions of the role of ethics and socialresponsibility in the overall success of the firm. Variables examined included Hofstede’s cultural dimensions (i.e., power distance, uncertainty avoidance, individualism, masculinity, and Confucian dynamism), as well as corporate ethical values and enforcement ofan ethics code. Additionally, individual variables such as ethical idealism and relativism were included. Results indicated that most ofthese variables impacted marketers’ perceptions of the importance of ethics and social responsibility, (...) although to varying degrees. (shrink)

This paper explores the concept of hope in Aristotle’s philosophy. First, I note that Aristotle contrasts hopefulness with the virtue of courage, although hopefulness can be a source of courage in some contexts, because hopefulness can create confidence. Next, I examine hope in relation to fear, defending Aristotle’s claim that without hope we cannot fear, and suggesting that hope, as a foundation for both fear and confidence, is a fundamental requirement for deliberation. Finally, I look at the hopefulness that underlies (...) Aristotle’s virtue of high-mindedness, concluding that hopefulness is a foundation for self-confidence and ethical self-improvement. (shrink)