The causal explanatory functions of medical diagnoses

Diagnoses in medicine are often taken to serve as explanations of patients’ symptoms and signs. This article examines how they do so. I begin by arguing that although some instances of diagnostic explanation can be formulated as covering law arguments, they are explanatory neither in virtue of their argumentative structures nor in virtue of general regularities between diagnoses and clinical presentations. I then consider the theory that medical diagnoses explain symptoms and signs by identifying their actual causes in particular cases. While I take this to be largely correct, I argue that for a diagnosis to function as a satisfactory causal explanation of a patient’s symptoms and signs, it also needs to be supplemented by understanding the mechanisms by which the identified cause produces the symptoms and signs. This mechanistic understanding comes not from the diagnosis itself, but rather from the theoretical framework within which the physician operates.     

Schizophrenia and Moral Responsibility: A Kantian Essay

In this paper, I give a Kantian answer to the question whether and why it would be inappropriate to blame people suffering from mental disorders that fall within the schizophrenia spectrum. I answer this question by reconstructing Kant’s account of mental disorder, in particular his explanation of psychotic symptoms. Kant explains these symptoms in terms of various types of cognitive impairment. I show that this explanation is plausible and discuss Kant’s claim that the unifying feature of the symptoms is the patient’s inability to enter into an exchange of reasons with others. After developing a Kantian Quality of Will Thesis, I analyze some real life cases. Firstly, I argue that delusional patients who are unable to enter into an exchange of epistemic reasons are exempted from doxastic rather than moral responsibility. They are part of the moral community and exonerated from moral blame only if their actions do not express a lack of good will. Secondly, I argue that disorganized patients who are unable to form intentions and to make plans are exempted from moral responsibility because they do not satisfy the conditions for agency.     

Heidegger and hallucination

Can Heidegger account for hallucination? I argue that while Heidegger does not develop an account of hallucination, he gives us all the resources we need to develop such an account. I first discuss a prominent argument against the very possibility of such an account. I argue that this argument is mistaken. I then discuss Heidegger's brief remarks on hallucination. In analysing a particular case study, Heidegger claims that the subject hallucinates for two reasons. First, he fails to realize the distinction between the different ways entities are present to him. For this reason, he cannot encounter a particular entity as it is present. Second, he is unable to do anything about the fact and manner of the presence of that entity. He is ‘unable to move in his world freely’, as Heidegger puts it. I show how these remarks, when taken in combination with Heidegger's broader ontology, allow us to explain the possibility of hallucination in a distinctively Heideggerian way.     

Liberal Naturalism: The Curious Case of Hegel

Abstract

My aim in this paper is to defend the claim that the absolute idealism of Hegel is a liberal naturalist position against Sebastian Gardner’s claim that it is not genuinely naturalistic, and also to defend the position of ‘liberal naturalism’ from Ram Neta’s charge that there is no logical space for it to occupy. By ‘liberal naturalism’, I mean a doctrine which is a non-reductive form of philosophical naturalism. Like Fred Beiser, I take the thesis of liberal naturalism to find support in the idealism of Hegel. I begin by first explaining what philosophical naturalism amounts to. I then move on to show, using Finn Spicer’s and Alison Stone’s understandings of philosophical naturalism, how there is a stronger form of philosophical naturalism but also how there is a weaker form as well. Having established the distinction between stronger and weaker variants of philosophical naturalism, I discuss Sebastian Gardner’s recent objections to treating absolute idealism as a genuinely naturalist position. I argue that Gardner is incorrect to claim that absolute idealism is not a genuinely naturalist position on both historical and interpretive grounds, where to do so I bring in features of Hegel’s idealism to show that Hegel was committed to liberal naturalism. In the next section of the paper, I address Ram Neta’s charge that there is no logical space for liberal naturalism. To counter this claim, I offer an Hegelian diagnosis of Neta’s charge and argue that Neta’s concern about the possibility of liberal naturalism is illegitimately motivated.     

Understanding phenomenological differences in how affordances solicit action. An exploration

Affordances are possibilities for action offered by the environment. Recent research on affordances holds that there are differences in how people experience such possibilities for action. However, these differences have not been properly investigated. In this paper I start by briefly scrutinizing the existing literature on this issue, and then argue for two claims. First, that whether an affordance solicits action or not depends on its relevance to the agent’s concerns. Second, that the experiential character of how an affordance solicits action depends on the character of the concern to which it is relevant. Concerns are conceived of as bodily forms of responsiveness, and solicitations are experienced through this responsiveness. The main aim of this paper is to make clear that an understanding of experiential differences in solicitations has to be based on a phenomenological appreciation of how one experiences one’s responsiveness to those solicitations. In the remainder of the paper I show how such a phenomenological appreciation reveals several characteristics of our responsiveness and I briefly explore three of them: valence, force and mineness. In the final section I discuss the self-referentiality of affordances in light of the current proposal, and argue that this self-referentiality is broader than is typically acknowledged.     

A new characterization of scientific theories

First, I discuss the older “theory-centered” and the more recent semantic conception of scientific theories. I argue that these two perspectives are nothing more than terminological variants of one another. I then offer a new theory-centered view of scientific theories. I argue that this new view captures the insights had by each of these earlier views, that it’s closer to how scientists think about their own theories, and that it better accommodates the phenomenon of inconsistent scientific theories.     

Neonatal Euthanasia Is Unsupportable: The Groningen Protocol Should Be Abandoned

The growing support for voluntary active euthanasia (VAE) is evident in the recently approved Dutch Law on Termination of Life on Request. Indeed, the debate over legalized VAE has increased in European countries, the United States, and many other nations over the last several years. The proponents of VAE argue that when a patient judges that the burdens of living outweigh the benefits, euthanasia can be justified. If some adults suffer to such an extent that VAE is justified, then one may conclude that some children suffer to this extent as well. In an attempt to alleviate the suffering of extremely ill neonates, the University Medical Center Groningen developed a protocol for neonatal euthanasia. In this article, I first present the ethical justifications for VAE and discuss how these arguments relate to euthanizing ill neonates. I then argue that, even if one accepts the justification for VAE in adults, neonatal euthanasia cannot be supported, primarily because physicians and parents can never accurately assess the suffering of children. I argue that without the testament of the patient herself as to the nature and magnitude of her suffering, physicians can never accurately weigh the benefits and burdens of a child’s life, and therefore any such system would condemn to death some children whose suffering is not unbearable. I conclude that because the primary duty of physicians is to never harm their patients, neonatal euthanasia cannot be supported.     

The Normativity of Meaning: Guidance and Justification

Abstract

The thesis that meaning is normative has come under much scrutiny of late. However, there are aspects of the view that have received comparatively little critical attention which centre on meaning’s capacity to guide and justify linguistic action. Call such a view ‘justification normativity’ (JN). I outline Zalabardo’s (1997) account of JN and his corresponding argument against reductive-naturalistic meaning-factualism and argue that the argument presents a genuine challenge to account for the guiding role of meaning in linguistic action. I then present a proposal regarding how this challenge may be met. This proposal is then compared to recent work by Ginsborg (2011; 2012), who has outlined an alternative view of the normativity of meaning that explicitly rejects the idea that meanings guide and justify linguistic use. I outline how Ginsborg utilises this notion of normativity in order to provide a positive account of what it is to mean something by an expression which is intended to serve as a response to Kripke’s semantic sceptic. Finally, I argue that Ginsborg’s response to the sceptic is unsatisfactory, and that, insofar as it is able to preserve our intuitive view of meaning’s capacity to guide linguistic action, my proposal is to be preferred.     

No Empathy for Empathy: An Existential Reading of Husserl’s Forgotten Question

ABSTRACT

Empathy is a term used to denote our experience of connecting or feeling with an Other. The term has been used both by psychologists and phenomenologists as a supplement for our biological capacity to understand an Other. In this paper I would like to challenge the possibility of such empathy. If empathy is employed to mean that we know another person’s feelings, then I argue that this is impossible. I argue that there is an equivocation in the use of the term ‘empathy’ which conditions the appropriation of the Other as we think that we know how the Other feels. To claim that we do know an Other’s feelings – or any kind of their intentional experience – means to appropriate their experience through our own. I will first reveal the equivocal use of the term ‘empathy’ and, then, I will explore Husserl’s use of the term. In Husserl, the understanding of an Other as empathy is only partial. I shall conclude by reiterating a thesis from philosophy of existence and feminist theory according to which to know another person comes from creating a community with them and not because we have a biological structure that can mirror each other’s feelings.     

Wittgenstein and the Animal Origins of Linguistic Communication

Wittgenstein's notorious sample of a ‘complete primitive language’ (viz. the builders’ game of the Philosophical Investigations) is often thought to be closer in kind to animal forms of communication than human language. Indeed, it has been criticised on precisely these grounds. But such debates make little sense if we take seriously Wittgenstein's idea that language is a family resemblance concept. So, rather than argue that the builders’ game ‘really is a language’ (or not), I propose to turn the debate on its head and welcome the comparison. By changing our perspective in this way, I suggest that we can see that the learning of language is crucially dependent on forms of communication that are animal in nature. I then discuss how these lessons might shed light on empirical research into both the ontogenetic and phylogenetic origins of linguistic communication.     

Kant's Argument that Existence is not a Determination

In this paper, I examine Kant's famous objection to the ontological argument: existence is not a determination. Previous commentators have not adequately explained what this claim means, how it undermines the ontological argument, or how Kant argues for it. I argue that the claim that existence is not a determination means that it is not possible for there to be non‐existent objects; necessarily, there are only existent objects. I argue further that Kant's target is not merely ontological arguments as such but the larger ‘ontotheist’ metaphysics they presuppose: the view that God necessarily exists in virtue of his essence being contained in, or logically entailed by, his essence. I show that the ontotheist explanation of divine necessity requires the assumption that existence is a determination, and I show that Descartes and Leibniz are implicitly committed to this in their published versions of the ontological argument. I consider the philosophical motivations for the claim that existence is a determination and then I examine Kant's arguments in the Critique of Pure Reason against it.     

Defending the Objective List Theory of Well‐Being

The objective list theory of well‐being holds that a plurality of basic objective goods directly benefit people. These can include goods such as loving relationships, meaningful knowledge, autonomy, achievement, and pleasure. The objective list theory is pluralistic (it does not identify an underlying feature shared by these goods) and objective (the basic goods benefit people independently of their reactive attitudes toward them). In this paper, I discuss the structure of this theory and show how it is supported by people's considered judgments. I then respond to three objections. First, I argue that there is no conceptual reason to favor a monistic theory of well‐being over a pluralistic one (such as the objective list theory). Second, I argue that states of affairs can benefit people even though they hold no positive reactive attitudes toward them. And, third, I argue that objective list theorists can identify a fairly‐determinate list of basic goods.     

Symptom modelling can be influenced by psychiatric categories: choices for research domain criteria (RDoC)

Psychiatric researchers typically assume that the modelling of psychiatric symptoms is not influenced by psychiatric categories; symptoms are modelled and then grouped into a psychiatric category. I highlight this primarily through analysing research domain criteria (RDoC). RDoC’s importance makes it worth scrutinizing, and this assessment also serves as a case study with relevance for other areas of psychiatry. RDoC takes inadequacies of existing psychiatric categories as holding back causal investigation. Consequently, RDoC aims to circumnavigate existing psychiatric categories by directly investigating the causal basis of symptoms. The unique methodological approach of RDoC exploits the supposed lack of influence of psychiatric categories on symptom modelling, taking psychiatric symptoms as the same regardless of which psychiatric category is employed or if no psychiatric category is employed. But this supposition is not always true. I will show how psychiatric categories can influence symptom modelling, whereby identical behaviours can be considered as different symptoms based on an individual’s psychiatric diagnosis. If the modelling of symptoms is influenced by psychiatric categories, then psychiatric categories will still play a role, a situation which RDoC researchers explicitly aim to avoid. I discuss four ways RDoC could address this issue. This issue also has important implications for factor analysis, cluster analysis, modifying psychiatric categories, and symptom based approaches.     

Schelling on understanding organisms

In this paper, I attempt to reconstruct Schelling’s theory of organism, primarily as it is elaborated in the First Outline of a System of the Philosophy of Nature and the Introduction to the Outline. First, I discuss the challenge that the properties of organisms presented to the dominant scientific viewpoint by the end of the eighteenth century. I present different responses to this challenge, including reductive materialism, metaphysical and heuristic vitalism, and the Kantian response, and I situate Schelling’s account of organism with respect to these responses. I argue that while Schelling agrees with vitalism in that he wants to preserve the specificity of organic phenomena, he rejects principles such as vital forces or the formative drive postulated by vitalism, even for purely heuristic purposes. I argue that Schelling understands organisms fundamentally in terms of the coordinated functioning of their organs. I further clarify Schelling’s account of problematic organic phenomena by focusing on his treatment of the relation between organic activity and organic receptivity. For Schelling, organic activity and organic receptivity mutually condition each other. I provide a detailed account of how this is supposed to work.     

CAN GROUPS HAVE CONCEPTS? SEMANTICS FOR COLLECTIVE INTENTIONS

A substantial literature supports the attribution of intentional states such as beliefs and desires to groups. But within this literature, there is no substantial account of group concepts. Since on many views, one cannot have an intentional state without having concepts, such a gap undermines the cogency of accounts of group intentionality. In this paper I aim to provide an account of group concepts. First I argue that to fix the semantics of the sentences groups use to make their decisions or express their beliefs, we need to appeal to a conventional semantics like that of Lewis. I then argue that the same reasons we have for taking group intentional states to be irreducible to the intentional states of their members apply also to the terms fixed by a conventional semantics. It follows that the meanings of terms in the sentences expressing a group's intentional states are also fixed by facts about the group, not its members. And recognizing this, I argue, amounts to attributing concepts to groups. Finally, I discuss a real‐life example of a group concept—the meaning of ‘meter’ as fixed by the International Bureau of Weights and Measurements—and I discuss the upshot of these considerations for the question of social externalism about concepts.     

On the Coherence of Dignāga’s Epistemology: Evaluating the Critiques of Candrakīrti and Jayarāśi

I discuss two critiques of Dignāga’s epistemology, one from Candrakīrti and another from Jayarā?i. I argue that they are two versions of what I call the core problem: if the content of Dignāga’s epistemology were correct, two fundamental beliefs within this epistemological theory could not be established or known to be true, as Dignāga claims they are. In response to objections found within the classical Indian tradition as well as several plausible contemporary objections, I then argue that the core problem remains a serious issue with which those sympathetic to Dignāga ought to contend.     

Supererogation and Intentions of the Agent

It has been claimed, by David Heyd, that in order for an act to count as supererogatory the agent performing the act must possess altruistic intentions (1982 p.115). This requirement, Heyd claims, allows us to make sense of the meritorious nature of acts of supererogation. In this paper I will investigate whether there is good reason to accept that this requirement is a necessary condition of supererogation. I will argue that such a reason can be found in cases where two people act in the same way but with only the person who acted with altruistic intent counting as having performed an act of supererogation. In such cases Heyd’s intention requirement plays an important role in ruling out acts that intuitively are not supererogatory. Despite this, I will argue that we should reject Heyd’s requirement and replace it with a moral intention requirement. I will then investigate how to formulate this requirement and respond to two objections that might be raised against it.     

Entitlement to Self‐Knowledge and Brute Error

Abstract

I discuss Burge’s argument that our entitlement to self‐knowledge consists in the constitutive relation between the second‐order review of thoughts and the thoughts reviewed, and defend it against Peacocke’s criticism. I then argue that though our entitlement to self‐knowledge is neutral to different environments, as Burge claims, the consideration of Burge’s own notion of brute error shows that Burge’s effort to reconcile externalism and self‐knowledge is not successful.     

Synchronic and diachronic responsibility

This paper distinguishes between synchronic responsibility (SR) and diachronic responsibility (DR). SR concerns an agent’s responsibility for an act at the time of the action, while DR concerns an agent’s responsibility for an act at some later time. While most theorists implicitly assume that DR is a straightforward matter of personal identity, I argue instead that it is grounded in psychological connectedness. I discuss the implications this distinction has for the concepts of apology, forgiveness, and punishment as well as the way in which this distinction can be used to defend quality of will accounts of responsibility against objections involving psychological manipulation. I argue that the intuition that a manipulated agent is not responsible can be explained by appeal to the conditions of DR and, as such, does not unproblematically shed light on the conditions of SR.