Whose harm? Which metaphysic?

Douglas Diekema has argued that it is not the best interest standard, but the harm principle that serves as the moral basis for ethicists, clinicians, and the courts to trigger state intervention to limit parental authority in the clinic. Diekema claims the harm principle is especially effective in justifying state intervention in cases of religiously motivated medical neglect in pediatrics involving Jehovah’s Witnesses and Christian Scientists. I argue that Diekema has not articulated a harm principle that is capable of justifying state intervention in these cases. Where disagreements over appropriate care are tethered to metaphysical disagreements (as they are for Jehovah’s Witnesses and Christian Scientists), it is moral-metaphysical standards, rather than merely moral standards, that are needed to provide substantive guidance. I provide a discussion of Diekema’s harm principle to the broader end of highlighting an inconsistency between the theory and practice of secular bioethics when overriding religiously based medical decisions. In a secular state, ethicists, clinicians, and the courts are purportedly neutral with respect to moral-metaphysical positions, especially regarding those claims considered to be religious. However, the practice of overriding religiously based parental requests requires doffing the mantle of neutrality. In the search for a meaningful standard by which to override religiously based parental requests in pediatrics, bioethicists cannot avoid some minimal metaphysical commitments. To resolve this inconsistency, bioethicists must either begin permitting religiously based requests, even at the cost of children’s lives, or admit that at least some moral-metaphysical disputes can be rationally adjudicated.

     

Whose Evolution? Which Theology?

The importance of scientific conflicts for theology andphilosophy is difficult to judge. In many disputes of significance, prominent scientists can be found on both sides. Profound philosophical and religious implications are sometimes said to be implied by the new theory as well. This article examines the dispute over natural selection between Richard Dawkins and Stephen Jay Gould as a contemporary instance of such a conflict. While both claim that profound philosophical conclusions flow from their own alternativeaccount of evolution, I suggest that the implication is not as great as is claimed and that the alleged implications have as much to do with their own perceptions of theology as with the actual theories themselves. Nevertheless, evolutionary theory is not irrelevant for theology. Theologians should be aware of the possible implications of evolutionary theory and at the same time theextent and limits of such implications.     

Constantine,Babel, and Yankee Doodling: Whose Indigeneity? Whose Psychology?

This essay addresses the issue of indigeneity in terms of local cultures. The authors do so in conversation with Kim, Yang, and Hwang’s recent book, Indigenous and Cultural Psychology: Understanding People in Context. The life and work of Virgilio Enriquez is reviewed briefly as an exemplary indigenous psychologist. He illustrates the possibility of an indigenous psychology with a local, regulative grammar of cognition, affect, behavior, and relationships. The accounts of the tower of Babel and Constantine point to the irreversible damage of homogenizing culture and imposing it on other cultures. We argue that the imposition of a local, particular Western psychology on a global scale might risk a similar cost. The authors propose that current research in indigenous psychologies might take more seriously the notion that culture is not monolithic but should be understood from the point of view of the analysis of power relationships. Secondly, the authors argue that the role of language has not received sufficient attention in terms of shaping thought and increasing the incommensurability between cultures. Thirdly, it is argued that positivist epistemology has dominated the field and that more hermeneutic approaches must be considered. Fourth, the question must be asked regarding who controls indigenous research. Too often control has been exogenous rather than in the hands of local leaders. Finally, it is suggested that North Americans would do well to examine and recognize the indigeneity of their own psychology.     

Whose Values? Whose Risk? Exploring Decision Making About Trial of Labor After Cesarean

In this article, we discuss decision making during labor and delivery, specifically focusing on decision making around offering women a trial of labor after cesarean section (TOLAC). Many have discussed how humans are notoriously bad at assessing risks and how we often distort the nature of various risks surrounding childbirth. We will build on this discussion by showing that physicians make decisions around TOLAC not only based on distortions of risk, but also based on personal values (i.e. what level of risk are you comfortable with or what types of risks are you willing to take) rather than medical data (or at least medical data alone). As a result of this, we will further suggest that the party who is best epistemically situated to make decisions about TOLAC is the woman herself.     

Whose voice are we hearing,really?

This article, written from the position of someone who has lived experience of therapy for ‘psychosis’ and an interest in participation, explores the degree to which qualitative research truly conveys the voice and perspective of research participants. By exploring five papers focused on diverse experiences of psychotherapy, from the perspective of clients and therapists, it draws out some of the tensions inherent in making interpretations and connections within research papers and the impact this may have on the quality of any conclusions drawn. Finally, it makes some suggestions for ways of meaningfully involving research participants in the process and argues for an ongoing dialogue to prevent our own assumptions and theoretical frameworks from obscuring the importance of this involvement to improve the quality of future research.     

Whose ideology? A rejoinder to M. Plon

M. Plon commits the same offense that he finds so odious in American social psychology: A confounding of political axioms and scientific reasoning. His desire to demonstrate ideological blindness in Americans leads him to misinterpret some published works on the Prisoner's Dilemma paradigm in bargaining research and to ignore the issue of the most useful balance in emphasis between conflict maintenance and conflict resolution when these topics are studied experimentally. Thus, M. Plon's angry attack is not a clarification of the deep issues that he essays but, rather, another data point that will itself need to be understood.     

Pain and Bodily Care: Whose Body Matters?

Pain is unpleasant. It is something that one avoids as much as possible. One might then claim that one wants to avoid pain because one cares about one's body. On this view, individuals who do not experience pain as unpleasant and to be avoided, like patients with pain asymbolia, do not care about their body. This conception of pain has been recently defended by Bain [2014 Bain, D. 2014. Pains That Don't Hurt, Australasian Journal of Philosophy 92/2: 305–20.[Taylor & Francis Online], [Web of Science ®] , [Google Scholar]] and Klein [forthcoming Klein, C. forthcoming. What Pain Asymbolia Really Shows, Mind. [Google Scholar]]. In their view, one needs to care about one's body for pain to have motivational force. But does one need to care about one's body qua one's own? Or does one merely need to care about the body that happens to be one's own? In this paper, I will consider various interpretations of the notion of bodily care, in light of a series of pathological cases in which patients report pain in a body part that they do not experience as their own. These cases are problematic if one adopts a first-personal interpretation of bodily care, according to which pain requires one to care about what is represented as one's own body. The objection can run as follows. If the patients experience the body part as alien, then they should not care about it. Therefore, they should be similar to patients with pain asymbolia. But they are not. Hence, bodily care is not necessary to pain. To resist this conclusion, one can try to revise the interpretation of the notion of bodily care and to offer alternative interpretations that are not first-personal. However, I will show that that those alternatives also fail to account for these borderline cases of pain.     

Whose DAM account? Attentional learning explains Booth and Waxman

Booth and Waxman (Cognition 84 (2002) B11) have recently shown that linguistic cues to animacy affect children's novel name extensions. They argue that this demonstration contradicts two central tenets of our attentional learning account of object naming, which Booth and Waxman characterize as the "dumb attentional mechanism" or "DAM" account. In the present article, we show that the first of these tenets has never been a feature of the attentional learning account, and that the second tenet, which is central to our account, is not addressed by Booth and Waxman's findings. We suggest that the debate about the nature of children's language and cognition would profit from an increased awareness of the different levels of analysis at which different researchers are working.     

Relational Diagnosis: An Idea Whose Time Has Come?

Many marital and family therapists in the U.S., as well as the major organizations to which they belong, recognize that the DSMs and ICDs have become the accepted manuals for classification of individual mental and emotional dysfunctions. Because we/they have come to believe that many disorders emanate from interpersonal problems rather than from individual intrapsychic distress, a strong movement has mushroomed to develop a diagnostic system that describes relational disorders and to press for the inclusion of these in future versions of DSM and ICD. This commentary chronicles the evolution and accomplishments to date of those involved in this effort.