The exploitation solution to the Non-Identity Problem

When discussing exploitation, we often say things like this, “sweatshop laborers have terrible working conditions and are paid almost nothing, but they are better off with that labor than with no labor.” Similarly, in describing the Non-Identity Problem, Derek Parfit points out: we cannot say that the individuals born in future generations are worse off because of our destructive environmental policies because the particular people living in those future generations wouldn’t even exist if it were not for these destructive policies. How can we explain these cases, exploitation and environmental destruction, as ones of wrongdoing when the victims in both cases are no worse off than they would have otherwise been? This paper investigates the link between these two moral puzzles and ultimately uses one to solve the other: an exploitation solution to the Non-Identity Problem.     

Denying the Suberogatory

Julia Driver has argued that there is a special set of actions, lodged between neutral actions and wrongful actions called suberogatory actions. These actions are not impermissible, according to Driver, but still strike us as troubling or bad, and are therefore worse than morally neutral (1992). Since this paper was written 20 years ago, many philosophers have utilized or alluded to this moral territory. The existence of some action-types that are not wrong but still carry some dis-value has become a staple in the realm of moral evaluation. However, Driver's argument for the existence of this moral territory amounts to three types of moral cases that, according to Driver, can only be explained by the existence of the suberogatory. In this short paper, I will respond by saying that we can account for these cases using our traditional notions of moral neutrality and moral wrongness. The temptation of invoking the suberogatory is that it can be used as a substitute for answering a variety of hard ethical questions. However appealing this substitute may be, we should resist it so long as the problem cases put forward to motivate the new evaluative realm can be handled, and handled well, by our traditional apparatus.     

Developing an Acceptance-Based Behavioral Treatment for Binge Eating Disorder: Rationale and Challenges

Binge eating disorder (BED), characterized by recurrent eating episodes in which individuals eat an objectively large amount of food within a short time period accompanied by a sense of loss of control, is the most common eating disorder. While existing treatments, such as cognitive behavioral therapy (CBT), produce remission in a large percentage of individuals with BED, room for improvement in outcomes remains. Two reasons some patients may continue to experience binge eating after a course of treatment are: (a) Difficulty complying with the prescribed behavioral components of CBT due to the discomfort of implementing such strategies; and (b) a lack of focus in current treatments on strategies for coping with high levels of negative affect that often drive binge eating. To optimize treatment outcomes, it is therefore crucial to provide patients with strategies to overcome these issues. A small but growing body of research suggests that acceptance-based treatment approaches may be effective for the treatment of binge eating. The goal of the current paper is to describe the development of an acceptance-based group treatment for BED, discuss the structure of the manual and the rationale and challenges associated with integrating acceptance-based strategies into a CBT protocol, and to discuss clinical strategies for successfully implementing the intervention.     

Counseling Outcomes From 1990 to 2008 for School‐Age Youth With Depression: A Meta‐Analysis

Clinical trials exploring the effectiveness of counseling and psychotherapy in treatment of depression in school‐age youth composed this meta‐analysis. Results were synthesized using a random effects model for mean difference and mean gain effect size estimates. No effects of moderating variables were evident. Counseling and psychotherapy are effective for treatment of depression in school‐age youth both at termination and follow‐up, and in school and nonschool settings.     

Working memory and intrusions of irrelevant information in a group of specific poor problem solvers

An important body of evidence has shown that reading comprehension ability is related to working memory and, in particular, to the success in Daneman and Carpenter's (1980) reading and listening span test. This research tested a similar hypothesis for arithmetic word problems, since, in order to maintain and process the information, they require working memory processes. A group of children possessing average vocabulary but poor arithmetic problem-solving skills was compared with a group of good problem solvers, matched for vocabulary, age, and socioeconomic status. Poor problem solvers presented lower recall and a greater number of intrusion errors in a series of tasks testing working memory and memory for problems. The results obtained over a series of six experimental phases, conducted during a 2-school-year period, offer evidence in favor of the hypotheses that groups of poor problem solvers may have poor performance in a working memory test requiring inhibition of irrelevant information (Hypothesis 1), but not in other short-term memory tests (Hypothesis 2), that this difficulty is related to poor recall of critical information and greater recall of to-be-inhibited information (Hypothesis 3), that poor problem solvers also have difficulty in remembering only relevant information included in arithmetic word problems (Hypothesis 4) despite the fact that they are able to identify relevant information (Hypothesis 5). The results show that problem-solving ability is related to the ability of reducing the memory accessibility of nontarget and irrelevant information.     

Impact of Panel Gene Testing for Hereditary Breast and Ovarian Cancer on Patients

Recent advances in next generation sequencing have enabled panel gene testing, or simultaneous testing for mutations in multiple genes for a clinical condition. With more extensive and widespread genetic testing, there will be increased detection of genes with moderate penetrance without established clinical guidelines and of variants of uncertain significance (VUS), or genetic variants unknown to either be disease-causing or benign. This study surveyed 232 patients who underwent genetic counseling for hereditary breast and ovarian cancer to examine the impact of panel gene testing on psychological outcomes, patient understanding, and utilization of genetic information. The survey used standardized instruments including the Impact of Event Scale (IES), Multidimensional Impact of Cancer Risk Assessment (MICRA), Satisfaction with Decision Instrument (SWD), Ambiguity Tolerance Scale (AT-20), genetics knowledge, and utilization of genetic test results. Study results suggested that unaffected individuals with a family history of breast or ovarian cancer who received positive results were most significantly impacted by intrusive thoughts, avoidance, and distress. However, scores were also modestly elevated among unaffected patients with a family history of breast and ovarian cancer who received VUS, highlighting the impact of ambiguous results that are frequent among patients undergoing genetic testing with large panels of genes. Potential risk factors for increased genetic testing-specific distress in this study included younger age, black or African American race, Hispanic origin, lower education level, and lower genetic knowledge and highlight the need for developing strategies to provide effective counseling and education to these communities, particularly when genetic testing utilizes gene panels that more commonly return VUS. More detailed pre-test education and counseling may help patients appreciate the probability of various types of test results and how results would be used clinically, and allow them to make more informed decisions about the type of genetic testing to select.     

Severe Mental Illness: A Bridge between Neurochemistry and the Collective Unconscious

This article builds a relationship between neurochemistry and Jung's a priori construct of the collective unconscious through an exploration of the psychotic delusions present in severe mental illness and the psychopharmacological drugs used to treat them. Jung's postulations of a collective unconscious were rooted in his clinical work with severely mentally ill patients, and he was aware, early on, that severe mental illness offered an example of the interplay between human biology and our psychological lives. Current post-Jungian discourse has moved away from addressing severe mental illness as a means of understanding the continued relevance of Jungian theory amidst advances in the fields of neuroscience. Narrative analysis of qualitative data on severe mental illness adds psychic dimension to medical research and offers evidence that the rise and fall of delusional content, replete with archetypal patterns of expression, are related to the presence or absence of psychopharmacological drugs used for the treatment of bipolar disorder.