Thursday, 22 June 2017

Mental Capacity in Relationship

Camillia Kong is Lecturer in Philosophy at the University of Kent and Research Associate at the Ethox Centre, University of Oxford. She researches and has published on moral and political philosophical issues around the medico-juridical concept of capacity, mental disorder, and intellectual impairment. Her recent work also examines ethical issues around psychiatric genomics.



What should medical and legal professionals do when a person with intellectual impairment chooses to remain within an abusive and disabling environment? Should these professionals even be considering the difference between relationships and care environments which promote or disable the autonomy of individuals with a learning disability or mental disorder? Or is this paternalism gone one step too far?



In my new book Mental Capacity in Relationship: Decision-making, dialogue, and autonomy I explore these complex issues through the prism of mental capacity legislation in England and Wales and human rights conventions. Legal developments have revealed a number internal and external criticisms around the concept of mental capacity: in England and Wales medico-juridical professionals protect the right of autonomy of those who pass a legal functional test of mental capacity, but how this test should be interpreted is subject to internal debate.

Some legal judgments suggest an intrapersonal focus of mental capacity, whilst others indicate that the promotion of autonomy amongst those with impairments should have an interpersonal focus, where mental capacity will depend on the relationships and communities around the individual in question. Moreover, with the advent of the UN Convention for the Rights of Persons with Disabilities (CRPD), external critiques charge that the concept of mental capacity represents outdated, paternalistic, and discriminatory attitudes towards those with impairments, fundamentally designed to undermine their right of autonomy.

Both these internal and external critiques are addressed in my defense of a relational concept of mental capacity, where relationships and intersubjective dialogue have an important impact on the decisional capacity of individuals with impairments. In the book, I recommend caution against disposing with the concept of mental capacity as endorsed by the ‘will and preferences’ interpretation of Article 12 in the CRPD and further argue that mental capacity cannot be reducible to abilities ‘within one’s own head’, despite this pre-eminent understanding in both theory and practice. Core philosophical ideas that are operationalised within mental capacity law – such as rights, rationality, autonomy, and beneficence – need not presume an individualistic focus, but can be interpreted relationally.

Tuesday, 20 June 2017

The Unencapsulated Nature of Episodic Memory



Johannes Mahr (pictured above) is a PhD student in the Department of Cognitive Science at Central European University in Budapest. His work centers on the question of how the capacity for complex forms of communication has shaped higher cognition in humans. During his PhD he developed a novel account of the nature and function of episodic memory, which focuses on its role in communication. You can read about it here.

We usually think that when we remember the past, we form beliefs based on whatever we remember. When you remember that you went to the supermarket and bought a bottle of champagne yesterday, you take yourself to believe that this is indeed what you did because you remember it. Similar to perception, it seems to us that remembering provides us with evidence on the basis of which we form our beliefs. In the case of perception it has been widely argued that the processes by which we perceive our environment are encapsulated from what we already believe. That is, just because you might believe that there is a bottle of champagne behind your computer screen, you will not suddenly perceive one when you walk around your desk. Rather, perceptual input will inform your higher-level beliefs so as to cause you to revise your mistaken belief about the location of the champagne.

Thursday, 15 June 2017

PERFECT 2017 Memory Workshop


On May 5th, Project PERFECT hosted our workshop at the University of Cambridge. In a previous post on the workshop, the individual talks were summarised, so the current post focuses on some of the common themes that emerged in the talks and discussion: (a) the active nature of episodic memory and its potential to generate knowledge; (b) the implications of the existence of observer memories; (c) the role of others in the generation of knowledge through episodic memory.




It seems obvious that we have knowledge of past episodes in our lives, but Kourken Michaelian and Dorothea Debus highlighted how humans are active in the process of forming our memories. This might seem to show that we cannot have knowledge through episodic memory because episodic memory systems do not passively represent the past. Michaelian discussed this point through the lens of work on the reconstructive nature of memory. In the cognitive sciences, it is now widely accepted that episodic memories are constructed from traces of information stored in memory. The process of construction involves activity from the person doing the remembering.

Debus focused on how people have to exert efforts to ensure that they remember a particular event, thinking, for example, What was it that I did last Sunday? Both Michaelian and Debus aimed to reconcile the activity involved in episodic memory with this memory producing knowledge. Michaelian argued that the reconstruction involved in remembering produces representations that are true to events as they occurred (even if they do not exactly replicate the experiences that people had of the events), so can produce accurate memories, and knowledge, of those events. Debus argued that as long as an active intervention does not interfere with the believer meeting epistemic norms, those that lead to accurate beliefs, the intervention does not prevent the formation of the memory leading to knowledge.



Relatedly, I argued that evidence of the activity involved in the formation of memory is not only consistent with memory systems producing knowledge, it provides reason for thinking that memory systems bring significant epistemic benefits. I discussed the idea that people actively construct memories and showed that this feature of human memory systems increases the chance of true beliefs belief formed about things other than past experiences.

Tuesday, 13 June 2017

The Argumentative Theory of Reasoning





This post is by Hugo Mercier, Cognitive Scientist (French National Center for Scientific Research) and co-author (with Dan Sperber) of The Enigma of Reason. In this post, he discusses the argumentative theory and refers to some of his most recent publications (1; 2; 3). 

It is easy nowadays to find long lists of biases (such as this one). In turn, these lists of biases have given rise to numerous attempts at debiasing. The popular system 1 / system 2 framework has been useful in framing these attempts at debiasing. System 1 would be a set of cognitive mechanisms that deliver quick, effortless intuitions, which tend to be correct but are prone to systematic mistakes. System 2 would be able to correct these intuitions through individual reflection. Teaching critical thinking, for instance, can then be thought of as a way of strengthening system 2 against system 1.

The problem is that, as Vasco Correia noted in a recent post, debiasing attempts, including the teaching of critical thinking, have not been quite as successful as we might like. He suggests that instead of trying to change individual cognition, we should manipulate the environment to make the best of the abilities we have.

Essentially, this is the point that Maarten Boudry, Fabio Paglieri, Emmanuel Trouche, and myself have made in a recent article. We ground our analysis in the argumentative theory of reasoning. According to this theory, reasoning is not a system 2 like homunculus that would be able to oversee other cognitive mechanisms. Instead, it is just another intuitive mechanism among many others. Its specificity is to bear on reasons: reasoning evaluates and finds reasons. By contrast, the vast majority of our inferences go one without any reasons being processed.

Thursday, 8 June 2017

Self-Injury, Medicine and Society

This post is by Amy Chandler.

I am a sociologist, currently holding a Chancellor’s Fellowship in Health, through Arts, Design and Humanities at the University of Edinburgh. In this blog I introduce my book, Self-Injury, Medicine and Society: Authentic Bodies, published by Palgrave Macmillan.


The book is the culmination of over 10 years research, and a much longer period of engagement and interest, in the practice of self-injury. In the book I focus on the different ways that people make sense of self-injury, through an analysis of accounts – or narratives – about the practice. 

Self-injury is commonly associated with mental ill-health, seen as ‘irrational’ or ‘impulsive’. As such, the ways in which self-injury is explained might be understood by some as an example of an ‘imperfect cognition’. People report injuring their bodies in order to make themselves feel better – how could this be possible? In the book, I explore the diverse ways that people attempt to explain, justify or excuse self-injury, highlighting the central role of broader cultural ideas about bodies, emotions, and medicine in shaping what can (and cannot) be said about self-injury.


One increasingly common way that self-injury is explained suggests that the act of injuring the outside of the body (usually via cutting) serves to ‘transform’ emotional pain into physical pain. This narrative rests on a number of assumptions: that ‘emotional’ and ‘physical’ pain are or can be separate; that, simultaneously, these potentially separate pains are irrevocably linked – since causing ‘physical’ pain affects the intensity or presence of ‘emotional’ pain. 

Tuesday, 6 June 2017

The Role of Epistemic Virtue in the Realization of Basic Goods


Anne Baril (pictured above) has research interests in ethics and epistemology, and is currently writing a book in which she argues for the moral and prudential importance of epistemic virtue. Starting in Fall 2017, she will be a Lecturer in the Department of Philosophy at Washington University in St. Louis. In this post, she summarizes a paper she recently published in Episteme.

Folk wisdom holds that ignorance can be bliss. We’re happier not knowing how many germs are on our toothbrushes or how many calories were in that cupcake. Likewise for personality traits, such as being disposed to be too curious or too strict about the truth. The kind of person who is disposed to press her spouse to say what he really thinks about his attractive colleague is in for some hurt feelings. And without a degree of self-deception – about others, and about ourselves – wouldn’t we just be too depressed?

Sometimes the work of psychologists is put forward in support of the claim that self-deception is good for us, such as Taylor and Brown’s (1988) paper, in which they argue that there are ways of being systematically biased in one’s perceptions of oneself that are predictive of criteria traditionally associated with mental health, such as perceived and actual popularity among peers, and having more positive mood after success at a task and less negative mood after failure. Being the kind of person who cares too much about the truth, it seems, carries a heavy price tag.

Monday, 5 June 2017

Brain Architecture and Biased Beliefs


Today's post is by Christina Moutsiana (pictured above), who is Lecturer in Cognitive Neuroscience at the University of Westminster. Her research focuses on perceptual and cognitive biases which she investigates using a variety of neuroscience tools, behavioural paradigms, and psychophysics. In this post she discusses some of her recent research on belief updating and brain architecture (see Moutsiana et al. 2015 for more details).

We make decisions every day, some of which are critical to our health and wellbeing. These decisions are driven by the beliefs we hold. But do we form beliefs in an accurate manner that allow us to avoid harm and maximize reward? Cognition is not impervious to error, especially when emotion comes into play. One of the most robust cognitive biases is asymmetric belief updating; the tendency for healthy individuals to alter beliefs about their future to a greater extent in response to good information compared with bad information.

Decision neuroscience research suggests that updating beliefs involves not only brain regions known to perform complex cognitive functions, but also key structures for emotion. I therefore wanted to know if individual differences in brain connectivity between these structures relate to biased belief updating. To investigate that I exploited DTI (diffusion tensor imaging) that enables tracking of neural pathways, together with the belief update paradigm (Sharot et al., 2011). The belief update paradigm allows us to compute individual differences in updating self-relevant beliefs about possible life events.

Let's imagine you hold a belief about the likelihood of having a bike accident. I provide you with evidence that this event is more likely than you had initially expected (bad news). I later ask you again how likely you are of have a bike accident, so that I can assess whether you had integrated the information I gave you to adjust your belief. I do the same with your friend. I can then calculate how you differ in your ability to update your beliefs and learn relative to your friend. Replicating previous findings, I found that people learnt better in response to good news than bad news.

Thursday, 1 June 2017

Depressive Realism: Interdisciplinary Perspectives

In this post, Colin Feltham, Emeritus Professor of Critical Counselling Studies, Sheffield Hallam University, and also an External Associate Professor of Humanistic Psychology, University of Southern Denmark, discusses his new book Depressive Realism: Interdisciplinary perspectives.


Although my academic and professional background was rooted in counselling and psychotherapy, my writing for the past ten years has also focused on what I call anthropathology (the principle of evolved, pervasive human pathology); on philosophies of failure and pessimism; on aspects of evolutionary psychology; and on the inescapably depressing features of human existence, most notably death.


In Depressive Realism: Interdisciplinary Perspectives I hijack the narrow psychological concept of depressive realism (DR) to look very broadly and pessimistically at human evolution and history, religion, philosophy, psychology and psychotherapy, socio-cultural phenomena, and science and technology. Undeniably, this book often adopts a stance that can be accused of grandiosity, grim cherry-picking and dogmatic negativity, but it is in line with the original claim that mild depressives are ‘sadder but wiser’ individuals. It’s clear that DR is at odds with the cognitive behaviour therapy assertion that negative thinking is mostly erroneous and depressogenic. Indeed, much of my argument here is at odds with the essentially pro-life ethos of everything from religious faith, through philosophy and politics and everyday life.

I pursue the observation raised by the Buddha and later surfacing in philosophers like Schopenhauer, Cioran, Zapffe, Benatar and Brassier, that life is characterised by suffering, absurdity, and senescence, and is ultimately always annihilating. Some similar material is found in Ernest Becker and the terror management psychologists, and is certainly unmissable in writers like Giacomo Leopardi, Thomas Hardy, Samuel Beckett and Philip Larkin.
         
In terms of imperfect cognitions and cognitive error, from a global DR perspective drawing on insights from evolutionary anthropathology, I question the implicit assumptions of human progress (as does John Gray) and in doing so inevitably find fault with philosophy, politics and psychotherapy as salvational projects: all turn out to claim much more than they ever deliver, and hence are often dishonest and disappointing.