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The Machine Speaks: Conversational AIs and the importance of effort to relationships of meaningJMIR Mental Health. forthcoming.The focus of debates about conversational AIs (CAIs) has largely been on social and ethical concerns that arise when we speak to machines. What is gained and what is lost when we replace our human interlocutors—including our human therapists— with AIs? Here, we focus instead on a distinct and growing phenomenon: letting machines speak for us. What is at stake when we replace our own efforts at interpersonal engagement with CAIs? The purpose of these technologies is, in part, to remove effort. Bu…Read more
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163Attentional Harms and Digital InequalitiesJMIR Mental Health 9 (2). 2022.Recent years have seen growing public concern about the effects of persuasive digital technologies on public mental health and well-being. As the draws on our attention reach such staggering scales and as our ability to focus our attention on our own considered ends erodes ever further, the need to understand and articulate what is at stake has become pressing. In this ethical viewpoint, we explore the concept of attentional harms and emphasize their potential seriousness. We further argue that …Read more
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68Obtaining informed consent for genomics research in Africa: analysis of H3Africa consent documentsJournal of Medical Ethics 42 (2): 132-137. 2016.Background The rise in genomic and biobanking research worldwide has led to the development of different informed consent models for use in such research. This study analyses consent documents used by investigators in the H3Africa (Human Heredity and Health in Africa) Consortium. Methods A qualitative method for text analysis was used to analyse consent documents used in the collection of samples and data in H3Africa projects. Thematic domains included type of consent model, explanations of gene…Read more
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33Psychiatric Disorders Are Soft Natural KindsPhilosophy, Psychiatry, and Psychology 29 (3): 183-185. 2022.Tilmes concludes his interesting and informative piece with the sentence that “analysis of psychiatric vagueness merits further consideration.” I agree with this point, as well as with his earlier assertion that how one understands psychiatric vagueness may implicate the diagnostic model that one adopts, and the research that one pursues. Fortunately, there has been recent attention to vagueness in psychiatry, addressing both degree-vagueness and combinatorial vagueness. Vagueness in psychiatry …Read more
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7Randolph M. Nesse. Good Reasons for Bad Feelings: Insights from the Frontier of Evolutionary PsychiatryEvolutionary Studies in Imaginative Culture 3 (2): 117-118. 2019.
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What is a Mental Disorder? A Perspective from Cognitive-Affective ScienceCanadian Journal of Psychiatry 12 (58): 656-662. 2013.
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9This study investigated the applicability of a novel instrument to assess parent–child attunement in free play interactions, in dyads with an infant with and without visual impairments. We here report the findings on the reliability and applicability of the newly developed Attune & Stimulate Mother–Infant 56-items Instrument in two separate samples: one with infants with VI and one with typically sighted infants. In addition, we assessed the contribution of parental sensitivity to attunement in …Read more
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239Ethical issues in global neuroimaging genetics collaborationsNeuroImage 117208 (221): 1-10. 2020.
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10Problems of Living: Perspectives from Philosophy, Psychiatry, and Cognitive-Affective Science addresses philosophical questions related to problems of living, including questions about the nature of the brain-mind, reason and emotion, happiness and suffering, goodness and truth, and the meaning of life. It draws on critical, pragmatic, and embodied realism as well as moral naturalism, and brings arguments from metaphysics, epistemology, and ethics together with data from cognitive-affective scie…Read more
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24Cognitive Embodiment and Anxiety DisordersPhilosophy, Psychiatry, and Psychology 27 (1): 53-55. 2020.Glas's article is one of several in an interesting special issue focused on applying concepts from enactivism to psychiatry; his focuses on anxiety in particular. Given ongoing developments in work on enactivism, and ongoing debates about how to progress psychiatry, this application is timely. Here, I make three general points about the application of enactivism to psychiatry; I exemplify these with occasional comments on social anxiety disorder.First, as de Haan notes in her introduction, the t…Read more
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4Global Mental Health and Neuroethics (edited book)Elsevier. 2020.Global Mental Health and Neuroethics explores conceptual, ethical and clinical issues that have emerged with the expansion of clinical neuroscience into middle- and low-income countries. Conceptual issues covered include avoiding scientism and skepticism in global mental health, integrating evidence-based and value-based global medicine, and developing a welfarist approach to the practice of global psychiatry. Ethical issues addressed include those raised by developments in neurogenetics, cosmet…Read more
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17Investigating assumptions of vulnerability: A case study of the exclusion of psychiatric inpatients as participants in genetic research in low‐ and middle‐income contextsDeveloping World Bioethics 20 (3): 157-166. 2020.Psychiatric genetic research investigates the genetic basis of psychiatric disorders with the aim of more effectively understanding, treating, or, ultimately, preventing such disorders. Given the challenges of recruiting research participants into such studies, the potential for long‐term benefits of such research, and seemingly minimal risk, a strong claim could be made that all non‐acute psychiatric inpatients, including forensic and involuntary patients, should be included in such research, p…Read more
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25Potential use of clinical polygenic risk scores in psychiatry – ethical implications and communicating high polygenic riskPhilosophy, Ethics, and Humanities in Medicine 14 (1): 1-12. 2019.Psychiatric disorders present distinct clinical challenges which are partly attributable to their multifactorial aetiology and the absence of laboratory tests that can be used to confirm diagnosis or predict risk. Psychiatric disorders are highly heritable, but also polygenic, with genetic risk conferred by interactions between thousands of variants of small effect that can be summarized in a polygenic risk score. We discuss four areas in which the use of polygenic risk scores in psychiatric res…Read more
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57Predictors of consent to cell line creation and immortalisation in a South African schizophrenia genomics studyBMC Medical Ethics 19 (1): 72. 2018.Cell line immortalisation is a growing component of African genomics research and biobanking. However, little is known about the factors influencing consent to cell line creation and immortalisation in African research settings. We contribute to addressing this gap by exploring three questions in a sample of Xhosa participants recruited for a South African psychiatric genomics study: First, what proportion of participants consented to cell line storage? Second, what were predictors of this conse…Read more
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68Psychopharmacological enhancement: a conceptual frameworkPhilosophy, Ethics, and Humanities in Medicine 7 5. 2012.The availability of a range of new psychotropic agents raises the possibility that these will be used for enhancement purposes (smart pills, happy pills, and pep pills). The enhancement debate soon raises questions in philosophy of medicine and psychiatry (eg, what is a disorder?), and this debate in turn raises fundament questions in philosophy of language, science, and ethics. In this paper, a naturalistic conceptual framework is proposed for addressing these issues. This framework begins by c…Read more
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26Ethical Challenges in Contemporary FASD Research and PracticeCambridge Quarterly of Healthcare Ethics 25 (4): 726-732. 2016.
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47Psychiatric Genomics: Ethical Implications for Public Health in Lower- and Middle-Income CountriesAmerican Journal of Bioethics 17 (4): 17-19. 2017.
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34Normal and Abnormal Anxiety in the Age of DSM-5 and ICD-11Emotion Review 7 (3): 223-229. 2015.Despite the effort on DSM-5 and ICD-11, few appear satisfied with these classification systems. We suggest that the core reason for dissatisfaction is expecting too much from them; they do not provide discrete categories that map to specific causes of disease, they describe clinical syndromes intended to guide treatment choices. Here we review work on anxiety and anxiety disorders to argue that while clinicians draw a pragmatic distinction between normal and abnormal emotions based on considerat…Read more
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Philosophy and cognitive-affective neurogeneticsIn Matthew Broome & Lisa Bortolotti (eds.), Psychiatry as Cognitive Neuroscience: Philosophical Perspectives, Oxford University Press. 2009.
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36Revenge and forgiveness in the New South AfricaBehavioral and Brain Sciences 36 (1): 37-38. 2013.Insofar as South Africa underwent a rapid transformation from apartheid to democracy, it may provide a unique laboratory for investigating aspects of revenge and forgiveness. Here we suggest that observations and data from South Africa are partially consistent with the hypotheses generated by MCullough and colleagues. At the same time, the rich range of revenge and forgiveness phenomena in real-life settings is likely to require explanatory concepts other than specialized modules and their compu…Read more
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15Philosophy of psychopharmacology: smart pills, happy pills, and pepp pillsCambridge University Press. 2008.Psychopharmacology - a remarkable development -- Philosophical questions raised by psychopharmacology -- How to think about science, language, and medicine : classical, critical, and integrated perspectives -- Conceptual questions about psychotropics -- Explanatory questions about psychotropics -- Moral questions about psychotropics.
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10Philosophy, Ethics, and Humanities in Medicine: expanding the open-access conversation on health carePhilosophy Ethics and Humanities in Medicine (1): 1-2. 2006.Natural philosophy once spanned the fields of philosophy, science, and medicine. Scientific disciplines and medical specialties have rapidly achieved independence, and the availability of the internet and open-access publishing promises a further expansion of knowledge. Nevertheless, a consideration of the grounding concepts and ethical principles that underlie health care remains paramount. It is timely, therefore, to contribute to the global conversation on health care with an open-access jour…Read more
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32Neural Networks and Psychopathology: Connectionist Models in Practice and Research (edited book)Cambridge University Press. 1998.Reviews the contribution of neural network models in psychiatry and psychopathology, including diagnosis, pharmacotherapy and psychotherapy.
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54BackgroundCommunity engagement within biomedical research is broadly defined as a collaborative relationship between a research team and a group of individuals targeted for research. A Community Advisory Board is one mechanism of engaging the community. Within genomics research CABs may be particularly relevant due to the potential implications of research findings drawn from individual participants on the larger communities they represent. Within such research, CABs seek to meet instrumental go…Read more
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3Philosophy of psychopharmacology : a naturalist approachDissertation, University of Stellenbosch. 2008.Thesis --Stellenbosch University, 2008
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30Cognitive and psychiatric science beyond determinismBehavioral and Brain Sciences 22 (5): 906-907. 1999.Many of Rose's criticisms of determinism in biology have clear relevance to modern cognitive and psychiatric science; too narrow a focus on the brain as an information processing machine runs the risk of neglecting the context in which information processing takes place, and too narrow a focus on the neuroscience of psychopathology runs the risk of neglecting other levels of explanation for these phenomena. It should be emphasized, however, that animal and genetic studies of phenomena of interes…Read more
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What is a mental/psychiatric disorder? From DSM-IV to DSM-VPsychological Medicine 40 1759-1765. 2010.
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University of Cape TownProfessor
Cape Town, Western Cape, South Africa
Areas of Specialization
Philosophy of Psychiatry and Psychopathology |