Michael Young

Insofar as psychiatrists and neurologists tend to the cognitive well-being of others, their work is interwoven with philosophical concerns and theoretical assumptions about the nature of the mind, its myriad functions, and the conditions governing its multiform pathologies. That the mind figures so prominently in their ordinary language attests to the wealth of insights that stands to be gained through a dialogue with philosophy. In one of the earliest efforts to taxonomize psychiatric medicine, Allgemeine Psychopathologie, Jaspers incisively remarks that "the exclusion of philosophy would be disastrous for psychiatry…if any psychopathologist thinks he can disregard philosophy and leave it aside as useless he will...

In Possibilities of Misidentification, Ashwell contends that the immunity principle developed and defended in my Pathologies of Thought and First Person Authority "doesn't show us anything about introspection or the first person—which should make us wonder whether it really captures that's at stake in discussions of IEM". Ashwell's argument hinges on two claims: IP turns on features that are not unique to introspection, to the first person, or to "subject matter that is thought to have IEM", and IP does not yet capture "the standard claim of IEM for introspective self-attribution". Ashwell thereupon contends that the immunity furnished by IP "might be merely contingent"...

Staggering advances in biotechnology within the past decade have given rise to pharmacological, surgical and prosthetic techniques capable of enhancing human functioning rather than merely treating or preventing disease. Bioenhancement technologies range from nootropics capable of enhancing cognitive abilities to distraction osteogenesis, a surgical technique capable of increasing height through limb lengthening. This paper examines whether the use of bioenhancements falls inside or outside the proper boundaries of healthcare, and if so, whether clinicians have professional responsibilities to administer bioenhancements to patients. After explicating two theoretical approaches to the concept of health, one objectivist and the other constructivist, I contend that clinicians' corresponding professional responsibilities hinge on which philosophical account of health is endorsed, and illustrate how the lack of analytic clarity with respect to this concept can lead to defective positions on the place of bioenhancements in healthcare. With this conceptual framework in place, an account of health as a cluster concept that incorporates both constructivist and objectivist components is developed and defended.

Ketamine, a dissociative anesthetic commonly used by US physicians, has recently been shown to be a powerful anti-depressant and is also capable of eliciting transpersonal experiences that can be transformative. Although currently approved in the US only for use as an anesthetic, physicians there can legally prescribe it off-label to treat various psychological/ psychiatric problems and it has been used for these non-anesthetic purposes in Argentina, Iran, Mexico, Russia, and the UK, as well as in the US. The literature on using ketamine psychotherapeutically is reviewed and two case studies using ketamine-enhanced psychotherapy for treating death anxiety in terminally-ill people are reported. The potential importance of beginning formal research on using KEP during end-of-life for those suffering death anxiety is emphasized.