The Patient’s View: Issues of Theory and Practice

Almost all the knowledge now produced about psychiatry includes what is called “the patient’s or client’s perspective.” This paper analyzes how this notion has been framed in the discourses on mental health over the last two decades, particularly in mental health research and in anthropology. The very concept of the “patient’s perspective” is a social and historical construct. Despite its remarkable prevalence, the notion remains vague. Mental health research pictures it as a stable attribute of the individual. Anthropologists integrate the contextual nature of the patient view; but they still largely envision the psychiatric patient as a rational actor producing narratives based on common sense. However, in psychiatric practice, the client’s perspective is not something the patient individually produces; it is rather shaped by and in a context. To explore this process, my research investigated interactions between staff and patients in a French community mental health center, and showed that the client’s perspective is the result of a collective process. Further analysis demonstrates that eliciting or producing the patient’s view is sometimes considered a therapeutic goal in itself, since being granted the status of a rational and narrative actor gives access to the most valued model of care, one that is based on partnership. Being an outcome that is negotiated between patients and care providers, the “patient’s view” then becomes a new resource in mental health settings.

The Social Impacts of Nanotechnology: an Ethical and Political Analysis

This paper attempts some predictions about the social consequences of nanotechnology and the ethical issues they raise. I set out four features of nanotechnology that are likely to be important in determining its impact and argue that nanotechnology will have significant social impacts in—at least—the areas of health and medicine, the balance of power between citizens and governments, and the balance of power between citizens and corporations. More importantly, responding to the challenge of nanotechnology will require confronting “philosophical” questions about the sort of society we wish to create and the role that technology might play in creating it. This in turn will require developing institutions and processes that allow the public to wield real power in relation to technological trajectories. My ultimate contention is that the immediate task established by the likely social impacts of nanotechnology is not so much to develop an ethics of nanotechnology as to facilitate an ethical conversation about nanotechnology.

Language and Emotional Knowledge: A Case Study on Ability and Disability in Williams Syndrome

Williams Syndrome provides a striking test case for discourses on disability, because the characteristics associated with Williams Syndrome involve a combination of “abilities” and “disabilities”. For example, Williams Syndrome is associated with disabilities in mathematics and spatial cognition. However, Williams Syndrome individuals also tend to “have a unique strength in their expressive language skills”, and are socially outgoing and unselfconscious when meeting new people. Children with Williams are said to be “typically unafraid of strangers and show a greater interest in contact with adults than with their peers.” This apparently keen social knowledge is a counterexample to the discussion of disability among academic philosophers, especially philosophers in the early modern period. Locke infamously used the example of disability to claim that Descartes’ arguments in favor of innate ideas were incorrect. On the contrary, Williams Syndrome may stand as an example of innate social knowledge; something that could benefit current discourse in philosophy, disability theory, and medical ethics.

Experimenting with Transmutation: Darwin, the Beagle, and Evolution

Detailed analysis of Darwin’s scientific notes and other writings from the Beagle voyage reveals a focus on endemism and replacement of allied taxa in time and in space that began early in the journey. Though it is impossible to determine exactly when Darwin became a transmutationist, the evidence suggests that he was conversant with the transmutational ideas of Lamarck and others and testing (“experimenting” with) them—before he received a copy of Lyell’s Principles of Geology, vol. 2, in November 1832, in which Lyell describes and disputes Lamarck’s theory. To the two rhea species of Patagonia and the four mockingbird species of the Galapagos, we can now add the living Patagonian cavy (rodent) species, and its extinct putatively related species that Darwin collected at Monte Hermoso (Bahia Blanca) in the Fall of 1832, as a replacement pattern absolutely critical to the development of Darwin’s transmutational thinking. Darwin developed his first transmutational theory by adopting “Brocchi’s analogy” (Rudwick 2008)—i.e. that births and deaths of species are analogous to the births and deaths of individuals. Births and deaths of species, as of individuals, are thus explicable in terms of natural causes. Darwin explored these themes and the replacement of the extinct cavy by the modern species explicitly in his February 1835 essay (Darwin 1835a).

The strategy of “The strategy of model building in population biology”

In this essay, I argue for four related claims. First, Richard Levins’ classic “The Strategy of Model Building in Population Biology” was a statement and defense of theoretical population biology growing out of collaborations between Robert MacArthur, Richard Lewontin, E. O. Wilson, and others. Second, I argue that the essay served as a response to the rise of systems ecology especially as pioneered by Kenneth Watt. Third, the arguments offered by Levins against systems ecology and in favor of his own methodological program are best construed as “pragmatic”. Fourth, I consider limitations of Levins’ arguments given contemporary population biology.

Blogging Evolution

A weblog (“blog”) is an publication on the WorldWideWeb in which brief entries are displayed in date order, much like a diary or journal. I describe the general characteristics of blogs, contrasting blogs with other of WWW formats for self-publishing. I describe four categories for blogs about evolutionary biology: “professional,” “amateur,” “apostolic,” and “imaginative.” I also discuss blog networks. I identify paradigms of each category. Throughout, I aim to illuminate blogs about evolutionary biology from the point of view of a user looking for information about the topic. I conclude that blogs are not the best type of source for systematic and authoritative information about evolution, and that they are best used by the information-seeker as a way of identifying what issues are of interest in the community of evolutionists and for generating research leads or fresh insights on one’s own work.

Leaf Chlorophyll Fluorescence: Background and Fundamentals for Plant Biologists

This review on chlorophyll a fluorescence starts with an overview of the primary photochemistry occurring at PSII and a characterization of the so-called “open” and “closed” states of its reaction centers. This provides the theoretical background for understanding the origin of PSII-emitted fluorescence and how its yield varies with the fraction of open reaction centers. The review proceeds to discuss the changes in fluorescence emission following illumination of a dark-adapted leaf and to define the PSII intrinsic quantum yield of photochemistry, which in turn provides an indication of PSII capacity. In light-adapted leaves, it is discussed how the use of modulated fluorometers and the double lighting technique allow an evaluation of photochemical and non-photochemical quenching, two parameters that give useful information about the plant’s photosynthetic performance under field conditions. Finally, it is described how the PSII operational efficiency can be used to calculate the photosynthetic electron transport rate and the conditions under which this is linearly related to the CO₂ assimilation rate. Some requirements for a valid application of the technique as well as some limitations in interpreting its results are discussed.

Forty Years of ‘The Strategy’: Levins on Model Building and Idealization

This paper is an interpretation and defense of Richard Levins’ “The Strategy of Model Building in Population Biology,” which has been extremely influential among biologists since its publication 40 years ago. In this article, Levins confronted some of the deepest philosophical issues surrounding modeling and theory construction. By way of interpretation, I discuss each of Levins’ major philosophical themes: the problem of complexity, the brute-force approach, the existence and consequence of tradeoffs, and robustness analysis. I argue that Levins’ article is concerned, at its core, with justifying the use of multiple, idealized models in population biology.

Where There is no Patient: An Anthropological Treatment of a Biomedical Category

This work anthropologically applies the concept of ‘personhood’ to the Western biomedical patient role, and through cross-cultural comparisons with wellness-seeker roles (e.g. among the Maya of Guatemala and others) it seeks to discern the implications for global healthcare of assuming the universality of the “patient” role. Here, particular ethnographic attention is given to the presumption of the “patient” role in places and situations where, because of cultural and linguistic variation in local wellness-seeker roles and practices, there may be no “patient.” It is hoped that establishing the biomedical patient role (with the clinical expectations, communicative and comportment practices that prefigure it) as acquired rather than intuitive, will help redirect cultural competence to the acquisition of patienthood, broadening it from an endless accrual of cultural inventories by physicians. Also it aims to shift existing biomedical associations of cultural variations in wellness-seeking away from a priori assessments of clinical defiance towards deeper understandings of the kinds of cultural differences that may make the difference treatment outcomes.

The Construction of “Cultural Difference” and Its Therapeutic Significance in Immigrant Mental Health Services in France

Since the early 1970s, the French public health system has been accorded considerable responsibility for immigrants identified by the educational, judicial or social service authorities as psychologically distressed or socially disruptive. In this paper we discuss three models of healing embedded in constructs of “cultural difference” and addressed at specialized mental health-care centers catering to immigrants in Paris: “cultural mediation,” transcultural psychiatry/ethnopsychiatry and clinical medical anthropology. Based on observations and interviews at three specialized mental health centers in Paris, we explore how these clinical approaches address migrant wellbeing and seek to resolve crises in migrant families, especially those of West African origin. We suggest that the prevalent approaches to therapy creatively blend concepts and practices of anthropology, psychiatry and psychology but, at the same time, confront challenges inherent in the use of a generic “African” healing modality. Cases studies demonstrate that in order for such interventions to be perceived as effective by patients, “cultural difference” must be acknowledged but also situated in broader social, political and economic contexts.

Fitness “kinematics”: biological function,altruism, and organism–environment development

It’s recently been argued that biological fitness can’t change over the course of an organism’s life as a result of organisms’ behaviors. However, some characterizations of biological function and biological altruism tacitly or explicitly assume that an effect of a trait can change an organism’s fitness. In the first part of the paper, I explain that the core idea of changing fitness can be understood in terms of conditional probabilities defined over sequences of events in an organism’s life. The result is a notion of “conditional fitness” which is static but which captures intuitions about apparent behavioral effects on fitness. The second part of the paper investigates the possibility of providing a systematic foundation for conditional fitness in terms of spaces of sequences of states of an organism and its environment. I argue that the resulting “organism–environment history conception” helps unify diverse biological perspectives, and may provide part of a metaphysics of natural selection.

Psychoontogeny and psychophylogeny: Bernhard Rensch’s (1900–1990) selectionist turn through the prism of panpsychistic identism

Toward the end of the 1930s, Bernhard Rensch (1900–1990) turned from Lamarckism and orthogenesis to selectionism and became one of the key figures in the making of the Synthetic Theory of Evolution (STE). He contributed to the Darwinization of biological systematics, the criticism of various anti-Darwinian movements in the German lands, but more importantly founded a macroevolutionary theory based on Darwinian gradualism. In the course of time, Rensch’s version of the STE developed into an all-embracing metaphysical conception based on a kind of Spinozism. Here we approach Rensch’s “selectionist turn” by outlining its context, and by analyzing his theoretical transformation. We try to reconstruct the immanent logic of Rensch’s evolution from a “Lamarckian Synthesis” to a “Darwinian Synthesis”. We will pay close attention to his pre-Darwinian works, because this period has not been treated in detail in English before. We demonstrate an astonishing continuity in topics, methodology, and empirical generalizations despite the shift in Rensch’s views on evolutionary mechanisms. We argue that the continuity in Rensch’s theoretical system can be explained, at last in part, by the guiding role of general methodological principles which underlie the entire system, explicitly or implicitly. Specifically, we argue that Rensch’s philosophy became an asylum for the concept of orthogenesis which Rensch banned from evolutionary theory. Unable to explain the directionality of evolution in terms of empirically based science, he “pre-programmed” the occurrence of human-level intelligence by a sophisticated philosophy combined with a supposedly naturalistic evolutionary biology.

Mapping the geographic distribution of <Emphasis Type="Italic">Aglaia bourdillonii</Emphasis> Gamble (Meliaceae), an endemic and threatened plant,using ecological niche modeling

Aglaia bourdillonii is a plant narrowly endemic to the southern portion of the Western Ghats (WG), in peninsular India. To understand its ecological and geographic distribution, we used ecological niche modeling (ENM) based on detailed distributional information recently gathered, in relation to detailed climatic data sets. The ENMs successfully reconstructed key features of the species’ geographic distribution, focusing almost entirely on the southern WG. Much of the species’ distributional potential is already under protection, but our analysis allows identification of key zones for additional protection, all of which are adjacent to existing protected areas. ENM provides a useful tool for understanding the natural history of such rare and endangered species.

The Social Aspects of Fishing Effort

While economic literature inspired by the “tragedy of the commons” has emphasised people’s tendency to increase fishing effort beyond desirable levels, sociologists and anthropologists who have studied the social aspects of fishing have often emphasised the capacity of these factors to restrict fishing effort. The article addresses the influence of social norms and communication on fishing effort in an empirical study of the Atlantic blue whiting fishery. The data were generated at a time when this fishery had yet to see efficient quota regulations, and had been subject to a rapid growth in fishing effort, making it the largest fishery in the Atlantic. The article argues that social norms and communication patterns in the fishing fleet create a synergic effect of co-operation and competition on fishing effort. The article questions the view that social norms and communication necessarily represent a solution to the tragedy of the commons.

The Use of Human Tissue

The use of human tissue raises ethical issues of great concern to health care professionals, biomedical researchers, ethics committees, tissue banks and policy makers because of the heightened importance given to informed consent and patient autonomy. The debate has been intensified by high profile scandals such as the “baby hearts” debacle and revelations about the retention of human brains in neuropathology laboratories worldwide. Respect for patient’s rights seems, however, to impede research and development of clinical knowledge in contemporary health care. The Common clinical endeavour argument and a Presumption for beneficial use argument suggest that the use of tissues for research and teaching in contemporary health care can respect patients and their values in multicultural communities where there are provisions for oversight and for opting not to contribute, both of which should respect the diverse views of different ethnic or cultural groups.

Mutual Gains and Distributive Ideologies in South Africa: Theorizing Negotiations between Communities and Protected Areas

With the rise of joint management of protected areas, community representatives are increasingly involved in formal negotiations with state officials, nongovernmental organizations (NGOs) and other actors. Policy recommendations have commonly idealized “win-win” scenarios. Theoretical work on negotiation from psychology and management studies, however, points to identifiable circumstances under which the goal of a mutually beneficial “win-win” situation may limit the strategies, and ultimately the benefits, available to communities. Instead, an antagonistic, “distributive” approach to negotiations may be more compatible with the pressures on and strategies available to community representatives. The tensions between a “mutual gains” and “distributive” approach to negotiations are evident in two land claims on protected areas in South Africa: the Dwesa-Cwebe Nature Reserves, and the Pafuri Triangle, a portion of Kruger National Park. In each, NGOs that operated with a “mutual gains” strategy, espousing a “win-win” scenario, came to be perceived as collaborating with conservation agencies. Meanwhile, as negotiation theory would suggest, community representatives inclined towards a “distributive” strategy and allied with a second set of explicitly advocatory NGOs. Expecting that communities should embrace a “win-win” scenario from the outset is unrealistic and likely to reduce communities’ power in negotiations.

Liberal and Conservative Protestant Denominations as Different Socioecological Strategies

It is common to portray conservative and liberal Protestant denominations as “strong” and “weak” on the basis of indices such as church attendance. Alternatively, they can be regarded as qualitatively different cultural systems that coexist in a multiple-niche environment. We integrate these two perspectives with a study of American teenagers based on both one-time survey information and the experience sampling method (ESM), which records individual experience on a moment-by-moment basis. Conservative Protestant youth were found to be more satisfied, family-oriented, and sociable than liberal Protestant youth, but also more dependent on their social environment, which is reflected in a deterioration of their mood when they are alone. Liberal Protestant youth appear to have internalized values that remain constant whether in the presence or absence of others. We relate these results to the social scientific literature on liberalism and conservatism and to evolutionary theory as a framework for explaining cultural systems as adaptations to multiple-niche environments.

“A carnival of promiscuous carnal indulgence”: bureaucrats’ ambivalence in reconciling capitalist production with native American habitus

In 1921 the U.S. Office of Indian Affairs (OIA) attempted to suppress ritual public performances in the Southwestern Pueblos. Several reams of documenting text were used to support this authorizing text. These documenting texts were affidavits purporting to describe “degrading tendencies” and “immoral relations” in the Puebloan habitus. The OIA used these sensationalized representations of the habitus of Native Americans’ communities to promote and justify the policy of forced acculturation in the waning days of its implementation. What is perplexing is that these supporting texts were trotted out so late, decades after the major thrusts of the forced acculturation program had first been put into play. My purpose is to analyze the place of these texts in the forced acculturation program. I suggest, following Anne McClintock (1995) that the obsessive fascination that the public performances seem to have held for those who reported on and condemned them, represent a layered and complex intertwining of ambivalence about domestic social relations and gender with confusion about culture and labor. Examining a slice of the U.S. Government’s policy of forced acculturation in a corner of the Native American world reveals a potentially implosive anxiety of reconciling the imposition of a desired mode of production with the persistence of a habitus perceived as celebrating the violation of appropriate domesticity.