Imperfect Cognitions

On today’s post, Mara Floris explores the role of existing medical evidence in identifying instances of epistemic injustice. Mara is a philosophy of science researcher at Università Vita-Salute San Raffaele in Milan, working on epistemic injustice, healthcare communication, and gender-fair language. Mara Floris Recent debates on epistemic injustice in healthcare have raised an important methodological question: how can we establish that epistemic injustice is occurring? Nielsen et al. (2025) argue that the field needs clearer conceptual criteria and stronger empirical evidence, particularly for claims about testimonial injustice. A response by members of the EPIC project develops this discussion, arguing for an empirically informed but methodologically pluralistic approach (Byrne et al., 2026) . Færge et al (2026) similarly emphasise methodological pluralism. My recent paper takes this discussion in another direction: we need better ways of identifying epistemic injustice, but shoul...

On today's post, Yufeng Liu (Lancaster University), whose research focuses on metaphor, health communication and AI, explores whether AI can understand the metaphors we use about illness. Yufeng Liu Can AI Understand the Metaphors We Use About Illness?  When people talk about cancer or depression, they often use metaphors. Cancer can be an “enemy” to fight, recovery can be a “journey”, and depression can feel like “darkness”, a “heavy burden”, or being “trapped in a box”. These expressions do more than describe illness. They help people make sense of difficult experiences and communicate feelings that may otherwise be hard to put into words.  I use “AI” broadly here to include large language models, and this study focuses on ChatGPT. As more people turn to it for comfort, or simply someone to talk to, I asked: can ChatGPT pick up the metaphors people use about illness, and does it respond differently when the same experience is expressed literally? In my recent article, “ Expl...

In today’s post, Mateo Boberg, Julie Nordgaard and Mads Gram Henriksen (University of Copenhagen) explore how reliable psychiatric diagnoses are in the 21st century.                                                                                                                                   Mads Gram Henriksen Mateo Boberg  Julie Nordgaard What happens if two psychiatrists assess the same patient? Most people, including many clinicians, would probably expect them to reach the same diagnosis. After all, modern psychiatry has spent decades developing operational diagnostic criteria intended to improve diagnostic reliability. But how reliable are psychiatri...

In today’s post, Lydia Tsiakiri, Research Fellow at the Centre for Biomedical Ethics, National University of Singapore, explores whether judgments of wrongful discrimination are sensitive to personal responsibility, drawing on her research into responsibility, discrimination, healthcare, and public policy. Lydia Tsiakiri Imagine two patients who both need a lung transplant. One developed severe lung disease after decades of smoking. The other has the same condition because of a rare genetic mutation. If the hospital gives priority to the second patient, is that an instance of wrongful discrimination? Most of us agree that wrongful discrimination is morally objectionable. Yet cases like this raise a more difficult question. Does it matter whether the characteristic on which people are treated differently is something they are responsible for? If two individuals are treated differently because one is responsible for the relevant characteristic and the other is not, are we less likely to ...

In today’s post, Hielke Bosma explores the role of inner strength in rehabilitation care. Hielke is a spiritual care professional and academic researcher affiliated with the Amsterdam Rehabilitation Research Center  and the University of Humanistic Studies in the Netherlands, whose research focuses on spiritual exercises and chronic pain. Hielke Bosma The idea for my research on inner strength began in a rehabilitation centre. I remember two young men of roughly the same age. One was a student; the other worked in construction. Both had sustained a spinal cord injury in an accident and faced the prospect of never walking again.  Their responses could hardly have been more different. The construction worker felt that his life was over. He believed he could no longer do anything. The student responded: “I was studying before the accident, and now I am studying again. I don’t see the problem.”  Neither wanted to join a discussion group. For one, talking seemed pointless: it ...

In today's post, Carme Isern-Mas (University of the Balearic Islands) discusses the potential harms of everyday self-help discourse in contexts of systemic oppression. Carme worked on this topic with Sally Latham (The Open University) and Manuel Almagro (University of Valencia).  Carme Isern-Mas When I was a teenager, Rhonda Byrne’s The Secret took everyone by storm. For some time, conversations about how to better “manifest” our life goals, or on the importance of having a “positive attitude” were frequent. Later I learned about the self-help industry and how The Secret , among others, was a paradigmatic product of it. Criticisms of this cultural phenomenon were not long in coming. But, in recent years, the discourse of the self-help industry has also conquered our everyday talk.  The Secret, by Rhonda Byrne Everyone knows what “vision boards” are, most of us have tried to keep a “gratitude diary”, and we try to “stay positive” despite the adversity. A worry with such d...

In this follow-up to last week's post , Sorin Baiasu (University of Liverpool) and Luke Jordan (NHS Compass Manchester) continue introducing their interdisciplinary project on philosophy and mental well-being. Luke Jordan We currently face a particularly serious problem: a global mental health crisis combined with the psychiatrisation of society and medicalisation of mental disorders. To contribute to a solution to this serious challenge, our interdisciplinary research relies on some of academic philosophy’s untapped resources. In particular, we examine philosophy’s training potential for the mental health workforce through continuing professional development (CPD) sessions. Providing training to mental health practitioners through philosophy may lead to a common problem : misaligned and irrelevant content. On one good account of the differences between psychotherapy and academic philosophy, the latter is a self-reflective discipline, usually classed among the ‘humanities’. These...

In today's post, and next week's follow-up, Sorin Baiasu, Professor of Philosophy and Director of the Liverpool-Oxford-St Andrews Kantian (LOSAK) Research Centre at the University of Liverpool, and Luke Jordan, Clinical Lead at NHS Compass Manchester (Later Life CERN Pathway) and an MBT, SCM and RO-DBT practitioner, introduce their new interdisciplinary project on philosophy and mental well-being. Sorin Baiasu Globally, we are going through a mental health crisis . In 2025, the World Health Organisation (WHO) noted that over 1 billion people were living with mental health disorders. In the UK, in 2021/22, the National Health Service (NHS) spent 12 billion pounds on mental health – 8% of the entire NHS budget (comparable to the amount allocated for the treatment of cancer). The total spend on mental health in 2025/26 increased to almost £14 billion . At the same time, we are experiencing a psychiatrisation of society and a medicalisation of mental disorders , both with their...

Currently on display at Birmingham Museum & Art Gallery is Christopher Samuel's Watch Us Lead . The exhibition explores themes of stigma, belonging and agency while encouraging conversations about under-representation, autonomy and the lived experience of disability. In this post, Kate Lynch reflects on the exhibition and the role museums can play in shaping whose stories are heard. One of the first works to catch the eye in this exhibition is a large stained glass panel. Stained glass is often associated with churches and public acts of remembrance, making it an especially powerful medium for an exhibition about stories that have been overlooked.   Pray For Me by Christopher Samuel Elsewhere, visitors encounter a series of portraits, each accompanied by a quotation and the opportunity to hear more. The stories touch on healthcare, education, employment, identity and family life, exploring not only the experience of stigma but also the ways participants have asserted their own ...

This week's post is by Benedetta Cogo from the University of Wollongong. Her interests lie in mental disorders and rationality and in narrative practices in mental health. Benedetta is the author of “ Making Room for Narrative Practices in Mental Health ” (published in Topoi), coauthored with Daniel Hutto. Benedetta Cogo This post is about rationality, persons, and mental disorders. Intuitively, these three terms seem to be interconnected, yet there is no obvious or innocent way to establish that persons are rational, that mental disorders are irrational, that mental disorders affect persons (and not, say, their brains). For example, let’s consider this question: are symptoms of mental disorders distorted forms of rationality – coherent and reason-responsive in their own, often very idiosyncratic, way? Or are they entirely unintelligible through the lens of rationality? I like to think that the answer is “both” – and hopefully, at the end of this post, you’ll see why.  So where do ...

Today's post is by Max F. Kramer , an  Assistant Professor of Bioethics at Geisinger College of Health Sciences, and Clinical Ethicist at Geisinger Health System. Kramer discussed the recent paper "Depressed, Not Disordered: Fittingness and Pathologies of Emotion", published in the Journal of Medicine & Philosophy .  Max F. Kramer A once-prevalent view in philosophy – and possibly still prevalent in public life – holds that reason and emotion are inherently opposed. An extension of this view would have us characterise mental illness as some imbalance between the two; typically, a pattern of excessive emotion or deficient reason. Although this perspective is misguided in certain important ways, it serves as a point of entry into the affective dimensions of psychopathology and especially the class of psychological phenomena categorised as affective disorders: mental illnesses characterised by some defect, impairment, or aberration in the functioning of one’s emotional a...

Today's post is by George Chapman, an academic psychiatrist-in-training currently based at the University of Oxford, and Robert Howard, Professor of Old Age Psychiatry at University College London and Honorary Consultant Psychiatrist at the North London NHS Foundation Trust.           George Chapman Robert Howard Delusions are classically described as ‘fixed’ false beliefs. This description was first articulated by Karl Jaspers and, while it is widely considered to be an overstatement or incomplete, it still forms the basis of definitions found in the Diagnostic Statistical Manual (DSM) and International Classification of Diseases (ICD). In recent years, there have been tremendous advances towards unravelling why and how delusions emerge . However, much less has been learned about why or how delusions are persistently sustained once formed. This discrepancy motivated our just-published narrative review, “ On the fixed nature of delusions”  which I briefly ...

Today's post is by Alessandro Fiorello, an adjunct philosophy professor at the University of Ottawa, where he also received his PhD in 2025. His main research interests are in free will, narrative views of personal identity, ethics, and related topics in the metaphysics of death and philosophy of religion. Alessandro Fiorello                                         All human beings have at least one thing in common: we are all going to die. Achievements in nutrition, public health, and medical science have increased human longevity. Many people believe that increasing our longevity indefinitely would be desirable. But what if being given indefinite extended longevity creates a kind of boredom with one’s life that cannot be solved by finding new things to do? In my recent essay, “Terminal Boredom, Longevity, and Narrative” I analyse a famous argument against the desirability of immortalit...

This post is by Maria Silvia Salvatori, a Master’s degree student in Philosophy, already holding a Bachelor’s degree in Philosophical Sciences from the University of Bologna, with a background in classical studies, editorial communication, and cognitive sciences. Currently working as a professional educator in primary education, with academic interests in philosophy of mind, delusions, and human cognition. Maria Silvia Salvatori Martha's clinical case, who is discussed by Sabine Spielrein at the Burghölzli clinic in the early twentieth century, is not merely the record of a psychiatric case, but an epistemological mirror. By analysing her delusion, crucial questions emerge: What is the difference between psychotic belief and ordinary belief?  Is there an inner logic in pathological language that can "translate" across cognitive sciences and biological science? Architectures of a Mind Martha N. is described by Spielrein in terms of incoherent affect and a confused, someti...

This week's post is by Joshua Sealy (Macquarie University) on his recent paper  Redefining disability and pathology as both developmental and relational: the ‘phenomenological congruence and flexibility’ approach to disability   in  Phenomenology and the Cognitive Sciences.  Joshua Sealy A popular sentiment in the deaf community is that deafness is not a disability, it is a ‘difference’, with deaf cultures all over the world acting as sources of various values and habits associated with sight, touch, sign language, and solidarity. On the other hand, deafness is hearing impairment, a dysfunction of the deaf person’s ear and/or brain; a disability. Many assume an irreconcilable tension between the two positions. But growing up as a deaf person, I knew intuitively that both positions were true at the same time. The solution required addressing messy definitions of ability, disability, impairment, and pathology. Indeed, a deaf person can be ‘healthy’ despite their disabi...

In Athens, you can visit the site of Plato's Academy. A few steps away, you find a Digital Museum of Plato's Philosophy. In this post, Lisa Bortolotti talks about her visit to the Museum and how the curators have made Plato's philosophy fun and relevant. Plato's Academy Digital Museum Plato founded his Academy in 388 BCE. Some people call this the very first university, as it was a place where people studied what we now consider to be the foundations of Western science and philosophy. Now there is not much left of the Academy, it is a small archaeological site in Athens, in a quiet park where people walk their dogs.  Plato! Not far from the Academy, there is a wonderful  philosophy museum  dedicated to Plato's life and philosophy. The museum was opened twelve years ago, and admission is free. The project was funded by the National Strategic Reference Framework (The Citizen and Society) and is supported by the Onassis Foundation, Athens University, the Municipality o...