This chapter demonstrates the positive impact of the pedagogical intervention on students’ attitudes, expressed in their own words. It presents key highlights and recommendations, followed by an in-depth discussion. The sustained influence of the intervention on students’ engagement with lectures is revealed through their reflections, alongside insights into research supervisees’ experiences during their third-year projects.

This chapter synthesises current research on mathematics anxiety, tracing its precursors – such as negative emotions and attitudes – and examining its wide-ranging consequences. It explores the gendered nature of mathematics anxiety and its contribution to the persistent underrepresentation of women in STEM fields. The chapter reviews established instruments for measuring mathematics anxiety and considers key moderating factors, such as resilience and self-efficacy. Drawing on the author’s own analyses of recent empirical data, it offers new insights into the complexity and persistence of mathematics anxiety, particularly among non-specialist university students. The chapter concludes with a call to action, advocating for inclusive and emotionally intelligent pedagogical approaches that address both the cognitive and affective dimensions of mathematics learning.

Chapter 3 analyzes some of the ways that stereotypes harm people’s sense of self and identity. One way is through expressive harm, which is the harm that results from the unwitting and inevitable perpetuation of stereotypes. Stereotypes have a pervasive cultural power that enables them to control people’s thoughts, feelings, behavior, and social interactions even when people actively disavow the stereotype. Other ways that stereotypes harm people’s sense of self and identity are through the internalization of oppressive social scripts, which ascribe motivations and expectations for behavior, and through stereotype threat, in which people inadvertently and paradoxically act in ways that correspond to stereotypes even as they are trying hard to avoid fitting stereotypes. When people with mental illness internalize oppressive social scripts and experience stereotype threat, they incorporate negative stereotypes into aspects of their experience and identity, which damages their identity and sense of self and also diminishes their autonomy.

Chapter 5 assesses harms that people with mental illness experience that are related to how their self is constituted. These include harms of de-individuation and mis-identification, but also, as this chapter focuses on, harms of social exclusion and dehumanization that result from status loss and moral distancing. Dehumanization occurs through both being reduced to a stereotyped trait and being viewed as lesser compared to others. Having a sense of belonging and being accepted as an equal member of a moral/epistemic/social community are important parts of being viewed as and viewing oneself as a full human being; these are also critical for developing and exercising autonomous agency as well as for well-being and flourishing. People with mental illness are often excluded from these communities as a result of public stigma, diminishing their autonomy and well-being. This chapter shows how dehumanization, social exclusion, and belonging uncertainty threaten belongingness and autonomy.

Chapter 6 examines what makes discrimination and microaggressions (as a form of discrimination) wrongful. Discrimination involves differential treatment where some people are treated in different, unequal, and worse ways compared to others, and where that differential treatment is based on possessing a socially undesirable trait that marks a person as bad and inferior. Discrimination is wrongful because it harms people in a variety of ways, impacting their circumstances, resources and opportunities, options, agency, autonomy, and well-being. It causes material disadvantage and distributive injustice that denies people access to resources and opportunities and prevents them from having the basic goods necessary to participation in society. It also demeans people and leads to unfair subordination, loss of deliberative freedom, and decreased autonomy. This chapter reviews the philosophical literature on discrimination to provide a pluralistic account of the many harms discrimination and microaggressions cause to people with mental illness, which altogether make discrimination wrongful.

Chapter 4 shows how internalized stigma often results in adaptive preferences that harm a person. When people incorporate aspects of negative stereotypes into their identity, they sometimes develop adaptive preferences by internalizing harmful social norms and beliefs embedded within these stereotypes. I show how people with mental illness often develop goals and desires that are shaped by these beliefs and social norms, which limits what they believe they are capable of, thus reducing their options for action and truncating their agency and autonomy. While adapting desires to one’s circumstances can be positive, as in positive adaptation, it is negative when it is harmful to a person. The adaptive preferences that result from this can be seen as rationality deficits that are oppressive and nonautonomous and that damage well-being and flourishing.

The element of duty of care is covered in three sections. Section 11.1 covers the role and nature of duty – what it is there for and what it covers. Section 11.2 deals with the law on the established categories of negligence (duties and immunities). Section 11.3 discusses the methodology of negligence in cases involving novel fact scenarios, where a duty is not pre-established and needs to be developed from scratch.

Because of the complexity of this area of the law, this chapter introduces a new ‘Summary points’ feature at the ends of sections 11.1 and 11.3. It summarises the matters you should take into account when approaching a problem question and asks you to engage in an active reading exercise, linking each point with a case in that section.

The rise of the #MeToo movement has prompted a public reckoning with sexual consent, with public discourse now squarely focused on issues of sexual coercion and culpability. However, the principle of consent has a much longer history and wider significance beyond recent events. Bolstered by a social contract model that prioritises individual personhood and the protection of private property, consent has been central to the development of modern law and liberal societies (Munro, 2008). As feminist legal scholar Vanessa Munro argues, in Western legal settings, it ‘demarcate[s] the terrain between acceptable and unacceptable intrusions upon property / bodies’ (Munro, 2008, pp. 923–4) and accredits the liberal subject with its defining features of individuality, rationality and autonomy. In the specific context of sexual violence, consent is endowed with significant power (Hindes, 2022): it is used to arbitrate legal disputes over sexual assault and violence, and determine whether violation has occurred.

In this chapter I address the problem of human suffering. After giving an account of the nature of suffering, I argue that suffering does not justify intending death. However, suffering needs to be understood within the larger story of Christ’s redemptive work.

The Introduction summarises my book’s contents and highlights its key themes. I will argue that there is a human nature, from which flow a raft of ‘pre-moral’ (or ‘ultimate intrinsic’) goods. My Aristotelian (teleological and essentialist) theory of ‘natural perfectionism’ is, I will argue, compatible with Darwinism and subsequent evolutionary biology. It is not an account of normativity across the board, however. Specifically, it does not tackle the manifold quandaries that arise in the domain of practical reason; it does not treat supernatural goods (supposing these to exist); and it does not examine natural perfections in plants or the lower (non-human) animals. Two cautionary notes: first, my book treats perfectionism in the philosophical, not the colloquial, psychological, sense; more specifically, it elaborates a perfectionism of powers or faculties. Second, by focusing on powers or faculties, it avoids the pseudo-essentialisms of class, race, nation, sex etc. Last, I tackle three values that are absent from my book: namely, autonomy, pleasure and wellbeing. These cannot be natural perfections, I argue, because they fall short of being ultimate intrinsic goods.

Anosognosia, a term that denotes a lack of insight into one’s own condition, is a defining characteristic of many psychotic illnesses. As a result, generations of psychiatrists have pursued a paternalistic approach to care. Yet in the past century, the overall trend in patient care has been toward autonomy. What does it mean to respect the autonomy of patients whose lack of insight may bring them harm ? This chapter will explore these questions through each of the four principles generally employed in bioethical analysis: beneficence, nonmaleficence, justice, and autonomy. Each will have an illustrative case study and explore how anosognosia can further complicate already perplexing ethical scenarios.

In the Netherlands, compulsory care of patients with mental disorders such as schizophrenia is regulated by the Law on Compulsory Mental Healthcare (Wet verplichte geestelijke gezondheidszorg or Wvggz). This law replaces its predecessor, the Law on Special Admissions to Psychiatric Hospitals (Wet bijzondere opnemingen in psychiatrische ziekenhuizen or Bopz). The legislative process for this new law took over a decade. Discussions in parliament, with clinicians and in civil society focused much on the complexity of the relevant legal procedures and on the autonomy and legal position of the patients. In this paper, we discuss the Wvggz, its background and the central procedures for the judicial authorization of compulsory care. We also discuss which forms of compulsory care the Wvggz allows – as the Wvggz provides options for compulsory care in mental health clinics, but also at home and in community settings. While the Wvggz is a complex law with many elements, in this paper we focus on various ways the Wvggz is purportedly aimed at enhancing autonomy of patients with severe mental illness. In conclusion, we show how Dutch regulations aimed at enhancing autonomy also create more complexity and bureaucracy for patients.

This chapter delves into the ethical dimensions of treating individuals with schizophrenia, emphasizing the need for a new perspective that integrates neuroethics into interventions. The author proposes a bio-systemic model to understand how schizophrenia impacts different levels of consciousness and freedom, highlighting the necessity for tailored interventions that restore autonomy rather than coercive measures. The chapter calls for a shift in policy towards early and assertive treatment, focusing on rebuilding autonomy and dignity for individuals with schizophrenia. Ultimately, the chapter serves as a call to action for a neuroethically informed approach to care that prioritizes the restoration of freedom and dignity for those affected by schizophrenia.

Human enhancement aims to make people ‘better than well’ by interventions in the human genome. I canvas four moral arguments against this – from (1) autonomy, (2) dignity, (3) inequality and (4) mastery – concluding that none is probative. Argument (1) overestimates the cost to autonomy of genetic technologies and underestimates the degree to which ordinary moral training is heteronomous. Argument (2) drives too sharp a wedge between the natural and the artefactual and thereby ignores the extent to which we already treat the body as a site of ameliorative intervention. Argument (3) invokes the spectre of a ‘genetic underclass’ that is ‘gene-poor’, but I argue that this can be guarded against by education and government policy. Argument (4) tends to rest on persuasive description and on consequentialist claims that are empirically weakly supported. I end by mounting my own, formal, argument against human enhancement. This holds that it collapses into transhumanism, this being an ultimately incoherent project, one that abandons the idea of human nature and with it any criteria for determining what it is to be ‘better than well’. Finally, I corroborate this argument from incoherence by unpacking a paper by Groll and Lott.

Balancing autonomy and beneficence remains an ongoing challenge in the ethical treatment of patients with schizophrenia and other psychiatric disorders of thought. Psychiatric advance directives (PADs) offer one mechanism through which individuals can guide their own care, but unlike medical advance directives, they are not widely utilized in the United States. They are also highly limited by state law in the scope of their legal authority. This article explores the evidentiary basis for PADs as well as the legal and ethical issues that arise in the use of PADsin individuals with schizophrenia, arguing that providers’ fears of complete opt-out from care by patients are likely unfounded and that PADs offer a powerful tool through which individuals with schizophrenia can ensure meaningful consideration of their own values and goals.

A neglected aspect of individual vulnerability is the limits it may pose for epistemological capacity, in particular, how specific circumstances of individual vulnerability may challenge the role individual introspection can play in leading autonomous lives. The chapter proposes and investigates the claim that individual vulnerability can jeopardise the role introspection is usually assumed to play in deciding what course we hope to give our lives. In some cases of vulnerability, individuals may not be able to endorse and take responsibility for choices they make because they don’t trust their introspective knowledge. In this way, vulnerable individuals lose the authoritative grip on their introspective self-knowledge. Yet self-knowledge is a vital condition of individual autonomy: without self-knowledge, individuals lack the internal requirements of personal autonomy. The final part of the chapter discusses of how this aspect of vulnerability plays out for considerations of relational equality.