Clinical medicine is the application of scientific principles, rules of thumb, and a store of practical wisdom embodied in narratives of individual cases to the care of a person who is ill. Physicians are taught to observe and report the individual case both as a means of fitting nomothetic generalizations to the given circumstances and as a way of refining those generalizations. This narrative construction of illness is a principal way of knowing in medicine. In this view, disease is not (...) so much an entity as an identifiable chronological organization of the events of illness, and medicine, rather than a science, a rational science-using activity in the service of the ill. Keywords: medical epistemology, casuistry, clinical judgment, narrative CiteULike Connotea Del.icio.us What's this? (shrink)

How Doctors Think defines the nature and importance of clinical judgment. Although physicians make use of science, this book argues that medicine is not itself a science but rather an interpretive practice that relies on clinical reasoning. A physician looks at the patient's history along with the presenting physical signs and symptoms and juxtaposes these with clinical experience and empirical studies to construct a tentative account of the illness. How Doctors Think is divided into four parts. Part one introduces the (...) concept of medicine as a practice rather than a science; part two discusses the idea of causation; part three delves into the process of forming clinical judgment; and part four considers clinical judgment within the uncertain nature of medicine itself. In How Doctors Think, Montgomery contends that assuming medicine is strictly a science can have adverse side effects, and suggests reducing these by recognizing the vital role of clinical judgment. (shrink)

How do we know what is right, or before that, how do we recognize what is morally salient? Such matters lie deeper than can be plumbed by traditional philosophical modes of inquiry alone. Careful study of them requires also the study of literature, with the meticulous appraisal that it encourages of the intricate, tangled issues involved in apprehending the world, finding our way in it, and representing it to others. In this way, the study of literature contributes to a richer (...) and more complex perspective on moral problems, and a more cautious view of the status and breadth of attempts to solve those problems. (shrink)

This essay attempts to rethink what is here called “the Socratic Moment” in Western philosophy, that is, the unique turn that philosophy takes in the early Socratic dialogues of Plato. The essay begins by contesting the traditional view that the goal of Socratic inquiry is to gain irrefutable knowledge of ethical concepts such as courage, justice, friendship, and the holy for the purposes of future action. It argues instead, through a close reading of key passages from Plato’s Apology and Euthyphro, (...) that Socratic inquiry actually begins with the concept under consideration in order to put the interlocutor themself—their beliefs and their actions—into question. (shrink)

In Moral Passages, Kathryn Pyne Addelson presents an original moral theory suited for contemporary life and its moral problems. Her basic principle is that knowledge and morality are generated in collective action, and she develops it through a critical examination of theories in philosophy, sociology and women's studies, most of which hide the collective nature and as a result hide the lives and knowledge of many people. At issue are the questions of what morality is, and how moral theories (...) (whether traditional or feminist) are implemented. Addelson takes up a large number of historical cases and contemporary social problems, including teen pregnancy, contraception and abortion, and gay rights. These cases allow her to see how the knowledge and lives of some people are declared deviant or immoral, while those of others appear to show the public consensus. One case she uses throughout the book is Margaret Sanger's early work on birth control with the anarcho-syndicalist movement--a revisionist history that reveals rather than hides the collective nature of morality and knowledge. Addelson shows how the usual individualist philosophies promote theories which hide the authority of the professionals who make them. A collectivist approach, she argues, must show the part professionals play in collective action. Her aim is to allow professional knowledge makers to be morally and intellectually responsible. Based on Addelson's twenty years of work in feminist philosophy and interactionist sociology as well as her long-standing involvement in women's community organization, Moral Passages investigates how morality and knowledge are collectively enacted in today's world. (shrink)

I am persuaded both by the theory of evil advanced by Claudia Card in The Atrocity Paradigm and by the idea that there are evils done to the environment; however, I argue that the theory of evil she describes has difficulty living up to her claim that it "can make sense of ecological evils the victims of which include trees and even ecosystems" (2002, 16). In this paper, I argue that Card's account of evil does not accommodate the kinds of (...) harms inflicted on ecosystems and such nonhuman individuals as trees. I consider the possibility that Card intends a much broader version of evils than the language of the atrocity paradigm lets on, with its attention to sentience and dignity. I'm so persuaded by the atrocity paradigm, however, that I retain the centrality of suffering and introduce the idea that atrocities are intuitively massive, that is, done to groups or generations and not an individual person, animal or tree, so that the paradigm encourages us to think of evil as it relates to far more holistic entities which include the sentient. Evil may require the sort of suffering that only sentience can give rise to, which is not to say we let out trees but says rather that it is impossible to identify wrongs to ecosystems and groups that are not also intertwined with the fates of their sentient dependents. I conclude that Card is right to emphasize victims' suffering as a chief component of evil, and that the ontology of what constitutes a victim must be interpreted broadly, not the notion of suffering. (shrink)

The article “Revive and Refuse: Capacity, Autonomy, and Refusal of Care After Opioid Overdose,” Marshall et al. (2024) highlights the critical issue of care after an opioid overdose. “Revive and Re...

Pretty much everyone knows that our genes have at least something to do with how able or how high achieving we are. Some believe that we should not speak of this common knowledge, nor inquire into how genetic influence works or what it might mean. If we do not keep an open mind to the fact of genetic influence on academic achievement, however, then we cannot explore its possible implications. And if we do not consider the implications, then we cannot, (...) as a society, harness any potential benefits or avoid possible pitfalls. So that's what this essay is about—exploring what behavioral genetics research might be able to offer to educational theory, policy, and practice.We cannot yet use biological information to make accurate predictions for all children. We do know, however, that academic achievement is heritable, which is to say that differences between individuals are influenced by differences in their DNA. If genes are part of the problem for some pupils (to take the negative spin on this), then it seems likely that studying them could be part of a solution. And that's what behavioral geneticists are trying to do—to chart and understand pathways from DNA to behavior and to identify interventions that can maximize outcomes for all. The fact is, though, that we have an awfully long way to go. (shrink)

This book is a complete re-thinking of Aristotle's metaphysical theory of material substances. The view of the author is that the 'substances' are the living things, the organisms: chiefly, the animals. There are three main parts to the book: Part I, a treatment of the concepts of substance and nonsubstance in Aristotle's Categories; Part III, which discusses some important features of biological objects as Aristotelian substances, as analysed in Aristotle's biological treatises and the de Anima; and Part V, which attempts (...) to relate the conception of substance as interpreted so far to that of the Metaphysics itself. The main aim of the study is to recreate in modern imagination a vivid, intuitive understanding of Aristotle's concept of material substance: a certain distinctive concept of what an individual material object is. (shrink)

Sometimes form-meaning mappings in language are not arbitrary, but iconic: they depict what they represent. Incorporating iconic elements of language into a compositional semantics faces a number of challenges in formal frameworks as evidenced by the lengthy literature in linguistics and philosophy on quotation/direct speech, which iconically portrays the words of another in the form that they were used. This paper compares the well-studied type of iconicity found with verbs of quotation with another form of iconicity common in sign languages: (...) classifier predicates. I argue that these two types of verbal iconicity can, and should, incorporate their iconic elements in the same way using event modification via the notion of a context dependent demonstration. This unified formal account of quotation and classifier predicates predicts that a language might use the same strategy for conveying both, and I argue that this is the case with role shift in American Sign Language. Role shift is used to report others’ language and thoughts as well as their actions, and recently has been argued to provide evidence in favor of Kaplanian “monstrous” indexical expressions. By reimagining role shift as involving either quotation for language demonstrations or “body classifier” predicates for action demonstrations, the proposed account eliminates one major argument for these monsters coming from sign languages. Throughout this paper, sign languages provide a fruitful perspective for studying quotation and other forms of iconicity in natural language due to their lack of a commonly used writing system which is otherwise often mistaken as primary data instead of speech, the rich existing literature on iconicity within sign language linguistics, and the ability of role shift to overtly mark the scope of a language report. In this view, written language is merely a special case of a more general phenomenon of sign and speech demonstration, which accounts more accurately for natural language data by permitting more strict or loose verbatim interpretations of demonstrations through the context dependent pragmatics. (shrink)

The authors examine the nature of the relationship between social science and philosophy and address the sort of work social science should do, and the role and sorts of claims that an accompanying philosophy should engage in. In particular, the authors reintroduce the question of ontology, an area long overlooked by philosophers of social science, and present a cricital engagement with the work of Roy Bhaskar. The book argues against the excesses of philosophising and commits itself to a philosophical approach (...) more deeply grounded in the social sciences. (shrink)

This book is a re-thinking of Aristotle's metaphysical theory of material substances. The view of the author is that the 'substances' are the living things, the organisms: chiefly, the animals. There are three main parts to the book: Part I, a treatment of the concepts of substance and nonsubstance in Aristotle's Categories; Part III, which discusses some important features of biological objects as Aristotelian substances, as analysed in Aristotle's biological treatises and the de Anima; and Part V, which attempts to (...) relate the conception of substance as interpreted so far to that of the Metaphysics itself. The main aim of the study is to recreate in modern imagination a vivid, intuitive understanding of Aristotle's concept of material substance: a certain distinctive concept of what an individual material object is. (shrink)

"Change is not merely necessary to life--it is life." That's Alvin Toffler, characteristically stating the profound in a profoundly direct way. And yes, even when we see change coming--as we're about to graduate from school, take a new job, get married--it's still not so easy to accept. And when we don't see it coming--oof, we have an even harder time. Here to help us embrace change and defuse its unsettling power is Change Happens, a full-color illustrated gift book to consult, (...) to share, to give, and to keep on a night table. Curated by Kathryn and Ross Petras, the ultimate connoisseurs of quotes whose books and calendars have over 4.5 million copies in print, these words of wisdom inspire us to be open to change and remind us that nothing positive in life ever happens without it. Arranged alphabetically by subject--including Adapting, Curveballs, Faith, Letting Go, Regrets, Second Chances, Vulnerability--it's a book to turn to in moments of need, when offering advice to a friend or loved one, when urging a child to find the courage to take a step, when marking an important occasion. (shrink)

The author develops her account of Claudia Card's ethical work as nonideal ethical theory (NET). She clarifies Card's role in ethical theorizing of the recent past, partly in order to brief the unfamiliar reader on Card's ethics and nonideal theory, and partly to enter Card's contributions into the story of nonideal theory's emergence in philosophy. She then recommends, to other NET philosophers, the prioritization of (i) Card's rejection of the "administrative point of view", and (ii) Card's focus on "intolerable harms" (...) as critical to excellent ethical theorizing. She ends with the observation that NET may helpfully point toward reasons to take a pessimistic stance toward moral progress as elaborated in some classic texts in political philosophy; her appreciation of Card's insights yields a variety of pessimism that Card herself did not share. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Elements of Eleatic Ontology' MONTGOMERY FURTH THE TASKOF AN INTERPRETERof Parmenides is to find the simplest, historically most plausible, and philosophically most comprehensible set of assumptions that imply (in a suitably loose sense) the doctrine of 'being' set out in Parmenides' poem. In what follows I offer an interpretation that certainly is simple and that I think should be found comprehensible. Historically, only more cautious claims are possible, (...) for several portions of the general view from which I 'deduce the poem' are not clearly stated in the poem itself; my explanation of this is that they are operating as tac/t assumptions, and indeed that the poem is best thought of as an attempt to force these very assumptions to the surface for formulation and criticism -that the poem is a challenge. To be sure, there are dangers in pretending, as for dramatic purposes I shall, that ideas are definite and explicit which for Parmenides himself must have been tacit or vague--that Parmenides knew what he was doing as clearly as I represent him; I try to avoid them, but the risk must be taken. I even believe that not to take it, in the name of preserving his thought pure from anachronous contamination, actually prevents us from seeing the extent to which he, pioneer, was ahead of his timc the argument works both ways. So let me hedge my historical claim in this way: the view I shall discuss could have been an active-indeed a controlling---element of Eleaticism; to suppose that Parmenides held it not only explains the poem, but also helps explain the subsequent reactions to Eleaticism of Anaxagoras, Democritus, and Plato (though there is not space to elaborate this here). In addition, it brings his thought astonishingly close to some contemporary philosophical preoccupations. In the first of the following sections, I lay down some sketchy but necessary groundwork concerning the early Greek concept of 'being.' Then in Section 2 an interpretation is given of what I take to be the central Parmenidean doctrine, that 'it cannot be said that anything is not.' This section is the lengthiest and most involved, but it also contains all the moves that appear to be important. Of the remaining sections, Section 3 exp]Mn.qthe principle: 'of what is, all that can be said is: it is,' Section 4 deals briefly with the remaining cosmology of "The Way of Truth," and Section 5 considers the question whether Parmenides himself believed the fantastic conclusions of his argument. There is a short postscript on a point of methodology. 1. A Word on 6v If we are to examine Parmenides' reasoning profitably, an indispensable pre1This paper wasprepared while the author was beneficiary of a Grant-in-Aid of Research from the American Council of Learned Societies, hereby gratefully acknowledged. [111] 112 HISTORY OF PHILOSOPHY liminary is to estabhsh at least a provisional reading for the Greek words translated "is" or "it is" (tar,v), "what is" or "being" (Sv,rb 5v), "to be" (alva0. For while it is evident enough that in his poem Parmenides purports to be delivering an insight of the utmost significance concerning rb tbv (as he calls it), still the construction which he puts upon the term and its cognates, and the understanding which he expects of his listener, are not so clear and have been topics of dispute. Especially notable, and often noted, is the fact that Parmenides' discussion of 'being' shows no sign of the conceptual distinction considered elementary nowadays, between the "is" linking subject and predicate and the "is" of existence; and in fact it needs no documentation here that this distinction was not reflected in either ordinary or philosophical Greek idiom until, at least, a much later date than his, the word tare expressing both concepts. Also highly visible in the poem is the abundance of occurrences of tare used absolutely, unaccompanied by any predicate expression. As a result of this last, the poem can create in the contemporary reader the impression that r5 tSv is being used to mean what is in the existential sense only, to mean what there is; indeed some students of the poem conclude not only that Parmenides... (shrink)

Marketers use autobiographical advertising as a means to create nostalgia for their products. This research explores whether such referencing can cause people to believe that they had experiences as children that are mentioned in the ads. In Experiment 1, participants viewed an ad for Disney that suggested that they shook hands with Mickey Mouse as a child. Relative to controls, the ad increased their confidence that they personally had shaken hands with Mickey as a child at a Disney resort. The (...) increased confidence could be due to a revival of a true memory or the creation of a new, false one. In Experiment 2, participants viewed an ad for Disney that suggested that they shook hands with an impossible character (e.g., Bugs Bunny). Again, relative to controls, the ad increased confidence that they personally had shaken hands with the impossible character as a child at a Disney resort. The increased confidence is consistent with the notion that autobiographical referencing can lead to the creation of false or distorted memory. ᭧ 2002 John Wiley & Sons, Inc. (shrink)

There is conflicting experimental evidence about whether the “stakes” or importance of being wrong affect judgments about whether a subject knows a proposition. To date, judgments about stakes effects on knowledge have been investigated using binary paradigms: responses to “low” stakes cases are compared with responses to “high stakes” cases. However, stakes or importance are not binary properties—they are scalar: whether a situation is “high” or “low” stakes is a matter of degree. So far, no experimental work has investigated the (...) scalar nature of stakes effects on knowledge: do stakes effects increase as the stakes get higher? Do stakes effects only appear once a certain threshold of stakes has been crossed? Does the effect plateau at a certain point? To address these questions, we conducted experiments that probe for the scalarity of stakes effects using several experimental approaches. We found evidence of scalar stakes effects using an “evidence seeking” experimental design, but no evidence of scalar effects using a traditional “evidence-fixed” experimental design. In addition, using the evidence-seeking design, we uncovered a large, but previously unnoticed framing effect on whether participants are skeptical about whether someone can know something, no matter how much evidence they have. The rate of skeptical responses and the rate at which participants were willing to attribute “lazy knowledge”—that someone can know something without having to check—were themselves subject to a stakes effect: participants were more skeptical when the stakes were higher, and more prone to attribute lazy knowledge when the stakes were lower. We argue that the novel skeptical stakes effect provides resources to respond to criticisms of the evidence-seeking approach that argue that it does not target knowledge. (shrink)

In this classic work, often described as "The History of the Rise, Decline, and Fall of the Love Affair," Denis de Rougemont explores the psychology of love from the legend of Tristan and Isolde to Hollywood. At the heart of his ever-relevant inquiry is the inescapable conflict in the West between marriage and passion--the first associated with social and religious responsiblity and the second with anarchic, unappeasable love as celebrated by the troubadours of medieval Provence. These early poets, according to (...) de Rougemont, spoke the words of an Eros-centered theology, and it was through this "heresy" that a European vocabulary of mysticism flourished and that Western literature took on a new direction.Bringing together historical, religious, philosophical, and cultural dimensions, the author traces the evolution of Western romantic love from its literary beginnings as an awe-inspiring secret to its commercialization in the cinema. He seeks to restore the myth of love to its original integrity and concludes with a philosophical perspective on modern marriage. (shrink)

The nature of moral action versus moral judgment has been extensively debated in numerous disciplines. We introduce Virtual Reality (VR) moral paradigms examining the action individuals take in a high emotionally arousing, direct action-focused, moral scenario. In two studies involving qualitatively different populations, we found a greater endorsement of utilitarian responses–killing one in order to save many others–when action was required in moral virtual dilemmas compared to their judgment counterparts. Heart rate in virtual moral dilemmas was significantly increased when compared (...) to both judgment counterparts and control virtual tasks. Our research suggests that moral action may be viewed as an independent construct to moral judgment, with VR methods delivering new prospects for investigating and assessing moral behaviour. (shrink)

Jaakko Hintikka points out the power of Skolem functions to affect both what there is and what we know. There is a tension in his presupposition that these functions actually extend the realm of logic. He claims to have resolved the tension by “reconstructing constructivism” along epistemological lines, instead of by a typical ontological construction; however, after the collapse of the distinction between first and second order, that resolution is not entirely satisfactory. Still, it does throw light on the conceptual (...) analysis Hintikka proposes. (shrink)

Feminist philosophy is now an established subdiscipline, but it began as an effort to transform the profession. Academics and activists worked together to make the new courses, and feminist theory was tested in the streets. As time passed, the "second wave" receded, but core elements of feminist theory were preserved in the academy. How can feminist philosophers today continue the early efforts of changing profession and the society, hand in hand with women outside the academy.

Nearly $2 trillion is spent annually in the U.S. treating chronic illness — yet accessibility to quality health care services in rural communities for the chronically ill and dying remains problematic. Unique barriers present special challenges to a meaningful discussion of and subsequent strategies for addressing these issues in the context of increasingly scarce resources.