Skip to main content
Log in

Knowledge, Authority and Identity: A Prolegomenon to an Epistemology of the Clinic

  • Published:
Theoretical Medicine and Bioethics Aims and scope Submit manuscript

Abstract

Disputes about theory in bioethics almost invariablyrevolve around different understandings of morality or practicalreasoning; I here suggest that the field would do well to becomemore explicitly contentious about knowledge, and start the taskof putting together a clinical epistemology. By way of providingsome motivation for such a discussion, I consider two cases ofresistance to shifts in clinical practice that are, by and large,not ethically controversial, highlighting how differentconceptions of epistemic authority may contribute to clinicians'unwillingness to adopt these changes, and sketching out someinitial suggestions for epistemic analysis of clinical practice.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

REFERENCES

  1. Antony L, Witt C, eds. A Mind of One's Own: Feminist Essays on Reason and Objectivity. Boulder, CO: Westview Press, 1993.

    Google Scholar 

  2. Lennon K, Whitford W, eds. Knowing the Difference: Feminist Perspectives in Epistemology. London and New York: Routledge, 1994.

    Google Scholar 

  3. Code L. What Can She Know? Ithaca: Cornell University Press, 1991.

    Google Scholar 

  4. Alcoff L, Potter E, eds. Feminist Epistemologies. New York: Routledge, 1993.

    Google Scholar 

  5. Fricker M, Hornsby J, eds. The Cambridge Companion to Feminism in Philosophy. Cambridge: Cambridge University Press, 2000.

    Google Scholar 

  6. Nelson LH. Who Knows? From Quine to a Feminist Empiricism. Philadelphia: Temple University Press, 1990.

    Google Scholar 

  7. Goldman AI. Knowledge in a Social World. Oxford: Oxford University Press, 1999.

    Google Scholar 

  8. Downie RS, Macnaughton J. Clinical Judgment: Evidence in Practice. Oxford: Oxford University Press, 2000.

    Google Scholar 

  9. Rubin S. When Doctors Say No: The Battleground of Medical Futility. Indianapolis: Indiana University Press, 1998.

    Google Scholar 

  10. Bogdan-Lovis EA. Misreading the power structure: Liberal feminists’ inability to influence childbirth. Michigan Feminist Studies 1996–1997; 11: 59–79.

    Google Scholar 

  11. Bogdan-Lovis EA. The Death of Birth: A Critical Interpretive Analysis of Second Wave Liberal Feminist Efforts to Influence Women's Childbirth Experiences in the United States During the Last Third of the Twentieth Century. Master's Thesis, Michigan State University, 1995.

  12. Curtin SC, Martin JA. Births: Preliminary data for 1999. National Vital Statistics Report 2000; 48(14): 1–21.

    Google Scholar 

  13. The SUPPORT Investigators. A controlled trial to improve care for seriously ill hospitalized patients. JAMA 1995; 274: 1591–1598.

    Google Scholar 

  14. Moskowitz EH, Nelson JL. Dying well in the hospital: The lessons of SUPPORT, Special Supplement. Hastings Center Report 1995; 25(6): S3–S6.

    Google Scholar 

  15. Schroeder S. The legacy of SUPPORT. Annals of Internal Medicine 1999; 131: 780–782.

    Google Scholar 

  16. Wittgenstein L. Philosophical Investigations. New York: Macmillian, 1958.

    Google Scholar 

  17. Walker MU. Moral Understandings: A Feminist Study in Ethics. New York: Routledge, 1998, pp. 153–176.

    Google Scholar 

  18. Bishop JP. Creating narratives in the clinical encounter. Medical Humanities Review 2000; 14(1): 10–23.

    Google Scholar 

  19. Frank AW. From suspicion to dialogue: Relations of storytelling in clinical encounters. Medical Humanities Review 2000; 14(1): 24–34.

    Google Scholar 

  20. Callahan D. The Troubled Dream of Life: Living With Mortality. New York: Simon and Schuster, 1993.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Nelson, J.L. Knowledge, Authority and Identity: A Prolegomenon to an Epistemology of the Clinic. Theor Med Bioeth 22, 107–122 (2001). https://doi.org/10.1023/A:1011460004423

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1011460004423

Navigation