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)
I sketch an explanatory framework that fits a variety of contemporary research programs in cognitive science. I then investigate the scope and the implications of this framework. The framework emphasizes (a) the explanatory role played by the semantic content of cognitive representations, and (b) the important mechanistic, non-intentional dimension of cognitive explanations. I show how both of these features are present simultaneously in certain varieties of cognitive explanation. I also consider the explanatory role played by grounded representational content, that is, (...) content evaluated by appeal to its truth, falsity, accuracy, inaccuracy and other relational properties. (shrink)
With some regularity, cognitive scientists seem to introduce cognitive values into their explanations. After identifying examples of this practice, I sketch an account of psychological explanation that, under certain conditions, legitimizes value-laden cognitive explanations in which evaluative claims appear in the explanandum. I then present and discuss two applications of the proposed account in order to show its viability and explore its consequences.
I offer support for the view that physicalist theories of cognition don't reduce to neurophysiological theories. On my view, the mind-brain relationship is to be explained in terms of evolutionary forces, some of which tug in the direction of a reductionistic mind-brain relationship, and some of which which tug in the opposite direction. This theory of forces makes possible an anti-reductionist account of the cognitive mind-brain relationship which avoids psychophysical anomalism. This theory thus also responds to the complaint which arguably (...) lies behind the Churchlands' strongest criticisms of anti-reductionism — namely the complaint that anti-reductionists fail to supply principled explanations for the character of the mind-brain relationship. While lending support to anti-reductionism, the view defended here also insures a permanent place for mind-brain reduction as an explanatory ideal analogous to Newtonian inertial motion or Aristotelian natural motion. (shrink)
A critical survey of recent work on the ontological status of colors supports the conclusion that, while some accounts of color can plausibly be dismissed, no single account can yet be endorsed. Among the remaining options are certain forms of color realism according which familiar colors are instantiated by objects in our extra-cranial visual environment. Also still an option is color anti-realism, the view that familiar colors are, at best, biologically adaptive fictions, instantiated nowhere.I argue that there is simply no (...) fact of the matter as to which of these remaining options is correct. I blame this indeterminacy on the fact that color vision exhibits several of the hallmarks of a modular input system, as described by Jerry Fodor in The Modularity of Mind. (shrink)
While private sector investment plays a key role in fostering sustainable economic development in developing countries, respect for internationally recognized worker rights is also a vital component. The paper presents a methodology to assist investors in largescale private infrastructure and other industry sector projects to utilize internationally recognized core labor rights and related standards for fostering sound labor management. The methodology involves due diligence or analysis of labor conditions and subsequent supervision and monitoring of performance and promotes the use of (...) best practices to complement existing minimum requirements. Case study examples are presented and challenges in applying the approach are discussed. (shrink)
Scholars have a history of crossing intellectual borders (Abbott, 2001). In particular, educators draw from a diversity of intellectuals upon which to base our understanding of, for example, schools and society, curriculum content, teaching, and learning. In addition to icons such as Marx, James, Freud, and Dewey, the works of the Frankfurt School (e.g., Horkheimer, Adorno, Marcuse), Foucault, Gilligan, Derrida, Gramsci, West, Arendt, and Fraser, just to name a few, have been used to guide our scholarship and practice. However, with (...) the exception of few scholars (e.g., Peters & Ghiraldelli, 2001), one of America's most controversial scholars,1 Richard Rorty, has been largely ignored. This situation is unfortunate .. (shrink)
Carpendale & Lewis (C&L) contend that correlations between sociolinguistic factors and theory-of-mind performance indicate that social knowledge develops from social interactive processes. However, theory-theory proponents also regard these correlations as compatible with their view of how mental concepts develop. A more fruitful distinction lies in the differences of both accounts in explaining how mental concepts acquire meaning.
We examine the link between the growing emphasis on corporate social responsibility at the organizational level and beliefs about social responsibility at work (SRW) expressed by individuals. Drawing from theories of professionalism and diffusion of innovations (including practices and beliefs), we advance hypotheses about beliefs of managers and non-managers in 11 countries at two time periods, and use a unique international data set to test our hypotheses. Our general prediction that managers would score higher than non-managers on a measure of (...) SRW was not supported. However, further analysis revealed a more complex relationship moderated by the contextual factors of time frame and country inequality level. We discuss implications and extensions for future research. (shrink)
Concerns are frequently raised about the extent to which formal consent procedures actually lead to “informed” consent. As part of a study of consent to high-risk medical procedures, we analyzed in-depth interviews with 16 health care professionals working in bone-marrow transplantation in Sydney, Australia. We find that these professionals recognize and act on their responsibility to inform and educate patients and that they expect patients to reciprocate these efforts by demonstrably engaging in the education process. This expectation is largely implicit, (...) however, and when it is not met, this can give rise to trouble that can have adverse consequences for patients, physicians, and relationships within the clinic. We revisit the concept of the sick role to formalize this new role expectation, and we argue that “informed” consent is a process that is usually incomplete, despite trappings and assumptions that help to create the illusion of completeness. (shrink)
Three case studies offered here will support the conclusion that a successful scientific theory of visual cognition still makes room for some rather systematic and rather striking semantic indeterminacies-W.V. Quine's well-known pessimism about the wages of such indeterminacy not withstanding. The first case concerns the perception of shape, the second concerns color vision, and the third concerns the rules of inference involved in "unconscious inference" within the visual system.
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)
In Use and Abuse Revisited: Response to Pluhar and Varner, Kathryn Paxton George misunderstands the point of my essay, In Defense of the Vegan Ideal: Rhetoric and Bias in the Nutrition Literature. I did not claim that the nutrition literature unambiguously confirms that vegans are not at significantly greater risk of deficiencies than omnivores. Rather than settling any empirical controversy, my aim was to show how the literature can give the casual reader a skewed impression of what is known (...) about the risks of a vegan diet. In this brief rejoinder, I illustrate how two essays by nutritionists in the same volume as George's and my essays, and a referee's report on my manuscript which was authored by a nutritionist, confirm the soundness of this basic insight. (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)