In this paper I formulate the thesis of the Division of Epistemic Labor as a thesis of epistemic dependence, illustrate several ways in which individual subjects are epistemically dependent on one or more of the members of their community in the process of knowledge acquisition, and draw conclusions about the cognitively distributed nature of some knowledge acquisition.

Sanford Goldberg investigates the role that others play in our attempts to acquire knowledge of the world.

Sanford C. Goldberg argues that a proper account of the communication of knowledge through speech has anti-individualistic implications for both epistemology and the philosophy of mind and language. In Part I he offers a novel argument for anti-individualism about mind and language, the view that the contents of one's thoughts and the meanings of one's words depend for their individuation on one's social and natural environment. In Part II he discusses the epistemic dimension of knowledge communication, arguing that the (...) epistemic characteristics of communication-based beliefs depend on features of the cognitive and linguistic acts of the subject's social peers. In acknowledging an ineliminable social dimension to mind, language, and the epistemic categories of knowledge, justification, and rationality, his book develops fundamental links between externalism in the philosophy of mind and language, on the one hand, and externalism is epistemology, on the other. (shrink)

Yes, Roya, a 2016 graphic novel written by C. Spike Trotman and illustrated by Emilee Denich, depicts Roya, a woman of color who writes and illustrates a comic strip; Joe, a white man who gave up his career after meeting Roya, who now publishes under his name; and Wylie, a young white man starting in the profession. Roya completely dominates Joe’s career, making it hers. She also partly dominates Wylie’s, acting as his mentor. Roya dominates Joe and Wylie personally too. (...) She is their sexual dominant, and they are her submissives. Professionally and personally, moreover, Joe and Wylie each submit to Roya consensually. Further, though Roya both writes and illustrates her comic strip, often writer and illustrator differ. The former, creating the story, dominates the latter, illustrating the story after the fact – as Trotman and Denich themselves did consensually via a contract when creating their graphic novel. Hence Yes, Roya highlights domination and submission in comics creation and in sex. More than that, the graphic novel also presents both kinds of domination and submission as ethical. Because Aristotle, Kant, and Mill are the most influential ethicists in the Western tradition, this chapter investigates how each could accommodate such professional and personal dominant/submissive relationships in their philosophy. (shrink)

Doctoral programs at U.S. universities play a critical role in the development of human resources both in the United States and abroad. This volume reports the results of an extensive study of U.S. research-doctorate programs in five broad fields: physical sciences and mathematics, engineering, social and behavioral sciences, biological sciences, and the humanities. Research-Doctorate Programs in the United States documents changes that have taken place in the size, structure, and quality of doctoral education since the widely used 1982 editions. This (...) update provides selected information on nearly 4,000 doctoral programs in 41 subdisciplines at 274 doctorate-granting institutions. This volume also reports the results of the National Survey of Graduate Faculty, which polled a sample of faculty for their views on the scholarly quality of program faculty and the effectiveness of doctoral programs in preparing research scholars/scientists. This much-anticipated update of such an essential reference will be useful to education administrators, university faculty, and students seeking authoritative information on doctoral programs. (shrink)

This book addresses how our revisionary practices account for relations between texts and how they are read. It offers an overarching philosophy of revision concerning works of fiction, fact, and faith, revealing unexpected insights about the philosophy of language, the metaphysics of fact and fiction, and the history and philosophy of science and religion. It will be of interest to a wide range of scholars and advanced students working in philosophy of language, metaphysics, philosophy of literature, literary theory and criticism, (...) and history and philosophy of science and religion. (shrink)

Written by an international team of leading scholars, this collection of thirteen new essays explores the implications of semantic externalism for self-knowledge and skepticism, bringing recent developments in the philosophy of mind, the philosophy of language, and epistemology to bear on the issue. Structured in three parts, the collection looks at self-knowledge, content transparency, and then meta-semantics and the nature of mental content. The chapters examine a wide range of topics in the philosophy of mind and the philosophy of language, (...) including 2D semantics, transparency views of self-knowledge, and theories of linguistic understanding, as well as epistemological debates on contextualism, contrastivism, pragmatic encroachment, anti-luminosity arguments and testimony. The scope of the volume will appeal to graduate students and researchers in epistemology, philosophy of mind, philosophy of language, cognitive science, psychology and linguistics. (shrink)

The scenario of the brain in a vat, first aired thirty-five years ago in Hilary Putnam's classic paper, has been deeply influential in philosophy of mind and language, epistemology, and metaphysics. This collection of new essays examines the scenario and its philosophical ramifications and applications, as well as the challenges which it has faced. The essays review historical applications of the brain-in-a-vat scenario and consider its impact on contemporary debates. They explore a diverse range of philosophical issues, from intentionality, external-world (...) scepticism, and the nature of truth, to the extended mind hypothesis, reference magnetism, and new versions of realism. The volume will be a rich and valuable resource for advanced students in metaphysics, epistemology, and philosophy of mind and language, as well as anyone interested in the relations between language, thought and the world. (shrink)

Internalism and Externalism in Semantics and Epistemology presents eleven specially written essays exploring these debates in metaphysics and epistemology and ...

Within the Judeo-Christian tradition, Sodom and Gomorrah represent locales in which threats to national formation are couched in sexual terms. The biblical narrative insists on a particular social invisibility for those sexual activities not blessed by the bonds of matrimony. Reclaiming Sodom surveys a number of institutions that have had an interest in perpetuating these views: the police, the state, the church and the law. The collection ranges through biblical scholarship, an investigation of the Founding Fathers' beliefs, the legal mobilization (...) towards the category of sodomy in 18th and 19th century England, and the US Supreme Court's 1986 Bowers vs. Hardwick decision. Analysis is provided of the ways in which the Judeo-Christian tradition has shaped anthropological accounts of the same-sex practices of non-Western people, as well as essays on how colonial gestures have marked lesbian identity in the Carribean, and derformed narratives about the racial geography of AIDS. Reclaiming Sodom explores alternatives to the force of the Sodomitic biblical narrative in Islamic, non-western, and western traditions, and discusses the ways in which sodomy calls into question normative definitions of sexuality and gender. The collection pursues the "pleasures and dangers" of these alternatives, and takes on Proust's refusal to imagine a social movement founded on the "stigma" of Sodom. The collection examines the relations between sex/gender identities and sexual acts in important and provocative ways, and argues for the political use and usefulness of both Sodom and sodomy. Reclaiming Sodom makes an important and controversial contribution to the literature on sexuality and gender, as well as the nature of sex in our culture. Contributors: Dorothy Allison, Robert Alter, Neil Bartlett, Leo Bersani, Gerald Creed, Marc Daniel, Lee Edelman, Janet E. Halley, Jonathan Ned Katz, Pierre Klossowski, Rocky O'Donovan, Guy Hocquenghem, Cindy Patton, Marquis de Sade, David Shannon, Makeda Silver, Jonathan Goldberg. (shrink)

One of the central points of contention in the epistemology of testimony concerns the uniqueness (or not) of the justification of beliefs formed through testimony--whether such justification can be accounted for in terms of, or 'reduced to,' other familiar sort of justification, e.g. without relying on any epistemic principles unique to testimony. One influential argument for the reductionist position, found in the work of Elizabeth Fricker, argues by appeal to the need for the hearer to monitor the testimony for credibility. (...) Fricker (1994) argues, first, that some monitoring for trustworthiness is required if the hearer is to avoid being gullible, and second, that reductionism but not anti-reductionism is compatible with ascribing an important role to the process of monitoring in the course of justifiably accepting observed testimony. In this paper we argue that such an argument fails. (shrink)

Given the growing importance of issue competition and the growing use of social media during elections, this study seeks to create a better understanding of how issue dynamics relating to political parties play out on social media. It tests whether issue ownership theory can explain how parties and issues are being discussed on Twitter and to what extent a mediated form of issue ownership aligns with citizens’ perceptions of issue ownership. The results indicate that perceptions of issue ownership as measured (...) in representative surveys correlate with variations of what issues parties are linked with on Twitter. Some deviations also emerged, which possibly reflect short-term changes in parties’ issue competition. Understanding how issue ownership mediates through social media platforms is important in order to evaluate the role of social media in contemporary opinion forming processes and sheds light on the issue competition among political parties in online fora. (shrink)

Marina Sbisà has long advocated that we think of the illocutionary force of a speech act in terms of the act’s (predictable) systematic effects on the normative relationship between a speaker and her audience. Building on this idea, I argue that the hypothesis of distinctive speech act norms can be used to explain how participants in a conversation coordinate the normative expectations they have of one another in conversation. Such an explanation earns its keep by explaining how speakers render themselves (...) illocutionarily intelligible to their audiences—thereby enabling us to articulate the sense of mutuality that characterizes speech exchanges. One important upshot of my reflections is that we should reject both Austin’s thesis that the successful performance of an illocutionary act depends on audience uptake and Sbisà’s claim that Austin’s thesis is required if we are to make sense of the illocutionary dimension of speech in terms of an act’s systematic effects on participants’ normative expectations of one another. (shrink)

Throughout the 3-year war in Lebanon (1982-1985) and throughout the 7 years of the first Intifada (1987-1994), about 170 objecting reservists chose to adopt an unconventional mode of moral resolution for their dilemma about service in the conflict: they disobeyed the order to serve in the war zone when their unit was called up. They argued that such service would contradict the dictates of their conscience. At the outset, the intention of most of these reservists was to comply with orders (...) for general military service. They asked to serve within the Green Line. When their request was overruled and they continued to disregard their call-up, they were charged with a disciplinary offense (Israel has no legal provision for selective conscientious objection). They subsequently were tried by court-martial and were sentenced to 14-35 days in military prison, some of them more than once when they refused additional drafts. Their major conscientious claims revolve around two major constraints: resisting the unfair physical load of military reserve service and resisting the obligation to face morally no-win situations. I would further argue that even though most of the public and the senior army echelons were familiar with these two types of moral voices, they preferred to remove the conscientious soldiers from their posts, or to ignore the claims themselves. (shrink)

This book challenges current thinking on professional ethics and suggests new ways of looking at ethical issues. The contributors to the volume (Michael Goldberg, Richard P. Vance, Deborah Fernhoff, Nancey Murphy, Theophus H. Smith, Jack L. Sammons Jr., William H. Willimon, and Senator John C. Danforth) are outstanding representatives of their respective professions. In this book, using the categories of religion and narrative as methodological tools, they move readers to a more responsive, hopeful, and truthful conduct of the professions.

Jürgen Habermas's theories have received enormous attention in the public sphere as well as in political science. It is therefore surprising that his method, rational reconstruction, is not more debated. In political science the method is of particular interest because of its ambition to bridge the gap between empirical and normative approaches. In this article the author traces Habermas's interest in rational reconstruction by going back to his writings on theory and practice and subsequently shows what the method's main principles (...) are. He then specifies how this methodological conception is used in Habermas's political theory. Finally, the introduction of an empirical design allows the author to discuss one of the fundamental tensions in Habermas's approach: the hypotheses arrived at through rational reconstruction are empirical hypotheses but cannot be tested by empirical means. (shrink)

Recently, we proposed a fundamental subdivision of the human cortex into two complementary networks—an “extrinsic” one which deals with the external environment, and an “intrinsic” one which largely overlaps with the “default mode” system, and deals with internally oriented and endogenous mental processes. Here we tested this hypothesis by contrasting decision making under external and internally-derived conditions. Subjects were presented with an external cue, and were required to either follow an external instruction or to ignore it and follow a voluntary (...) decision process . Our results show that a well defined component of the intrinsic system—the right inferior parietal cortex—was preferentially activated during the “free-will” condition. Importantly, this activity was significantly higher than the base-line resting state. The results support a self-related role for the intrinsic system and provide clear evidence for both hemispheric and regional specialization in the human intrinsic system. (shrink)

Alan Moore and Dave Gibbons’ Watchmen may be the most acclaimed graphic novel of the twentieth century. This chapter examines how it explores two metaphysical questions: What is the nature of time? Does free will exist? Moore and Gibbons explore these questions together, illuminating connections between time and free will through connections between the graphic novel’s form and content. The chapter introduces three views of the nature of time: presentism, the view that only the present exists; growing-universe theory, the view (...) that only the present and past exist; and eternalism, the view that past, present, and future exist. Because of Moore and Gibbons’ distinct use of images and words within the visual structure and their depiction of a character who is simultaneously aware of past, present, and future events, the chapter deduces that the operative view in Watchmen is eternalism. After discussing three views of the existence of free will, the chapter then argues that eternalism entails that people could not have acted otherwise than they actually acted. Hence the operative view in Watchmen is either determinism, according to which no one has free will because no one could have done otherwise, or compatibilism, according to which people can have free will because having it merely requires having acted. The chapter concludes that the operative view is compatibilism. Finally it responds to the objection that compatibilism is mistaken. If no one could have done otherwise, then determinism must be true. (shrink)

For the inaugural Workshop on Philosophy & Engineering (WPE-2007), this abstract asks why engineers are turning now to philosophy. Upon reflection, philosophy and engineering are very different occupations, and engineering has rarely turned to philosophy in the long history of the systematic design and production of complex artifacts. After briefly examining events since World War 2, the extended abstract carries over Kuhn's explanation of the rise of philosophy of science during the intellectual tumult of relativity and quantum physics in the (...) opening moments of the 20th century to the case of engineering in the early moments of the 21st century. Specifically, the paper argues that the crisis of the rapid pace of technological change, reflected in the centripetal forces of the O's (bio, nano, and info) may help explain increased interest in a philosophy of engineering at this time. The abstract concludes by citing a number of ways that philosophy may help clarify what otherwise might be confusing times. (shrink)

In this paper I argue, first, that the most influential (and perhaps only acceptable) account of the epistemology of self-knowledge, developed and defended at great length in Wright (1989b) and (1989c) (among other places), leaves unanswered a question about the psychology of self-knowledge; second, that without an answer to this question about the psychology of self-knowledge, the epistemic account cannot be considered acceptable; and third, that neither Wright's own answer, nor an interpretation-based answer (based on a proposal from Jacobsen (1997)), (...) will suffice as an acceptable answer to the psychological question. My general ambition is thus to establish that more work is needed if we are to have a full account of self-knowledge in both its epistemological and psychological aspects. I conclude by suggesting how my thesis bears on those who aim to provide an empirical account of the cognition involved in self-knowledge. (shrink)

This paper follows a paper by Mitcham and considers whether engineering is among a group of occupations he calls philosophically weak, in the sense that engineering does not aspire to good-in-themselves ideals as do medicine and law. The paper agrees that engineering is philosophically weak, but in the different sense that engineering is not as reflective upon its nature and place in the world as some other professions. The paper recovers Mitcham's distinction by consider the institutional complexity of a given (...) occupation, suggesting that engineering's practice in the context of complex institutional arrangements precludes the relative ethical simplicity of such occupations as medicine and law. (shrink)

The incredible story of the woman--actress, dancer, yogi, globetrotter--who brought yoga to America and to much of the rest of the western world. Born Eugenia Peterson in early 20th century Russia, Indra Devi was a rebel from earliest childhood. In the 1930s she fled to Berlin, and then--driven by her passion for yoga and a fascination with yogic philosophy (and Theosophy)--she journeyed to India, at a time when unaccompanied young European women were unheard of. In India she performed perhaps her (...) greatest feat--convincing even the most recalcitrant yogis, from Krishnamurti to Krishnamacharya, to reveal to her the secrets of their art. She would go on to share what she learned with men and women around the world--teaching Gloria Swanson and Greta Garbo in Hollywood, then moving to Mexico and later to Buenos Aires--helping to usher in the craze for yoga that continues unabated in the U.S. and throughout the world today. Written with vivid clarity, and describing the extraordinary spread and popularization of a philosophical movement, The Goddess Posebrings Indra Devi's little known but wholly remarkable story to life. (shrink)

This paper presented at WPE-2008 uses an industrial-based senior design as an opportunity to understand what what students don't learn in a fairly traditional cold war engineering curriculum. The paper identifies seven deficient skills: questioning, labeling, qualitative modeling, decomposing, visualizing/ideation, empirical testing, and communicating. The talk also identifies five reasons why engineers don't learn these things, and philosophy plays a prominent role in recifying the problem by aiding in providing conceptual clarity and offering alternative models of rigor.

Miranda Fricker's Epistemic Injustice is a wide-ranging and important book on a much-neglected topic: the injustice involved in cases in which distrust arises out of prejudice. Fricker has some important things to say about this sort of injustice: its nature, how it arises, what sustains it, and the unhappy outcomes associated with it for the victim and the society in which it takes place. In the course of developing this account, Fricker also develops an account of the epistemology of testimony. (...) Focusing my attention on that account, my central claims are two. First, at least some of Fricker's arguments against existing (inferentialist and non-inferentialist) views in the epistemology of testimony are less than fully persuasive, and the (non-inferentialist) view she ends up endorsing is not all that different from the views she criticizes. Second, her reasons for harboring doubts regarding the role of a principle of default entitlement within a non-inferentialist account are not persuasive. Neither of these claims affects the overall argument Fricker is trying to run. Rather, they suggest that Fricker may have picked more fights than she needed to in the epistemology of testimony. If so, we have reason to detach Fricker's important work on epistemic injustice from some of the details of the story she tells regarding the epistemology of testimony. (shrink)

Substance addiction affects millions of individuals worldwide and yet there is no consensus regarding its conceptualisation. Recent neuroscientific developments fuel the view that addiction can be classified as a brain disease, whereas a different body of scholars disagrees by claiming that addictive behaviour is a choice. These two models, the Brain Disease Model and the Choice Model, seem to oppose each other directly. This article contends the belief that the two models in the addiction debate are polar opposites. It shows (...) that it is not the large amount of addiction research in itself what sets the models apart, but rather their extrapolated conclusions. Moreover, some of the most fiercely debated aspects - for instance, whether or not addiction should be classified as a disease or disorder - are irrelevant for the conceptualisation of addiction. Instead, the real disagreement is shown to revolve around capacities. Discussing addiction-related capacities, especially regarding impaired control, rather than the assumed juxtaposition of the two models can be considered the true addiction debate. More insight into the extent to which the capacities of the addicted individual were affected would be highly useful in various other areas, especially legal responsibility. (shrink)

Substance addiction affects millions of individuals worldwide and yet there is no consensus regarding its conceptualisation. Recent neuroscientific developments fuel the view that addiction can be classified as a brain disease, whereas a different body of scholars disagrees by claiming that addictive behaviour is a choice. These two models, the Brain Disease Model and the Choice Model, seem to oppose each other directly. This article contends the belief that the two models in the addiction debate are polar opposites. It shows (...) that it is not the large amount of addiction research in itself what sets the models apart, but rather their extrapolated conclusions. Moreover, some of the most fiercely debated aspects - for instance, whether or not addiction should be classified as a disease or disorder - are irrelevant for the conceptualisation of addiction. Instead, the real disagreement is shown to revolve around capacities. Discussing addiction-related capacities, especially regarding impaired control, rather than the assumed juxtaposition of the two models can be considered the true addiction debate. More insight into the extent to which the capacities of the addicted individual were affected would be highly useful in various other areas, especially legal responsibility. (shrink)

Substance addiction affects millions of individuals worldwide and yet there is no consensus regarding its conceptualisation. Recent neuroscientific developments fuel the view that addiction can be classified as a brain disease, whereas a different body of scholars disagrees by claiming that addictive behaviour is a choice. These two models, the Brain Disease Model and the Choice Model, seem to oppose each other directly. This article contends the belief that the two models in the addiction debate are polar opposites. It shows (...) that it is not the large amount of addiction research in itself what sets the models apart, but rather their extrapolated conclusions. Moreover, some of the most fiercely debated aspects - for instance, whether or not addiction should be classified as a disease or disorder - are irrelevant for the conceptualisation of addiction. Instead, the real disagreement is shown to revolve around capacities. Discussing addiction-related capacities, especially regarding impaired control, rather than the assumed juxtaposition of the two models can be considered the true addiction debate. More insight into the extent to which the capacities of the addicted individual were affected would be highly useful in various other areas, especially legal responsibility. (shrink)

The idea that correspondences relating grammatical relations and semantics (argument structure constructions) are needed to account for simple sentence types is reviewed, clarified, updated and compared with two lexicalist alternatives. Traditional lexical rules take one verb as ‘input’ and create (or relate) a different verb as ‘output’. More recently, invisible derivational verb templates have been proposed, which treat argument structure patterns as zero derivational affixes that combine with a root verb to yield a new verb. While the derivational template perspective (...) can address several problems that arise for traditional lexical rules, it still faces problems in accounting for idioms, which often contain specifications that are not appropriately assigned to individual verbs or derivational affixes (regarding adjuncts, modification, and inflection). At the same time, it is clear that verbs play a central role in determining their distribution. The balance between verbs and phrasal argument structure constructions is addressed via the Principles of Semantic Coherence and Correspondence together with a usage‐based hierarchy of constructions that contains entries which can include particular verbs and other lexical material. (shrink)

The paper starts by reflecting on what senior engineering students don't know how to do when they confront a real-world project in an industrially sponsored senior design project. Seven, largely qualitatively, skills are found to be lacking: questioning, labeling, qualitatively modeling, decomposing, measuring, ideating, and communicating. These skills, some of the most important critical and creative thinking skills in the arsenal of modern civilization, are termed "the missing basics" and contrasted with what engineering faculty usually call "the basics." The paper (...) critically examines the term "the basics" and other terms that are conceptual hurdles to fundamental reassessment of engineering education at this time. The paper concludes that the engineering academy is stuck in a Kuhnian paradigm born in the cold war, that the reflexive belief in the superiority of math, science, and engineering science to the exclusion of other topics is not itself scientific, and that the use of tired code words is not an argument or a rational defense of a paradigm that may have outlived its usefulness. The paper concludes by highlighting the role philosophy can play in clearing away the conceptual confusion, thereby permitting a more reasoned conversation on the needs of engineering education in our times. (shrink)

A unique Middle English text on the seven liberal arts survives in Cambridge, Trinity College, MS R. 14.52, a manuscript of ca. 1458–85. Latin texts on the seven liberal arts were certainly in circulation in medieval England, but this text is, to my knowledge, the earliest one written in English. It thereby offers evidence of the vernacular English reader's knowledge of the arts that were the foundation of medieval university education. This text is also unique in that it includes in (...) its chapter on grammar an attempt to describe the phonetic production of the letters of the alphabet, providing the only surviving contemporary approximation of the pronunciation of medieval English, and in that it adds a chapter on the mechanical sciences, relating them as no other medieval author to the English craft guilds. (shrink)

The stereotype content model defines warmth and competence as basic dimensions of social judgment, with warmth often dominating perceptions; it also states that many group-related stereotypes are ambivalent, featuring high levels on one dimension and low levels on the other. Persuasion theories feature both direct and indirect source effects. Combining both the approaches, we studied the persuasiveness of ambivalently stereotyped sources. Participants read persuasive arguments attributed to groups stereotyped as either low in competence but high in warmth or vice versa. (...) In Study 1, high competence/low warmth sources were more persuasive than low competence/high warmth sources. In Study 2, this pattern replicated when an accuracy motive had been induced, whereas it reversed when a connectedness motive had been induced. These source effects were direct, that is, independent of message processing. We discuss our findings in terms of the persuasiveness of warmth vs. competence of the source as being dependent on recipient motivation; we also consider theoretical implications and perspectives for future research. (shrink)

To what extent are meaning, on the one hand, and knowledge, on the other, determined by aspects of the 'outside world'? Internalism and Externalism in Semantics and Epistemology presents twelve specially written essays exploring these debates in metaphysics and epistemology and the connections between them. In so doing, it examines how issues connected with the nature of mind and language bear on issues about the nature of knowledge and justification. Topics discussed include the compatibility of semantic externalism and epistemic internalism, (...) the variety of internalist and externalist positions, semantic externalism's implications for the epistemology of reasoning and reflection, and the possibility of arguments from the theory of mental content to the theory of epistemic justification. (shrink)

If funding allocation is an indicator of a field’s priorities, then the priorities of the field of bioethics are misaligned because they perpetuate injustice. Social justice mandates priority for the factors that drive systematic disadvantage, which tend not to be the areas supported by funding within academic bioethics. Current funding priorities violate social justice by overemphasizing technologies that aim to enhance the human condition without addressing underlying structural inequalities grounded in racism, and by deemphasizing areas of inquiry most frequently pursued (...) by Scholars of Color. This lack of attention to upstream determinants of health in bioethics research perpetuates a gap in the resources needed to understand the experiences of communities disproportionately experiencing poor health, which is itself a form of epistemic injustice. Both social and epistemic injustices are apparent in the impact of these funding priorities on people of color, both in the public and in the bioethics community. (shrink)

No political, economic, or cultural segment of society has escaped the universal impact of recent cataclysmic change. Physicians were no exception. During the 20th century, all members of society, including physicians, have experienced change of enormous speed and magnitude. Futurist Alvin Toffler noted that global societal transformation has created a of personal malaise that poses difficulty for both individual and group adaptation. Toffler further described current change as a fundamental shift and conflict in all aspects of civilization (how we live, (...) work, and relate to each other). Toffler also noted major alterations in the basis for distribution of societal power (who controls what, why, and how). One manifestation of recent change directly affecting all members of society, includingphysicians, has been the social transformation of medicine that has been a power shift from the individual physicians to control by organizations and management. (shrink)