This paper praises and criticizes Peter-Paul Verbeek’s What Things Do ( 2006 ). The four things that Verbeek does well are: (1) remind us of the importance of technological things; (2) bring Karl Jaspers into the conversation on technology; (3) explain how technology “co-shapes” experience by reading Bruno Latour’s actor-network theory in light of Don Ihde’s post-phenomenology; (4) develop a material aesthetics of design. The three things that Verbeek does not do well are: (1) analyze the material conditions in which (...) things are produced; (2) criticize the social-political design and use context of things; and (3) appreciate how liberal moral-political theory contributes to our evaluation of technology. (shrink)
Abstract: Don Ross’ Economic Theory and Cognitive Science (2005) provides an elaborate philosophical defense of neoclassical economics. He argues that the central features of neoclassical theory are associated with what he calls the Robbins-Samuelson argument pattern and that it can be reconciled with recent developments in experimental and behavioral economics, as well as contemporary cognitive science. This paper argues that Ross’ Robbins-Samuelson argument pattern is not in the work of either Robbins or Samuelson and in many ways is in conflict (...) with their own versions, and defenses, of neoclassical theory. (shrink)
En muchos lugares y ambientes asistimos a condiciones muy preocupantes para los seres humanos. Las relaciones que establecemos, en ocasiones, no humanizan. Urgen otras posibilidades y condiciones antropológicas para reorientar nuestras acciones y los vínculos con los otros. La antropología de la donación prescribe la gratuidad de la existencia y entiende al hombre como un don. Propone entonces una revisión de muchas categorías antropológicas para instaurar un orden de gratuidad y donación para la existencia.
The implementation of Responsible Research and Innovation is not without its challenges, and one of these is raised when societal desirability is included amongst the RRI principles. We will argue that societal desirability is problematic even though it appears to fit well with the overall ideal. This discord occurs partly because the idea of societal desirability is inherently ambiguous, but more importantly because its scope is unclear. This paper asks: is societal desirability in the spirit of RRI? On von Schomberg’s (...) account, it seems clear that it is, but societal desirability can easily clash with what is ethically permissible; for example, when what is desirable in a particular society is bad for the global community. If that society chose not to do what was desirable for it, the world would be better off than if they did it. Yet our concern here is with a more complex situation, where there is a clash with ethical acceptability, but where the world would not be better off if the society chose not do what was societally desirable for itself. This is the situation where it is argued that someone else will do it if we do not. The first section of the paper gives an outline of what we take technology to be, and the second is a discussion of which criteria should be the basis for choosing research and innovation projects. This will draw on the account of technology outlined in the first section. This will be followed by an examination of a common argument, “If we don’t do it, others will”. This argument is important because it appears to justify acting in morally dubious ways. Finally, it will be argued that societal desirability gives support to the “If we don’t…” argument and that this raises some difficulties for RRI. (shrink)
The clash between these two dimensions of human condition – but also their complementary nature – make utopia and melancholy specially compelling as they address us today from Don Quixote’s text, providing an accurate standing from which both the author and his protagonist become our contemporaries. Taking an ethic point of departure, we shall consider the aim of the fantasies of Don Quixote is to modify the reality in a certain moral sense, despite of his ridiculously and impractical goals. At (...) the same time The Quixote’s utopia is interrelated with the melancholic Quixote’s character. The melancholy arises from the ethic conscience which is leaded by the moral duty of the justice. This article shows clearly the double melancholic and utopian nature of Don Quixote’s character, which is chaired by a modern ethic conscience. (shrink)
Book Symposium on Don Ihde’s Expanding Hermeneutics: Visualism in Science Content Type Journal Article Category Book Symposium Pages 1-22 DOI 10.1007/s13347-011-0060-5 Authors Jan Kyrre Berg Olsen Friis, University of Copenhagen, Nørre Farimagsgade 5 A, Room 10.0.27, 1014 Copenhagen, Denmark Larry A. Hickman, The Center for Dewey Studies, Southern Illinois University Carbondale, Carbondale, IL 62901, USA Robert Rosenberger, School of Public Policy, Georgia Institute of Technology, DM Smith Building, 685 Cherry Street, Atlanta, GA 30332-0345, USA Robert C. Scharff, University of New (...) Hampshire, Durham, NH 03824-3574, USA Don Ihde, Stony Brook University, Harriman Hall 221, Stony Brook, NY 11794-3750, USA Journal Philosophy & Technology Online ISSN 2210-5441 Print ISSN 2210-5433. (shrink)
En este artículo se utiliza el mito y la figura de Anfitrión para analizar el juego situacional entre los roles antitéticos, pero también complementarios, del anfitrión y el invitado, así como la dialéctica entre lo privado y lo público. Por último, el mito da pie para analizar el complejo papel de la deuda moral en dicha interactuaciónDon, público, privado, deuda moral, anfitrión, invitado.
You’re imagining, in the course of a different game of make-believe, that you’re a bank robber. You don’t believe that you’re a bank robber. You are moved to point your finger, gun-wise, at the person pretending to be the bank teller and say, “Stick ‘em up! This is a robbery!”.
This paper takes on several distinct but related tasks. First, I present and discuss what I will call the “Ignorance Thesis,” which states that whenever an agent acts from ignorance, whether factual or moral, she is culpable for the act only if she is culpable for the ignorance from which she acts. Second, I offer a counterexample to the Ignorance Thesis, an example that applies most directly to the part I call the “Moral Ignorance Thesis.” Third, I argue for a (...) principle—Don’t Know, Don’t Kill—that supports the view that the purported counterexample actually is a counterexample. Finally, I suggest that my arguments in this direction can supply a novel sort of argument against many instances of killing and eating certain sorts of animals. (shrink)
Clayton Littlejohn claims that the permissibility solution to the lottery paradox requires an implausible principle in order to explain why epistemic permissions don't agglomerate. This paper argues that an uncontentious principle suffices to explain this. It also discusses another objection of Littlejohn's, according to which we’re not permitted to believe lottery propositions because we know that we’re not in a position to know them.
Resistance to contextualism comes in the form of many very different types of objections. My topic here is a certain group or family of related objections to contextualism that I call “Now you know it, now you don’t” objections. I responded to some such objections in my “Contextualism and Knowledge Attributions” a few years back. In what follows here, I will expand on that earlier response in various ways, and, in doing so, I will discuss some aspects of David Lewis’s (...) recent paper, “Elusive Knowledge.”. (shrink)
Internalism about a person's good is roughly the view that in order for something to intrinsically enhance a person's well-being, that person must be capable of caring about that thing. I argue in this paper that internalism about a person's good should not be believed. Though many philosophers accept the view, Connie Rosati provides the most comprehensive case in favor of it. Her defense of the view consists mainly in offering five independent arguments to think that at least some form (...) of internalism about one's good is true. But I argue that, on closer inspection, not one of these arguments succeeds. The problems don't end there, however. While Rosati offers good reasons to think that what she calls 'two-tier internalism' would be the best way to formulate the intuition behind internalism about one's good, I argue that two-tier internalism is actually false. In particular, the problem is that no substantive theory of well-being is consistent with two-tier internalism. Accordingly, there is reason to think that even the best version of internalism about one's good is in fact false. Thus, I conclude, the prospects for internalism about a person's good do not look promising. (shrink)
Deliberation is often seen as the site of human freedom, but the binding power of rationality seems to imply that deliberation is, in its own way, a deterministic process. If one knows the starting preferences and circumstances of an agent, then, assuming that the agent is rational and that those preferences and circumstances don’t change, one should be in a position to predict what the agent will decide. However, given that an agent could conceivably confront equally attractive alternatives, it is (...) an open question whether rational choice theory can ever eliminate indeterminacy. The clearest support for such a limitation comes from the “Buridan’s ass” scenario, where an agent is confronted with two (or more) equally attractive/unattractive options. Does rationality by itself have the resources needed to prevent such paralysis of action? Those who cannot accept the idea of decisional impotence devise various ways to avoid it: postulating a neutral valence, tipping the utilities, positing sub-personal influences, and bunching the options. I argue that each of these responses is either unwarranted or flawed. All parties to the debate agree that, factually, paralysis of action is not a pervasive phenomenon. This is either because (i) the utilities one assigns to two or more options can never be balanced or because (ii) thanks to some non-rational faculty (say, the will), we would not be stuck even if those utilities were perfectly counterpoised. By looking critically at four untenable responses, I aim to show that (i) is often just a dogma and (ii) is by no means a silly position. (shrink)
By way of an example, Lewis imagines your being invited to join Schrödinger’s cat in its box for an hour. This box will either fill up with deadly poison fumes or not, depending on whether or not some radioactive atom decays, the probability of decay within an hour being 50%. The invitation is accompanied with some further incentive to comply (Lewis sets it up so there is a significant chance of some pretty bad but not life-threatening punishment if you don’t (...) get in the box). Lewis argues that the many minds theory implies that you should get in the box with the cat, despite this making it 50% likely you will die. (shrink)
We are rational creatures, in that we are beings on whom demands of rationality are appropriate. But by our rationality it doesn't follow that we always live up to those demands. In those cases, we fail to be rational , but it is in a way that is different from how rocks, tadpoles, and gum fail to be rational. For them, we use the term ‘arational.’ They don't have the demands, but we do. The demands of rationality bear on us (...) because we have minds that can move us to act, inspire us to create, and bring us to believe in ways that are responsible and directed. My interests here are the demands rationality places on our beliefs. Beliefs aim at the truth, and so one of the demands of being a rational creature with beliefs is that we manage them in a way that is pursuant of the truth. Reasons and reasoning play the primary role in that management – we ought to believe on the basis of good reasons. That is, if you believe something, you think that you're right about the world in some way or another. You believe because you think that something is true. Now, p's truth is different from all ways it could be false, and your being right about p isn't just some arbitrary commitment, one that could just as well have been its negation. This non-arbitrary specificity of beliefs is constituted by the fact that they are held on the basis of reasons. Arguments are our model for how these reasons go – we offer some premises and show how they support a conclusion. Of course, arbitrary premises won't do, so you've got to have some reason for holding them as opposed to some others. Every premise, then, is a conclusion in need of an argument, and for arguments to be acceptable, we've got to do due diligence on the premises. This, however, leads to a disturbing pattern – for every premise we turn into a conclusion, we've got at least one other premise in need of another argument. Pretty soon, even the simplest arguments are going to get very, very complicated. (shrink)
I discuss the characters Don Quixote and Sancho Panza and their relationship in order to understand better the place of idealistictheory and realistic practice in business ethics. The realism of Sancho Panza is required to make the idealism of Don Quixote effective.Indeed, the interaction and development of these characters can serve as a model for both the effective communication between andblending of the idealistic moral theoretician and the practical businessperson. Specifically, I argue that a quixotified Sancho Panza,as a combination of (...) theoretical idealism and practical realism, is necessary for managerial statesmanship. I first consider the positionthat this concept is unrealistic. In the final section, however, I show that a number of leadership and business theorists believe thatmanagerial statesmanship requires a quixotified Sancho Panza. I also consider the question, what helps to make a quixotic vision forbusiness ethical, and what is its content? (shrink)
Examination is made of a range of cyborg solutions to bodily problems due to damage, but here with particular reference to aging. Both technological and animal implants, transplants and prosthetic devices are phenomenologically analyzed. The resultant trade-off phenomena are compared to popular culture technofantasies and desires and finally to human attitudes toward mortality and contingency. The parallelism of resistance to contingent existence and to becoming a cyborg is noted.
Don Ihde: Heidegger’s technologies: Postphenomenological perspectives Content Type Journal Article Pages 1-10 DOI 10.1007/s11007-012-9215-z Authors Robert C. Scharff, Department of Philosophy, University of New Hampshire, Durham, NH 03824-3574, USA Journal Continental Philosophy Review Online ISSN 1573-1103 Print ISSN 1387-2842.
This note responds to criticism put forth by Don Fallis of an account of lying in terms of the Stalnakerian view of assertion. According to this account, to lie is to say something one believes to be false and thereby propose that it become common ground. Fallis objects by presenting an example to show that one can lie even though one does not propose to make what one says common ground. It is argued here that this objection does not present (...) a problem for the view of lying as Stalnakerian assertion. Responding to the objection brings out important features of this view of discourse and of assertion. (shrink)
Abstract. Don Browning's career involved a deep exploration into the frequently hidden philosophical assumptions buried in various forms of psychotherapeutic healing. These healing methodologies were based on metaphors and metaphysical assumptions about both the meaning of human fulfillment and the ultimate context of our lives. All too easily, psychological theories put forward philosophical anthropologies while claiming to be operating within a modest, empirical approach. Browning does not fault or criticize these psychotherapeutic enterprises for making such claims because he thinks these (...) claims are implicit in all discussions of psychological health. But he does fault these methodologies for not being more forthcoming about their shift from a narrow empirical investigation to a broad-ranging philosophical and even quasireligious orientation. Browning can be described as a “horizon analyst” who constantly pulled back the curtains and helped us see the deeper symbols, images, and metaphysical assumptions behind our psychological investigations. (shrink)
Le terme ktitor accompagne souvent la représentation d'un acte de don dans la peinture murale byzantines et post-byzantines. Même si le terme "ktitor" a été traduit le plus souvent par "fondateur", sémantiquement et historiquement, on retrouve dans le mot le sens de possession. Les ktitores - des propriétaires modaux, offrent leurs dons, dont le destinataire final est Dieu. Les panneaux votifs de Théodore Métochite , du sebastokrator Kalojan , de Stefan Uroš III , de Mircea l'Ancien témoignent des droits, des (...) intentions et de la foi du ktitor. Avec le christianisme, le sens du don s'est inversé et out don humain n'est qu'un contre-don à Dieu pour son sacrifice premier. (shrink)
The papers in this issue are based on presentations by the authors at the 163nd National Meeting of the American Association for the Advancement of Science, Seattle, Washington, 13–18 February 1997 in the session entitled Damned If You Do, Damned If You Don’t: What the Scientific Community Can Do about Whistleblowing organized by Stephanie J. Bird and Diane Hoffman-Kim. The papers have been modified following double blind peer review.
Suppose you can save only one of two groups of people from harm, with one person in one group, and five persons in the other group. Are you obligated to save the greater number? While common sense seems to say ‘yes’, the numbers skeptic says ‘no’. Numbers Skepticism has been partly motivated by the anti-consequentialist thought that the goods, harms and well-being of individual people do not aggregate in any morally significant way. However, even many non-consequentialists think that Numbers Skepticism (...) goes too far in rejecting the claim that you ought to save the greater number. Besides the prima facie implausibility of Numbers Skepticism, Michael Otsuka has developed an intriguing argument against this position. Otsuka argues that Numbers Skepticism, in conjunction with an independently plausible moral principle, leads to inconsistent choices regarding what ought to be done in certain circumstances. This inconsistency in turn provides us with a good reason to reject Numbers Skepticism. Kirsten Meyer offers a notable challenge to Otsuka’s argument. I argue that Meyer’s challenge can be met, and then offer my own reasons for rejecting Otsuka’s argument. In light of these criticisms, I then develop an improved, yet structurally similar argument to Otsuka’s argument. I argue for the slightly different conclusion that the view proposed by John Taurek that ‘the numbers don’t count’ leads to inconsistent choices, which in turn provides us with a good reason to reject Taurek’s position. (shrink)
We consider the implications of trends in the number of U.S. farmers and food imports on the question of what role U.S. farmers have in an increasingly global agrifood system. Our discussion stems from the argument some scholars have made that American consumers can import their food more cheaply from other countries than it can produce it. We consider the distinction between U.S. farmers and agriculture and the effect of the U.S. food footprint on developing nations to argue there might (...) be an important role for U.S. farmers, even if it appears Americans don’t need them. For instance, we may need to protect U.S. farmland and, by implication, U.S. farmers, for future food security needs both domestic and international. We also explore the role of U.S. farmers by considering the question of whether food is a privilege or a right. Although Americans seem to accept that food is a privilege, many scholars and commentators argue that, at least on a global scale, food is a right, particularly for the world’s poor and hungry. If this is the case, then U.S. farmers might have a role in meeting the associated obligation to ensure that the poor of the world have enough food to eat. We look at the consequences of determining that food is a right versus a privilege and the implications of that decision for agricultural subsidies as well as U.S. agriculture and nutrition policies. (shrink)
Stephen Pinker sets out over a dozen arguments in The language instinct (Morrow, New York, 1994) for his widely shared view that natural language is inadequate as a medium for thought. Thus he argues we must suppose that the primary medium of thought and inference is an innate propositional representation system, mentalese. I reply to the various arguments and so defend the view that some thought essentially involves natural language. I argue mentalese doesn't solve any of the problems Pinker cites (...) for the view that we think in natural language. So I don't think I think the way he thinks I think. (shrink)
This paper takes on several distinct but related tasks. First, I present and discuss what I will call the "Ignorance Thesis," which states that whenever an agent acts from ignorance, whether factual or moral, she is culpable for the act only if she is culpable for the ignorance from which she acts. Second, I offer a counterexample to the Ignorance Thesis, an example that applies most directly to the part I call the "Moral Ignorance Thesis." Third, I argue for a (...) principle--Don't Know, Don't Kill--that supports the view that the purported counterexample actually is a counterexample. Finally, I suggest that my arguments in this direction can supply a novel sort of argument against many instances of killing and eating certain sorts of animals. (shrink)
What does it mean to know who you are? Is it a matter of knowing your name? The things that you’ve done? The people you love? Such indispensible knowledge is somehow not enough; I can know all of these things, and still feel puzzled about who I am. “I am not the person I once was,” “I am not myself today,” and “I am learning who I am,” are all commonplace poems of a kind: expressive sentences completely at home both (...) in literature and ordinary life. Such a poem is the sentence “I know who I am.” This last is one of the many grand and emblematic boasts of Miguel de Cervantes’s hilariously self-fashioned knight, Don Quixote de la Mancha, a boast that can seem both impossible and yet utterly sensible, part quixotic and... (shrink)
This paper explores the problem of how we perceive built space and the ways that we relate to its abstract representations. Poincaré presented the problem that space poses for the 20th century in his essay ‘The Relativity of Space’, in which the human body and technics are already a part of our spatial perceptions. Merleau-Ponty, the “philosopher of the body”, and Don Ihde, a philosopher of technology, ground their work on the phenomenology of Edmund Husserl and Martin Heidegger (to different (...) degrees). For Merleau-Ponty, our primordial perception is general, pre-reflective, and ambiguous. One’s own body (body-subject) is the means of having an already inter-subjective world. Merleau-Ponty explicates our irreducible relation to the world by showing that bodily motility, the spatiality of one’s body, and habit acquisition inform our spatial experiences, as well as the syntheses of our perceptions and the unity of the world. Merleau-Ponty describes the constitution of embodiment relations (by means of habit acquisition) with artefacts that mediate our interaction and perceptions in the world. Ihde poses his intentional human-technology (artefactual) relations that transform our perceptions of the world and ourselves. These relations are ever-present in our everyday lifeworld of which built space forms the background or foreground of our projects and actions. In this paper, I provide a phenomenological explication of a specific space to test how both philosophers’ work compare to and/or supplement each other. (shrink)
Since the early 1970s, Marcel Mauss’s Essai sur le Don, translated into English as The Gift in 1954, has been a standard reference in the social science and bioethical literature on the use of human body parts and substances for medical and research purposes. At that time, three social scientists—political scientist Richard Titmuss in the United Kingdom and sociologist Renée C. Fox working with historian Judith Swazey in the United States—had the idea of using this concept to highlight the fundamental (...) structure of the biomedical practices they were studying, respectively, blood donation, and hemodialysis and organ transplantation. The fact that these first applications of Mauss’s essay should emerge in English- rather than in French-speaking countries raises the question of what the translation of the essay, and notably of the word don as gift, may have to do with this fact. Reading Mauss in translation undoubtedly inspired a seminal approach to interpreting medical and research practices based on bodily giving. This article posits that something may have also been lost: a much broader concept of giving with unquestionable links to the Durkheimian concept of solidarity, which Mauss conceptualizes not only as an obligation but also as a liberty to give. (shrink)
Don Garrett’s Hume constitutes a demanding introduction to the entirety of Hume’s philosophy as articulated in the Treatise, the two Enquiries, and the Dialogues Concerning Natural Religion. Its goal is to provide a clear representation of the problems Hume addresses, the solutions he provides to those problems, and the arguments he constructs in so doing. Achieving its three goals remarkably well, Garrett’s Hume provides what, in my judgment, is the very best introduction to Hume’s philosophy available. It will be an (...) invaluable resource for students—undergraduate and graduate—encountering Hume’s work. It would prove accessible and illuminating for scholars in fields other than philosophy but interested in.. (shrink)
Abstract. Don Browning's intellectual artfulness is particularly evident in three areas: as analyst of basic assumptions in intellectual systems, as fundamental ethicist, and as mediating theologian. His work in each area has been extraordinarily fruitful, both theoretically and practically. In each area, however, his skillful handling of complex issues also has subtle limitations. This paper identifies those limitations, analyzes them as facets of an articulate but preemptive defense of a preferred theological outlook, and thus as a limited failure of Browning's (...) otherwise broadly successful implementation of a critical hermeneutical method. (shrink)
What I want to talk about here is a puzzle for historians of philosophy who, like me, have spent a fair amount of time studying the history of mediaeval logic and semantic theory. I don’t know how to solve it, but in various forms it has come up repeatedly in my own work and in the work of colleagues I have talked with about it. I would like to share it with you now.
If the so-called 'science wars' are futile shouting-matches between extremists, some of the more bewildering skirmishes have been contested in the realm of colour science and culture. Ethnographers, postmodernists, and Wittgensteinians stress the specificity of local colour naming strategies, or the peculiarity of objects and emotions with which colours are associated, and may confess lingering attraction to Whorf's idea that cultures carve up an intrinsically unstructured colour space into quite arbitrary linguistic categories. Self-proclaimedly hard-headed biological and evolutionary psychologists, in contrast, (...) argue that the pan-human physiology of colour perception determines our colour categorization, and constrains whatever minimal linguistic variability there is. Don Dedrick's wonderful study in the philosophy of cognitive science offers not only a careful survey of the relevant evidence in this stand-off, but also a persuasive set of tools for thinking the issues through quite differently, and for avoiding the dichotomous terms in which the debates have previously been couched. The book should be essential reading for colour scientists, and for philosophers interested in links between cognition and culture; and it offers useful advanced introductions to detailed technical literatures in psychophysics, colour linguistics, and cognitive anthropol. (shrink)
"In 'I Don't Know, Just Wait: Remembering Remarriage in Eternal Sunshine of the Spotless Mind', William Day shows how Kaufman's Eternal Sunshine of the Spotless Mind should be considered part of the film genre known as remarriage comedy; but he also shows how Kaufman contributes something new to the genre. Day addresses, in particular, how the conversation that is the condition for reunion involves discovering 'what it means to have memories together as a way of learning how to be together'. (...) One of the most innovative aspects of Kaufman's filmic representation of such a conversation is its effect on the audience: how the narrative structure 'replicates for the viewer the felt contingency of memory that we attribute' to the characters we see onscreen - a couple contending with the interrelated experiences of remarriage and remembering." --David LaRocca, Introduction to The Philosophy of Charlie Kaufman, 12. (shrink)
Of growing concern over Jehovah's Witnesses' (JWs) refusal of blood is the intrusion of the religious organisation into its members' personal decision making about medical care. The organisation currently may apply severe religious sanctions to JWs who opt for certain forms of blood-based treatment. While the doctrine may be maintained as the unchangeable "law of God", the autonomy of individual JW patients could still be protected by the organisation modifying its current policy so that it strictly adheres to the right (...) of privacy regarding personal medical information. The author proposes that the controlling religious organisation adopt a "don't-ask-don't-tell" policy, which assures JWs that they would neither be asked nor compelled to reveal personal medical information, either to one another or to the church organisation. This would relieve patients of the fear of breach of medical confidentiality and ensure a truly autonomous decision on blood-based treatments without fear of organisational control or sanction. (shrink)
This paper is about Cervante's hero, Don Quijote, who is not, axiological speaking, a comical character, as he was usually viewed, but a profound and tragicfigure. He is the idealist who believes sincerely in the high values and ideals and fights for their accomplishment. Don Quijote is like a mirror in which is reflected the moral pettiness of the others, and this is the reason for his hard punishment. The reputation of the nicest crazy man on earth represents such punishment.
Only a fool would attempt to discuss the morality of strikes in twenty-five pages or less, and even he will fail. For one thing he can be sure in advance that whatever conclusions he might come to will be ridiculed as outrageous, prejudiced or self-serving by one party or the other. There is, in particular, the accusation that the attempt to discuss in moral terms what is essentially a political issue, is itself an exercise in bourgeois politics disguised as morals, (...) their morals but not ours. But there is also, and more worrying to my mind, the sheer complexity of the issues. This complexity is, however, simply unmanageable in the space available, and I have gone instead for the simple story, in the hope that the essentials will stand out that much more clearly. Whether I have got the right essentials, whether the elegance of the picture compensates for its lack of realism, is something that will have to emerge. (shrink)
Working retrospectively in an uncertain field of knowledge, physicians are engaged in an interpretive practice that is guided by couterweighted, competing, sometimes paradoxical maxims. When you hear hoofbeats, don't think zebras, is the chief of these, the epitome of medicine's practical wisdom, its hermeneutic rule. The accumulated and contradictory wisdom distilled in clinical maxims arises necessarily from the case-based nature of medical practice and the narrative rationality that good practice requires. That these maxims all have their opposites enforces in students (...) and physicians a practical skepticism that encourages them to question their expectations, interrupt patterns, and adjust to new developments as a case unfolds. Yet medicine resolutely ignores both the maxims and the tension between the practical reasoning they represent and the claim that medicine is a science. Indeed, resolute epistemological naivete is part of medicine's accommodation to uncertainty; counterweighted, competing, apparently paradoxical (but always situational) rules enable physicians simultaneously to express and to ignore the practical reason that characterizes their practice. (shrink)