In lieu of an abstract, here is a brief excerpt of the content:Is Expertise-by-Experience Impossible?The author reports no conflict of interests.In his article, "Experience and expertise: Can personal experience of mental illness make someone an expert?" Abdi Sanati uses Wittgenstein's arguments on private language and Ryle's philosophy of knowledge to critique the concept of Expertise-by-Experience. The principal argument is that introspection on personal experiences cannot constitute the basis for knowledge underpinning expertise. From the start, and in various sections of the (...) article, Sanati highlights the importance of patient involvement in the delivery of mental healthcare. He clarifies the contributions made by the community of patients in the design and delivery of mental health services are not only valuable but also necessary and long overdue. He argues patients must be involved in their care independently of how knowledgeable they are and, in a way, considers the attribution of a status of expertise as potentially counterproductive, since it may restrict the involvement of those who do not possess this status. I will explore initially the core premise made by Sanati that is then subjected to a thorough philosophical scrutiny. This is important because, as we shall see, there can be a different reading of the core premise that throws a slightly different lens into the Inquiry made. We'll end by discussing the future of expertise in the unfamiliar landscape of artificial intelligence (AI) systems, such as large language models and multimodal AI.Necessary and Sufficient Conditions for Expertise-by-ExperienceIn his initial section titled "Philosophical views on Expert-by-Experience," Sanati examines the literature on Expertise-by-Experience and the recognition it gradually gained as a form of knowledge stemming from the privileged position of subjective experience. Thomasina Borkman (1976), within the context of her research with self-help groups such as Alcoholic Anonymous developed the concept of experiential knowledge. By studying these groups, she saw how some individuals developed valuable skills to help others recover. Borkman (1976), Noorani (2013) and Mazanderani et al. (2020) stress the importance of more than just experience for acquiring expert knowledge. For someone within a community, to emerge as an expert, they must be able to effectively articulate and share the content of their experience, for it to stand a kind of reality testing on its usefulness in guiding and helping other members of it.Ultimately, it appears for the authors cited, Expertise-by-Experience is not conceived on essentialist, a priori theoretical grounds, but on pragmatic outcomes achieved via a constructivist approach. Expertise by experience can't be articulated in context independent propositions. Sanati, in the summary provided at the end of [End Page 109] this section, does not appear to highlight as much this latter formative pragmatic element as a necessary condition for gaining a status of expert-by-experience. He articulates his critique portraying a linear progression from "personal experience" to "unique expertise". In my view, and at least on paper, the claim made for a status of Expertise-by-Experience is a modest one. While it is true, personal experience is acknowledged as a source of a unique type of knowledge, for it to amount to expertise it needs to fulfill the pragmatic test where, by being articulated, shared, tested, and refined accordingly, leads to a know-how relevant to non-experts of the same community. Personal experience as a source of expertise is a necessary condition, but not a sufficient one.Knowledge and Expertise: A Philosophical ViewIn the following sections of the article, Sanati provides an in-depth exploration of the concept of expertise and the philosophical reasoning underpinning his core argument. If we assume Sanati has made a correct interpretation of the cited literature, then a lot of the philosophical analysis provided subsequently assists him convincingly in the task. Collins' (2008) emphasis on the central role of language and discourse in acquiring expertise within a community, and how this leads to a form of life (p. 12), that is also characterized by the possession of a substantial body of true beliefs compared to most people, appears to exclude any possibility for a personal experience on its own to become a source... (shrink)

A methodological framework is presented for the analysis of the discursive function of the science exhibit, which is treated as a multimodal “text” with conceptual, structural, and operational features encoding science knowledge. This analytical model is founded on Bernstein's theory of cultural codes (classification and framing) and socio-linguistics (formality). By using this framework, it is hoped that the museum researcher, the science museum practitioner, and the science communicator are empowered to retrieve the science exhibit “message,” to reconstruct the image of (...) the represented science, and the socio-cultural positioning of the model visitor in the communicative context of the science museum. (shrink)

The aim of this study is to explore how Greek youth understands their relationship to education, and how this understanding might change as a result of the interplay between participation in different educational/social arrangements and structural factors such as gender, socio?economic background and area of residence. In total, 800 young people (i.e. four groups?students in upper?secondary school, tertiary education, vocational education and training and working young people) were surveyed. The results yield an impressive homogeneity of the young people?s views corresponding (...) to a ?pragmatic? image of schooling, though they are partially differentiated with respect to attitudes and practices. Moreover, boundaries are discerned between the young people following academic and non?academic educational trajectories, and between the learning opportunities provided within and outside the formal educational system. Finally, females appear to be more mobilized, but less satisfied by educational services. These findings are contextualized and discussed against a background of relevant trends in other European countries, as well as of wider social, historical and political forces affecting Greek society. (shrink)

This article examines Re Imogen (No 6) (2020) 61 Fam LR 344, a decision of the Family Court of Australia, which held that an application to the Family Court is mandatory if a parent or a medical practitioner of a child or adolescent diagnosed with gender dysphoria disputes the diagnosis, the capacity to consent, or the proposed treatment. First, we explain the regulatory framework for the medical treatment of gender dysphoria in children and adolescents, including the development of the welfare (...) jurisdiction under Section 67ZC of the Family Law Act 1975 (Cth). We then provide an overview of the Re Imogen decision, and discuss the balancing exercise involved in determining a child’s best interests in the medical treatment context. We challenge the Family Court’s conclusion that, in relation to a dispute about diagnosis or treatment, a finding that the child or adolescent is Gillick competent to consent to treatment is not determinative, and the Family Court must determine the dispute. We argue that this conclusion represents an unjustified incursion into the right of Gillick competent transgender children and adolescents to make decisions about their own bodies and identities, and that the protective role of parents and the Family Court cannot justify interfering with their bodily autonomy in this context. Finally, we propose an alternative regulatory framework that removes the Family Court from the medical treatment process for gender dysphoria in circumstances of dispute between a parent and their Gillick competent child. (shrink)

Argumentation has been an important topic in knowledge representation, reasoning and multi-agent systems during the last twenty years. In this paper, we propose a new abstract framework where arguments are associated with a strength, namely a quantitative information which is used to determine whether an attack between arguments succeeds or not. Our Strength-based Argumentation Framework combines ideas of Preference-based and Weighted Argumentation Frameworks in an original way, which permits to define acceptability semantics sensitive to the existence of accruals between arguments. (...) The question of accruals arises in situations where several arguments defending the same position against another argument are unable to individually defeat this argument, but could do it collectively if they combine their strengths. We investigate some of the theoretical and computational properties of our new framework and semantics, and present a reasoning algorithm that is based on a translation of the problem into pseudo-boolean constraint satisfaction. This paper proposes an intuitive framework which allows strength compensations in an argumentation context where attacks may not succeed, completed by an approach which detects accruals throughout the reasoning process without requiring the elicitation of all compensatory combinations of arguments as an input. (shrink)

In the face of environmental crises such as climate change, pollution and biodiversity loss—which all adversely impact on health—Gils-Schmidt and Salloch explore whether physicians can be justified in taking climate issues into account in clinical care.1 While their approach centres on the ‘climate-sensitive’ decisions, physicians can carry out on the micro-level of clinical decision-making, they encourage further discussions on how climate-related issues can be included across different levels of decision-making in healthcare. We propose a list of tasks and a model (...) to assist with navigating the range of factors and structural elements an environmentally sensitive ethics must address. Stephen Gardiner’s notion of a perfect moral storm is central to understanding these issues.2 Gardiner describes how a perfect moral storm occurs in the centre of three overlapping conditions for human action and policymaking in the face of climate change. This storm is driven by: (1) a lack of interest among current generations to meet global needs and accommodate the well-being of future generations, (2) a lack of ecological concerns for other parts of nature than humans and (3) weak ethical and political theories and institutions shaping policy decisions on issues with severe implications across borders and generations. Moreover, these conditions are embedded in the existing, complex world of ethically unjustified power imbalances and social injustice. The growing awareness of healthcare’s climate footprint has amplified and accelerated global, grassroots action to make healthcare more environmentally friendly. This includes incorporating environmental impacts into quality improvement methodologies, building communities of practice to explore how to make …. (shrink)

Many senior doctors have had little in the way of formal ethics training, but express considerable interest in extending their education in this area. This paper is the report of an initiative in continuing medical education in which doctors were introduced to narrative ethics. We review the theoretical basis of narrative ethics, and the structure of and response to the two-day workshop.

The Genetic Information Nondiscrimination Act of 2008 prohibits most forms of discrimination on the basis of genetic information in health insurance and employment. The findings cited as justification for the act, the almost universal political support for it, and much of the scholarly literature about genetic discrimination, all betray a confusion about what is really at issue. They imply that genetic discrimination is wrong mainly because of genetic exceptionalism: because some special feature of genetic information makes discrimination on the basis (...) thereof wrong. I suggest, to the contrary, that the best arguments against genetic discrimination assume that health care is an entitlement . I do this by examining two different exceptionalist arguments for genetic nondiscrimination, showing that they do not furnish good reasons for prohibiting genetic discrimination unless one supposes that health care is an entitlement. (shrink)

This article examines the Kantian thesis of the a priori nature of our knowledge of space. Because it makes the representation of objects possible as external to us and all others, and consequently, as distinct and individualized, space (whatever its structure may be) claims the status as necessary condition and as apriori possibility of all knowledge. However, in the light of various physical, psychological and philosophical considerations, it seems that the particular structure allocated by Kant to space (i.e. uniqueness, infinity, (...) continuity, homogeneity, isotropy, Euclidean character and three-dimensional character) is neither necessary nor a priori but is rather contingent and dependent on experience. For this reason a pragmatist relativization of the transcendental approach appears to be necessary: the structure of space which makes knowledge possible is not apriori in an absolute sense, but rather, it is determined within the context of a certain practice, which is characterized by a certain mode of interaction with the environment and reveals particular empirical constraints to which this spatial structure must fit. (shrink)

“Medicalization” has been a contentious notion since its introduction centuries ago. While some scholars lamented a medical overreach into social domains, others hailed its promise for social justice advocacy. Against the backdrop of a growing commitment to health equity across the nation, this article reviews historical interpretations of medicalization, offers an application of the term to non-biologic risk factors for disease, and presents the case of housing the demonstrate the great potential of medicalizing poverty.

One theme in Continental Philosophy is to militate against structures, of language and institutions, as Nietzsche and Foucault did, and Habermas to some extent. That is called ‘poststructuralism’ by some. In this brief note, I do not oppose institutions, because societies cannot do without them. However, I am seeking a structure that leaves some room for freedom of individuals.

At the moment in Britain and elsewhere the debate inside and outside of Parliament on various medical issues which are essentially moral never ends. Everybody has his own point of view--or principles. But what emerges for society to adopt can often be called in lay terminology 'compromise'. Professor Mitchell argues in this paper that a moral consensus is possible and indeed ought to be achieved, as today the medical practitioner can no longer make his decision only in accordance with the (...) strict code of ethics of the medical profession. The task of the philosopher, says Professor Mitchell, is to interpret the actions and attitudes demanded by modern medical practice. (shrink)

Multifactorial analyses of data from representative British and German national contraception surveys were used to examine the principal demographic determinants of contraceptive use by women. Contraceptive use appeared to be determined mainly by reference to ‘reproductive status’. Women who were postponing pregnancies were using oral contraceptives, whereas those who wanted no more children relied more on intrauterine devices or sterilisation. Differences between the countries suggested that the choice of contraceptive method was influenced by health care policy, the organisation of the (...) relevant services and differential provider preferences. The contraceptive method used was also related to having occasional rather than steady sexual partners, lower educational level and frequent church attendance. Contraception decisions appeared to follow a fixed pattern, based more on a couple's demographic situation than on the characteristics of the contraceptive methods. This resulted in an unnecessarily restricted choice of methods. (shrink)

"This title was first published in 2003.Developments in genetic science are opening up new possibilities for human beings; both the creation and the shaping of human life are now possible in the laboratory. As these techniques develop, questions are increasingly asked about how far everything that is scientifically possible should - morally, legally and socially - be pursued. Whilst much attention and policy-making has focussed on the development of regulation of technologies affecting human reproduction, regulation where plants and animals are (...) concerned is much more limited. In this book, developments in genetics are addressed in the broad sense by an international range of contributors. This includes not only issues such as eugenics and the modification of the human embryo, but also the genetic modification of plants and animals in the pursuit of commerce, agriculture and biomedical research. This book is published in association with the Society for Applied Philosophy"--Provided by publisher. (shrink)

Ever since Newton created dynamics, there has been controversy about its foundations. Are space and time absolute? Do they form a rigid but invisible framework and container of the universe? Or are space, time, and motion relative? If so, does Newton's 'framework' arise through the influence of the universe at large, as Ernst Mach suggested? Einstein's aim when creating his general theory of relativity was to demonstrate this and thereby implement 'Mach's Principle'. However, it is widely believed that he achieved (...) only partial success. This question of whether motion is absolute or relative has been a central issues in philosophy; the nature of time has perennial interest. Current attempts to create a quantum description of the whole universe keep these issues at the cutting edge of modern research. Written by the world's leading expert on Mach's Principle, The Discovery of Dynamics is a highly original account of the development of notions about space, time, and motion. Widely praised in its hardback version, it is one of the fullest and most readable accounts of the astronomical studies that culminated in Kepler's laws of planetary motion and of the creation of dynamics by Galileo, Descartes, Huygens, and Newton. Originally published as Absolute or Relative Motion?, Vol. 1: The Discovery of Dynamics, The Discovery of Dynamics provides the technical background to Barbour's recently published The End of Time, in which he argues that time disappears from the description of the quantum universe. (shrink)