This essay argues that, while much has been gained by medicine's focus on the spatial aspects of disease in light of developments in modern pathology, too little attention has been given to the temporal experience of illness at the subjective level of the patient. In particular, it is noted that there is a radical distinction between subjective and objective time. Whereas the patient experiences his immediate illness in terms of the ongoing flux of subjective time, the physician conceptualizes the illness (...) as a disease state according to the measurements of objective time. A greater understanding of this disparity in temporal experiencing provides insights into the lived experience of illness and can preclude difficulties in communication between physician and patient. (shrink)

In this paper I briefly summarize Pellegrino’s phenomenological analysis of the ethics of the physician–patient relationship. In delineating the essential elements of the healing relationship, Pellegrino demonstrates the necessity for health care professionals to understand the patient’s lived experience of illness. In considering the phenomenon of illness, I identify certain essential characteristics of illness-as-lived that provide a basis for developing a rigorous understanding of the patient’s experience. I note recent developments in the systematic delivery of health care that make it (...) difficult for health care professionals to realize Pellegrino’s ethical model of the role of healer. Such developments limit both the physician’s freedom to act on behalf of the patient without the constraint of third parties and the physician’s freedom to act in light of his or her own ethical or religious convictions. Given these difficulties, I note MacIntyre’s call for the development of moral communities, as an alternative to the prevailing culture, and share a first-hand example illustrating how intentional Christian community provides an alternative nurturing context that permits the full development of the healing relationship. (shrink)

Yet, the central conviction that informs this volume is that phenomenology provides extraordinary insights into many of the issues that are directly addressed ...

In this essay I discuss Edith Stein's analysis of empathy and note its application in the field of clinical medicine. In identifying empathy as the basic mode of cognition in which one grasps the experiences of others, Stein notes, 'I grasp the Other as a living body and not merely as a physical body'. The living body is given in terms of five distinctive characteristics - characteristics that disclose important facets of the illness experience. Empathy plays an important role in (...) clinical practice in aiding physicians to grasp the content of first-person reports of bodily disorder, and to comprehend the meaning of illness-as-lived. I suggest that an important task for medical education should be that of developing students' capacity for empathic understanding and I note several ways in which this task might be accomplished. (shrink)

Definite descriptions, I shall argue, have two possible functions. 1] They are used to refer to what a speaker wishes to talk about, but they are also used quite differently. Moreover, a definite description occurring in one and the same sentence may, on different occasions of its use, function in either way. The failure to deal with this duality of function obscures the genuine referring use of definite descriptions. The best known theories of definite descriptions, those of Russell and Strawson, (...) I shall suggest, are both guilty of this. Before discussing this distinction in use, I will mention some features of these theories to which it is especially relevant. (shrink)

In this paper I reflect upon my personal experience of chronic progressive multiple sclerosis in order to provide a phenomenological account of the human experience of disability. In particular, I argue that the phenomenological notion of lived body provides important insights into the profound disruptions of space and time that are an integral element of changed physical capacities such as loss of mobility. In addition, phenomenology discloses the emotional dimension of physical disorder. The lived body disruption engendered by loss of (...) mobility includes a change in the character of surrounding space, an alteration in one's taken-for-granted awareness of objects, the disruption of corporeal identity, a disturbance in one's relations with others, and a change in the character of temporal experience. The loss of upright posture is of particular significance since it not only concretely diminishes autonomy but affects the way one is treated by others. Such a change in posture is, therefore, particularly disruptive in the social world of everyday life. An understanding of the lived body disruption engendered by disability has important applications for the clinical context in devising effective therapies, as well as for the social arena in determining how best to resolve the various challenges posed by chronic disabling disorders. (shrink)

This essay argues that philosophical phenomenology can provide important insights into the patient-physician relationship. In particular, it is noted that the physician and patient encounter the experience of illness from within the context of different "worlds", each "world" providing a horizon of meaning. Such phenomenological notions as focusing, habits of mind, finite provinces of meaning, and relevance are shown to be central to the way these "worlds" are constituted. An eidetic interpretation of illness is proposed. Such an interpretation discloses certain (...) essential characteristics that pertain to the experience of illness, per se , regardless of its manifestation in terms of a particular disease state. It is suggested that, if a shared world of meaning is to be constituted between physician and patient, the eidetic characteristics of illness must be recognized by the physician. Keywords: phenomenology, patient-physician relationship, illness-as-lived, habits of mind, relevance, eidetic CiteULike Connotea Del.icio.us What's this? (shrink)

This paper suggests that the paradigm of lived body (as it is developed in the works of Merleau-Ponty, Sartre and Zaner) provides important insights into the experience of illness. In particular it is noted that, as embodied persons, we experience illness primarily as a disruption of lived body rather than as a dysfunction of biological body. An account is given of the manner in which such fundamental features of embodiment as bodily intentionality, primary meaning, contextural organization, body image, gestural display, (...) lived spatiality and temporality, are disrupted in illness causing a concurrent disorganization of the patient's self and world. The paradigm of lived body has important applications for medical practice. It provides a fuller account of illness than does the prevailing reductionist Cartesian paradigm of body, more directly addresses the existential predicament of illness, and orients the clinical focus around the personhood of the patient. (shrink)

Book reviewed in this article: The Meaning of Illness. By S. Kay Toombs.

Previous research on associative learning has uncovered detailed aspects of the process, including what types of things are learned, how they are learned, and where in the brain such learning occurs. However, perceptual processes, such as stimulus recognition and identification, take time to unfold. Previous studies of learning have not addressed when, during the course of these dynamic recognition processes, learned representations are formed and updated. If learned representations are formed and updated while recognition is ongoing, the result of learning (...) may incorporate spurious, partial information. For example, during word recognition, words take time to be identified, and competing words are often active in parallel. If learning proceeds before this competition resolves, representations may be influenced by the preliminary activations present at the time of learning. In three experiments using word learning as a model domain, we provide evidence that learning reflects the ongoing dynamics of auditory and visual processing during a learning event. These results show that learning can occur before stimulus recognition processes are complete; learning does not wait for ongoing perceptual processing to complete. (shrink)

At 14 months, children appear to struggle to apply their fairly well-developed speech perception abilities to learning similar sounding words (e.g., bih/dih; Stager & Werker, 1997). However, variability in nonphonetic aspects of the training stimuli seems to aid word learning at this age. Extant theories of early word learning cannot account for this benefit of variability. We offer a simple explanation for this range of effects based on associative learning. Simulations suggest that if infants encode both noncontrastive information (e.g., cues (...) to speaker voice) and meaningful linguistic cues (e.g., place of articulation or voicing), then associative learning mechanisms predict these variability effects in early word learning. Crucially, this means that despite the importance of task variables in predicting performance, this body of work shows that phonological categories are still developing at this age, and that the structure of noninformative cues has critical influences on word learning abilities. (shrink)

Research into learners' ideas aboutscience suggests that school and collegestudents often hold alternative conceptionsabout `the atom'. This paper discusses whylearners acquire ideas about atoms which areincompatible with the modern scientificunderstanding. It is suggested that learners'alternative ideas derive – at least in part –from the way ideas about atoms are presented inthe school and college curriculum. Inparticular, it is argued that the atomicconcept met in science education is anincoherent hybrid of historical models, andthat this explains why learners commonlyattribute to atoms properties (...) (such as beingthe constituent particles of all substances, orof being indivisible and conserved inreactions) that more correctly belong to otherentities (such as molecules or sub-atomicparticles). Bachelard suggested that archaicscientific ideas act as `epistemologicalobstacles', and here it is argued thatanachronistic notions of the atom survive inthe chemistry curriculum. These conceptualfossils encourage learners to develop an`atomic ontology' (granting atoms `ontologicalpriority' in the molecular model of matter); tomake the `assumption of initial atomicity' whenconsidering chemical reactions; and to developan explanatory framework to rationalisechemical reactions which is based on thedesirability of full electron shells. Theseideas then act as impediments to thedevelopment of a modern chemical perspective onthe structure of matter, and an appreciation ofthe nature of chemical changes at the molecularlevel. (shrink)

This paper describes how the physics department of the University of Bristol grew from relative provincial obscurity to international stature. Emphasis is placed on the role of Arthur Tyndall, who as head of the department played a crucial role by attracting external funding to provide for and maintain modern laboratory facilities, through his skill in recruiting staff and his general management of resources. Such essentially entrepreneurial qualities, it is argued, were fundamental to the rapid expansion of Bristol physics and for (...) its emergence as a new centre of excellence. (shrink)

Constructivism has been a key referent for research into the learning of science for several decades. There is little doubt that the research into learners’ ideas in science stimulated by the constructivist movement has been voluminous, and a great deal is now known about the way various science topics may commonly be understood by learners of various ages. Despite this significant research effort, there have been serious criticisms of this area of work: in terms of its philosophical underpinning, the validity (...) of its most popular constructs, the limited scope of its focus, and its practical value to science teaching. This paper frames this area of work as a Lakatosian Research Programme (RP), and explores the major criticisms of constructivism from that perspective. It is argued that much of the criticism may be considered as part of the legitimate academic debate expected within any active RP, i.e. arguments about the auxiliary theory making up the ‘protective belt’ of the programme. It is suggested that a shifting focus from constructivism to ‘contingency in learning’ will allow the RP to draw upon a more diverse range of perspectives, each consistent with the existing hard core of the programme, which will provide potentially fruitful directions for future work and ensure the continuity of a progressive RP into learning science. (shrink)

Koriat & Goldsmith restrict their definition of memory to “being about some past event,” which causes them to ignore the most common use of memory: everyday visual-motor tasks. New techniques make it possible to study memory in the context of these natural tasks with which memory is so tightly coupled. Memory can be more fully understood in the context of these actions.

In order to gain greater insight into the nature of corporate social responsibility (CSR) during a time of crisis, the study examines the commitment of firms to continue to engage in CSR activity despite financial pressures to divert their slack resources elsewhere. The setting of the study is CSR activity during the perhaps unprecedented global crisis associated with the COVID-19 pandemic. Based on a qualitative research method approach, both a variety of media sources and the relevant academic literature are reviewed (...) in order to identify examples of CSR activity related specifically to COVID-19. The examples are then categorized and situated according to Professor Archie Carroll’s well-known CSR Pyramid framework describing the economic, legal, ethical, and philanthropic domains of CSR. As such, this study is the first to extend the rich literature stream utilizing Carroll’s CSR Pyramid within the unique context of a global pandemic. (shrink)

This paper considers the nature of a curriculum as presented in formal curriculum documents, and the inherent difficulties of representing formal disciplinary knowledge in a prescription for teaching and learning. The general points are illustrated by examining aspects of a specific example, taken from the chemistry subject content included in the science programmes of study that are part of the National Curriculum in England. In particular, it is suggested that some statements in the official curriculum document are problematic if we (...) expect a curriculum to represent canonical disciplinary knowledge in an unambiguous and authentic manner. The paper examines the example of the requirement for English school children to be taught that chemical reactions take place in only three different ways and considers how this might be interpreted in terms of canonical chemistry and within the wider context of other curriculum statements, in order to make sense of neutralisation and precipitation reactions. It is argued that although target knowledge that is set out as the focus of teaching and learning cannot be identical to disciplinary knowledge, the English National Curriculum offers a representation of chemistry which distorts and confuses canonical ideas. It is suggested that the process of representing the disciplinary knowledge of chemistry as curriculum specifications is worthy of more scholarly attention. (shrink)

Book reviewed in this article: The Meaning of Illness. By S. Kay Toombs.