The American design.--The liberating arts.--The threshold of independence.--Beyond independence.

In most areas of medicine, the physician's primary task is to diagnose the patient's presenting problem by correctly identifying the underlying pathology causing that problem. Diagnoses are established through a process of correlating the information obtained from an interview with the patient about his history of illness and circumstances, with additional evidence of the underlying disease derived from physical examination findings and/or the results of laboratory investigations and diagnostic imaging. In contemporary health care, various movements that call for a shift (...) in clinical care away from underlying disease pathology toward understanding people and their experience of disease are receiving growing... (shrink)

This article develops and defends a full account of the nature and normativity of resistance to evidence, according to which resistance to evidence is an instance of input-level epistemic malfunctioning. At the core of this epistemic normative picture lies the notion of knowledge indicators, as evidential probability increasing facts that one is in a position to know; resistance to evidence is construed as a failure to uptake knowledge indicators.

Phillip R. Sloan - Performing the Categories: Eighteenth-Century Generation Theory and the Biological Roots of Kant's A Priori - Journal of the History of Philosophy 40:2 Journal of the History of Philosophy 40.2 229-253 Preforming the Categories: Eighteenth-Century Generation Theory and the Biological Roots of Kant's A Priori Phillip R. Sloan Situating Kant's philosophical project in relation to the natural sciences of his day has been of concern to several scholars from both the history of science and the history of (...) philosophy. Historians of philosophy have displayed an expanded awareness of, and interest in, the importance of the scientific context of the period in which Kant carried out his "Copernican" revolution. Most commonly among philosophers, this interest has been analyzed in relation to Kant's concerns with the foundations of mechanics, matter theory, and the epistemology of Newtonian science, with the central text of interest being the Metaphysische Anfangsgründe. On the other hand, historians of philosophy and historians of science, interested in the issues of the third Critique and in the several papers of Kant dealing with biological and anthropological issues, have emphasized the unified nature of Kant's inquiries into the natural sciences, and the importance of his continued interest in the life and human sciences alongside his interests in the foundations of the physical sciences. The effort to understand the unity of Kant's.. (shrink)

According to anti‐reductionism in the epistemology of testimony, testimonial entitlement is easy to come by: all you need to do is listen to what you are being told. Say you like anti‐reductionism; one question that you will need to answer is how come testimonial entitlement comes so cheap; after all, people are free to lie.This paper has two aims: first, it looks at the main anti‐reductionist answers to this question and argues that they remain unsatisfactory. Second, it goes on a (...) rescue mission on behalf of anti‐reductionism. I put forth a novel, knowledge‐first anti‐reductionist account, which I dub ‘Testimonial Contractarianism’. According to the view defended here, in virtue of the social contract in play, compliance with the norms governing speech acts is the default position for speakers. Insofar as norm compliance is the default for speakers, I argue, all else equal, entitlement to believe is the default for hearers. (shrink)

Can we engineer conceptual change? While a positive answer to this question would be exciting news for philosophy, there has been a growing number of pessimistic voices in the literature. This paper resists this trend. Its central aim is to argue not only that conceptual engineering is possible but also that it is not even distinctively hard. In order to achieve this, we will develop a novel approach to conceptual engineering that has two key components. First, it proposes a reorientation (...) of the conceptual engineering project away from fixing conceptual defects and towards bringing about conceptual innovation. Second, it offers a new account of when conceptual engineering is successful in terms of etiological functions. We then turn to the reasons that have motivated various forms of pessimism about conceptual engineering and show that, on our novel approach, none of them stands up to scrutiny. (shrink)

DNR decisions are frequently made in oncology and hematology care and physicians and nurses may face related ethical dilemmas. Ethics is considered a basic competence in health care and can be understood as a capacity to handle a task that involves an ethical dilemma in an adequate, ethically responsible manner. One model of ethical competence for healthcare staff includes three main aspects: being, doing and knowing, suggesting that ethical competence requires abilities of character, action and knowledge. Ethical competence can be (...) developed through experience, communication and education, and a supportive environment is necessary for maintaining a high ethical competence. The aim of the present study was to investigate how nurses and physicians in oncology and hematology care understand the concept of ethical competence in order to make, or be involved in, DNR decisions and how such skills can be learned and developed. A further aim was to investigate the role of guidelines in relation to the development of ethical competence in DNR decisions. Individual interviews were conducted with fifteen nurses and sixteen physicians. The interviews were analyzed using thematic content analysis. Physicians and nurses in the study reflected on their ethical competence in relation to DNR decisions, on what it should comprise and how it could be developed. The ethical competence described by the respondents related to the concepts being, doing and knowing. In order to make ethically sound DNR decisions in oncology and hematology care, physicians and nurses need to develop appropriate virtues, improve their knowledge of ethical theories and relevant clinical guidelines. Ethical competence also includes the ability to act upon ethical judgements. Continued ethical education and discussions for further development of a common ethical language and a good ethical working climate can improve ethical competence and help nurses and physicians cooperate better with regard to patients in relation to DNR decisions, in their efforts to act in the best interest of the patient. (shrink)

This work is a manifesto for epistemic independence: the independence of good thinking from practical considerations. It presents a functionalist account of the normativity of assertion in conjunction with an integrated view of the normativity of constative speech acts.

One popular view in recent years takes the source of testimonial entitlement to reside in the intrinsically social character of testimonial exchanges. This paper looks at two extant incarnations of this view, what we dub ‘weak’ and ‘modest’ social anti-reductionism, and questions the rationales behind their central claims. Furthermore, we put forth an alternative, strong social anti-reductionist account, and show how it does better than the competition on both theoretical and empirical grounds.

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 9.1 (2002) 93-96 [Access article in PDF] Phenomenological Methods in Psychiatry:A Necessary First Step M. Gupta and L. Rex Kay Keywords: behavior, empathy, human science, methodology, natural science, phenomenology. WE ARE GRATEFUL to the journal for prviding the opportunity for exchange and discussion of some of the themes raised in our paper, "The impact of phenomenology on North American psychiatric assessment" and we are pleased (...) to be able to reply to the two excellent commentaries by McMillan and Morley. Both McMillan and Morley question the prospect of employing phenomenology and its methods in psychiatric assessment, and in psychiatric practice more generally. McMillan questions the utility of such a step, and Morley is pessimistic about its feasibility. We shall address each author's concerns in turn.Initially, let us restate the aims of our paper to contextualize our arguments and those made in the commentaries. First, we sought an understanding of what is meant by North American psychiatrists, working within the DSM framework, when they refer to the phenomenological approach to psychiatric assessment. To elucidate this meaning, we compared the contemporary North American usage to a small number of definitions of phenomenology, particularly those definitions that were, and are now, applied to clinical psychiatric work. Contrary to McMillan's suggestion, we did not intend to state definitively what should or should not count as phenomenological, but rather to compare North American psychiatric assessment to what typically has counted as phenomenological. Second, we sought to examine phenomenology's influence on North American psychiatric practice, particularly psychotherapy.Morley argues that such influences usually exemplify the inappropriate appending of phenomenology to psychiatric practice rather than true integration of different paradigms. Although we do not disagree with this general contention, we will argue that the deployment of phenomenological methods in psychiatric assessment is a necessary first step toward the kind of integration he proposes.McMillan makes two related but unintegrated points. First, he argues that objective, behavioral data are phenomenological, according to his broad definition of the term. Second, he proposes that, if the behavioral and the phenomenological are different, we are better off staying with the behavioral when it comes to psychiatric nosology. Let us consider these two points in succession.McMillan seeks to broaden Jasper's definition of phenomenology to include objective observations [End Page 93] as phenomenological. To this end, he distinguishes methods from aims. He summarizes Jasper's definition of phenomenology as "an empirical method for investigating 'individual psychic experience (p 55)" and claims that this is a statement of aim or objectives. He then urges us to "consider the merits of different phenomenological methodologies in terms of their success in achieving this objective" whether or not they utilize "all the methods" of phenomenology. This is much like saying that if we treat waving one's hand as a method for greeting someone, we are then free to treat the objective of the wave as one of greeting someone, and then say that anything that serves as a greeting is, by definition, a "wave." Whatever else McMillan's objective observations are, he has not convinced us that they are phenomenological, anymore than we are likely to convince you that a kiss on the lips is really just a wave.Nonetheless, it is worthwhile seeing what McMillan does with this argument. He tells us that we can "read the first-person experience from behavior in a fairly accurate and informative way." He uses the example of a father gazing at his young child and notes that it is not unreasonable to infer that he is experiencing loving and nurturing feelings. It is, indeed, not unreasonable to draw such an inference. But it is far more reasonable to infer that the father is experiencing a cacophony of feelings, including, but not limited to, love, concern, anxiety, pride, envy, hope, and sadness (Stern 1995, 18-58). If we are able to distinguish which of these feelings is dominant at any given moment—which we are—and if we are also able to track subtle shifts in such feelings... (shrink)

Scientific evidence is crucial in a burgeoning number of litigated cases, legislative enactments, regulatory decisions, and scholarly arguments. Evaluating Scientific Evidence explores the question of what counts as scientific knowledge, a question that has become a focus of heated courtroom and scholarly debate, not only in the United States, but in other common law countries such as the United Kingdom, Canada and Australia. Controversies are rife over what is permissible use of genetic information, whether chemical exposure causes disease, whether future (...) dangerousness of violent or sexual offenders can be predicted, whether such time-honored methods of criminal identification have any better foundation than ancient divination rituals, among other important topics. This book examines the process of evaluating scientific evidence in both civil and criminal contexts, and explains how decisions by nonscientists that embody scientific knowledge can be improved. (shrink)

This article reflects upon the monopoly and repertoires of violence in the city of Cairo perpetrated in counter-revolutionary moments by the successive military and Islamist regimes, which lack alternative visions and imaginaries. It counters the myth that the Egyptian revolution was non-violent. It also reflects upon some of the debates about the Arab revolutions, the question of militarization, and the return of ‘order’ with the re-emergence of the army in public life. It also reflects upon the multiplication of segregating walls, (...) first as buffer zones to isolate protesters, then as the walls of the gated communities and compounds of the rich, examining the extent to which the supposed revitalization of downtown Cairo actually represents the flight of wealth and capital to isolated areas far from the city center. (shrink)

According to anti-reductionism in the epistemology of testimony, testimonial entitlement is easy to come by: all you need to do is listen to what you are being told. Say you like anti-reductionism; one question that you will need to answer is how come testimonial entitlement comes so cheap; after all, people are free to lie. This paper has two aims: first, it looks at the main anti-reductionist answers to this question and argues that they fail. Second, it goes on a (...) rescue mission on behalf of anti-reductionism. I put forth a novel anti-reductionist account, which I dub ‘Testimonial Contractarianism’. According to the view defended here, in virtue of the social contract in play, compliance with the norms governing speech acts is the default position for speakers. Insofar as norm compliance is the default for speakers, I argue, all else equal, entitlement to believe is the default for hearers. (shrink)

ABSTRACTSeveral philosophers have inquired into the metaphysical limits of conceptual engineering: ‘Can we engineer? And if so, to what extent?’. This paper is not concerned with answering these questions. It does concern itself, however, with the limits of conceptual engineering, albeit in a largely unexplored sense: it cares about the normative, rather than about the metaphysical limits thereof. I first defend an optimistic claim: I argue that the ameliorative project has, so far, been too modest; there is little value theoretic (...) reason to restrict the project to remedying deficient representational devices, rather than go on a more ambitious quest: conceptual improvement. That being said, I also identify a limitation to the optimistic claim: I show that the ‘should’ in ameliorative projects suffers from a ‘wrong-kind-of-reasons’ problem. Last but not least, I sketch a proposal of normative constraining meant to address both the above results. The proposal gives primacy to epistemic constraints: accordingly, a concept should be ameliorated only insofar as this does not translate into epistemic loss. (shrink)

French historian Mona Ozouf argues that French feminism lacks the rancor and resentment of its counterpart in America and explains why this placid brand of feminism is uniquely French. Ozouf portrays ten French women of letters whose lives span the period from the eve of the French Revolution to the resurgence of the feminist movement in the late 20th century.

BackgroundIn cancer care, do not resuscitate (DNR) orders are common in the terminal phase of the illness, which implies that the responsible physician in advance decides that in case of a cardiac arrest neither basic nor advanced Coronary Pulmonary Rescue should be performed. Swedish regulations prescribe that DNR decisions should be made by the responsible physician, preferably in co-operation with members of the team. If possible, the patient should consent, and significant others should be informed of the decision. Previous studies (...) have shown that physicians and nurses can experience ethical dilemmas in relation to DNR decisions, but knowledge about what ethical reasoning they perform is lacking. Therefore, the aim was to describe and explore what ethical reasoning physicians and nurses apply in relation to DNR-decisions in oncology and hematology care.MethodsA qualitative, descriptive and explorative design was used, based on 287 free-text comments in a study-specific questionnaire, answered by 216 physicians and nurses working in 16 oncology and hematology wards in Sweden. Comments were given by 89 participants.ResultsThe participants applied a situation-based ethical reasoning in relation to DNR-decisions. The reasons given for this were both deontological and utilitarian in kind. Also, expressions of care ethics were found in the material. Universal rules or guidelines were seen as problematic. Concerning the importance of the subject, nurses to a higher extent underlined the importance of discussing DNR-situations, while physicians described DNR-decisions as over-investigated and not such a big issue in their daily work.ConclusionThe study revealed that DNR-decisions in oncology and hematology care gave rise to ethical considerations. Important ethical values described by the participants were to avoid doing harm and to secure a peaceful and “natural” death with dignity for their dying patients. A preference for the expression “allow for natural death” instead of the traditional term “do not resuscitate” was found in the material. (shrink)

As forms of employment and migration changed, the financial crisis which began in 2007 affected the human rights of individuals, particularly those in developing countries. How the media reported on these consequences is essential in understanding how and why public and political perceptions of the importance of human rights may have changed since the crisis began. Using quantitative and qualitative analysis of major newspapers in the UK and the USA, this paper seeks to understand the ways in which the media (...) presented the relationship between the negative changes in the economy and human rights. The analysis of the findings uses framing theory to understand how the text in news articles communicates the relevance of human rights to readers before concluding with some further avenues for research. (shrink)

Cet ouvrage, issu d’une thèse soutenue en 2006, est parmi les premiers à aborder l’histoire soviétique sous l’angle de la mode et de la culture vestimentaire, et il s’agit d’une contribution unique grâce aux sources nombreuses et variées – archives étatiques et privées, presse, entretiens... – sur lesquelles il s’appuie. L’ouvrage de Larissa Zakharova vise à faire se rejoindre l’histoire « d’en haut » et l’histoire « d’en bas » en analysant l’articulation entre les attitudes officielles vis-à...

Summary This paper will consider the range of British participation in mathematics internationally during the nineteenth century through an analysis of British mathematical contributions to scientific journals outside of Britain. Viewing scientific papers contained in journals as significant indicators of research, we consider scientists who authored or read and responded in print to papers in a given area within a given group of journals to constitute a publication community. The extent of publication by British mathematicians in these journals can help (...) characterize the role of foreign publication in nineteenth-century British mathematics. Moreover, the isolation of educational, societal, and personal circumstances which motivated British mathematicians to present their work to foreign journals highlights limited but concentrated groups of mathematicians committed to developing and strengthening international mathematical ties with Britain. (shrink)

In his paper, A Logic in Madness, Aaron Hauptman describes the evolving clinical picture of Mr. A, a patient with Asperger’s syndrome who presents with symptoms consistent with a major depressive episode. In his case discussion, Hauptman describes the difficulties, both conceptual and practical, faced by the clinical team in trying to help this man recover from his depression. Among these he identifies: ‘the ethics of mandated treatment, definitions of mental illness, rationality in the context of psychiatric disorders, and the (...) limitations on patient autonomy in a psychiatric inpatient setting’. In this response to Hauptman’s paper, I discuss the first and last concerns with emphasis on... (shrink)

How trustworthy can you be? Take on the challenge to be the most awesome you, you can be. Approachable text filled with examples from the child's world paired with engaging photos makes important SEL learning fun. Plus, a bonus activity at the end lets young readers practice their new skills.

The article analyses programmes against gender-based violence (GBV) in Cambodia in order to understand what notions of power, agency and resistance reside within these programmes. The text relies on in-depth interviews with four different organisations in Cambodia. The interviews display a number of hands-on practices of resistance against GBV, which require a broad discussion of identity in order to be fully understood. In particular, the organisations emphasize the importance of approaching men—in men's groups, as trainers and role models—in the resistance (...) against GBV. In their approach to Cambodian men, the trainers mixed representations of a more ‘particular’ character with representations of a more ‘universal’ appearance. Both in the establishment of new subject positions and new discourses, the Cambodian trainers leaned upon and alternated between universal and particular notions. In addition, men's ‘particular’ subject positions became the very lens through which they considered ‘universal’ notions of violent masculinities. New aspects of the resistance against GBV thus become visible as the concepts of universalism and particularism are put in use. It is in the nexus between ‘universal’ and ‘particular’ representations that a non-violent masculinity is fostered. (shrink)

One very popular assumption in the epistemological literature is that belief and assertion are governed by one and the same epistemic norm. This paper challenges this claim. Extant arguments in defence of the view are scrutinized and found to rest on value-theoretic inaccuracies. First, the belief-assertion parallel is shown to lack the needed normative strength. Second, I argue that the claim that assertion inherits the norm of belief in virtue of being an expression thereof rests on a failed instance of (...) deontic transmission. Third, the inheritance argument from the norm for action is proven guilty of deontic equivocation. Last but not least, it is argued that, on a functionalist normative picture, assertion and belief are governed by different epistemic norms, in virtue of serving different epistemic functions. (shrink)

Gold Stripe on a Jackass is a conceptually rich description of one naval officer's career journey. Author Stephen B. Sloane began his career in Annapolis, where the commandment of obedience holds sway, and finished in Berkeley, a place where questioning authority is woven deeply into the cultural fabric.

When in the business of offering an account of the epistemic normativity of belief, one is faced with the following dilemma: strongly externalist norms fail to account for the intuition of justification in radical deception scenarios, while milder norms are incapable to explain what is epistemically wrong with false beliefs. This paper has two main aims; we first look at one way out of the dilemma, defended by Timothy Williamson and Clayton Littlejohn, and argue that it fails. Second, we identify (...) what we take to be the problematic assumption that underlies their account and offer an alternative way out. We put forth a knowledge-first friendly normative framework for belief which grants justification to radically deceived subjects while at the same time acknowledging that their false beliefs are not epistemically good beliefs. (shrink)

In this groundbreaking book, psychiatrist and ethicist Mona Gupta analyzes the basic assumptions of Evidence-based medicine (EBM), and critically examines their applicability to psychiatry. Highlighting ethical tensions between psychiatry and EBM, she asks the controversial question - should psychiatrists practice evidence-based medicine at all?

In this article I explore the contribution of ethical analysis and theological reflection to understanding and responding to moral injury of healthcare workers in light of the COVID pandemic. I begin by critically appraising the relevance of moral injury for healthcare contexts, and suggest that the term ‘medical moral injury’ should be used to differentiate it from ‘military moral injury’. I briefly relate medical moral injury to other relevant phenomena, such as moral dilemmas, moral distress, and moral residue, arguing that (...) moral injury in healthcare contexts might take chronic as well as acute forms. I suggest that agent regret might play an important role in understanding medical moral injury. The associated distinction between harms and wrongs, and so regret and remorse, help us identify different kinds of moral injury, and the distinct role that apology plays in each instance. Theological reflection on penitence, forgiveness, and lament also contributes to understanding and responding to potentially morally injurious events. I conclude that while psychological intervention plays an important role in medical moral injury, moral and theological perspectives provide both crucial lenses through which to understand these potentially injurious moral landscapes, and resources to assist healthcare workers in navigating them more safely. (shrink)

This paper has two aims. The first is critical: I identify a set of normative desiderata for accounts of justified belief and I argue that prominent knowledge first views have difficulties meeting them. Second, I argue that my preferred account, knowledge first functionalism, is preferable to its extant competitors on normative grounds. This account takes epistemically justified belief to be belief generated by properly functioning cognitive processes that have generating knowledge as their epistemic function.

The authors demonstrate that unselfish behavior is in fact an important feature of both biological and human nature. Their book provides a panoramic view of altruism throughout the animal kingdom--from self-sacrificing parasites to the human capacity for selflessness--even as it explains the evolutionary sense of such behavior.

Down Girl: The Logic of Misogyny. By Manne Kate.

One central debate in recent literature on epistemic normativity concerns the epistemic norm for action. This paper argues that this debate is afflicted by a category mistake: strictly speaking, there is no such thing as an epistemic norm for action. To this effect, I introduce a distinction between epistemic norms and norms with epistemic content; I argue that while it is plausible that norms of the latter type will govern action in general, epistemic norms will only govern actions characteristically associated (...) with delivering epistemic goods. (shrink)

Talk of epistemic dilemmas is old talk in epistemology. But are there such things? In this paper I argue for modest skepticism about epistemic dilemmas. In order to do that, I first point out that not all normative conflicts constitute dilemmas: more needs to be the case. Second, I look into the moral dilemmas literature for inspiration and identify a set of conditions that need to be at work for a mere normative conflict to be a genuine normative dilemma. Last, (...) I argue that, while our epistemic life is peppered with epistemic normative conflict, epistemic dilemmas are much harder to find than we thought. (shrink)