Adipose tissue (AT) inflammation, a hallmark of the metabolic syndrome, is triggered by overburdened adipocytes sending out immune cell recruitment signals during obesity development. An AT immune landscape persistent throughout weight loss and regain constitutes an immune‐obesogenic memory that hinders long‐term weight loss management. Lipid‐associated macrophages (LAMs) are emerging as major players in diseased, inflamed metabolic tissues and may be key contributors to an obesogenic memory in AT. Our previous study found that LAM abundance increases with weight loss via intermittent (...) fasting (IF) in obese mice, which is driven by adipocyte p53 signalling. However, the specific signals causing LAM accumulation in AT under IF remain unknown. In this piece, we hypothesise on a range of adipocyte‐secreted signals that can harbor immune‐attractive features upon fasting/refeeding cycles. We highlight possible mechanisms including cell death signalling, matrikines, and other damage‐associated molecular patterns (DAMPs), as well as adipo(‐cyto)kines, lipid mediators, metabolites, extracellular vesicles, and epigenetic rewiring. Finally, we consider how advances in mechanisms of AT LAM recruitment gleaned from preclinical models might be translatable to long‐term weight management in humans. Thus, we provide vantage points to study signals driving monocyte recruitment, polarisation towards LAMs, and LAM retention, to harness the therapeutic potential of modulating AT LAM levels by impacting the immune‐obesogenic memory in metabolic disease. (shrink)

Over the past decade, investments in agricultural and food technology startups have grown to previously unknown dimensions. Mushrooming agri-food tech startups that promise to solve critical issues in the agri-food system through technological innovation are increasingly perceived as an attractive new investment opportunity for venture capitalists and investors. This paper investigates how digital agri-food technologies are narrated, constructed, and promoted for financial investment. Through qualitative content analysis of agri-food tech industry reports, articles, and commentaries we trace the logic, rationales, and (...) narratives of this most recent investment rush, and reveal its immanent techno-finance fixes. We conceptualize the agri-food imaginaries produced within the agri-food tech discourse as financialized imaginaries, and argue that they are specifically tailored to construct, incentivize, and legitimize this new agri-food tech space for financial investment. In their attempt to raise money from investors, venture capital firms further fuel this development by discursively creating an ‘agri-food tech investment rush’—similar to the land and gold rushes of the past. Investments in agri-food tech startups, however, are presented to investors as both a profitable investment opportunity as well as a moral obligation, allowing for food production to cope with neo-malthusian and environmental threats. This paper contributes to our understanding of digitization as a socio-technical project, which includes the active envisioning and promotion of desirable agri-food futures. (shrink)

All of us have personal ideals. We are committed to being good (enough) friends, parents, neighbors, teachers, citizens, human beings, and more. In this paper, I examine the thick and thin aspects of these ideals: (i) their substance (to internalize an ideal is to endorse a particular way of being) and (ii) their accountability to reason (to internalize an ideal is to assume that this is really a good way to be). In considering how these two aspects interact in the (...) ideal of rational agency, I address two philosophical debates that are generally conducted in isolation of each other: (i) debates over the anti-ideal of normative “fetishism” and (ii) debates over whether acting for a reason is acting “under the guise of the good.” In the final two sections of the paper, I further explore the relations among the thick and the thin. I note the role that coherence constraints play in the process whereby our ideals gain determinacy. At the same time, I argue, our ideals constrain the possibility and desirability of coherence. This has implications for a third debate: the debate over the possibility of moral dilemmas. (shrink)

I argue that it can be morally permissible to coerce people into doing what is good for their own health. I discuss recent initiatives in New York City that are designed to take away certain unhealthy options from local citizens, and argue that this does not impose on them in unjustifiable ways. Good paternalistic measures are designed to promote people's long-term goals, and to prevent them from making short-term decisions that interfere with reaching those, and New York's attempts to ban (...) the sale of sugary drinks larger than 16 ounces and the use of trans fats fall within those parameters. Given our tendency to cognitive bias, we need help in making choices that truly instantiate our values. (shrink)

This paper uses some modest claims about knowledge to identify a significant problem for contemporary American trial procedure. First, suppose that legal proof requires knowledge. In particular, suppose that the defendant in a jury trial is proven guilty only if the jury knows that the defendant is guilty. Second, suppose that knowledge is subject to pragmatic encroachment. In particular, whether the jury knows the defendant is guilty depends on what’s at stake in their decision to convict, including the consequences that (...) the defendant may face if convicted. Then in order to know whether a defendant has been proven guilty, jurors may need to know something about the potential consequences of conviction. But in nearly every American criminal trial, this information is withheld from jurors. -/- In §1, I lay out the philosophical premises of my argument. In §2, I say more about why these premises present a problem for American trial procedure, and I identify social and political structures that exacerbate the problem. I describe the reasoning that has led courts to withhold sentencing information from jurors, and I diagnose the flaw in this reasoning. In §3, I expand my initial argument, strengthening its conclusions and offering alternative sets of premises that still entail them. I argue that the legal ramifications of pragmatic encroachment depend on highly controversial questions in epistemology, questions about the precise nature of practical stakes. In §4, I propose strategies for legal reform. (shrink)

This article reports the findings of a qualitative study that explored the organizational influences on moral distress for health professionals working in pediatric intensive care units across Canada. Participants were recruited to the study from PICUs across Canada. The PICU is a high-tech, fast-paced, high-pressure environment where caregivers frequently face conflict and ethical tension in the care of critically ill children. A number of themes including relationships with management, organizational structure and processes, workload and resources, and team dynamics were identified. (...) This study provides a rare and important multi-disciplinary perspective on this topic and the findings have implications for administrators and leaders who seek to improve the moral climate of healthcare delivery. (shrink)

The nature of farming is – still – an essentially biological, and thus volatile, system, which poses substantial challenges to its integration into financialized capitalism. Financial investors often seek stability and predictability of returns that are hardly compatible with agriculture – but which are increasingly seen as achievable through data and digital farming technologies. This paper investigates how farmland investment brokers engage with, perceive, and produce farming data for their investors within a co-constructive process. Tackling land’s ‘stubborn materiality’ for investment, (...) I argue, has material and immaterial components: it includes the re-imagination of farming as a financial asset that delivers reliable income streams for investors; and the re-engineering of farmland’s concrete materialities with digital farming technologies. Farmland investment brokers develop investor-suitable farmland imaginaries, underpinned by storytelling as well as the calculative ‘evidence’ of (digital) data. At the same time, digital technologies have become a key tool for transforming farms into ‘investment grade assets’ endowed with the rich data on farm performance and financial returns requested by investors. I conclude that the assetization and digitization of farmland need to be seen as closely intertwined and mutually reinforcing processes and identify key areas for future research on this intersection. (shrink)

Although I quickly review Philip Rossi’s larger argument in The Ethical Commonwealth in History, my focus in this article is on the implications of Rossi’s work for our characterizations of justice and citizenship on a Kantian account. For in arguing that a wise reading of Kant’s political theory allows us better to grasp his overarching aims, Rossi provides convincing evidence for a pair of challenges to the currently popular interpretation of that theory. These address the relationship between Kant’s moral and (...) political theories and the nature of the political task or project that Kantian citizens undertake. In challenging popular readings of these elements of Kant’s view, I suggest, Rossi supports an interpretation of Kantian political thought with particular resonance for our time. (shrink)

This article considers an apparent tension between, on the one hand, a widespread belief among literature teachers that the appreciation of a poem involves an experience of form-content inseparability and, on the other hand, these same teachers’ use of paraphrase to encourage appreciation. Using Terrence Deacon’s model of art experience, I argue that the tensions of this ‘paraphrase paradox’ mirror tensions inherent in poetic experience. Section II draws upon work by Rafe McGregor, Peter Lamarque, and Peter Kivy to frame an (...) approach to the form-content distinction, and to offer a brief overview of the paraphrase paradox. Sections III-IV summarize Deacon’s model of aesthetic experience, and argue that this model implies that poetic experience both triggers an impulse towards paraphrase, and frustrates this impulse. Section V looks at implications for the poetry teacher’s attempts to navigate the paraphrase paradox. Section VI tests these implications through an analysis of Philip Larkin’s poem ‘Faith Healing’. (shrink)

This paper defends a version of epistemic contextualism that accounts for the ordinary judgements and theoretical principles that motivate pragmatic encroachment. Adopting this contextualist view, we can avoid the counterintuitive consequences of pragmatic encroachment, while still preserving its attractive applications.

In team-based tasks, successful communication and mutual understanding are essential to facilitate team coordination and performance. It is well-established that an important component of human conversation is the maintenance of common ground. Maintaining common ground has a number of associated processes in which conversational participants engage. Many of these processes are lacking in current synthetic teammates, and it is unknown to what extent this lack of capabilities affects their ability to contribute during team-based tasks. We focused our research on how (...) teams package information within a conversation, by which we mean specifically whether information is explicitly mentioned or implied, and how multiple pieces of information are ordered both within single communications and across multiple communications. We re-analyzed data collected from a simulated remotely-piloted aerial system task in which team members had to specify speed, altitude, and radius restrictions. The data came from three experiments: the “speech” experiment, the “text” experiment, and the “evaluation” experiment. We asked first whether teams settled on a specific routine for communicating the speed, altitude, and radius restrictions, and whether this process was different if the teams communicated in speech compared to text. We then asked how receiving special communication instructions in the evaluation experiment impacted the way the human teammates package information. We found that teams communicating in either speech or text tended to use a particular order for mentioning the speed, altitude, and radius. Different teams also chose different orders from one another. The teams in the evaluation experiment, however, showed unnaturally little variability in their information ordering and were also more likely to explicitly mention all restrictions even when they did not apply. Teams in the speech and text experiments were more likely to leave unnecessary restrictions unmentioned, and were also more likely to convey the restrictions across multiple communications. The option to converge on different packaging routines may have contributed to improved performance in the text experiment compared some of the conditions in the evaluation experiment. (shrink)

Since the mid-nineteenth century, women in Europe, North America and elsewhere have played an increasing role in the workforce. Women started pursuing jobs in factories, offices and businesses instead of being dependent on men for their livelihood. However, along with this significant improvement in the status of women, they still face obstacles, such as the gender pay gab and harassment in the workplace. Although both males and females experience harassment, the available literature clearly suggests that females are more likely to (...) be harassed. Much of the research concerning workplace harassment against women has been conducted in the West while little is known about this phenomenon in workplaces across the Arab and Muslim countries. In fact, gender relations and the nature of workplaces in Arab countries vary significantly from the Western workplace due to religious, social and cultural traditions. Muslim women live in the midst of patriarchal cultures where women’s honour is believed to be sacred. The ideology of women’s seclusion and subordination resulted in the restriction of their ability to participate in the labour force even where females are in urgent need of earned income. In this regard, harassment considers a crucial subject on various international agendas. The Convention on the Elimination of all Forms of Discrimination Against Women (CEDAW) for instance, reinforces the implementation of legislation that protects women against gender discrimination. Islam in a similar manner respects women and acknowledges their major role within a society. Therefore, as women living in Muslim communities where issues related to sexuality are sensitive, and people are reluctant to discuss such questions in public, this paper aims to discuss women seclusion, the situation of Muslim women with regard to harassment in the workplace, how international human rights deals with harassment as well as the relation between the Islamic jurisprudence and the international human rights with regard harassment in the workplace. (shrink)

Some recent trade decisions, such as the U.S.’s imposition of protectionist measures against China, have attracted fervent popular support as well as outrage. Critics of these trade policies argue that they fail to promote society’s own interests. This paper catalogues the different ways that trade decisions can hinder and facilitate a society’s pursuit of social justice. I adopt a simple description of trade liberalization: a society forgoes the use of certain policy options, in order to pursue greater economic productivity through (...) increased trade flows. Using this simple descriptive account, the paper identifies two pathways for a society’s trade policies to shape its pursuit of social justice. First, greater economic productivity improves a society’s capacities to realize justice, especially distributive justice. I will argue that the value of greater economic capacities depends upon the society’s existing capacities and its inclinations to pursue justice. When a society has greater capacities and fails to extend their benefits to its worse-off citizens, these citizens have more serious grounds for complaint. Second, a society forgoes certain policy options when it liberalizes trade, and some of these options may be instrumentally valuable or even necessary for the society’s pursuit of justice. I will argue that, under non-ideal conditions, it can be desirable for a society to limit its own policy space so it cannot feasibly select policies that are unjust. Certain protectionist policies have taken on the expressive meaning that some groups are inferior in social and moral status. (shrink)

This article historicises a dream analytic intervention launched in the 1930s by Scottish psychiatrist and future professor of psychological medicine at the University of Glasgow (1948–73), Thomas Ferguson Rodger (1907–78). Intimate therapeutic meetings with five male patients are preserved within the so-called ‘dream books’, six manuscript notebooks from Rodger’s earlier career. Investigating one such case history in parallel with lecture material, this article elucidates the origins of Rodger’s adapted, rapport-centred psychotherapy, offered in his post-war National Health Service, Glasgow-based department. Oriented (...) in a reading of the revealing fourth dream book, the article unearths a history of the reception and adaptation of psychoanalysis from within a therapeutic encounter and in a non-elite context. Situating Rodger’s psychiatric development in his Glasgow environment, it then contextualises the psychosocial narrative of the fourth book in relation to contrasting therapeutic commitments: an undiluted Freudianism and a pragmatic ‘commonsense’ psychotherapy, tempered to the clinical psychiatric, and often working-class, interwar Glasgow context. An exploration of pre-recorded dreams, transcribed free associations, and ‘weekly reports’ reveals that in practice, Rodger’s Meyerian attitude worked productively with Freudian techniques to ennoble the patient’s psychosocial testimony and personal wisdom. This psychotherapeutic eclecticism underpinned and made visible the patient’s concurrent faith in and resistance to psychoanalytic interpretation. Chronicling a collaborative route to psychotherapeutic knowledge within a discrete encounter, the article situates post-war treatment values in the interwar impasse of outpatient psychiatry. (shrink)

This reply sets out an argument that demonstrates that a contrastive theory of self-knowledge is inconsistent with internalism in the philosophy of mind. It follows from my paper 'Contrastive Self-Knowledge', Social Epistemology, 2014, 28: 139-152.

Le renouvellement de la compréhension des concepts de normal et de pathologique qu’opère Georges Canguilhem vise le champ de la médecine somatique. La référence à la psychopathologie, quoique succincte, y joue néanmoins un rôle d’importance, puisque Canguilhem lui accorde un statut de précurseur et de révélateur d’une conception de la maladie comme valeur et altérité qualitativement hétérogène au normal. Mais l’examen de ce qui fait la spécificité de la psychopathologie semble aboutir à un paradoxe : est-il possible de concilier le (...) fait que la qualification d’un état comme pathologique émerge du malade lui-même et la méconnaissance de l’état de maladie, symptôme essentiel de certaines pathologies psychiques? (shrink)

Sociological accounts usually emphasise the primacy of phenotype (cor, colour) over ancestry for orienting concepts of ‘race’ in Brazil. In this paper, I present an alternative account of the cultural and political significance of ancestry in contemporary Brazil, drawing on qualitative interviews conducted with 50 Brazilians who had recently taken personalised DNA ancestry tests. The interviewees’ attitudes towards their ancestry are interpreted in relation to Brazil’s longstanding national myth of mestiçagem and the history of eugenic Whitening ideologies (ideologias do branqueamento) (...) that have sought to erase traces of Brazil’s African origins. However, they are also interpreted also against the backdrop of contemporary Black Movement activism that aims to actively recovering Afro-Brazilian histories and memories from these processes of erasure. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Storytelling and Narrative Knowing:An Examination of the Epistemic Benefits of Well-Told StoriesSarah E. Worth (bio)IntroductionPeople love to tell stories. When something scary, or funny, or out of the ordinary happens, we cannot wait to tell others about it. If it was really funny, etc., we tell the story repeatedly, embellishing as we see fit, shortening or lengthening it as the circumstances prescribe. When people are bad storytellers we tend (...) not to pay as close attention to their stories; our minds drift, and we hope for a swift conclusion. We tend not to remember those stories as well as the ones that were carefully constructed and skillfully delivered. Storytelling is one of our primary forms of communication with other people. Narrativity is the principle way that human beings order their experience in time. It is also one of the primary ways that humans make coherent sense out of seemingly unrelated sequences of events. Thus, an account of how this ordering works is essential to understanding one of the many ways of knowing used by humans, one that has been widely unaccounted for, I believe. What I will argue in this article is that reading, telling, and hearing well-constructed narratives are not just idle pastimes that we have created for entertainment purposes or even as a mere means of communication. Rather, there are epistemological benefits to reading, hearing, and telling well-constructed narratives. In particular, by practicing what I call narrative reasoning, we develop this skill, just as by practicing discursive reasoning we develop discursive reasoning skills. In turn, we develop an enhanced reasoning ability that arises from narrative reasoning and narrative meaning construction. Ultimately, I will argue that those who are able to develop the capacity to reason narratively will be able to have a more comprehensive understanding of the human experience. [End Page 42]Defining NarrativeTo begin, I will go into some detail about what I mean when I talk about narratives since the reasoning skills that will ultimately come from engaging with narratives will be related to the way that we come to understand and make sense of them. Since I do not intend to posit a theory of narrative, I will talk about what constitutes narrativity and what sort of features contribute to increasing the narrativity of a story. To begin, narrative is generally the representation of an event or sequence of events. It is closely tied to description, but it goes beyond description. "My cat has fleas" is a description of a state of affairs. "My cat was bitten by a flea" is a narrative about my cat, which includes a description. Some theorists (such as Barthes and Rimmon-Kenan) argue that a narrative must consist of more than one event or state of affairs in order to be minimally considered a narrative. For my purposes, the change in states of affairs from one to another will be essential for understanding the cognitive aspects that can be gained from engaging with narrative. Although I do not advocate a minimal requirement for something to be considered a narrative, at least two, if not multiple, states of affairs increase narrativity significantly. Narratives also have a unified subject and some relatively easily understood temporal structure. Although many narratives do not order all of their events sequentially, good narratives will have a temporal order that can be gleaned by its reader.1An annal might be something that is temporally ordered and likely have more than two events or states of affairs, and for this reason it might be put into a category of "story form." The primary principle of organization of an annal, however, is merely a temporal list of events. It cannot count as a full-fledged narrative since it may be a temporal list of events that has no unified subject. For example,A: "The Space shuttle Challenger explodes in 1988, the Berlin wall comes down in 1989, there is a massacre at Srebenica, Bosnia in 1995."B: "The Space Shuttle Columbia blows up upon reentry to Earth; the Space Shuttle Challenger explodes upon take off."A is a temporally ordered list of events and is an annal; B, however, is... (shrink)

This essay examines two distinct modes of sonic disjunction in Rosanna Bruno and Anne Carson’s The Trojan Women: A Comic and Carson’s H of H Playbook. The Trojan Women shows how noticing sounds that are dislocated from expectations exposes hard truths about reality. H of H interrogates our “regular” mode of hearing other people and implies that there is a gap in how we can know others and know ourselves. Thus, though both are graphic texts, their power and effect are (...) nonetheless garnered also through the sounds they describe and conjure in the minds of their readers. (shrink)

Les Socrate(s) de Platon; le Socrate de Hegel, de Kierkegaard et de Nietzsche.

Environmental law and environmental protection have long been portrayed as requiring tradeoffs between incompatible ends: "jobs versus environment;" "markets versus regulation;" "enforcement versus incentives." Behind these views are a variety of concerns, including resistance to government regulation, skepticism about the importance or extent of environmental harms, and sometimes even pro-environmental views about the limits of Earth's carrying capacity. This framework is perhaps best illustrated by the Trump Administration, whose rationales for a host of environmental and natural resources policies have embraced (...) a zero-sum approach, seemingly preferring a world divided into winners and losers. Given the many significant challenges we face, does playing the zero-sum game cause more harm than good? And, if so, how do we move beyond it? This book is the third in a series of books authored by members of the Environmental Law Collaborative (ELC), an affiliation of environmental law professors that began in 2011. In it, the authors tackle the origins and meanings of zero-sum frameworks and assess their implications for natural resource and environmental protection. The authors have different angles on the usefulness and limitations of zero-sum framing, but all go beyond the oversimplified view that environmental protection always imposes a dead loss on some other societal value. (shrink)

Following the evolution towards media-saturated societies, this article presents practice theory as an alternative framework for mediatization studies. We discuss how it can help us grasp the diversity of social and cultural changes related to the highly integrated media. This is demonstrated by studying politicians' personalization, not as a product of media logic but by looking at politicians' media-related practices and media's anchoring of practices. Our in-depth interviews with Flemish politicians show that their practices are in many ways organized by (...) the media, but through this mediatization at the same time aim to retain control over them. It is also shown that politicians' practices are not only directly influenced by media, but also by other politicians' media-related practices. Together, these findings draw a complex picture of the mediatization and personalization process. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Disturbances and Dislocations: Understanding Teaching and Learning Experiences in Indigenous Australian Women’s Music and DanceSarah H. WattsElizabeth Mackinlay. Disturbances and Dislocations: Understanding Teaching and Learning Experiences in Indigenous Australian Women’s Music and Dance (Bern: Peter Lang, 2007).Elizabeth Mackinlay, a lecturer in the Aboriginal and Torres Strait Islander Studies Unit at the University of Queensland, documents her unique pedagogical approaches and ways of thinking about the teaching and learning (...) of music and dance in her book, Disturbances and Dislocations: Understanding Teaching and Learning Experiences in Indigenous Australian Women’s Music and Dance. A university-level anthropology course dealing with the music and dance traditions of Australia’s Yanyuwa women was the setting for this “ethnographic case study” (p. 17). Through this course, Mackinlay sought to help students connect Indigenous Australian performance practices to social and political issues while fostering awareness of gender issues and learning processes within Indigenous Australian music and dance performance contexts. These objectives were met through a distinctive approach—by disposing of the strict lecture class format and bringing the field into the classroom. Disturbances and Dislocations documents the experiences of Mackinlay, her students, and several Yanyuwa women who come together as part of the course to engage in hands-on, authentic music and dance exchanges that bring the Yanyuwa women’s voices to the fore. [End Page 90]From the very beginning of the book, Mackinlay highlights her unique point of view as author of this work. She is a “white, middle class, educated woman” (p. 15) researching the experiences of and teaching university-level courses relating to Indigenous Australian and Torres Strait Islander peoples, a cultural background that is not her own. She is a political, educational, and ethnic outsider to the groups of peoples she studies. The wife of an Aboriginal man and mother to Aboriginal children, she is afforded links to the Yanyuwa people that provide her with a measure of status as a family member within the community. The dichotomy of being at once an insider and an outsider in the Yanyuwa community lends a fascinating level of complexity to Mackinlay’s exploration and analysis of the presence and impact of Yanyuwa culture-bearers in her classroom. The warmth, honesty, and openness with which she addresses her unique role in this learning exchange is engaging to the reader, and allows her personal situation to add humanity and life to the words on the page.The eight-chapter book commences with an introductory section that reflects upon her personal experiences in engaging in scholarship relating to Indigenous Australian issues. Additionally, the reader is introduced to the site of the ethnography, her classroom, in which her personal and professional lives intertwine. The next chapter further establishes the context of the ethnography by discussing a pilot project that laid foundations for the main study presented in the book. In this 1999 pilot project, a group of Mackinlay’s students, largely white women, participated in hands-on music and dance workshops under the guidance of Mackinlay and several Yanyuwa women. Student responses from this pilot project indicated that they felt awkward at times, but valued the time spent with the Yanyuwa guests and wished for more of these types of class sessions. Mackinlay determined that this cultural exchange could be even richer if more class time could be dedicated to it, an important observation for her own work, and also for others who seek to furnish cultural encounters for students.The fourth chapter delves into a theoretical discussion of the meanings of the inclusion of the study of Aboriginal and Torres Strait Islander peoples in contemporary classroom settings. Issues of political positioning, representation of Indigenous voices, identity, and “speaking from and of in-between spaces” (p. 64) as one with a foothold in both white and Indigenous worlds are all addressed, engaging the reader in Mackinaly’s own complex journey of coming to terms with her own teaching and scholarly pursuits. It is refreshing to the reader that Mackinlay acknowledges her unique viewpoint as facilitator of this course and this research study. While she is an authority in this realm, she highlights her own backgrounds and biases, her individual lens... (shrink)

Well-being advocates state that it provides a more holistic, humanistic focus for public policy. Paradoxically, however, well-being debates tend to be dominated by highly quantitative, de-contextualised statistical methods accessible to only a minority of technical experts. This paper argues the need to reverse this trend. Drawing on original primary mixed method research in Zambia and India it shows the critical contribution of qualitative methods to the development of a quantitative model of subjective perspectives on well-being. Such contributions have a political, (...) ethical and practical urgency if subjective measures of well-being are to be used in policy. (shrink)

BackgroundExpertise has been a contentious concept in Evidence-Based Medicine. Especially in the early days of the movement, expertise was taken to be exactly what EBM was rebelling against—the authoritarian pronouncements about “best” interventions dutifully learned in medical schools, sometimes with dire consequences. Since then, some proponents of EBM have tried various ways of reincorporating the idea of expertise into EBM, with mixed results. However, questions remain. Is expertise evidence? If not, what is it good for, if anything?MethodsIn this article, I (...) describe and analyze the three historical models of expertise integration in EBM and discuss the difficulties in putting each into practice. I also examine accounts of expertise from disciplines outside of medicine, including philosophy, sociology, psychology, and science and technology studies to see if these accounts can strengthen and clarify what EBM has to say about expertise.ResultsOf the accounts of expertise discussed here, the Collins and Evans account can do most to clarify the concept of expertise in EBM.ConclusionsWith some additional clarification from EBM proper, theoretical resources from other disciplines might augment the current EBM account of expertise. (shrink)

My doctoral project is a study of epistemological and ethical issues in Evidence-Based Medicine, a movement in medicine which emphasizes the use of randomized controlled trials. Much of the research on EBM suggests that, for a large part of the movement's history, EBM considered expertise, mechanisms, and values to be forces contrary to its goals and has sought to remove them, both from medical research and from the clinical encounter. I argue, however, that expertise, mechanisms and values have important epistemological (...) and ethical roles to play and can be incorporated into the current EBM movement. (shrink)

Context -- Overview of themes -- Reading the text -- Reception and influence.