Working retrospectively in an uncertain field of knowledge, physicians are engaged in an interpretive practice that is guided by couterweighted, competing, sometimes paradoxical maxims. When you hear hoofbeats, don't think zebras, is the chief of these, the epitome of medicine's practical wisdom, its hermeneutic rule. The accumulated and contradictory wisdom distilled in clinical maxims arises necessarily from the case-based nature of medical practice and the narrative rationality that good practice requires. That these maxims all have their opposites enforces in students (...) and physicians a practical skepticism that encourages them to question their expectations, interrupt patterns, and adjust to new developments as a case unfolds. Yet medicine resolutely ignores both the maxims and the tension between the practical reasoning they represent and the claim that medicine is a science. Indeed, resolute epistemological naivete is part of medicine's accommodation to uncertainty; counterweighted, competing, apparently paradoxical (but always situational) rules enable physicians simultaneously to express and to ignore the practical reason that characterizes their practice. (shrink)

How Doctors Think defines the nature and importance of clinical judgment. Although physicians make use of science, this book argues that medicine is not itself a science but rather an interpretive practice that relies on clinical reasoning. A physician looks at the patient's history along with the presenting physical signs and symptoms and juxtaposes these with clinical experience and empirical studies to construct a tentative account of the illness. How Doctors Think is divided into four parts. Part one introduces the (...) concept of medicine as a practice rather than a science; part two discusses the idea of causation; part three delves into the process of forming clinical judgment; and part four considers clinical judgment within the uncertain nature of medicine itself. In How Doctors Think, Montgomery contends that assuming medicine is strictly a science can have adverse side effects, and suggests reducing these by recognizing the vital role of clinical judgment. (shrink)

How do we know what is right, or before that, how do we recognize what is morally salient? Such matters lie deeper than can be plumbed by traditional philosophical modes of inquiry alone. Careful study of them requires also the study of literature, with the meticulous appraisal that it encourages of the intricate, tangled issues involved in apprehending the world, finding our way in it, and representing it to others. In this way, the study of literature contributes to a richer (...) and more complex perspective on moral problems, and a more cautious view of the status and breadth of attempts to solve those problems. (shrink)

In Moral Passages, Kathryn Pyne Addelson presents an original moral theory suited for contemporary life and its moral problems. Her basic principle is that knowledge and morality are generated in collective action, and she develops it through a critical examination of theories in philosophy, sociology and women's studies, most of which hide the collective nature and as a result hide the lives and knowledge of many people. At issue are the questions of what morality is, and how moral theories (...) (whether traditional or feminist) are implemented. Addelson takes up a large number of historical cases and contemporary social problems, including teen pregnancy, contraception and abortion, and gay rights. These cases allow her to see how the knowledge and lives of some people are declared deviant or immoral, while those of others appear to show the public consensus. One case she uses throughout the book is Margaret Sanger's early work on birth control with the anarcho-syndicalist movement--a revisionist history that reveals rather than hides the collective nature of morality and knowledge. Addelson shows how the usual individualist philosophies promote theories which hide the authority of the professionals who make them. A collectivist approach, she argues, must show the part professionals play in collective action. Her aim is to allow professional knowledge makers to be morally and intellectually responsible. Based on Addelson's twenty years of work in feminist philosophy and interactionist sociology as well as her long-standing involvement in women's community organization, Moral Passages investigates how morality and knowledge are collectively enacted in today's world. (shrink)

This book is a complete re-thinking of Aristotle's metaphysical theory of material substances. The view of the author is that the 'substances' are the living things, the organisms: chiefly, the animals. There are three main parts to the book: Part I, a treatment of the concepts of substance and nonsubstance in Aristotle's Categories; Part III, which discusses some important features of biological objects as Aristotelian substances, as analysed in Aristotle's biological treatises and the de Anima; and Part V, which attempts (...) to relate the conception of substance as interpreted so far to that of the Metaphysics itself. The main aim of the study is to recreate in modern imagination a vivid, intuitive understanding of Aristotle's concept of material substance: a certain distinctive concept of what an individual material object is. (shrink)

This book is a re-thinking of Aristotle's metaphysical theory of material substances. The view of the author is that the 'substances' are the living things, the organisms: chiefly, the animals. There are three main parts to the book: Part I, a treatment of the concepts of substance and nonsubstance in Aristotle's Categories; Part III, which discusses some important features of biological objects as Aristotelian substances, as analysed in Aristotle's biological treatises and the de Anima; and Part V, which attempts to (...) relate the conception of substance as interpreted so far to that of the Metaphysics itself. The main aim of the study is to recreate in modern imagination a vivid, intuitive understanding of Aristotle's concept of material substance: a certain distinctive concept of what an individual material object is. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Elements of Eleatic Ontology' MONTGOMERY FURTH THE TASKOF AN INTERPRETERof Parmenides is to find the simplest, historically most plausible, and philosophically most comprehensible set of assumptions that imply (in a suitably loose sense) the doctrine of 'being' set out in Parmenides' poem. In what follows I offer an interpretation that certainly is simple and that I think should be found comprehensible. Historically, only more cautious claims are possible, (...) for several portions of the general view from which I 'deduce the poem' are not clearly stated in the poem itself; my explanation of this is that they are operating as tac/t assumptions, and indeed that the poem is best thought of as an attempt to force these very assumptions to the surface for formulation and criticism -that the poem is a challenge. To be sure, there are dangers in pretending, as for dramatic purposes I shall, that ideas are definite and explicit which for Parmenides himself must have been tacit or vague--that Parmenides knew what he was doing as clearly as I represent him; I try to avoid them, but the risk must be taken. I even believe that not to take it, in the name of preserving his thought pure from anachronous contamination, actually prevents us from seeing the extent to which he, pioneer, was ahead of his timc the argument works both ways. So let me hedge my historical claim in this way: the view I shall discuss could have been an active-indeed a controlling---element of Eleaticism; to suppose that Parmenides held it not only explains the poem, but also helps explain the subsequent reactions to Eleaticism of Anaxagoras, Democritus, and Plato (though there is not space to elaborate this here). In addition, it brings his thought astonishingly close to some contemporary philosophical preoccupations. In the first of the following sections, I lay down some sketchy but necessary groundwork concerning the early Greek concept of 'being.' Then in Section 2 an interpretation is given of what I take to be the central Parmenidean doctrine, that 'it cannot be said that anything is not.' This section is the lengthiest and most involved, but it also contains all the moves that appear to be important. Of the remaining sections, Section 3 exp]Mn.qthe principle: 'of what is, all that can be said is: it is,' Section 4 deals briefly with the remaining cosmology of "The Way of Truth," and Section 5 considers the question whether Parmenides himself believed the fantastic conclusions of his argument. There is a short postscript on a point of methodology. 1. A Word on 6v If we are to examine Parmenides' reasoning profitably, an indispensable pre1This paper wasprepared while the author was beneficiary of a Grant-in-Aid of Research from the American Council of Learned Societies, hereby gratefully acknowledged. [111] 112 HISTORY OF PHILOSOPHY liminary is to estabhsh at least a provisional reading for the Greek words translated "is" or "it is" (tar,v), "what is" or "being" (Sv,rb 5v), "to be" (alva0. For while it is evident enough that in his poem Parmenides purports to be delivering an insight of the utmost significance concerning rb tbv (as he calls it), still the construction which he puts upon the term and its cognates, and the understanding which he expects of his listener, are not so clear and have been topics of dispute. Especially notable, and often noted, is the fact that Parmenides' discussion of 'being' shows no sign of the conceptual distinction considered elementary nowadays, between the "is" linking subject and predicate and the "is" of existence; and in fact it needs no documentation here that this distinction was not reflected in either ordinary or philosophical Greek idiom until, at least, a much later date than his, the word tare expressing both concepts. Also highly visible in the poem is the abundance of occurrences of tare used absolutely, unaccompanied by any predicate expression. As a result of this last, the poem can create in the contemporary reader the impression that r5 tSv is being used to mean what is in the existential sense only, to mean what there is; indeed some students of the poem conclude not only that Parmenides... (shrink)

Constitutivist accounts in metaethics explain the normative standards in a domain by appealing to the constitutive features of its members. The success of these accounts turns on whether they can explain the connection between normative standards and the nature of individuals they authoritatively govern. Many such explanations presuppose that any member of a norm-governed kind must minimally satisfy the norms governing its kind. I call this the Threshold Commitment, and argue that constitutivists should reject it. First, it requires constitutivists to (...) restrict the scope of their explanatory ambitions, because it is not plausibly true of social kinds. Second, despite the frequent reliance on physical artifacts in constitutivists’ illustrations of the Threshold Commitment, it counter-intuitively entails that physical artifacts can cease to exist without being physically destroyed. Third, it misconstrues the normative force of authoritative norms on very defective kind-members because it locates this force not in the norm, but in the threat of non-existence. Fortunately, constitutivism can be decoupled from the Threshold Commitment, and I close by sketching a promising alternative account. (shrink)

There is conflicting experimental evidence about whether the “stakes” or importance of being wrong affect judgments about whether a subject knows a proposition. To date, judgments about stakes effects on knowledge have been investigated using binary paradigms: responses to “low” stakes cases are compared with responses to “high stakes” cases. However, stakes or importance are not binary properties—they are scalar: whether a situation is “high” or “low” stakes is a matter of degree. So far, no experimental work has investigated the (...) scalar nature of stakes effects on knowledge: do stakes effects increase as the stakes get higher? Do stakes effects only appear once a certain threshold of stakes has been crossed? Does the effect plateau at a certain point? To address these questions, we conducted experiments that probe for the scalarity of stakes effects using several experimental approaches. We found evidence of scalar stakes effects using an “evidence seeking” experimental design, but no evidence of scalar effects using a traditional “evidence-fixed” experimental design. In addition, using the evidence-seeking design, we uncovered a large, but previously unnoticed framing effect on whether participants are skeptical about whether someone can know something, no matter how much evidence they have. The rate of skeptical responses and the rate at which participants were willing to attribute “lazy knowledge”—that someone can know something without having to check—were themselves subject to a stakes effect: participants were more skeptical when the stakes were higher, and more prone to attribute lazy knowledge when the stakes were lower. We argue that the novel skeptical stakes effect provides resources to respond to criticisms of the evidence-seeking approach that argue that it does not target knowledge. (shrink)

The nature of moral action versus moral judgment has been extensively debated in numerous disciplines. We introduce Virtual Reality (VR) moral paradigms examining the action individuals take in a high emotionally arousing, direct action-focused, moral scenario. In two studies involving qualitatively different populations, we found a greater endorsement of utilitarian responses–killing one in order to save many others–when action was required in moral virtual dilemmas compared to their judgment counterparts. Heart rate in virtual moral dilemmas was significantly increased when compared (...) to both judgment counterparts and control virtual tasks. Our research suggests that moral action may be viewed as an independent construct to moral judgment, with VR methods delivering new prospects for investigating and assessing moral behaviour. (shrink)

Sometimes form-meaning mappings in language are not arbitrary, but iconic: they depict what they represent. Incorporating iconic elements of language into a compositional semantics faces a number of challenges in formal frameworks as evidenced by the lengthy literature in linguistics and philosophy on quotation/direct speech, which iconically portrays the words of another in the form that they were used. This paper compares the well-studied type of iconicity found with verbs of quotation with another form of iconicity common in sign languages: (...) classifier predicates. I argue that these two types of verbal iconicity can, and should, incorporate their iconic elements in the same way using event modification via the notion of a context dependent demonstration. This unified formal account of quotation and classifier predicates predicts that a language might use the same strategy for conveying both, and I argue that this is the case with role shift in American Sign Language. Role shift is used to report others’ language and thoughts as well as their actions, and recently has been argued to provide evidence in favor of Kaplanian “monstrous” indexical expressions. By reimagining role shift as involving either quotation for language demonstrations or “body classifier” predicates for action demonstrations, the proposed account eliminates one major argument for these monsters coming from sign languages. Throughout this paper, sign languages provide a fruitful perspective for studying quotation and other forms of iconicity in natural language due to their lack of a commonly used writing system which is otherwise often mistaken as primary data instead of speech, the rich existing literature on iconicity within sign language linguistics, and the ability of role shift to overtly mark the scope of a language report. In this view, written language is merely a special case of a more general phenomenon of sign and speech demonstration, which accounts more accurately for natural language data by permitting more strict or loose verbatim interpretations of demonstrations through the context dependent pragmatics. (shrink)

This paper provides an argument for a more socially relevant philosophy of science (SRPOS). Our aims in this paper are to characterize this body of work in philosophy of science, to argue for its importance, and to demonstrate that there are significant opportunities for philosophy of science to engage with and support this type of research. The impetus of this project was a keen sense of missed opportunities for philosophy of science to have a broader social impact. We illustrate various (...) ways in which SRPOS can provide social benefits, as well as benefits to scientific practice and philosophy itself. Also, SRPOS is consistent with some historical and contemporary goals of philosophy of science. We’re calling for an expansion of philosophy of science to include more of this type of work. In order to support this expansion, we characterize philosophy of science as an epistemic community and examine the culture and practices of philosophy of science that can help or hinder research in this area. (shrink)

The increasing complexity of human subjects research and its oversight has prompted researchers, as well as institutional review boards, to have a forum in which to discuss challenging or novel ethical issues not fully addressed by regulations. Research ethics consultation services provide such a forum. In this article, we rely on the experiences of a national Research Ethics Consultation Collaborative that collected more than 350 research ethics consultations in a repository and published 18 challenging cases with accompanying ethical commentaries to (...) highlight four contexts in which REC can be a valuable resource. REC assists: 1) investigators before and after the regulatory review; 2) investigators, IRBs, and other research administrators facing challenging and novel ethical issues; 3) IRBs and investigators with the increasing challenges of informed consent and risk/benefit analysis; and 4) in providing flexible and collaborative assistance to overcome study hurdles, mediate conflicts within a team, or directly engage with research participants. Institutions that have established, or plan to establish, REC services should work to raise the visibility of their service and engage in open communication with existing clinical ethics consult services as well as the IRB. While the IRB system remains the foundation for the ethical review of research, REC can be a valuable service for investigators, regulators, and research participants aligned with the goal of supporting ethical research. (shrink)

As in other fields, scholarly publication in sociology is not only the key to career success but also the route by which feminist analyses and perspectives become known to others in the discipline. A growing literature has analyzed women's and men's rates of publication, but the gender politics of the prepublication production of research and gender differences in reputation building after publication remain underexplored. This report reviews the current state of knowledge about sociological publishing at three phases: prepublication, the publication-seeking (...) phase, and postpublication. It concludes with critical questions to be addressed in developing a comprehensive model of gender effects on sociological publishing. (shrink)

The paper identifies the phenomenal rise of increasingly invasive forms of elective cosmetic surgery targeted primarily at women and explores its significance in the context of contemporary biotechnology. A Foucauldian analysis of the significance of the normalization of technologized women's bodies is argued for. Three "Paradoxes of Choice" affecting women who "elect" cosmetic surgery are examined. Finally, two utopian feminist political responses are discussed: a Response of Refusal and a Response of Appropriation.

Building upon Thornton's (1991) work on teachers as “curricular-instructional gatekeepers,” the author explores what guided the curricular decision-making for one novice teacher concerning controversial issues that center on race, social class, and lesbian, gay, bisexual, and transgender (LGBT) issues. Qualitative case study revealed context, student demographics, and teacher positionality as influencing this teacher's choices regarding these themes in her curriculum. Findings indicated that this teacher was willing and able to challenge racist views in her classroom when she was a student (...) teacher and her students more closely mirrored her own race and social class. When she was a full-time teacher of students who were of a different racial and class background, she was unable to similarly challenge their homophobic beliefs. Implications for teacher education are discussed. (shrink)

In recent work, Michael Smith argues that particular desires are constitutive of ideal agency and draws on his dispositional account of reasons to establish the normative significance of those desires. In a sustained critique, Michael Bukowski objects that Smith’s recent arguments that particular desires are constitutive of ideal agency rely on indefensible premises and his dispositional account of reasons is unable to establish the normative significance of such desires. On the contrary, I argue not only that Smith has the resources (...) to respond to these objections but also that the form of Smith’s constitutivist explanation has unappreciated explanatory strengths. (shrink)

Jaakko Hintikka points out the power of Skolem functions to affect both what there is and what we know. There is a tension in his presupposition that these functions actually extend the realm of logic. He claims to have resolved the tension by “reconstructing constructivism” along epistemological lines, instead of by a typical ontological construction; however, after the collapse of the distinction between first and second order, that resolution is not entirely satisfactory. Still, it does throw light on the conceptual (...) analysis Hintikka proposes. (shrink)

Philosophers of science are increasingly arguing for the importance of doing scientifically- and socially-engaged work, suggesting that we need to reduce barriers to extra-disciplinary engagement and broaden our impact. Yet, we currently lack empirical data to inform these discussions, leaving a number of important questions unanswered. How common is it for philosophers of science to engage other communities, and in what ways are they engaging? What barriers are most prevalent when it comes to broadly disseminating one’s work or collaborating with (...) others? To what extent do philosophers of science actually value an engaged approach? Our project addresses this gap in our collective knowledge by providing empirical data regarding the state of philosophy of science today. We report the results of a survey of 299 philosophers of science about their attitudes towards and experiences with engaging those outside the discipline. Our data suggest that a significant majority of philosophers of science think it is important for non-philosophers to read and make use of their work; most are engaging with communities outside the discipline; and many think philosophy of science, as a discipline, has an obligation to ensure it has a broader impact. Interestingly, however, many of these same philosophers believe engaged work is generally undervalued in the discipline. We think these findings call for cautious optimism on the part of those who value engaged work—while there seems to be more interest in engaging other communities than many assume, significant barriers still remain. (shrink)

Indeterminate Bodies organizes a number of theoretical and empirical studies around the concept and actuality of indeterminacy, as it relates to body and society. Located within the struggle to apprehend different categories of ‘body’ in the volatile flows of late-capital, indeterminacy is considered through such multiple incarnations as economy, contingency, inheritance, question, force, uncertainty, materiality and affective resistance to determination. While indeterminacy is often positioned as the ‘trouble’ or friction in subject/object knowledge-formation (framed as ontological or empirical challenge), it also (...) engenders affects such that some subjects are both in and out of recognition. Questions of indeterminacy overlap with work on imperceptibility, giving rise to interlocked questions about the modes of representation, categorization, inclusion, exclusion and sensibility in the production of bodies. We address the hesitancies, difficulties and necessities of working with and through indeterminacy in order open up new descriptions, visions and modes of political work. (shrink)

The authors examine the nature of the relationship between social science and philosophy and address the sort of work social science should do, and the role and sorts of claims that an accompanying philosophy should engage in. In particular, the authors reintroduce the question of ontology, an area long overlooked by philosophers of social science, and present a cricital engagement with the work of Roy Bhaskar. The book argues against the excesses of philosophising and commits itself to a philosophical approach (...) more deeply grounded in the social sciences. (shrink)

Inspired by Mariana Ortega's invitation to reflect on diverse iterations of intersectionality, this article focuses on María Lugones's engagements with two Black feminist concepts, namely, interlocking oppressions and intersectionality. It explores these concepts alongside Lugones's use of her own terms such as intermeshed, curdling, multiplicity, and fusion, in several paradigm shifting essays, specifically, “Purity, Impurity, and Separation”, “Tactical Strategies of the Street Walker”, “On Complex Communication”, “Heterosexism and the Colonial/Modern Gender System”, “Toward a Decolonial Feminism”, “Methodological Notes Toward a Decolonial (...) Feminism”, and “Radical Multiculturalism and Women of Color Feminisms”. It also underscores Ortega's important contributions bringing these Black and Latina feminist concepts together in philosophically productive ways—in a spirit of collaboration and coalition rather than zero-sum competition. (shrink)

Pretty much everyone knows that our genes have at least something to do with how able or how high achieving we are. Some believe that we should not speak of this common knowledge, nor inquire into how genetic influence works or what it might mean. If we do not keep an open mind to the fact of genetic influence on academic achievement, however, then we cannot explore its possible implications. And if we do not consider the implications, then we cannot, (...) as a society, harness any potential benefits or avoid possible pitfalls. So that's what this essay is about—exploring what behavioral genetics research might be able to offer to educational theory, policy, and practice.We cannot yet use biological information to make accurate predictions for all children. We do know, however, that academic achievement is heritable, which is to say that differences between individuals are influenced by differences in their DNA. If genes are part of the problem for some pupils (to take the negative spin on this), then it seems likely that studying them could be part of a solution. And that's what behavioral geneticists are trying to do—to chart and understand pathways from DNA to behavior and to identify interventions that can maximize outcomes for all. The fact is, though, that we have an awfully long way to go. (shrink)

Presently, there is a movement in the UK research governance framework towards what is referred to as proportional ethical review. Proportional ethical review is the notion that the level of ethical review and scrutiny given to a research project ought to reflect the level of ethical risk represented by that project. Relatively innocuous research should receive relatively minimal review and relatively risky research should receive intense scrutiny. Although conceptually attractive, the notion of proportional review depends on the possibility of effectively (...) identifying the risks and ethical issues posed by an application with some process other than a full review by a properly constituted research ethics committee. In this paper, it is argued that this cannot be achieved and that the only appropriate means of identifying risks and ethical issues is consideration by a full committee. This implies that the suggested changes to the National Health Service research ethics system presently being consulted on should be strenuously resisted. (shrink)

If the Anthropocene represents a new epoch of thought, it also represents a new form of materiality and historicity for the human as strata and stratigrapher of the geologic record. This collision of human and inhuman histories in the strata is a new formation of subjectivity within a geologic horizon that redefines temporal, material, and spatial orders of the human. I argue that the Anthropocene contains within it a form of Anthropogenesis – a new origin story and ontics for man (...) – that radically rewrites material modes of differentiation and concepts of life, from predominantly biopolitical notions of life toward an understanding of life’s geophysical origination. Here, I use the term Anthropogenesis to suggest that two things explicitly happen in the nomination of the Anthropocene: 1) the production of a mythic Anthropos as geologic world-maker/destroyer of worlds, and 2) a material, evolutionary narrative that re-imagines human origins and endings within a geologic rather than an exclusively biological context. In contrast to the homogeneous geomorphizing of the Anthropocene, I suggest that socializing the strata needs a more nuanced notion of ‘geologic life’ that challenges the construction of the Anthropocene as an undifferentiated social stratification. (shrink)

A significant portion of the scholarship in analytic philosophy of psychiatry has been devoted to the problem of what kind of kind psychiatric disorders are. Efforts have included descriptive projects, which aim to identify what psychiatrists in fact refer to when they diagnose, and prescriptive ones, which argue over that to which diagnostic categories should refer. In other words, philosophers have occupied themselves with what I call “diagnostic kinds”. However, the pride of place traditionally given to diagnostic kinds in psychiatric (...) research has recently come under attack, most notably by a recent initiative of the National Institute of Mental Health, the Research Domain Criteria Project, that seeks to exclude diagnostic categories from experimental designs and focus on other sorts of psychiatric kinds. I argue that philosophical accounts privileging diagnostic kinds must respond to this new line of criticism, and conclude that philosophers need to either counter psychiatrists’ growing suspicion about the hegemony of diagnostic categories in the clinic and the laboratory, or join in redirecting their efforts toward the development of robust accounts of other sorts of psychiatric objects and processes. (shrink)

While acknowledging Hannah Arendt's keen philosophical and political insights, Kathryn T. Gines claims that there are some problematic assertions and oversights regarding Arendt’s treatment of the "Negro question." Gines focuses on Arendt's reaction to the desegregation of Little Rock schools, to laws making mixed marriages illegal, and to the growing civil rights movement in the south. Reading them alongside Arendt's writings on revolution, the human condition, violence, and responses to the Eichmann war crimes trial, Gines provides a systematic analysis (...) of anti-black racism in Arendt’s work. (shrink)