In their attempt to defend philosophy from accusations of uselessness made by prominent scientists, such as Stephen Hawking, some philosophers respond with the charge of ‘scientism.’ This charge makes endorsing a scientistic stance, a mistake by definition. For this reason, it begs the question against these critics of philosophy, or anyone who is inclined to endorse a scientistic stance, and turns the scientism debate into a verbal dispute. In this paper, I propose a different definition of scientism, and thus a (...) new way of looking at the scientism debate. Those philosophers who seek to defend philosophy against accusations of uselessness would do philosophy a much better service, I submit, if they were to engage with the definition of scientism put forth in this paper, rather than simply make it analytic that scientism is a mistake. (shrink)

As one component of a broader social and normative response to the problem of suicide, scientism served to minimize sociopolitical and religious conflict around the issue. As such, it embodied, and continues to embody, a number of interests and values, as well as serving important social functions. It is thus comparable with other normative frameworks and can be appraised, from an ethical perspective, in light of these values, interests, and functions. This work examines the key values, interests, and functions of (...) scientism in suicidology and argues that although scientism has had some social benefit, it primarily serves to maintain political and professional interests and has damaging implications for suicide research and prevention. (shrink)

Effective person-centred care requires recognition of the personhood not only of patients but of practitioners. This chapter explores the consequences of this recognition for major debates in medical epistemology, regarding clinical reasoning and the relationship between research and practice. For too long these debates have been dominated by false dichotomies - subjectivity versus objectivity, judgement versus evidence, reason versus emotion. Based on flawed understandings of such core concepts as “objectivity” and “engagement”, this distorted dissection of the subject-object relationship has served (...) to depersonalise practice. The costs of this depersonalisation include over-regulation and micromanagement of healthcare processes by administrators and payers at the same time that information from clinical research remains under-utilized and the personhood of patients risks being ignored. Science is a human practice, founded in a broader conception of human reasoning, ontologically dependent on human beings living and engaging with the world in social, emotional and ethical contexts. After looking at different conceptions of epistemic hierarchies and their uses in the analysis and evaluation of reasoning in a range of practice contexts, we propose a “nested hierarchy” that effectively turns upside-down the flawed evidence hierarchies that have helped to depersonalise care. T.S. Eliot’s “wisdom, knowledge, information” scheme (to which we add “data” below “information”) provides a model for a person-centred epistemic hierarchy. This crucial, person-centred inversion represents levels of awareness that characterise more or less developed thinking and judgement on the part of the particular practitioner. (shrink)

The ideas and terminology of person-centred care have been part of health discourse for a very long time. Arguments that in healthcare one treats the whole person, not her/his component parts, date back at least to antiquity and the need to treat the patient as a person is articulated persuasively by clinical authors in the early twentieth century. Yet it is only in recent years that we have seen a growing consensus in health policy and practice literature that PCC, and (...) associated ideas including patient expertise, co-production and shared decision-making, are not simply “fine ideals” or “ethical add-ons” to sound scientific clinical practice, but rather they represent indispensable components of any genuinely integrated, realistic and conceptually sound account of healthcare practice. The underlying conviction of this volume - one belief that, despite their differences, unites all of its contributors - is that PCC should not become the latest “revolutionary” concept to be “operationalised” before being “conceptualised”. It is imperative that we develop an open and inclusive dialogue about what we do and do not mean by “person-centred” to inform our attempts to implement PCC. (shrink)

Scientific facts are constituted as consensus about observable phenomena against the background of an accepted, or at least plausible, theory. Empirical data without a theoretical framework are at best curiosities and anomalies, at worst they are neglected. The problem of parapsychological research since its inception with the foundation of the Society of Psychical Research in 1882 was that no sound theoretical basis existed. On the contrary, the proponents of the SPR often indulged in a theoretical model that ran contrary to (...) the perceived materialism of mainstream science, and many tried to use the data of parapsychological research to bolster the case of “mind over matter,” yet without producing a good model of how such effects could be conceptualized. In general, parapsychological (PSI) research has been rather devoid of theorizing and, if anything, assumed a tacit signal-theoretical, local-causal model of some sort of subtle energy that would be vindicated, once enough empirical data were amassed. History, and data, proved this stance wrong. We will present a theoretical approach that challenges this local-causal, signal-theoretical approach by proposing that parapsychological phenomena are instances of a larger class of phenomena that are examples of nonlocal correlations. These are predicted by Generalized Quantum Theory (GQT) and can be expected to occur, whenever global descriptions of a system are complementary to or incompatible with local descriptions of elements of such a system. We will analyze the standard paradigms of PSI-research along those lines and describe how they can be reconceptualized as instances of such generalized nonlocal correlations. A direct consequence of this conceptual framework is that misrepresentations of these phenomena as local causes, as is done in direct experimentation, is bound to fail long-term. Strategies to escape this problem are discussed. (shrink)

Philosophy of medicine encompasses a broad range of methodological approaches and theoretical perspectives—from the uses of statistical reasoning and probability theory in epidemiology and evidence-based medicine to questions about how to recognize the uniqueness of individual patients in medical humanities, person-centered care, and values-based practice; and from debates about causal ontology to questions of how to cultivate epistemic and moral virtue in practice. Apart from being different ways of thinking about medical practices, do these different philosophical approaches have anything in (...) common? Are they committed to incompatible assumptions about the nature of science and its relationship to experience, value, and the art of medicine, or are different approaches nonetheless complementary? The chapter examines the questions these different approaches and perspectives raise and considers why so many theorists of medicine seek to find a “base” or “center” for medicine—as though there is, or should be, some general conceptual thread linking the things we call “usual clinical practice” in the real world. It further considers whether there are alternative approaches to the philosophy of medicine, which do not embody this philosophical assumption; and it suggests that a key tool for evaluating approaches must be their ability to contribute something of genuine value to clinical medicine. (shrink)

Discussions of diagnosis in mental illness are still beset by the suspicion that ‘value judgements’ are in some special sense ‘subjective’. The history of the debate about the reality of mental illness has seen a divide between those who accept that diagnosis is ‘value-laden’ and therefore accept a relativist/subjectivist account of mental illness, and those who feel the need to deny the value-laden nature of diagnosis to defend the reality of mental illness. More nuanced analyses note that all medical diagnosis (...) is arguably value-laden & this does not imply that medical conditions are unreal. All judgement requires a subject, but it does not follow that it is ‘subjective’ in any sense implying ontological relativity. The implications are substantial: either all medical judgement is relative or realism about value is true. To justify our claims in diagnosis, we need to discuss and defend our value-judgements. We must reject ‘scientism’ for an openly value-laden account of human functioning. Medical epistemology requires value-realism. The contentious nature of the value-judgements in the case of mental illness should not mislead us into concluding they are relative. (shrink)