It is fundamental assumption in nursing theory that it is important for nurses to understand how patients experience states of ill health. This assumption is often related to aims of empathic understanding, but normative principles of social interpretation can have an important action‐guiding role whenever nurses seek to understand patients’ subjective horizons on the basis of active or passive expressions of meaning. The aim of this article is to present a philosophical theory of concept possession and to argue that it (...) can shed light on how nurses should seek to understand patients’ subjective perspectives on the meaning of illness. The two basic ideas in the theory are that patients’ beliefs and thoughts about their experiences involve concepts and that concepts can be communicated on the basis of shared implicit conceptions of what they mean. These conditions of understanding have a striking application: nurse‐patient communication is limited by many contextual factors, but it is often possible for nurses to detect shared implicit conceptions of the meaning of concepts of disease and illness. Furthermore, by acting as sympathetic linguistic experts and creating an atmosphere for dialogue, nurses can make patients feel comfortable about deferring to medical explanations of meaning that can constitute a communicative platform. The last part of the article uses a number of cases studies to show how these implications can be implemented as conceptual tools for securing meaningful communication about illness experiences in patient dialogue. (shrink)

Influential holistic analyses of patient perspectives assume that the concepts that patients associate with medical terms are formed by their total social and cultural contexts. Holistic analyses presuppose conceptual role semantics in the sense that they imply that a medical term must have the same role for a nurse and a patient in order for them to associate the same concept with the term. In recent philosophy of mind, social externalism has emerged as a non‐holistic alternative to conceptual role theories. (...) According to social externalism, a nurse and a patient express the same concept by a term if they both have a minimal or better understanding of the term. Three arguments in favour of social externalism are presented in connection with nurse–patient interaction. The first concerns successful communication, the second focuses on belief reports made by patients and the third centres on the need for including medical terms in medical discourse. Finally, the practical implications of the arguments are clarified. The most important of these is that, in cases of misunderstanding, a nurse should not conform to a patient's idiosyncratic understanding, but instead correct the mistaken applications of the term in question. (shrink)

Tyler Burge has in many writings distinguished between mental content externalism based on incorrect understanding and mental content externalism based on partial but not incorrect understanding. Both and have far-reaching implications for analyses of communication and concept possession in various expert-layperson relations, but Burge and his critics have mainly focused on . This article first argues that escapes the most influential objection to . I then raise an objection against Burge’s argument for . The objection focuses on Burge’s claim that (...) a person with a partial understanding of a term in our community expresses our standard concept because he is willing to defer to our standard understanding, while his “Putnamian” twin in a counterfactual community does not. The problem with Burge’s argument for this claim is that he does not consider the possibility that the person in our community and the twin would defer to the same understanding if they were presented with the same alternatives. Drawing from widespread dispositional assumptions about meaning, I argue that Burge must accept that they express the same concept if they would defer to the same understanding. The article closes with an examination on various ways the externalist may attempt to avoid this problem and concludes that none of them succeeds. (shrink)

Tyler Burge has argued that an incorrect understanding of a word can be sufficient for possessing the concept the word literally expresses. His well-known 'arthritis' case involves a patient who understands 'arthritis' incorrectly, but who nevertheless, according to Burge, possesses the concept arthritis. Critics of Burge have objected that there is an alternative concept that best matches the patient's understanding and that this, therefore, is the patient's concept. The paper first argues that Burge's response to this objection is unconvincing. A (...) better response is then developed. It is argued that there is no alternative concept that matches the incorrect understanding, since the patient thinks he has a partial understanding. This, together with points about ordinary psychological explanation and modes of presentations of concepts, establish that it is impossible to undermine Burge's social externalism by appealing to the idea that an alternative concept matches the incorrect understanding. (shrink)

Tyler Burge's critique of individualistic conceptions of mental content is well known.This paper employs a novel strategy to defend a strong form of Burge's conclusion. The division of epistemic labor rests on the possibility of language-mediated transactions, such as asking for something in a store and getting it. The paper shows that any individualistic conception of content will render such transactions unintelligible.