This collection of 17 essays by the author offers a comprehensive theory of mind, encompassing traditional issues of consciousness and free will.

I describe two concepts of epistemic injustice. The first of these concepts is explained through a critique of Alvin Goldman's veritistic social epistemology. The second is closely based on Miranda Fricker's concept of epistemic injustice. I argue that there is a tension between these two forms of epistemic injustice and tentatively suggest some ways of resolving the tension.

Patient support tools have drawn on a variety of disciplines, including psychotherapy, social psychology, and social care. One discipline that has not so far been used to support patients is philosophy. This paper proposes that a particular philosophical approach, phenomenology, could prove useful for patients, giving them tools to reflect on and expand their understanding of their illness. I present a framework for a resource that could help patients to philosophically examine their illness, its impact on their life, and its (...) meaning. I explain the need for such a resource, provide philosophical grounding for it, and outline the epistemic and existential gains philosophy offers. Illness often begins as an intrusion on one’s life but with time becomes a way of being. I argue that this transition impacts on core human features such as the experience of space and time, human abilities, and adaptability. It therefore requires philosophical analysis and response. The paper uses ideas from Husserl and Merleau-Ponty to present such a response in the form of a phenomenological toolkit for patients. The toolkit includes viewing illness as a form of phenomenological reduction, thematizing illness, and examining illness as altering the ill person’s being in the world. I suggest that this toolkit could be offered to patients as a workshop, using phenomenological concepts, texts, and film clips to reflect on illness. I conclude by arguing that examining illness as a limit case of embodied existence deepens our understanding of phenomenology. (shrink)

Recent work at the junction of epistemology and political theory focuses on the notion of epistemic injustice, the injustice of being wronged as a knower. Miranda Fricker (2007) identifies two kinds of epistemic injustice. I focus here on hermeneutical injustice in an attempt to identify a difficulty for Fricker's account. In particular, I consider the significance of background social conditions and suggest that an epistemic injustice should not rely on other forms of disadvantage to achieve its status as an injustice. (...) Thus reformulated, the notion of epistemic injustice can help us to achieve an even deeper understanding of the relationship between knowledge and privilege. (shrink)

In Epistemic injustice, Miranda Fricker makes a tremendous contribution to theorizing the intersection of social epistemology with theories of justice. Theories of justice often take as their object of assessment either interpersonal transactions (specific exchanges between persons) or particular institutions. They may also take a more comprehensive perspective in assessing systems of institutions. This systemic perspective may enable control of the cumulative effects of millions of individual transactions that cannot be controlled at the individual or institutional levels. This is true (...) not only with respect to the overall distribution of such goods as income and wealth, but also with respect to the goods of testimonial and hermeneutical justice. Cognitive biases that may be difficult for even epistemically virtuous individuals to correct on their own may be more susceptible to correction if we focus on the principles that should govern our systems of testimonial gathering and assessment. Hence, while Fricker’s focus on individual epistemic virtue is important, we also need to consider what epistemic justice as a virtue of social systems would require. My paper will indicate some directions forward on this front, focusing on the need for integration of diverse institutions and persons engaged in inquiry. (shrink)

What makes this work so important is that it returned the body to the forefront of philosophy for the first time since Plato.

I examine a distinctive kind of injustice which arises when people are maltreated in their capacity as potential conveyors of knowledge. Extant discussions of testimonial injustice usually assume that the injustice occurs when an audience ignores the claims made by a testifier. This assumption obscures the fact that there are occasions where the best framework for thinking about testimonial injustice is that of inappropriately rejecting, not ignoring, those claims; the injustice differs in these two kinds of case. Light is thrown (...) on the injustice involved in inappropriate rejection by examining the epistemic import of the distinctive second-person interrelations in play in such testimonial interactions. (shrink)

This essay argues that philosophical phenomenology can provide important insights into the patient-physician relationship. In particular, it is noted that the physician and patient encounter the experience of illness from within the context of different "worlds", each "world" providing a horizon of meaning. Such phenomenological notions as focusing, habits of mind, finite provinces of meaning, and relevance are shown to be central to the way these "worlds" are constituted. An eidetic interpretation of illness is proposed. Such an interpretation discloses certain (...) essential characteristics that pertain to the experience of illness, per se , regardless of its manifestation in terms of a particular disease state. It is suggested that, if a shared world of meaning is to be constituted between physician and patient, the eidetic characteristics of illness must be recognized by the physician. Keywords: phenomenology, patient-physician relationship, illness-as-lived, habits of mind, relevance, eidetic CiteULike Connotea Del.icio.us What's this? (shrink)

Book reviewed in this article: The Meaning of Illness. By S. Kay Toombs.

There are many Christian theologies of depression. Depression is spoken of variously as the result of personal or original sin, as a kind of sin, as a sign of demonic possession or as involving demons, as a test of faith, as a sign of holiness, or as an occasion for spiritual transformation. Although it is difficult to draw any absolute distinctions, we might helpfully split them into the following three categories for the sake of discussion:Spiritual illness SI), in which depression (...) and other forms of mental illness are believed to be a kind of SI. This includes the ideas that depression is caused by sin or demons or both);Spiritual health SH), where depression is viewed as an indication of and... (shrink)

This paper focuses on several issues that arise in Miranda Fricker?s book Epistemic injustice surrounding her claims about our (moral) culpability for perpetrating acts of testimonial injustice. While she makes frequent claims about moral culpability with respect to specific examples, she never addresses the issue in its full generality, and we are left to extrapolate her general view about moral culpability for acts of testimonial injustice from these more restricted and particular claims. Although Fricker never describes testimonial injustice in such (...) terms, I argue that the fundamental wrong done in acts of testimonial injustice is a form of negligence. Once we understand testimonial injustice in this way, it is easier to see when and why we are culpable for perpetrating such injustices. Indeed, explicitly recognizing testimonial injustice as a form of negligence solves several problems for Fricker?s view, which are elucidated briefly along the way. However, construing testimonial injustice as a form of negligence has a cost as well. It highlights the fact that the normative core of Fricker?s view is deontological, rather than virtue-theoretic. Fricker claims to be offering a theory of the virtue of testimonial justice along the model of current virtue theories in epistemology, yet it seems that there is no compelling reason to think of what she has offered as a virtue theory, at least not on the model of virtue theories that one finds in epistemology. This is not to say that her view is any less plausible for not being a virtue theory. But calling it a virtue theory affects how one interprets its various claims, and tends to lead one away from, rather than toward, a proper understanding of the deep deontological nature of her account. (shrink)

Abstract This paper proposes that adopting a ?phenomenological stance? enables a distinctive kind of empathy, which is required in order to understand forms of experience that occur in psychiatric illness and elsewhere. For the most part, we interpret other people's experiences against the backdrop of a shared world. Hence our attempts to appreciate interpersonal differences do not call into question a deeper level of commonality. A phenomenological stance involves suspending our habitual acceptance of that world. It thus allows us to (...) contemplate the possibility of structurally different ways of ?finding oneself in the world?. Such a stance, I suggest, can be incorporated into an empathetic appreciation of others' experiences, amounting to what we might call ?radical empathy? (shrink)

This paper is a critique of ‘integrative medicine’ as an ideal of medical progress on the grounds that it fails to realise the cognitive value of alternative medicine. After a brief account of the cognitive value of alternative medicine, I outline the form of ‘integrative medicine’ defended by the late Stephen Straus, former director of the US National Centre for Complementary and Alternative Medicine. Straus’ account is then considered in the light of Zuzana Parusnikova’s recent criticism of ‘integrative medicine’ and (...) her distinction between ‘cognitive’ and ‘opportunistic’ engagement with alternative medicine. Parusnikova warns that the medical establishment is guilty of ‘dogmatism’ and proposes that one can usefully invoke Karl Popper’s ‘critical rationalism’ as an antidote. Using the example of Straus, I argue that an appeal to Popper is insufficient, on the grounds that ‘integrative medicine’ can class as a form of cognitively-productive, critical engagement. I suggest that Parusnikova’s appeal to Popper should be augmented with Paul Feyerabend’s emphasis upon the role of ‘radical alternatives’ in maximising criticism. ‘Integrative medicine’ fails to maximise criticism because it ‘translates’ alternative medicine into the theories and terminology of allopathic medicine and so erodes its capacity to provide cognitively-valuable ‘radical alternatives’. These claims are then illustrated with a discussion of ‘traditional’ and ‘medical’ acupuncture. I conclude that ‘integrative medicine’ fails to exploit the cognitive value of alternative medicine and so should be rejected as an ideal of medical progress. (shrink)

I describe two concepts of epistemic injustice. The first of these concepts is explained through a critique of Alvin Goldman's veritistic social epistemology. The second is closely based on Miranda Fricker's concept of epistemic injustice. I argue that there is a tension between these two forms of epistemic injustice and tentatively suggest some ways of resolving the tension.

Miranda Fricker's important study of epistemic injustice is focussed primarily on testimonial injustice and hermeneutic injustice. It explores how agents' capacities to make assertions and provide testimony can be impaired in ways that can involve forms of distinctively epistemic injustice. My paper identifies a wider range of forms of epistemic injustice that do not all involve the ability to make assertions or offer testimony. The paper considers some examples of some other ways in which injustice can prevent someone from participating (...) in inquiry. (shrink)

It is generally accepted that the therapeutic relationship between professionals and patients is one of trust. Nonetheless, some patient groups carry certain social vulnerabilities that can be exacerbated when they extend trust to health-care professionals. In exploring the epistemic and ethical implications of expert status, this paper examines how calls to trust may increase epistemic oppression and perpetuate the vulnerability of people with impairments. It critically evaluates the processes through which epistemic communities are formed or determined, and examines the institutional (...) structure and power relations that contribute to or sustain such self-affirming ideological communities. It also argues for a two-way collaborative approach between professionals and people with impairments that recognizes the role of local knowledge in enhancing professionals’ own understanding of their theoretical framework and promoting responsive practices and policies. (shrink)

Fricker shows that virtue epistemology provides a general epistemological idiom in which these issues can be forcefully discussed.

This book explores the epistemic side of racial and sexual oppression. It elucidates how social insensitivities and imposed silences prevent members of different groups from listening to each other.

In At the Will of the Body , Arthur Frank told the story of his own illnesses, heart attack and cancer. That book ended by describing the existence of a "remission society," whose members all live with some form of illness or disability. The Wounded Storyteller is their collective portrait. Ill people are more than victims of disease or patients of medicine they are wounded storytellers. People tell stories to make sense of their suffering when they turn their diseases into (...) stories, they find healing. Drawing on the work of authors such as Oliver Sacks, Anatole Broyard, Norman Cousins, and Audre Lorde, as well as from people he met during the years he spent among different illness groups, Frank recounts a stirring collection of illness stories, ranging from the well-known--Gilda Radner's battle with ovarian cancer--to the private testimonials of people with cancer, chronic fatigue syndrome, and disabilties. Their stories are more than accounts of personal suffering: they abound with moral choices and point to a social ethic. Frank identifies three basic narratives of illness in restitution, chaos, and quest. Restitution narratives anticipate getting well again and give prominence to the technology of cure. In chaos narratives, illness seems to stretch on forever, with no respite or redeeming insights. Quest narratives are about finding that insight as illness is transformed into a means for the ill person to become someone new. (shrink)

What is illness? Is it a physiological dysfunction, a social label, or a way of experiencing the world? How do the physical, social and emotional worlds of a person change when they become ill? And can there be well-being within illness? In this remarkable and thought-provoking book, Havi Carel explores these questions by weaving together the personal story of her own serious illness with insights and reflections drawn from her work as a philosopher. Carel shows how the concepts and language (...) used to describe illness today are inappropriate and misleading. Too often illness is viewed as a localised biological dysfunction while ignoring the actual experience of the ill person, their fears, their hopes, the way they interact with others and, ultimately, experience life. By focusing on the impact of illness on the ill person's life and reflecting on the experience of illness as lived from within, Carel shows how illness is a life-changing process rather than a limited physiological problem. Carel's fresh approach to illness raises some uncomfortable questions about how we all - whether healthcare professionals or not - view the ill and challenges us to become more thoughtful. "Illness" unravels the tension between the universality of illness and its intensely private, often lonely, nature. It offers a new way of looking at a matter that affects every one of us. For those who are ill, it offers insights on our ability to remain happy within the constraints of illness. (shrink)

Emotions and bodily feelings -- Existential feelings -- The phenomenology of touch -- Body and world -- Feeling and belief in the Capgras delusion -- Feelings of deadness and depersonalization -- Existential feeling in schizophrenia -- What William James really said -- Stance, feeling, and belief -- Pathologies of existential feeling.

In this paper I explore the tacit underlying sense of bodily certainty that characterizes normal everyday embodied experience. I then propose illness as one instance in which this certainty breaks down and is replaced by bodily doubt. I characterize bodily doubt as radically modifying our experience in three ways: loss of continuity, loss of transparency, and loss of faith in one's body. I then discuss the philosophical insights that arise from the experience of bodily doubt. The paper uses a Humean (...) framework with regards to bodily certainty, treating it as a taken for granted tacit aspect of normal experience. I argue that although bodily certainty is not rationally justifiable, we are nonetheless unable to reject it. Bodily certainty is thus revealed to be part of our brute animal nature. I conclude by suggesting that the study of pathology is a philosophical method useful for illuminating tacit aspects of experience. (shrink)

Some recent considerations of religion and psychiatry have drawn a distinction between pathological and spiritual/mystical experiences of mental phenomena typically regarded as within the realm of psychiatry (e.g. depression, hearing voices, seeing visions/hallucinations). Such a distinction has clinical implications, particularly in relation to whether some religious people who suffer from depression, hear voices, or see visions should be biomedically treated. Approaching this question from a theological and philosophical perspective, I draw a distinction between (what I call) ‘spiritual health’ (SH) and (...) ‘potentially transformative’ (PT) theologies, arguing that a PT model is therapeutically and philosophically more sound than a SH one. I then apply this to the clinical debate in critical dialogue with Dein and Durà-Vilà’s 2009 article, ‘The Dark Night of the Soul: spiritual distress and psychiatric implications’. My primary focus is on depression, though the discussion is also relevant to debates about psychosis and schizophrenia. (shrink)