This book uses the framework of care ethics to articulate a novel theory of our epistemic obligations to one another. It presents an original way to understand our epistemic vulnerabilities, our obligations in education, and our care-duties toward others with whom we stand in epistemically vulnerable relationships. As embodied and socially interdependent knowers, we have obligations to one another that are generated by our ability to care-that is to meet each other's epistemic vulnerabilities. The author begins the (...) book by arguing that the same motivations that moved social epistemologists away from individualistic epistemology should motivate a move to a care-based theory. The following chapters outline our epistemic care-duties to vulnerable agents, and offer criteria of epistemic goodness for communities of inquiry. Finally, the author discusses the tension between epistemic care and epistemic paternalism. Epistemic Care will be of interest to scholars and advanced students working in social epistemology, ethics, feminist philosophy, and philosophy of education. (shrink)

The manuscript explores the plausibility of care-based epistemology in a comparative key. Investigating the epistemic virtue of care-giving, the work weaves together insights from care ethics, virtue epistemology and a particular reading of the Mah=abh=arata which, left to themselves, do not appear compatible with one another. Drawing on these traditions, the work goes on to provide a feminist vision of search for truth that is consistent with both ethical relations and interventions for justice.

Last year saw the 20th anniversary edition of JECP, and in the introduction to the philosophy section of that landmark edition, we posed the question: apart from ethics, what is the role of philosophy ‘at the bedside’? The purpose of this question was not to downplay the significance of ethics to clinical practice. Rather, we raised it as part of a broader argument to the effect that ethical questions – about what we should do in any given situation – are (...) embedded within whole understandings of the situation, inseparable from our beliefs about what is the case, what it is that we feel we can claim to know, as well as the meaning we ascribe to different aspects of the situation or to our perception of it. Philosophy concerns fundamental questions: it is a discipline requiring us to examine the underlying assumptions we bring with us to our thinking about practical problems. Traditional academic philosophers divide their discipline into distinct areas that typically include logic: questions about meaning, truth and validity; ontology: questions about the nature of reality, what exists; epistemology: concerning knowledge; and ethics: how we should live and practice, the nature of value. Any credible attempt to analyse clinical reasoning will require us to think carefully about these types of question and the relationships between them, as they influence our thinking about specific situations and problems. So, the answers to the question we posed, about the role of philosophy at the bedside, are numerous and diverse, and that diversity is illustrated in the contributions to this thematic edition. (shrink)

I develop two different epistemic roles for emotion and desire. Caring for moral ends and people plays a pivotal though contingent role in ensuring reliable awareness of morally salient details; possession of various emotions and motives is a necessary condition for autonomous understanding of moral concepts themselves. Those who believe such connections compromise the "objective" status of morality tend to assume rather than argue for the bifurcated conception of reason and affect this essay challenges.

In this article, I argue that various epistemic challenges associated with eating disorders (EDs) can negatively affect the care of already marginalized patient groups with various EDs. I will first outline deficiencies in our understanding of EDs—in research, healthcare settings, and beyond. I will then illustrate with examples cases where discriminatory misconceptions about what EDs are, the presentation and treatment of EDs, and who gets EDs, instantiate obstacles for the treatment of various ED patient groups.

Cuba currently has more than 38,000 health workers providing emergency relief, long-term community-based care and medical education to some of the most vulnerable communities in the world. This current outreach to 76 countries positions Cuba as a leader in global health outreach. This has been well documented and praised by many scholars and policy makers alike. While many acknowledge the importance and impact of the Cuba’s global effort, there is very little understanding as to why Cuba makes such a (...) large global health commitment in the first place. I argue that solidarity is in fact a mixture of national pride, self-interest and humanistic outreach. Ultimately, it is a calculated effort to overcome current structures of inequity and exploitation on a global scale by expanding new opportunities for health professionals dedicated to providing care in marginalized communities. (shrink)

A perennial debate in the field of global ethics revolves around the possibility of a universalist ethics as well as arguments over the nature, and significance, of difference for moral deliberation. Decolonial literature, in particular, increasingly signifies a pluriverse – one with radical ontological and epistemological differences. This book examines the concept of the pluriverse alongside global ethics and the ethics of care in order to contemplate new ethical horizons for engaging across difference. Offering a challenge to the current (...) state of the field, this book argues for a rethinking of global ethics as it has been conceived thus far. (shrink)

This book, first published in 1987, examines the notion of truth and then discusses knowledge and the way in which much of our knowledge revises or rejects the common-sense we start from. The author argues that our knowledge is not as secure as some would like to think and that there are important limits to the possibility for explanation. He shows how values permeate our ordinary thinking and argues against the objectivity of these values, showing the practical consequences of this (...) argument for teaching in schools. This stimulating approach to a fundamental educational issue does not require previous experience of formal philosophy and will be useful to both education students and teachers in schools. (shrink)

Parents in the US and other societies are increasingly refusing to vaccinate their children, even though popular anti-vaccine myths – e.g. ‘vaccines cause autism’ – have been debunked. This book explains the epistemic and moral failures that lead some parents to refuse to vaccinate their children. First, some parents have good reasons not to defer to the expertise of physicians, and to rely instead upon their own judgments about how to care for their children. Unfortunately, epistemic self-reliance systematically distorts (...) beliefs in areas of inquiry in which expertise is required. Second, vaccine refusers and mainstream medical authorities are often committed to different values surrounding health and safety. For example, while vaccine advocates stress that vaccines have low rates of serious complications, vaccine refusers often resist vaccination because it is ‘unnatural’ and because they view vaccine-preventable diseases as a ‘natural’ part of childhood. Finally, parents who refuse vaccines rightly resist the utilitarian moral arguments – ‘for the greater good’ – that vaccine advocates sometimes make. Unfortunately, vaccine refusers also sometimes embrace a pernicious hyper-individualism that sanctions free-riding on herd immunity and that cultivates indifference to the interpersonal and social harms that unvaccinated persons may cause. (shrink)

A rigorous, authoritative new anthology which brings together some of the most significant contemporary scholarship on the theory of knowledge Carefully-calibrated and judiciously-curated, this strong and contemporary new anthology builds upon Epistemology: An Anthology, Second Edition (Wiley Blackwell, 2008) by drawing a concise and well-balanced selection of higher-level readings from a large, diverse, and evolving body of research. Includes 17 readings that represent a broad and vital part of contemporary epistemology, including articles by female philosophers and emerging thought (...) leaders Organized into seven thoughtful and distinct sections, including virtue epistemology, practical reasons for belief, and epistemic dysfunctions among others Designed to sit alongside the highly-successful anthology of canonical essays, Epistemology: An Anthology, Second Edition (Wiley Blackwell, 2008) Edited by a distinguished editorial team, including Ernie Sosa, one of the most influential active epistemologists Highlights cutting edge methodologies and contemporary topics for advanced students, instructors, and researchers. (shrink)

This paper attempts to establish the epistemological import and limits of informed consent in clinical research. It points out that informed consent is a necessary requirement in clinical research because it ensures adequate participation of care receivers in issues relating to their health. Besides ensuring that care receivers have knowledge of whatever medical intervention they are consenting to, informed consent, as an ideal, provides assurance that care receivers and others are neither coerced nor deceived. While the question (...) of the value of informed consent in health care delivery is not so much controverted, in contest is the question of whether or not complete and wholly specifically informed consent can indeed be realized in medical intervention. Two orientations are identified in this debate. One insists that an individual will be able to make an informed decision and make reasonable choices amongst alternatives when fully informed. The other orientation sees as an epistemic illusion, achieving full informed consent, and rather opts for informed request. This paper examines this debate by clarifying the notion of informed consent, its components and its nexus with knowledge. The position of the paper is that informed consent is not only an ethical ideal in clinical research and health care; it is also an epistemic virtue that must be continuously strived towards. This paper establishes that health care receivers can only have an epistemic claim of their medical situation if all requirements of informed consent in health care delivery such as provision of adequate information, the risk and benefits of treatment, avoidance of vague/ambiguous statements, voluntariness, etc. are met. (shrink)

For those working in Epistemology dizzying questions such as the following arise: - When are beliefs rational, or justified? - How should we update our beliefs in the light of new evidence? - Is it possible to gain knowledge, or justification? - How do we know what we know, and why do we care about whether--and what--others know? - How can the exploration of pre-Socratic philosophical questions about knowledge assist with the design of twenty-first-century computer interfaces? Addressing the (...) need for an authoritative and comprehensive reference work to enable users to answer these and other questions, and to make sense of--and to navigate around--an ever more complex corpus of scholarly literature, Epistemology is a new title in Routledge's acclaimed Critical Concepts in Philosophy series. Edited by Ram Neta, it is a four-volume collection which brings together foundational and the very best cutting-edge scholarship in a unique one-stop 'mini library'. Supplemented with a full index, and including an introduction to each volume, newly written by the editor, which places the assembled materials in their historical and intellectual context, Epistemology is destined to be valued by scholars and students as a vital research resource. (shrink)

Essentialists claim that at least some individuals or kinds have essences. This raises an important but little-discussed question: how do we come to know what the essence of something is? This paper examines Aristotle’s answer to this question. One influential interpretation (viz., the Explanationist Interpretation) is carefully expounded, criticized, and then refined. Particular attention is given to what Aristotle says about this issue in DA I.1, APo II.2, and APo II.8. It is argued that the epistemological claim put forward in (...) DA I.1 differs from that put forward in APo II.2 and II.8, contrary to what has been claimed by Explanationists, and that each of these distinct epistemological claims rests on a distinct non-epistemological thesis about essence. Consequently, an ‘Enriched Explanationist Interpretation’ is developed which takes into account both of the aforementioned elements in Aristotle’s epistemology of essence. The paper concludes by highlighting an insight the preceding exegetical discussion offers to contemporary essentialists seeking to explain how we come to know what something’s essence is. (shrink)

This paper argues that the concept of care is significant not only for ethics, but for epistemology as well. After elucidating caring as a five-step dyadic relation, I go on to show its epistemic significance within the general framework of virtue epistemology as developed by Ernest Sosa, Alvin Goldman, and Linda Zagzebski. The notions of "care-knowing" and "care-based epistemology" emerge from construing caring (respectively) as a reliabilist and responsibilist virtue.

An Innovating approach to Plato’s philosophy Through a careful survey of several significant Platonic texts, mainly focussing on the nature of knowledge, Essays on Plato’s Epistemology offers the reader a fresh and promising approach to Plato’s philosophy as a whole. From the very earliest reception of Plato’s philosophy, there has been a conflict between a dogmatic and a sceptical interpretation of his work and thought. Moreover, the two sides are often associated, respectively, with a metaphysical and an anti-metaphysical approach. (...) This book, continuing a line of thought that is nowadays strongly present in the secondary literature – and also followed by the author in over thirty years of research –, maintains that a third way of thinking is required. Against the widespread view that an anti-dogmatic philosophy must go together with an anti-metaphysical stance, Trabattoni shows that for Plato, on the contrary, a sober and reasonable assessment of both the powers and limits of human reason relies on a proper metaphysical outlook. (shrink)

Bruno Latour is one of the founding figures in social network theory and a broadly influential systems thinker. Although his work has always been relational, little scholarship has engaged the relational morality, ontology, and epistemology of feminist care ethics with Latour’s actor–network theory. This article is intended as a translation and a prompt to spur further interactions. Latour’s recent publications, in particular, have focused on the new climate regime of the Anthropocene. Care theorists are just beginning to (...) address posthuman approaches to care. The argument here is that Latourian analysis is helpful for such explorations, given that caring for the earth and its inhabitants is the dire moral challenge of our time. The aim here is not to characterize Latour as a care theorist but rather as a provocative scholar who has much to say that is significant to care thinking. We begin with a brief introduction to Latour’s scholarship and lexicon, followed by a discussion of care theorist Puig de la Bellacasa’s work on Latour. We then explore recent work on care and the environment consistent with a Latourian approach. The conclusion reinforces the notion that valuing relationality across humans and non-human matter is essential to confronting the Anthropocene. (shrink)

A caring approach to knowledge production has been portrayed as epistemologically radical, ethically vital and as fostering continuous responsibility between researchers and research-subjects. This article examines these arguments through focusing on the ambivalent role of care within the first large-scale experimental beagle colony, a self-professed ‘beagle utopia’ at the University of California, Davis. We argue that care was at the core of the beagle colony; the lived environment was re-shaped in response to animals ‘speaking back’ to researchers, and (...) ‘love’ and ‘kindness’ were important considerations during staff recruitment. Ultimately, however, we show that care relations were used to manufacture compliancy, preventing the predetermined ends of the experiment from being troubled. Rather than suggesting Davis would have been less ethically troubling, or more epistemologically radical, with ‘better’ care, however, we suggest the case troubles existing care theory and argue that greater attention needs to be paid to histories, contexts, and exclusions. (shrink)

This is a critical discussion of the accuracy-first approach to epistemic norms. If you think of accuracy (gradational or categorical) as the fundamental epistemic good and think of epistemic goods as things that call for promotion, you might think that we should use broadly consequentialist reasoning to determine which norms govern partial and full belief. After presenting consequentialist arguments for probabilism and the normative Lockean view, I shall argue that the consequentialist framework isn't nearly as promising as it might first (...) appear. (shrink)

SARGENT A. Nursing Inquiry 2012; 19: 134–143 [Epub ahead of print]Reframing caring as discursive practice: a critical review of conceptual analyses of caring in nursingThis study critically examines the way in which the concept of caring is presented in the nursing literature through conceptual analytic approaches. A critical reflection on the potential consequences of representing a concept of caring as vague and ambiguous, yet central to ontology and epistemology in professional nursing is presented drawing on comparisons between the conceptual (...) analyses of caring, and of structuralist perspectives of language, and how this potentially limits scholarship in this area. A search of the literature revealed nine conceptual papers. These papers highlight the self‐referential characteristics of the concept of caring, and of analytical methods in general. It is proposed that this is the result of a systematic adherence to a rigid, structuralist view of language, whereby stable relationships between words and their meanings are assumed. An alternative perspective is offered by viewing caring as a discursive practice rather than a fixed conceptual entity, calling into question the role that the concept plays in nursing practice. A poststructuralist perspective requires caring to be perceived as a discourse of nursing that is fluid and contingent, rather than a central and guiding concept, opening up a new orientation for nursing scholarship in caring research. (shrink)

This paper applies a virtue epistemology approach to using the Internet, as to improve our information-seeking behaviours. Virtue epistemology focusses on the cognitive character of agents and is less concerned with the nature of truth and epistemic justification as compared to traditional analytic epistemology. Due to this focus on cognitive character and agency, it is a fruitful but underexplored approach to using the Internet in an epistemically desirable way. Thus, the central question in this paper is: How (...) to use the Internet in an epistemically virtuous way? Using the work of Jason Baehr, it starts by outlining nine intellectual or epistemic virtues: curiosity, intellectual autonomy, intellectual humility, attentiveness, intellectual carefulness, intellectual thoroughness, open-mindedness, intellectual courage and intellectual tenacity. It then explores how we should deploy these virtues and avoid the corresponding vices when interacting with the Internet, particularly search engines. Whilst an epistemically virtuous use of the Internet will not guarantee that one will acquire true beliefs, understanding or even knowledge, it will strongly improve one’s information-seeking behaviours. The paper ends with arguing that teaching and assessing online intellectual virtues should be part of school and university curricula, perhaps embedded in critical thinking courses, or even better, as individual units. (shrink)

Abstract Like the logical empiricists many contemporary philosophers wish to bring the determinateness of scientific judgment to epistemology. Recent efforts to naturalise epistemology (such as those of the Churchlands) seem to jeopardise the position of epistemology as a normative discipline. Putnam argues that attempts to naturalise epistemology are self?refuting. My goal is not to defeat the project for the naturalisation of epistemology, but rather to help clarify what it does and does not amount to. I (...) maintain that attempts to completely eliminate the normative will be either forever incomplete or inimical to the progress of science. However, because it is the first horn of this dilemma which will prevail, these considerations do not undermine the importance of future epistemology carefully attending to the results of the relevant sciences. (shrink)

Evidence based medicine has been a topic of considerable controversy in medical and health care circles over its short lifetime, because of the claims made by its exponents about the criteria used to assess the evidence for or against the effectiveness of medical interventions. The central epistemological debates underpinning the debates about evidence based medicine are reviewed by this paper, and some areas are suggested where further work remains to be done. In particular, further work is needed on the (...) theory of evidence and inference; causation and correlation; clinical judgment and collective knowledge; the structure of medical theory; and the nature of clinical effectiveness. (shrink)

The paper begins by drawing a number of ‘levels’ distinctions in epistemology. It notes that a theory of knowledge must be an attempt to obtain knowledge . It is suggested that we can make sense of much of the work found in analytic theory of knowledge by seeing three framework assumptions as underpinning this work. First, that to have philosophical knowledge of knowledge requires us to have an analysis. Second, that much of what we require from a theory of (...) knowledge may be obtained by developing such analyses of first-order, concrete, empirical, propositional knowledge. Third, that the final arbiter of the correctness of such analyses is to be the carefully examined intuitions of the epistemologist. The paper attacks each aspect of this framework on the ground that this methodology will precisely not give us knowledge . In passing, comparisons are drawn with arguments that led to the demise of phenomenalism. The paper concludes with remarks about realism/anti-realism and consensus/disagreement in analytic epistemology. The paper recommends that we seek to develop theories of knowledge rather than analyses, and defends the position that such theories will precisely not be analyses. (shrink)

Caring to Know by Vrinda Dalmiya is a remarkable, and remarkably original, work. It develops a significant extension of the care-ethical framework for epistemology, builds on as well as critiques Western feminist philosophy, and offers an original interpretation of the Mahābhārata's implication for epistemic norms. But perhaps most importantly, it invents an entirely original epistemology unlike anything, really, in English. The revolutionary dimensions of the book are clear from the beginning: this is a work of decolonial (...) class='Hi'>epistemology.For the period of our shared presence in the profession of philosophy, moral theory and epistemology have begun a cautious conversation. There is now moral epistemology, a field of... (shrink)

Many extant theories of placebo focus on their causal structure wherein placebo effects are those that originate from select features of the therapy (e.g., client expectations or “incidental” features like size and shape). Although such accounts can distinguish placebos from standard medical treatments, they cannot distinguish placebos from everyday occurrences, for example, when positive feedback improves our performance on a task. Providing a social-epistemological account of a treatment context can rule out such occurrences, and furthermore reveal a new way to (...) distinguish clinical placebos from standard medical treatments. (shrink)

Departing from an epistemological tradition for which knowledge properly achieved must be objective, especially in eschewing affect and/or special interests; and against a backdrop of my thinking about epistemic responsibility, I focus on two situations where care informs and enables good knowing. The implicit purpose of this reclamation of care as epistemically vital is to show emphatically that standard alignments of care with femininity—the female—are simply misguided. Proposing that the efficacy of epistemic practices is often enhanced when (...) would-be knowers care about the outcomes of investigation, I suggest that epistemic responsibility need not be compromised when caring motivates and animates research. Indeed, the background inspiration comes from the thought, integral to feminist and post-colonial theory and practice that, despite often-justified condemnations of research that serves "special interests," particularities do matter, epistemically. Such thoughts, variously articulated, are integral to enacting a shift in epistemology away from formal abstraction and toward engaging with the specificities of real-world, situated knowledge projects. They are not unequivocally benign, for villains too care about the outcomes of their projects. Hence multi-faceted engagements with epistemic practices and processes are urgently required across the social-political world. (shrink)

In this article, we explicate evidence-based nursing (EBN), critically appraise its framework and respond to nurses’ concern that EBN sidelines the caring elements of nursing practice. We use resources from care ethics, especially Vrinda Dalmiya’s work that considers care as crucial for both epistemology and ethics, to show how EBN is compatible with, and indeed can be enhanced by, the caring aspects of nursing practice. We demonstrate that caring can act as a bridge between ‘external’ evidence and (...) the other pillars of the EBN framework: clinical expertise; patient preferences and values. Drawing on an influential EBN handbook, section 1 presents the aims and features of EBN, including the normative principle that EBN should take place within a ‘context of caring’. We aim to understand this context and whether it can be neatly detached from the EBN framework, as the handbook seems to suggest. In section 2, we highlight the grounds for resistance to EBN from the nursing community, before mounting the argument that nursing practices can be understood fruitfully through feminist care ethics and/or virtue ethics lenses. In section 3, we deepen that analysis using Dalmiya’s concepts of care-knowing and care as a hybrid ethico-epistemic virtue, which are ideally suited to the complex practices of nursing. In section 4, we bring this rich understanding of care into conversation with EBN, showing that its framework cannot be adequately theorised without paying proper attention to care. Caring can be neither an innocuous background assumption of nor an afterthought to the EBN framework. (shrink)

Philosophers of science have recently taken care to highlight different modeling practices where scientific models primarily contribute modal information, in the form of for example possibility claims, how-possibly explanations, or counterfactual conditionals. While examples abound, comparatively little attention is being paid to the question of under what conditions, and in virtue of what, models can perform this epistemic function. In this paper, we firstly delineate modal modeling from other modeling practices, and secondly reviewattempts to spell out and explain the (...) epistemic success conditions of modal modeling. The aim is to more clearly expose the respective justificatory strategies of these accounts, and secondly, to identify lacunae where further work is needed. (shrink)

This essay seeks to explain a morally important class of psychological incapacity—the class of what Bernard Williams has called “incapacities of character.” I argue for two main claims: (1) Caring is the underlying psychological disposition that gives rise to incapacities of character. (2) In competent, rational adults, caring is, in part, a cognitive and deliberative disposition. Caring is a mental state which disposes an agent to believe certain considerations to be good reasons for deliberation and action. And caring is a (...) mental state which structures an agent’s practical deliberation, by establishing presumptive boundaries on the landscape of possibilities over which her deliberative imagination ranges. Incapacities of character are a consequence of the structure which these presumptive boundaries give to an agent’s deliberation. (shrink)

matter of knowing that -- that injustice is wrong, courage is valuable, and care is As a result, what I'll be doing is primarily defending in general -- and due. Such knowledge is embodied in a range of capacities, abilities, and skills..

Resonance examines some building blocks of epistemology as a prelude to the careful analysis of the foundations of probability. The concept of resonance is introduced to shed light on the philosophical problems of induction, consciousness, intelligence and free will. The same concept is later applied to provide support for a new philosophical theory of probability.Although based on existing ideas and theories, the epistemological concept of resonance is investigated for the first time in this book. The best-known philosophical theories of (...) probability, frequency and subjective, are shown to be unrealistic and dissociated from the two main branches of statistics: frequency statistics and Bayesian statistics.Written in an accessible style, this book can be enjoyed by philosophers, statisticians and mathematicians, and also by anyone looking to expand their understanding of the disciplines of epistemology and probability. (shrink)

Epistemology orthodoxy is a purist one in the sense that it separates out the epistemic from the practical. What counts as evidence is independent of what we care about. Which beliefs count as justified and which count as knowledge are independent of our practical concerns. In recent years, many epistemologists have abandoned such purist views and embraced varying degrees of pragmatic encroachment on the epistemic. I survey a variety of these views and explore the main arguments that proponents (...) of pragmatic encroachment have offered in addition to the main criticisms of the pragmatic approach. (shrink)

This book constitutes the revised versions of the invited and selected papers from the Second Epistemological Perspectives on Simulation Workshop, EPOS 2006, which was held in Brescia, Italy, during October 5-6, 2006. The 11 papers presented together with 2 invited papers were carefully reviewed and selected from 35 submissions. The topics addressed were epistemological and methodological contents, such as the relevance of empirical foundations for agent-based simulations, the role of theory, the concepts and meaning of emergence, the trade-off between simplification (...) and complexification of models. (shrink)

Marine ecosystems are under increasing pressure from human activity, yet successful management relies on knowledge. The evidence-based policy (EBP) approach has been promoted on the grounds that it provides greater transparency and consistency by relying on ‘high quality’ information. However, EBP also creates epistemic responsibilities. Decision-making where limited or no empirical evidence exists, such as is often the case in marine systems, creates epistemic obligations for new information acquisition. We argue that philosophical approaches can inform the science-policy interface. Using marine (...) biosecurity examples, we specifically examine the epistemic challenges in the acquisition and acceptance of evidence to inform policy, discussing epistemic due care and biases in consideration of evidence. (shrink)

It is a privilege to have such extensive engagement with one's work as in the responses of Linda Alcoff, Eva Kittay, Keya Maitra, and Nilanjan Das. I am sincerely thankful for the intellectual generosity and thoughtfulness of their critiques. Before responding to their specific concerns, however, I lay out the general argument of Caring to Know in broad strokes to serve as the common backdrop to their comments.The central idea of Caring to Know is that notions of 'knowing well' are (...) intertwined with ideas of 'living well,' and so epistemology is linked with ethics and politics, and epistemic normativity is reconfigured to involve goodness and justice. Of course, reference to moral concepts when delineating epistemic... (shrink)

Social justice is concerned with fair distribution of the benefits and burdens of living together in society. Regarding nursing care, social justice is concerned with who should receive its benefits, how much they should receive, and who should take up the burden of providing and paying for it. A specific thesis is offered: ‘Health care, including nursing care, should be distributed on the basis of need, free at the point of use, the cost being born by the (...) community involved.’ This thesis is shown to be incompatible with consequentialist (utilitarian) and libertarian approaches to social justice, but reasons are given for rejecting these theories. It is shown that it may be compatible with Rawl's liberal theory of justice and definitely compatible with a version of the teleological (Aristotelian) theory. The thesis is then defended against criticisms concerned with desert and responsibility: that the provident ought not to pay for the improvident, and that those who are responsible for their health do not deserve free care. There are answered by an epistemological argument concerning what we need to know before we can decide what people deserve, and an argument about social cohesion. The conclusion is that the thesis can be offered as a moral principle for a fair society. (shrink)

Robert Truog describes the controversial randomized controlled trials (RCTs) of extracorporeal membrane oxygenation (ECMO) therapy in newborns. Because early results with ECMO indicated that it might be a great advance, saving many lives, Truog argues that ECMO should not have been tested using RCTs, but that a long-term, large-scale observational study of actual clinical practice should have been conducted instead. Central to Truog’s argument, however, is the idea that ECMO is an unusual case. Thus, it is an open question whether (...) Truog’s conclusions can be extended to other areas of medical research. In this paper, I look at epistemological and ethical issues arising in the care of patients with chronic diseases, using ECMO as a starting point. Both the similarities and the dissimilarities of these two cases highlight important issues in biomedical research and support a conclusion similar to Truog’s. Observational studies of clinical practice provide the best evidence to inform the treatment of patients with chronic disease. (shrink)

A philosophy might take its general inspiration from (1) commonsense; (2) careful observation; (3) philosophical argumentation; (4) the sciences; (5) "higher" sources of illumination. It is argued in this paper that it is bedrock commonsense, and the sciences, which are the most reliable foundations for a philosophy. This result is applied to the discussion and defense of a materialist theory of the mind.

While evidence-based medicine (EBM) is often accused on relying on a paradigm of 'absolute truth', it is in fact highly consistent with Karl Popper's criterion of demarcation through falsification. Even more relevant, the first three steps of the EBM process are closely patterned on Popper's evolutionary approach of objective knowledge: (1) recognition of a problem; (2) generation of solutions; and (3) selection of the best solution. This places the step 1 of the EBM process (building an answerable question) in a (...) pivotal position for the understanding of the whole process, and underscores a few aspects which are often overlooked in EBM courses. First in this step internal evidence (including personal expertise) must be appraised and integrated in the problem. Second, issues of applicability of the possible solution should be anticipated. Third, and possibly more important, the goal of the intervention should be set at this stage (typically by choosing the outcome in a PICO question). Depending whether or not goals depend on the goals of others, and whether they concern others' voluntary behaviour, goals may be classified as self-serving, moral, altruistic or moralistic. Thus, delicate ethical questions must be addressed at this stage, which means that patient preferences and values must be carefully sought, so that empathy, counselling and narrative medicine must be mastered to be able to formulate correctly an answerable question. The need to modify the current description of the EBM process to increase the recognition of implicit assumptions and increase the consistency of this model is discussed. (shrink)

This paper attempts to show how Adorno’s thought can illuminate our reflections on the future of work. It does so by situating Adorno’s conception of genuine activity in relation to his negativist critical epistemology and his subtle account of the distinction between true and false needs. What emerges is an understanding of work that can guide our aspirations for the future of work, and one we illustrate via discussions of creative work and care work. These are types of (...) work which cater to persistent human needs, albeit ones that are distorted under present social conditions. Adorno’s thought helps us to understand why this is the case. (shrink)

A sociological study of science is not very recent and has never been seen as particularly problematic since science, and especially modern science, constitutes an impressive and extremely ramified "social system" of activities, institutions, relations and interferences with other social systems. Less favourable, however, has been the consideration of a more recent trend in the philosophy of science known as the "sociological" philosophy of science, whose most debatable point consists in directly challenging the traditional epistemology of science and, in (...) particular, in stripping scientific knowledge of its most appreciated characteristics of objectivity and rigour . A vicious circle seems to lie at the root of this sociological epistemology because, on the one hand, criticism of the traditional concept of scientific knowledge is developed by relying upon sociology, but this, on the other hand is reasonable only if sociology is credited with the status of a reliable instrument, that is, because it has been recognized as a science through an epistemological debate . In this paper it is shown that not all circles are vicious: in particular, feedback loops, positive and negative, are normally considered in cybernetic models of various processes. Negative feedback loops are fundamental in self-regulating processes and have already occurred from time to time in readjusting the concept of science itself. Therefore, a sociological epistemology of science can contribute to a more careful analysis of the real meaning and purport of the cognitive aspect of science, provided that it is not pushed to the self-defeating extreme of challenging the legitimacy of considering objectivity and rigour as the characteristic features of scientific knowledge. (shrink)

Through a philosophical engagement with “Arju” (communal dormitories for children/adolescents among the Ao tribe, India), we develop a distinct conceptualization of it as “caring space, in-between”. In its various ontological, epistemological, and ethical dimensions, Arju becomes a space for mothering of Ao children and of caring for the tribe at large. It provides a basis for developing a notion of “caring space” within a philosophy of care. Finally, while theorizing its “in-between” character, we argue that Arju resists mapping onto (...) dominant Western spatial binaries such as private/public, home/world, etc. This essay is not only an articulation of a non-dominant group’s philosophy of “mothering” and “care”, but also aims to create an alternative theoretical space from which to engage with the dominantly Western feminist philosophies of care. (shrink)