Open peer commentary on the article “Constructing Constructivism” by Hugh Gash. Upshot: Gash describes some very interesting and exemplary work using RC-influenced research and practices. I worry that his third stage of a three-stage emergence of constructivist epistemology in the study of cognitive development is consistent with a distinction between focus on individual cognitive development and focus on knowledge not in the mind but in the group, inconsistent with RC. An alternative is given and the issue of an RC perspective (...) on social justice is discussed. (shrink)

Open peer commentary on the target article “Arguments Opposing the Radicalism of Radical Constructivism” by Gernot Saalmann. Excerpt: Gernot Saalmann uses the term “radical” in the sense of something “extreme.” For example, in §1, he contrasts “radical” constructivists with “moderate” constructivists. This adjectival usage of the word “radical” as “extreme” is a slang usage from the American sub-culture called “Surfers” which originated in the late 1950s or early 1960s. “Radical,” in their slang means: “At or exceeding limits of control or (...) safety…” (Oxford English Dictionary OED 2007) . (shrink)

Open peer commentary on the target article “Who Conceives of Society?” by Ernst von Glasersfeld. Excerpt: What follows is offered as an alternative explanation of the nature and status of the concept of society. This alternative is entirely compatible with radical constructivism as described elsewhere by von Glasersfeld and some others. This is not a claim of the truth-value of this alternative interpretation, but instead is no more and no less than a claim that there is an alternative explanation that (...) fits and is useful. It is not even a claim of primacy or superiority in some comparative sense. It is merely the claim that this alternative explanation of the nature and status of the concept of society exists, is viable, and is compatible with radical constructivism: a radical constructivist’s explanation of “society.”. (shrink)

Purpose: This contribution to the Festschrift honoring Ernst von Glasersfeld gives some insight into the perpetual problem of understanding radical constructivism (RC). Parallels with the Middle Way school of Buddhism appear to shed light on this challenge. Conclusion: The hegemony realism has over the thinking of even the most highly educated in our civilization plays a major role in their failure to understand RC. Those still subject to realism in their thinking interpret statements by those in RC in ways incompatible (...) with RC. Until realists disequilibrate over mismatches between realist expectations and experiences, no alternative way of thinking is accessible to them and misinterpretations of RC will continue. Practical implications: While we cannot change someone else's understanding, in our interactions with them we can focus on creating situations in which those who do not understand us might disequilibrate. If we are successful, they are likely to begin to escape the domination of realism in their thinking. Original value: This insight may enable eventual success in our assisting others to understand RC. (shrink)

4E pedagogy is being promoted in the target article by Videla, Veloz, and Pino. In my commentary, the nature of teaching and whether or not 4E cognition is radical constructivist are discussed.

Open peer commentary on the article “I Can’t Yet and Growth Mindset” by Fiona Murphy & Hugh Gash.: What Murphy and Gash are attempting to do is to solve a significant problem some students have being successful in school, one that is not often addressed in any significant way. The language used to describe the lessons has some significant departures from radical constructivism. It is, no doubt, beneficial that the students in the study may have developed improvements in self-image, but, (...) as seen in other work, the application of radical constructivism to develop and extend the work started in the study could result in more and more lasting improvements. (shrink)

Can philosophy help ordinary people confront their personal or interpersonal problems of living? Can it help a couple whose marriage is on the rocks, or someone going through a midlife crisis, or someone depressed over the death of a significant other, or who suffers from anxiety about making a life change? These and many other behavioral and emotional problems are ordinarily referred to psychologists, psychiatrists, clinical social workers, or other mental health specialists. Less mainstream is the possibility of consulting a (...) philosophical counselor or practitioner. Yet, there is presently a steadily increasing, world-wide movement among individuals with postgraduate credentials in philosophy to harness their philosophical training and skills in helping others to address their life problems. But is this channeling of philosophy outside the classroom into the arena of life a good idea? Are philosophers, as such, competent to handle all or any of the myriad emotional and behavioral problems that arise in the context of life; or should these matters best be left to those trained in psychological counseling or psychotherapy? Through a diverse and contrasting set of readings authored by prominent philosophers, philosophical counselors, and psychologists, this volume carefully explores the nature of philosophical counseling or practice and its relationship to psychological counseling and psychotherapy. Digging deeply into this relational question, this volume aims to spark more rational reflection, and greater sensitivity and openness to the potential contributions of philosophical practice. It is, accordingly, intended for students, teachers, scholars, and practitioners of philosophy, counseling, or psychotherapy; as well as those interested in knowing more about philosophical counseling or practice. (shrink)

This essay explores the significance and implications of the causal theory of reference for the current debate on the necessity and exchangeability of the divine title ‘Father’ in the discourse of the Church. Identifying ‘Father’ as a vocative term historically grounded in the speech of Jesus and his Apostles, the authors assert that it successfully refers to God, functioning very much like a proper name. They also identify linguistic barriers to its replacement by other terms.

The disagreement over whether Aristotle recognized rights in some form unavoidably involves disagreement over what rights are, and the theory of rights itself is still highly contested. There is no consensus concerning how " right'? is to be defined, how rights are to be theoretically grounded, or how rights theory is to be applied in particular circumstances. This is not, however, a good reason to dismiss the issue of whether there are rights in Aristotle: for Aristotle, like modern rights theorists, (...) is concerned about the moral and legal status of the individual within the community, and he expresses this in terms of claims of justice. The issue is worthy of study not only because it can lead to a deeper understanding of Aristotle's conceptions of justice and the common good, but also because it may shed valuable light on the theoretical foundations of human rights, since he offers a theory of political justice which is based on a metaphysical theory of human nature. (shrink)

Gadamer's book extends and codifies the main hermeneutical concepts of Bultmann, Heidegger, and their adherents, and can be considered a summa of what Robinson calls "The New Hermeneutic." By Robinson and other theologians, and by Continental literary critics, Wahrheit und Methode has been welcomed as a philosophical justification for "vital and relevant" interpretations that are unencumbered by a concern for the author's original intention. On this point "The New Hermeneutic" reveals its affinities with "The New Criticism" and the newer "Myth (...) Criticism." All three have impugned the author's prerogative to be the determiner of textual meaning. Gadamer, however, grounds his anti-intentionalism only partially in aesthetics and not at all in the collective unconscious but primarily in the radical historicism of Martin Heidegger. (shrink)

This Experian Corporate Social Responsibility (CSR) report case study was informed by the 3Ps of sustainability along with legal, ethical, economic, and philanthropic CSR practices. Text network analysis yielded keywords, an overall theme, and 15 sub-themes. In its CSR report, Experian described and emphasised how its services can help consumers develop and protect their financial identity, which lead to greater choices, opportunities, and a sustainable quality life. At the same time, some of Experian's business practices suggest a misalignment with stated (...) strategic goals and practices. This research is unique in that it examines CSR reporting of an organisation in which its key stakeholders are both customers and the product at the same time, making them vital to the company's existence. Results suggest how legitimacy theory and lack of disclosing negative events are deployed to maintain credibility between the organisation and these essential stakeholders. (shrink)

The first-ever multivolume treatment of the issues in legal philosophy and general jurisprudence, from both a theoretical and a historical perspective. The work is aimed at jurists as well as legal and practical philosophers. Edited by the renowned theorist Enrico Pattaro and his team, this book is a classical reference work that would be of great interest to legal and practical philosophers as well as to jurists and legal scholar at all levels. The work is divided in two parts. The (...) theoretical part, consisting of five volumes, covers the main topics of the contemporary debate; the historical part, consisting of six volumes, accounts for the development of legal thought from ancient Greek times through the twentieth century. The entire set will be completed with an index. Volume 6: A History of the Philosophy of Law from the Ancient Greeks to the Scholastics 2nd revised edition, edited by Fred D. Miller, Jr. and Carrie-Ann Biondi Volume 6 is the first of the Treatise’s historical volumes and is dedicated to the philosophers’ philosophy of law from ancient Greece to the 16th century. The volume thus begins with the dawning of legal philosophy in Greek and Roman philosophical thought and then covers the birth and development of European medieval legal philosophy, the influence of Judaism and the Islamic philosophers, the revival of Roman and Christian canon law, and the rise of scholastic philosophy in the late Middle Ages, which paved the way for early-modern Western legal philosophy. This second, revised edition comes with an entirely new chapter devoted to the later Scholastics and an epilogue on the legacy of ancient and medieval thought for modern legal philosophy, as well as with updated references and indexes. (shrink)

DEBATE CONTINUES OVER WHETHER AN “Aristotelian philosophy of mind” is still credible. Recent commentators wonder whether Aristotle’s view lies somewhere in the constellation of modern theories of mind, or whether he might point to an uncharted theory. Because he viewed his own account as an alternative to both Platonic dualism and Presocratic materialism, moderns seeking a middle way between Cartesian dualism and reductionist physicalism have looked to Aristotle for inspiration. As Jonathan Barnes observes, “Philosophy of mind has for centuries been (...) whirled between a Cartesian Charybdis and a scientific Scylla: Aristotle has the look of an Odysseus.”. (shrink)

A MAJOR THESIS OF CONTEMPORARY LIBERAL PHILOSOPHY is that its theory of justice, which incorporates strong rights to negative liberty, must be prior to and independent of a theory of the good. This priority is necessary, according to liberal theorists, in view of the requirement that any adequate theory accommodate a plurality of contending views of the good, no one of which is capable of eliciting public assent to it. Recent critics of liberalism have disputed this thesis, maintaining instead that (...) there is indeed an objective good, rather than a plurality of contending goods, which at least seriously compromises and possibly undermines the negative liberty with which liberals traditionally associated their theories. Variously called communitarians, virtue theorists, or republicans, these critics have presented an important challenge to contemporary liberalism whether of the individualist or welfare state variety. (shrink)

Purpose: Often radical constructivists are confronted with arguments why radical constructivism is wrong. The present work presents a radical constructivist alternative to such arguments: a comparison of the results of two instructional practices, the standard, realist-based instruction and a radical constructivist-based instruction, both in physics courses. Design: Evidence from many studies of student conceptions in standard instruction (Duit 2004) is taken into account. In addition, diagnostic data, pre and post instruction, were collected from over 1,000 students in multiple institutions across (...) the U. S. over a period of about 15 years via an established diagnostic of conceptual understanding of motion and force. Findings: Evidence from many studies of student conceptions in standard instruction (Duit, 2004) is that little or no change in student conceptions happens in standard instruction. About half the students in the particular study reported, all science and engineering majors, experienced standard, realist-based instruction and show an average effect size of 0.6 standard deviations and an average normalized gain of 15%. The other half of the students, none of whom were science and engineering majors, experienced radical constructivist-based instruction and show an average effect size over 2.5 standard deviations and an average normalized gain over 60%. Diagnostic pre scores were nearly the same for both groups. Practical implications: The outcome, that students, neither science nor engineering majors, made changes in understanding foundational topics in physics far greater than science and engineering students, poses (1) an ethical challenge to the continued adherence to standard, realist-based instructional practices and (2) an intellectual challenge to the usefulness and appropriateness of the elitist-realist paradigm on which such standard instruction is based. Conclusion: This radical constructivist argument uses the effect of paradigms to judge their pragmatic value, not their truth-value. Based on pragmatic value, radical constructivism results in superior outcomes when applied to physics instruction. The approach to instruction can be applied generally in education. (shrink)

Context: In spite of its advantages and its ability to make valid responses to objections, radical constructivism is not mainstream. Problem: Extolling the virtues of radical constructivism and responding logically to the objections does not work. We know this from the evidence of many attempts. Our theoretical stance, radical constructivism, also suggests this approach is not likely to have much influence on realists. We cannot transmit understanding in the signals with which we attempt to communicate. How can we in radical (...) constructivism enable those outside of RC to understand our explanation of human knowing? Method: Examine our understanding of radical constructivism itself, because it is an explanation of how, why and under what circumstances people change their understandings of their experiential worlds. Results: We must find ways to direct the attention of others to situations that they cannot explain with their existing understanding of the world. Then we must create conditions conducive to their revising and testing new understandings for fit with the evidence of their experience. Implications: Since radical constructivism is a theory of human knowing, it tells us how humans develop knowledge, hence it is an answer to the questions central to this special issue. This answer is not one to be used to win in debates with realists. Radical constructivism gives us an answer to the problem of engaging realists in understanding our position, but strategies consistent with radical constructivism are not easily carried out. Developing and executing such strategies is the work at hand. (shrink)

Problem: What alternative strategies from our experiences using a Piaget-based radical constructivist pedagogy might have more and better results than the current practice of responding in debate form, each side trying to prove the other wrong? Method: Use of Slezak’s paper to illuminate the point that the central problem with the interpretation of RC generally used in such writing is that the authors seem not to be able to operate from the central tenet of RC, which is the opposite of (...) that used in realism. Description of how this failure to use the central tenet of RC results in claims that RC is irrelevant to education and to definitions of good teaching. Results: A specific approach shown to be useful in facilitating the construction of new understanding in science is adapted in order to guide interaction between an RC and a realist, which can result in the realist understanding the RC point of view. Implications: Instead of debating with critics of RC, where each side is trying to prove the other side wrong, we need to change the interaction to one in which members of opposing sides attempt to understand the other’s position. In this situation we are in a position to use a pedagogical strategy in which the realist examines her own fundamental assumption that we can know a mind-independent world, and considers the implications of a starting assumption that is exactly the opposite. (shrink)

Copyright © 2015 by the Society of Criti. Objective: Global lung stress varies considerably with low tidal volume ventilation for acute respiratory distress syndrome. High stress despite low tidal volumes may worsen lung injury and increase risk of death. No widely available parameter exists to assess global lung stress. We aimed to determine whether the volume delivered during a recruitment maneuver is inversely associated with lung stress and mortality in acute respiratory distress syndrome. Design: Substudy of an acute respiratory distress (...) syndrome clinical trial on esophageal pressure-guided positive end-expiratory pressure titration. Setting: U.S. academic medical center. Patients: Forty-two patients with acute respiratory distress syndrome in whom airflow, airway pressure, and esophageal pressure were recorded during the recruitment maneuver. Interventions: A single recruitment maneuver was performed before initiating protocol-directed ventilator management. Recruitment maneuvers consisted of a 30-second breath hold at 40 cm H2O airway pressure under heavy sedation or paralysis. VRM was calculated by integrating the flow-time waveform during the maneuver. End-inspiratory stress was defined as the transpulmonary pressure during end-inspiratory pause of a tidal breath and tidal stress as the transpulmonary pressure difference between end-inspiratory and end-expiratory pauses. Measurements and Main Results: VRM ranged between 7.4 and 34.7 mL/kg predicted body weight. Lower VRM predicted high end-inspiratory and tidal lung stress. After adjusting for Pao2/Fio2 and either driving pressure, tidal volume, or plateau pressure and positive end-expiratory pressure, VRM remained independently associated with both end-inspiratory and tidal stress. In unadjusted analysis, low VRM predicted increased risk of death. VRM remained significantly associated with mortality after adjusting for study arm. Conclusions: Low VRM independently predicts high lung stress and may predict risk of death in patients with acute respiratory distress syndrome. (shrink)

Some people have found my distinction between meaning and significance useful. In the following revision of that distinction, I hope to improve its accuracy and perhaps, therefore, its utility as well. My impulse for making the revision has been my realization, very gradually achieved, that meaning is not simply an affair of consciousness and unconsciousness. In 1967, in Validity in Interpretation, I roundly asserted that “there is no magic land of meanings outside human consciousness.” 1 That assertion would be true (...) if, godlike, we could oversee the whole of human consciousness, past, present, and future. But we language users, being limited creatures, intend our verbal meanings to go beyond what we can pay attention to at any moment. We intend our meanings to transcend our momentary limitations of attention and knowledge. Hence there is a land of meanings beyond past and present human consciousness—the land of the future. What I should have said originally is that there is no magic lance of meanings beyond the whole extent of human consciousness, past, present, and future. This correction of my original statements leads to a deepening of the concept of meaning.In 1960 I first proposed the analytical distinction between two aspects of textual interpretation. One of them, meaning, was fixed and immutable; the other, significance, was open to change.2 I acknowledged that significance, changeable or not, is the more valuable object of interpretation, because it typically embraces the present use of texts, and present use is present value. But I argued that, in academic criticism, the significance and use of a text ought to be rooted in its fixed meaning, since otherwise criticism would lack a stable object of inquiry and would merely float on tides of preference. The claim that one reader’s opinion is as valid as another’s would then be right, despite any indignant protest to the contrary. I did not wish to dissuade people from floating on the tides of preference if that was what they wished to do. I intended to provide a firm justification for those who wished to pursue historical scholarship. 3 I also assumed that even those who did not pursue historical scholarship might sometimes wish to exploit the possibility of historically fixed meaning. In my experience, even antiauthorial theorists sometimes with to regard their own texts as having a historically fixed meaning and will complain if someone misunderstands that meaning. 1. E. D. Hirsch, Jr., Validity in Interpretation, p. 4.2. See my “Objective Interpretation,” PMLA 75 : 463-79.3. See, for instance, W. K. Wimsatt, Jr., and Monroe C. Beardsley, “The Intentional Fallacy,” in Wimsatt, The Verbal Icon: Studies in the Meaning of Poetry, which ends:We submit that this is the true and objective way of criticism, as contrasted to what the very uncertainty of exegesis might tempt a second kind of critic to undertake: the way of biographical or genetic inquiry …. Our point is that such an answer to such an inquiry would have nothing to do with the poem “Prufrock”; it would not be a critical inquiry. Critical inquiries, unlike bets, are not settled in this way. Critical inquiries are not settled by consulting the oracle. [P. 18] E. D. Hirsch, Jr., professor of English at the University of Virginia, is the author of numerous works, including Validity in Interpretation and The Aims of Interpretation. His previous contributions to Critical Inquiry are “Against Interpretation?”, “The Politics of Theories of Interpretation, and “Stylistics and Synonymity”. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reflections on Academic ReflectionJohn D. Copenhaver Jr.Contemplative pedagogy deserves both the careful scrutiny and the sustained exploration that the Society for Buddhist-Christian Studies is uniquely well suited to provide. As higher education comes under increased pressure for accountability, we need to be able to explain clearly both the pedagogical value and academic integrity of these elements in our curriculum. Academics seeking to incorporate contemplative practices into their teaching need (...) to pay careful attention to their institutional setting. While people in all types of higher education may share certain values (e.g., free inquiry, critical thinking, intellectual rigor, clear reasoning), different institutional settings offer different kinds of opportunities and challenges. Shenandoah University, where I teach, is one of five private universities in Virginia related to the United Methodist Church (UMC). All these schools acknowledge the relationship, but some seem rather embarrassed by it. For us it is a warm embrace.In its mission statement, our university characterizes the relationship this way: “As an institution affiliated with the United Methodist Church, Shenandoah University practices the highest ethical standards in its interactions with the community and with students of other faiths.”1 While the university is clear about its church affiliation, the phrase “highest ethical standards in its interaction with students of other faiths” indicates the kind of mutual respect and understanding that characterize pluralism. Among its core values are “respect for diverse cultures, experiences, and perspectives” and “dedication to global outreach.”2 Dedication to “global outreach” sounds like window dressing, but it is genuine. With its Global Citizenship Project, the university funds all expenses for fifty-five students each year to travel to one of five countries over spring break for cultural immersion. This mission statement and our core values make it much easier to root our religious studies curriculum in an atmosphere of religious pluralism than one might expect at a church-related university.Our Department of Religion recognizes two purposes for religious studies. The first is to offer an array courses to meet general education needs for moral reasoning and cross-cultural understanding. One of the department’s goals for general education religion courses is to promote interreligious and multicultural understanding. Another is to serve the church by offering a program to train students for religious leadership roles, called the JustFaith Christian Leadership Program. It is designed to integrate theological education and spiritual formation that promotes social justice. [End Page 41] In the department’s view, this commitment to justice is consistent with our Wesleyan heritage, but is often neglected in churches and rare in higher education. Although our religion major requirements reflect the university’s Christian heritage, we do require a course in world religions and one course in a religious tradition other than Christianity.This institutional setting invites me to teach in very different ways. Of the eight courses I teach over a two-year rotation, two take a philosophical approach, two take a phenomenological approach without any contemplative practices, and two blend the phenomenological approach with contemplative practices.3 The other two I teach “from the inside,” as a Christian ordained in the United Methodist Church. I present my own experience and convictions as part of that tradition, and the course emphasizes religious practices such as fasting, prayer, meditation, contemplative prayer, and/or periods of solitude. This confessional approach would not be possible at a state university, but I think students should have this option at church-related schools. The delicate issue is that most students do not come to our university because of its religious heritage. Our students are much like their counterparts at state universities, and often register for courses on the basis of what fits their academic schedules rather than any particular interest in or affinity for the topic. For this reason, we try to be as clear as possible in course descriptions about the various contents and approaches of our courses. Still, that does not prevent a poorly advised agnostic or atheist from registering occasionally for my course on Christian spirituality. On the first day of class I discuss the confessional nature of the course and the spiritual exercises students will be expected to do. I do not screen anyone... (shrink)

A bivalent valuation is snt iff sound (standard PC inference rules take truths only into truths) and non-trivial (not all wffs are assigned the same truth value). Such a valuation is normal iff classically correct for each connective. Carnap knew that there were non-normal snt valuations of PC, and that the gap they revealed between syntax and semantics could be "jumped" as follows. Let $VAL_{snt}$ be the set of snt valuations, and $VAL_{nrm}$ be the set of normal ones. The bottom (...) row in the table for the wedge 'v' is not semantically determined by $VAL_{snt}$ , but if one deletes from $VAL_{snt}$ all those valuations that are not classically correct at the aforementioned row, one jumps straights to $VAL_{nrm}$ and thus to classical semantics. The conjecture we call semantic holism claims that the same thing happens for any semantic indeterminacy in any row in the table of any connective of PC, i.e., to remove it is to jump straight to classical semantics. We show (i) why semantic holism is plausible and (ii) why it is nevertheless false. And (iii) we pose a series of questions concerning the number of possible steps or jumps between the indeterminate semantics given by $VAL_{snt}$ and classical semantics given by $VAL_{nrm}$. (shrink)

Professors Battersby and Phelan have presented a lively challenge. They urge readers to reject the later, fuzzy Hirsch, in favor of an earlier, truer Hirsch.Their first objection is that Hirsch 2 has mistaken the nature of literary meaning. Battersby and Phelan reject the view that a literary work carries a general meaning analogous to the concept of “bicycle” that can be exemplified by all bicycles. They propose that a literary work is “more appropriately conceived as … a Schwinn or even (...) a red Schwinn three-speed with a blue seat and two flat tires”. They object to my adoption of Sir Philip Sidney’s claim that literature provides both the general concept and the particular example simultaneously. By saying that literature does both things at once I conflate and confuse, they say, two different intentions, because, as they aver, an exemplified concept cannot be further exemplified”.This claim reinstates the familiar New Critical doctrine that a literary concept is unique among concepts in that it can never be dissevered from its particular embodiment. E. D. Hirsch, Jr., professor of English at the University of Virginia, is the author of numerous works including Validity in Interpretation and The Aims of Interpretation. His previous contributions to Critical Inquiry include “Against Interpretation?” and “The Politics of Theories of Interpretation”. His most recent contributions is “Meaning and Significance Reinterpreted”. (shrink)

Among philosophers as well as linguists the battle is still joined between those who view the correlation between meaning and linguistic form as strictly determined by convention and those who argue for the essential indeterminacy of the relationship between meaning and form.1 Plato's Cratylus aside, the philosphical dialogue that forms the locus classicus of this debate is the following: "You're holding it upside down!" Alice interrupted. "To be sure I was!" Humpty Dumpty said gaily, as she turned it round for (...) him. "I thought it looked a little queer. As I was saying. that seems to be done right - though I haven't time to look it over thoroughly just now - and that shows that there are three hundred and sixty-four days when you might get un-birthday presents -" "Certainly," said Alice. "And only one for birthday presents, you know. There's glory for you!" "I don't know what you mean by 'glory,'" Alice said. Humpty Dumpty smiled contemptuously. "Of course you don't - till I tell you. I meant 'there's a nice knock-down argument for you!'" "But 'glory' doesn't mean 'a nice knock-down argument,'" Alice objected. "When I use a word," Humpty Dumpty said in rather a scornful tone, "it means just what I choose it to mean - neither more nor less."2 · 1. This should not be taken as an argument for the indeterminacy of linguistic meaning itself. Quite the contrary; it is because meaning can be stable and determinate despite variations in mental acts and linguistic forms that the relation between form and meaning must be indeterminate on the basis merely of rules and conventions.· 2. Lewis Carroll, Through the Looking Glass, chap. 6. E. D. Hirsch, Jr. is Kenan Professor of English at the University of Virginia. He is the author of Validity in Interpretation and Wordsworth and Schelling: A Typological Study of Romanticism. A second edition of his book on Blake, Innocence and Experience, will appear next year, as will a new book on critical theory. (shrink)

The twenty‐six‐year‐old patient requested a prophylactic bilateral mastectomy with reconstruction because of an extensive family history of cancer. She reported that she had developed melanoma at twenty‐five; that her mother, sister, aunts, and a cousin all had breast cancer; that a cousin had ovarian cancer at nineteen; and that a brother was treated for esophageal cancer at fifteen. The treating team was skeptical about this history, and they could find no documentation of the patient's reported melanoma. The surgeon wrote the (...) patient's primary care physician, explaining that he had seen the patient and planned to proceed with the bilateral mastectomy and reconstruction. The primary care physician responded that he was unable to substantiate several of the patient's claims; some of his colleagues believed the family history to be fabricated. Trying to make sense of the discrepancies, the genetic counselor called a counselor colleague who had met with this patient. The colleague suggested that the in‐house genetic counselor “google” the patient. The search revealed two Facebook pages linked to the patient. In one, apparently a personal profile, the patient stated that in addition to battling stage four melanoma, she had recently been diagnosed with breast cancer. She provided a link to a site where she solicited donations to attend a summit for young cancer patients. The other Facebook page featured numerous pictures of her with a bald head, as though she has been through chemotherapy. The genetic counselor showed the Facebook pages to the surgeon, who then decided not to operate. Should health care professionals “google” their patients? (shrink)