Exploring informal components of clinical reasoning, we argue that they need to be understood via the analysis of professional wisdom. Wise decisions are needed where action or insight is vital, but neither everyday nor expert knowledge provides solutions. Wisdom combines experiential, intellectual, ethical, emotional and practical capacities; we contend that it is also more strongly social than is usually appreciated. But many accounts of reasoning specifically rule out such features as irrational. Seeking to illuminate how wisdom operates, we therefore build (...) on Aristotle’s work on informal reasoning. His account of rhetorical communication shows how non-formal components can play active parts in reasoning, retaining, or even enhancing its reasonableness. We extend this account, applying it to forms of healthcare-related reasoning which are characterised by the need for wise decision-making. We then go on to explore some of what clinical wise reasoning may mean, concluding with a case taken from psychotherapeutic practice. (shrink)

Reasoning and judgement in health care entail complex responses to problems whose demands typically derive from several areas of specialism at once. We argue that current evidence- or value-based models of health care reasoning, despite their virtues, are insufficient to account for responses to such problems exhaustively. At the same time, we offer reasons for contending that health professionals in fact engage in forms of reasoning of a kind described for millennia under the concept of wisdom. Wisdom traditions refer to (...) forms of deliberation which combine knowledge, reflection and life experience with social, emotional and ethical capacities. Wisdom is key in dealing with problems which are vital to human affairs but lack prescribed solutions. Uncertainty and fluidity must be tolerated in seeking to resolve them. We illustrate the application of wisdom using cases in psychiatry, where non-technical aspects of problems are often prominent and require more systematic analysis than conventional approaches offer, but we argue that our thesis applies throughout the health care field. We argue for the relevance of a threefold model of reasoning to modern health care situations in which multifaceted teamwork and complex settings demand wise judgement. A model based on practical wisdom highlights a triadic process with features activating capacities of the self, other and aspects of the problem itself. Such a framework could be used to develop current approaches to health care based on case review and experiential learning. (shrink)

In Pragmatism’s Evolution, Trevor Pearce demonstrates that the philosophical tradition of pragmatism owes an enormous debt to specific biological debates in the late 1800s, especially those concerning the role of the environment in development and evolution. Many are familiar with John Dewey’s 1909 assertion that evolutionary ideas overturned two thousand years of philosophy—but what exactly happened in the fifty years prior to Dewey’s claim? What form did evolutionary ideas take? When and how were they received by American philosophers? Although (...) the various thinkers associated with pragmatism—from Charles Sanders Peirce to Jane Addams and beyond—were towering figures in American intellectual life, few realize the full extent of their engagement with the life sciences. In his analysis, Pearce focuses on a series of debates in biology from 1860 to 1910—from the instincts of honeybees to the inheritance of acquired characteristics—in which the pragmatists were active participants. If we want to understand the pragmatists and their influence, Pearce argues, we need to understand the relationship between pragmatism and biology. (shrink)

This short book is a history of what might be called the Chicago school of pragmatist evolutionary ethics. It places John Dewey and Jane Addams in their late-nineteenth-century intellectual context, emphasizing in particular how they drew on the work of Herbert Spencer, Thomas Henry Huxley, and Peter Kropotkin. Eddy suggests in her introduction that because today’s “social climate” is similar in many respects to that of the United States circa 1900, pragmatism may offer “significant insights for our situation now” (...) (p. xi). Her overall thesis is that although the ethical approach of Dewey and Addams was sometimes marred by a commitment to “teleological progress” (p. 38), at its best it defended a “melioristic hope” (p. 119): we try to make the world better, but there are no guarantees. Although the book provides some helpful context for the ethical work of the Chicago pragmatists, Eddy does not convincingly show that Addams and Dewey ever saw progress as “teleological,” in the sense of inevitable movement toward a specific end. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Pragmatism's Evolution: Organism and Environment in American Philosophy by Trevor PearceAlexander KleinTrevor Pearce. Pragmatism's Evolution: Organism and Environment in American Philosophy. Chicago: The University of Chicago Press, 2020. Pp. 384. Paperback, $35.00.Pragmatist pioneers were young lions in the days of Darwin. Evolutionary-biological thinking infused this philosophical movement from the start. And yet the last time a major monograph appeared on classic pragmatism and evolutionary biology—Philip Wiener's Evolution (...) and the Founders of Pragmatism (New York: Harper Torchbooks, 1949)—the author could personally thank Ralph Barton Perry, William James's junior colleague and eventual biographer. John Dewey himself wrote the foreword.Almost seventy-five years later, we have Trevor Pearce's painstakingly researched Pragmatism's Evolution. The author has graduate training in both biology and philosophy and is a former student of William Wimsatt and Robert Richards's (343). The book offers an intricate portrait of how debates about evolutionary biology informed the thinking of a loose-knit group of pragmatists between the years 1860 and 1910. While a remarkable variety of figures are discussed, ten pragmatists command the most attention: Chauncey Wright, C. S. Peirce, Francis Ellingwood Abbot, John Fiske, William James, Josiah Royce, John Dewey, Jane Addams, G. H. Mead, and W. E. B. Du Bois (18). Call them "the American Ten."Without downplaying Darwin, an overarching theme is the special significance of Herbert Spencer. Despite many specific disagreements with him (see e.g. 74, 207–8, 253–54, 281), the American Ten all accepted something more fundamental from Spencer: an intellectual framework that explains mind and morality in terms of functional relationships between organism and environment.After an introduction outlining what Pearce identifies as four chronological "cohorts" of pragmatists (more on this concept below), he examines the 1860s and 1870s reception of Darwin (chapter 1) and Spencer (chapter 2), showing how senior pragmatists like Wright, Peirce, and James defended evolution during this period. In chapter 2, we meet the Metaphysical Club's arch Spencerian, John Fiske, and we get a reading of James's critique of Spencer's psychology and sociology. Chapter 3 gives a highly detailed, reference-work-like portrait of the second cohort's training in evolutionary biology during the 1880s—chiefly Royce, Dewey, Addams, Mead, and Du Bois. In chapter 4, we learn that in the 1880s and 1890s, idealists like Edward Caird, Samuel Alexander, David George Ritchie, and Josiah Royce all co-opted ideas from evolutionary biology, which they apparently thought compatible with Hegelian dialectics. Chapter 5 shows that central planks of Peirce's metaphysics and Dewey's ethics are responsive to an 1890s dispute over the causes of the biological variation upon which selection acts (the so-called "factors" debate). The final two chapters show how pragmatist ethics (chapter 6) and epistemology (chapter 7) were infused with substantive ideas about evolution and about scientific experiment more generally.The depth and use of historical scholarship on offer here are both remarkable. On depth, Pearce draws from nineteen special collections and archives housed at institutions from California to Manchester, UK. The reference list (published on Pearce's website) runs [End Page 160] to 118 pages and was apparently too long for inclusion in the book. Archival research and lengthy bibliographies are to be expected in today's history of philosophy. But the sheer range of sources Pearce draws from is, by any measure, impressive.The use to which he puts those sources is provocative. Close reading, and in particular argument reconstruction, is usually the stock in trade for historians of philosophy. Pearce takes a different approach (7), seeking interpretive insight through a kind of philosophical network analysis. The nodes are mainly philosophers, scientists, and social critics. Unlike digital network analyses, Pearce connects his nodes by hand, via a great multiplicity of social, educational, and intellectual relations. We learn who studied evolution where, with whom, and when; what specific texts were assigned in classes taken, in classes taught; who attacked whom, who sided with whom; and so on.The resulting networks are rich, though they can be difficult to track due to their complexity. At its best, the book uses networks to produce genuine insights that... (shrink)

"It is well to remind ourselves, from time to time, that "Ethics" is but another word for "righteousness," that for which many men and women of every generation have hungered and thirsted, and without which life becomes meaningless. Certain forms of personal righteousness have become to a majority of the community almost automatic. But we all know that each generation has its own test, the contemporaneous and current standard by which alone it can adequately judge of its own moral achievements. (...) To attain individual morality in an age demanding social morality, to pride one's self on the results of personal effort when the time demands social adjustment, is utterly to fail to apprehend the situation. This book is a study of various types and groups who are being impelled by the newer conception of Democracy to an acceptance of social obligations involving in each instance a new line of conduct."--. (shrink)

Several recent papers dealing with Plato's position on the imperfection of the phenomenal world draw heavily on the differences between two kinds of predicates in order to show the following: In the middle dialogues, Plato posits Forms only as referents of what the writers call incomplete predicates. He does not posit Forms as referents for complete predicates. When interpreters ignore the differences between these kinds of predicates, they ascribe too radical a view regarding the imperfection of the phenomenal world to (...) the middle dialogues. The ontology of these dialogues includes sensible particulars which retain their identity over time even though they are continually changing in some respect or other. (shrink)

Recent philosophy of mind has had a mistaken conception of the nature of psychological concepts. It has assumed too much similarity between psychological judgments and those of natural science and has thus overlooked the fact that other people are not just objects whose thoughts we may try to predict and control but fellow creatures with whom we talk and co-operate. In this collection of essays, Jane Heal argues that central to our ability to arrive at views about others' thoughts (...) is not knowledge of some theory of the mind but rather an ability to imagine alternative worlds and how things appear from another person's point of view. She then applies this view to questions of how we represent others' thoughts, the shape of psychological concepts, the nature of rationality and the possibility of first person authority. This book should appeal to students and professionals in philosophy of mind and language. (shrink)

A paradigm for peace discovered in the cosmopolitan neighborhoods of poor urban immigrants.

To consciously bolster behaviour that is disapproved by others (i.e., stigmatised behaviour) people may hold and report a favourable attitude toward the behaviour. However, achieving such bolstering outside awareness may be more difficult. Explicit attitudes were measured with self-report measures, and the Implicit Association Test was used to assess implicit attitudes toward behaviour held by stigmatised actors (smokers) and nonstigmatised actors (vegetarians and omnivores). Smokers' showed greater attitude-behaviour consistency in their explicit attitudes toward smoking that in their implicit attitudes. By (...) contrast, vegetarians and omnivores showed attitude-behaviour-consistency at both implicit and explicit levels. Smokers' implicit negative attitudes toward smoking may reflect its status as a stigmatised behaviour, or its addictive nature. (shrink)

This book is the result of a three-year study undertaken by a multidisciplinary working party of the Institute of Medical Ethic (UK). The group was chaired by a moral theologian, and its members included biological and ethological scientists, toxicologists, physicians, veterinary surgeons, an expert in alternatives to animal use, officers of animal welfare organizations, a Home Office Inspector, philosophers, and a lawyer. Coming from these different backgrounds, and holding a diversity of moral views, the members produced the agreed report as (...) a result of detailed and rigorous discussions. The book sets out facts about animal experiments and about animal abilities to experience pain, distress and anxiety. There is a detailed examination of the moral claims related to the benefits likely to accrue from animal research, and of strategies for weighing these benefits against the harm caused to animals, in order to decide whether particular research projects ought or ought not to proceed. This leads to consideration of the statutory and non-statutory controls which safeguard standards in such research. The final section explores a variety of philosophical arguments about the use of animals in research, and offers a philosophical justification for the Working Party's more practical conclusions. Written in clear, nontechnical language, this book is accessible to lay people as well as to scientists. It is the first such document to emerge from a meeting of people with such widely differing views on this highly controversial subject, and represents a major contribution towards informing and raising the quality of contemporary debate. The book is unique in drawing together material and ideas never before found in one volume. It will interest a broad spectrum of readers, from ethicists and animal rights advocates to scientific researchers and laboratory administrators, along with general readers concerned about this compelling issue. (shrink)

Drawing on recent advances in analytic epistemology, feminist scholarship, and philosophy of science, Jane Duran's Toward a Feminist Epistemology is the first book that spells out in the detail required by a supportable epistemology what a feminist theory of knowledge would entail.

We have investigated the emotional profile of dreams and the relationship between dream emotion and cognition using a form that specifically asked subjects to identify emotions within their dreams. Two hundred dream reports were collected from 20 subjects, each of whom produced 10 reports. Compared to previous studies, our method yielded a 10-fold increase in the amount of emotion reported. Anxiety/fear was reported most frequently, followed, in order, by joy/elation, anger, sadness, shame/guilt, and, least frequently, affection/eroticism. Unexpectedly, there was no (...) significant difference in the profiles of emotion reported by men and women. When the reports were scored for bizarreness, a significant correlation was found between the occurrence of bizarreness and major shifts in emotion. These results support the conclusion that dreaming is a mental state whose general emotional features are widely shared across individuals and strongly linked to cognitive features within individual dreams. (shrink)

Is it possible for postmodernism to offer viable, coherent accounts of ethics? Or are our social and intellectual worlds too fragmented for any broad consensus about the moral life? These issues have emerged as some of the most contentious in literary and philosophical studies. In Renegotiating Ethics in Literature, Philosophy, and Theory a distinguished international gathering of philosophers and literary scholars address the reconceptualisations involved in this 'turn towards ethics'. An important feature of this has been a renewed interest in (...) the literary text as a focus for the exploration of ethical issues. Exponents of this trend include Charles Taylor, Bernard Williams, Iris Murdoch, Cora Diamond, Richard Rorty and Martha Nussbaum, the latter a contributor and a key figure in this volume. This book assesses the significance of this development for ethical and literary theory and attempts to articulate an alternative postmodern account of ethics which does not rely on earlier appeals to universal truths. (shrink)

Jane Heal; XII*—Insincerity and Commands, Proceedings of the Aristotelian Society, Volume 77, Issue 1, 1 June 1977, Pages 183–202, https://doi.org/10.1093/arist.

The likelihood of nurse reflection is examined from the theoretical perspectives of Habermas' Theory of Communicative Action and Moral Action and Sumner's Moral Construct of Caring in Nursing as Communicative Action, through a critical social theory lens. The argument is made that until the nurse reaches the developmental level of post-conventional moral maturity and/or Benner's Stage 5: expert, he or she is not capable of being inwardly directed reflective on self. The three developmental levels of moral maturity and Benner's stages (...) are presented with discussion on whether or not there can be self-reflection because of an innate vulnerability that leads to self-protective behaviours. It is only when the confidence from mastery of practice has been achieved can the nurse be comfortable with reflection that enables him or her to become enlightened, emancipated, and empowered. The influences and constraints of the knowledge power between nurse and patient are acknowledged. The power hierarchy of the institution is recognized as constraining. (shrink)

This paper offers an extended critique of the proliferation of talk and writing of business ethics in recent years. FollowingLevinas, it is argued that the ground of ethics lies in our corporeal sensibility to proximate others. Such moral sensibility, however, isreadily blunted by a narcissistic preoccupation with self and securing the perception of self in the eyes of powerful others. Drawing upon a Lacanian account of the formation of the subject, and a Foucaultian account of the workings of disciplinary power, (...) it is then argued that the governance of the corporation is effected precisely through encouraging such a narcissistic preoccupation with the self. For themost part our narcissistic concerns are bound to ethically indifferent financial interests. But in recent years they have also been harnessed to the demand for environmental, social and ethical responsibility by the corporation. It is argued, however, that the desire to be seen to be ethical-the ethics of narcissus-is the obverse of "being responsible for.". (shrink)

Responsible Research and Innovation (‘RRI’) is a cross-cutting priority for scientific research in the European Union and beyond. This paper considers whether the way such research is organised and delivered lends itself to the aims of RRI. We focus particularly on international consortia, which have emerged as a common model to organise large-scale, multi-disciplinary research in contemporary biomedical science. Typically, these consortia operate through fixed-term contracts, and employ governance frameworks consisting of reasonably standard, modular components such as management committees, advisory (...) boards, and data access committees, to co-ordinate the activities of partner institutions and align them with funding agency priorities. These have advantages for organisation and management of the research, but can actively inhibit researchers seeking to implement RRI activities. Conventional consortia governance structures pose specific problems for meaningful public and participant involvement, data sharing, transparency, and ‘legacy’ planning to deal with societal commitments that persist beyond the duration of the original project. In particular, the ‘upstream’ negotiation of contractual terms between funders and the institutions employing researchers can undermine the ability for those researchers to subsequently make decisions about data, or participant remuneration, or indeed what happens to consortia outputs after the project is finished, and can inhibit attempts to make project activities and goals responsive to input from ongoing dialogue with various stakeholders. Having explored these challenges, we make some recommendations for alternative consortia governance structures to better support RRI in future. (shrink)

This chapter contains section titled: Introduction Background Central Philosophical Issues in Works on the Passions The Weakness of Reason “Reason Directs and the Affections Execute”19 Hume's Connection to the Earlier Literature Central Philosophical Issues regarding the Passions: Hume's Alternative Analyses Conclusion Notes References and further reading.