The evidence-based medicine movement advocates basing all medical decisions on certain types of quantitative research data and has stimulated protracted controversy and debate since its inception. Evidence-based medicine presupposes an inaccurate and deficient view of medical knowledge. Michael Polanyi’s theory of tacit knowledge both explains this deficiency and suggests remedies for it. Polanyi shows how all explicit human knowledge depends on a wealth of tacit knowledge which accrues from experience and is essential for problem solving. Edmund Pellegrino’s classic treatment of (...) clinical judgment is examined, and a Polanyian critique of this position demonstrates that tacit knowledge is necessary for understanding how clinical judgment and medical decisions involve persons. An adequate medical epistemology requires much more qualitative research relevant to the clinical encounter and medical decision making than is currently being done. This research is necessary for preventing an uncritical application of evidence-based medicine by health care managers that erodes good clinical practice. Polanyi’s epistemology shows the need for this work and provides the structural core for building an adequate and robust medical epistemology that moves beyond evidence-based medicine. (shrink)

Most clinicians take for granted a simple, reductionist understanding of medical knowledge that is at odds with how they actually practice medicine; routine medical decisions incorporate more complicated kinds of information than most standard accounts of medical reasoning suggest. A better understanding of the structure and function of knowledge in medicine can lead to practical improvements in clinical medicine. This understanding requires some familiarity with epistemology, the study of knowledge and its structure, in medicine. Michael Polanyi's theory of tacit knowing (...) is advanced as the basis for developing a more accurate understanding of medical knowledge. Tacit knowing, which explores the taken-for-granted background knowledge that underlies all human knowing, is explained in detail with a focus on its relevance for clinical medicine. The implications of recognizing tacit knowing in medicine and medical decisions are discussed. These include the ability to explain the importance of the clinical encounter in medical practice, mechanisms for analysing patient and doctor as persons, and the need for humility given the uncertainty that the tacit dimension injects into all medical decisions. This more robust medical epistemology allows clinicians to better articulate the nature and importance of patient-centred care, to avoid pitfalls inherent in reductionist approaches to medical knowledge, and to think more clearly about the relationships between medicine and health care at the individual and population levels. (shrink)

Scientific developments take place in a socio-political context but scientists often ignore the ways their innovations will be both interpreted by the media and used by policy makers. In the rush to neuroscientific discovery important questions are overlooked, such as the ways: (1) the brain, environment and behavior are related; (2) biological changes are mediated by social organization; (3) institutional bias in the application of technical procedures ignores race, class and gender dimensions of society; (4) knowledge is used to the (...) advantage of the powerful; and (5) its applications may reinforce existing structures of power that pose ethical questions about distributive justice. The case of crime, deception and functional Magnetic Resonance Imaging (fMRI) shows the complexity, and the political and ethical challenges that confront those who seek to use neuroscience to explain the etiology of crime, and who base policy on its findings. An ethically grounded neuroscience needs to take account of existing structures of power and difference, and to develop a public neuropolitical consciousness that ensures that those subject to risk by the application of science and technology are participants in the decision-making processes involving the implementation of policies that affect them. (shrink)

We show that for any uncountable cardinal λ, the category of sets of cardinality at least λ and monomorphisms between them cannot appear as the category of points of a topos, in particular is not the category of models of a ${L_{\infty,\omega }}$-theory. More generally we show that for any regular cardinal $\kappa < \lambda$ it is neither the category of κ-points of a κ-topos, in particular, nor the category of models of a ${L_{\infty,\kappa }}$-theory.The proof relies on the construction (...) of a categorified version of the Scott topology, which constitute a left adjoint to the functor sending any topos to its category of points and the computation of this left adjoint evaluated on the category of sets of cardinality at least λ and monomorphisms between them. The same techniques also apply to a few other categories. At least to the category of vector spaces of with bounded below dimension and the category of algebraic closed fields of fixed characteristic with bounded below transcendence degree. (shrink)

Good,No Highlights,No Markup,all pages are intact, Slight Shelfwear,may have the corners slightly dented, may have slight color changes/slightly damaged spine.

Harry Collins’ book Tacit and Explicit Knowledge seeks to clarify the concept of tacit knowledge made famous by Michael Polanyi. Collins’ tripartite taxonomy of tacit knowledge is explained using illustrative examples from clinical medicine. Collins focuses on distinguishing the kinds of tacit knowledge that can (in principle) be made wholly explicit from the kinds of tacit knowledge that are inescapably tacit. Polanyi’s writings, on the other hand, emphasize the process of tacit knowing. Collins’ investigation of tacit knowledge makes an important (...) scholarly contribution that is distinct from and complementary to investigations that focus on tacit knowing. (shrink)

This chapter contains sections titled: Mothering and the Quest for Certainty Finding Answers to Mothering Questions Both/And Not Either/Or Toward a Pragmatic Approach to Mothering Notes.

Sociology has long recognized the centrality of the body in the reciprocal construction of individuals and society, and recent research has explored the influence of a variety of social institutions on the body. Significant research has established the influence of social class, child-rearing practices, and variable language forms in families and children. Less well understood is the influence of children's social class status on their gestures, comportment, and other bodily techniques. In this essay Sue Ellen Henry brings these two areas (...) of study together to explore how working-class children's bodies are shaped by the child-rearing practices associated with their social class status, and the potential effects these bodily techniques have on their experience in schools. (shrink)

This paper explores comedy as a queer pedagogical form that subverts problematic representational tropes of queerness pervading mainstream depictions of queer experience. Articulating ‘form’ less as a fixed arrangement of characters, images, objects, and ideas, and more as a kind of formation that positions these in dynamic relation to the wider context in which comedies are encountered, we mobilise the idea of queer pedagogical forms to capture how comedy can foster new modes of thinking about and embodying queerness for, and (...) with, audiences. Drawing on specific examples from Schitt’s Creek and Derry Girls, we document the potential of specific comedic modalities (e.g. irony, sarcasm, irreverence, and slapstick) to foster alternative representations of queerness, in which normative tropes are poked fun at, problematised, and reimagined. Through these examples, we demonstrate how comedies can enable us to ‘laugh ourselves out of the closets’ we live by, feel, navigate, and embody. (shrink)

The purpose of this paper is to set out the contours for a pedagogy of dissent, i.e., a pedagogical approach to religion that recognizes the role of dissent in bridging the conventional antagonism between religious and LGBTQ concerns for education. Seán Henry begins it with the view that a pedagogy conducive to this kind of work can be engaged with if the relation between education and religion is framed in radically conservative terms. From here, Henry inquires into the pedagogical commitments (...) necessary for dissent as a mode of bridge-building to occur. These commitments are (1) an orientation toward remembrance, understood less in terms of a commonality of religious identity and more in terms of a “structural condition of the present”; and (2) an embodied attention to the proximity of the other. The paper concludes with some thoughts on the nature of the pedagogical content that could be helpful in enacting these commitments. Henry suggests that pedagogies of dissent require theological content that (1) reworks past traditions, without justifying or downplaying their shortcomings; and (2) is explicit in its rejection of heteronormativity through a sensitivity to the lived experiences of LGBTQ people. (shrink)

The relationship between sexuality education and religion is often framed antagonistically, especially when it comes to tensions between the teaching of sexuality education and the priorities of some religious communities. In this paper, we argue that this antagonism can be structured as much by the prevalent forms of engagement that display it (dialogue and debate), as it is by the antagonism between contrasting ethical systems. While we acknowledge the importance of debate and dialogue in the public sphere, we contend that (...) appeals to these discursive forms in schools and classrooms can limit possibilities for rethinking engagements across sexuality education and religion. This is because of the tendency within certain manifestations of dialogue (for example, dialogical models connected to liberal political projects) to err on the side of predictability, rationality and abstraction. To address some of these limits, we draw on the recent turn to conversation in educational thinking. We think through the significance of conversation in offering a mode of engagement for students, teachers and school communities that is conditioned by the dispossession of the self and is attuned to the unpredictable, affective and contextual landscapes of shared encounters. We conclude with some thoughts on the practical implications of conversation for rethinking the role of the sexuality education teacher, practices of parental consultation and processes of policy enactment in schools. (shrink)

First Published in 2005. Routledge is an imprint of Taylor & Francis, an informa company.

This paper examines the importance of aspirations as reference points in a multi-period decision-making context. After stating their personal aspiration level, 172 individuals made six sequential decisions among risky prospects as part of a choice experiment. The results show that individuals make different risky-choices in a multi-period compared to a single-period setting. In particular, individuals’ aspiration level is their main reference point during the early stages of decision-making, while their starting status (wealth level at the start of the experiment) becomes (...) the central reference point during the later stages of their multi-period decision-making. (shrink)