Wisdom in clinical reasoning and medical practice

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.

Acceptance,Belief, and Descartes’s Provisional Morality

This paper explores Descartes’s work with an eye towards abiding issues in moral epistemology. In so doing, I focus on the role played by the so-called provisional morality that surfaces in “Discourse on the Method”. What I argue is that despite the tenuousness with which it seems to be held, Descartes remained committed to the truth of this morality even in the midst of his most strenuous philosophical reflections. Put in the contemporary epistemological terms which provide the context of my discussion, I argue that Descartes believed in the goodness of his provisional morality as opposed to merely accepting its maxims.

‘Foolishness to Greeks’: Plantinga and the Epistemology of Christian Belief

A central theme in the Christian contemplative tradition is that knowing God is much more like ‘unknowing’ than it is like possessing rationally acceptable beliefs. Knowledge of God is expressed, in this tradition, in metaphors of woundedness, darkness, silence, suffering, and desire. Philosophers of religion, on the other hand, tend to explore the possibilities of knowing God in terms of rational acceptability, epistemic rights, cognitive responsibility, and propositional belief. These languages seem to point to very different accounts of how it is that we come to know God, and a very different range of critical concepts by which the truth of such knowledge can be assessed. In this paper, I begin to explore what might be at stake in these different languages of knowing God, drawing particularly on Alvin Plantinga’s epistemology of Christian belief. I will argue that his is a distorted account of the epistemology of Christian belief, and that this has implications for his project of demonstrating the rational acceptability of Christian faith for the 21st century.

Adorno and Heidegger on language and the inexpressible

I argue that the reflections on language in Adorno and Heidegger have their common root in a modernist problematic that dissected experience into ordinary experience, and transfiguring experiences that are beyond the capacity for expression of our language. I argue that Adorno’s solution to this problem is the more resolutely “modernist” one, in that Adorno is more rigorous about preserving the distinction between what can be said, and what strives for expression in language. After outlining the definitive statement of this problematic in Nietzsche’s early epistemological writings, I outline Heidegger’s solution and subsequently Adorno’s critique of Heidegger. Finally, I argue that situating Adorno within the modernist problem of language and expression is crucial for making sense of his philosophy as a form of critical theory.

Consciousness and Modal Empiricism

David Chalmers supports his contention that there is a possible world populated by our zombie twins by arguing for the assumption that conceivability entails possibility. But, I argue, the modal epistemology he sets forth, ‘modal rationalism,’ ignores the problem of incompleteness and relies on an idealized notion of conceivability. As a consequence, this epistemology can’t justify our quotidian judgments of possibility, let alone those judgments that concern the mind/body connection. Working from the analogy that the imagination is to the possible as perception is to the actual, I set forth a competing epistemology, ‘modal empiricism.’ This epistemology survives the incompleteness objection and allows some of our everyday modal judgments to be justified. But this epistemology can’t justify the claim that Zombie World is possible, which leaves Chalmers’s property dualism without the support it needs.

Structural equations and causation: six counterexamples

Hall [(2007), Philosophical Studies, 132, 109–136] offers a critique of structural equations accounts of actual causation, and then offers a new theory of his own. In this paper, I respond to Hall’s critique, and present some counterexamples to his new theory. These counterexamples are then diagnosed.

Pragmatic Reflexivity in Self-defeating and Self-justifying Expressions

Self-defeating and self-justifying expressions are reflexive insofar as they pertain to themselves. However, the reflexivity involved is often pragmatic, i.e., does not entirely depend upon the logical properties of what is expressed but also upon the expressive act. In this paper I present a general account of pragmatic reflexivity and apply it to some familiar self-defeating and self-justifying expressions in epistemology. This application indicates some important, if often neglected features of the epistemological issues involved. The account I defend suggests that epistemology is particularly sensitive to pragmatic reflexivity since what epistemologists do, i.e., inquire, theorize, and defend theories, is also the subject of the inquiry and resultant theories.

The epistemically virtuous clinician

Today, modern Western medicine is facing a quality-of-care crisis that is undermining the patient–physician relationship. In this paper, a notion of the epistemically virtuous clinician is proposed in terms of both the reliabilist and responsibilist versions of virtue epistemology, in order to help address this crisis. To that end, a clinical case study from the literature is first reconstructed. The reliabilist intellectual virtues, including the perceptual and conceptual virtues, are then discussed and applied to the case study. Next, a similar method is employed to examine the responsibilist intellectual virtues, including curiosity, courage, honesty, and humility, and to apply them to the case study. To round out the discussion, the love of knowledge and both theoretical and practical wisdom are explored and applied to the case study. The paper concludes with a brief discussion of how the notion of an epistemically virtuous clinician addresses the quality-of-care crisis, in terms of the connection between ethical and intellectual virtues, and of the notion’s implications for medical education.

Contrastivism and Lucky Questions

There’s something deeply right in the idea that knowledge requires an ability to discriminate truth from falsity. Failing to incorporate some version of the discrimination requirement into one’s epistemology generates cases of putative knowledge that are at best problematic. On the other hand, many theories that include a discrimination requirement thereby appear to entail violations of closure. This prima facie tension is resolved nicely in Jonathan Schaffer’s contrastivism, which I describe herein. The contrastivist take on relevant alternatives is implausible, however, and this then threatens to undermine contrastivism’s anti-skeptical results.

Blair on Rodin: Rejoinder

The article is a brief response to Jacob Blair’s critique of David Rodin’s argument in War and Self-Defense that there are circumstances in which war conceivably could be justified not as self-defence, but as law enforcement or punishment. It argues that while Rodin’s position potentially is less dilemmatic than Blair suggests, Blair nevertheless usefully highlights tensions within it. Blair’s own argument in favour of ar as law-enforcement is suggestive, but in no way conclusive.

Towards a New Epistemology of Mathematics

In this introduction we discuss the motivation behind the workshop “Towards a New Epistemology of Mathematics” of which this special issue constitutes the proceedings. We elaborate on historical and empirical aspects of the desired new epistemology, connect it to the public image of mathematics, and give a summary and an introduction to the contributions to this issue.

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Epistemology without metaphysics

The paper outlines a view of normativity that combines elements of relativism and expressivism, and applies it to normative concepts in epistemology. The result is a kind of epistemological anti-realism, which denies that epistemic norms can be (in any straightforward sense) correct or incorrect; it does allow some to be better than others, but takes this to be goal-relative and is skeptical of the existence of best norms. It discusses the circularity that arises from the fact that we need to use epistemic norms to gather the facts with which to evaluate epistemic norms; relatedly, it discusses how epistemic norms can rationally evolve. It concludes with some discussion of the impact of this view on “ground level” epistemology.

On the Alleged Connection between Moral Evil and Human Freedom: A Response to Trakakis’ Third Critique

In this essay, I respond to Nick Trakakis’ “A Third (Meta-)Critique.” This critique is directed against my argument concerning the inadequacy of the traditional theistic argument from free will. I contend that the argument from free will does not adequately explain the distribution of moral evil in the world. I maintain that the third critique, like Trakakis’ earlier critiques, is unconvincing. I remain convinced that my original argument regarding the inadequacy of the traditional argument from free will is compelling. The argument from freedom of the will, considered in itself, is unpersuasive.

Anti-Autonomism Defended: A Reply to Hill

In the current issue of this journal, Scott Hill critiques some of my work on the “is”-“ought” controversy, the Hume-inspired debate over whether an ethical conclusion can be soundly, or even validly, derived from only non-ethical premises. I’ve argued that it can be; Hill is unconvinced. I reply to Hill’s critique, focusing on four key questions to which he and I give different answers.

A critique of causality in Islamic philosophy

After the problems of epistemology, the most fundamental problem of Islamic philosophy is that of causality. Causality has been studied from various perspectives. This paper endeavors first to analyze the issues of causality in Islamic philosophy and then to critique them. A sketch is provided of the history of the development of theories of causality in Islamic philosophy, with particular attention to how religious considerations came to determine the shape of the philosophical theories that were accepted. It is suggested that outstanding philosophical and theological problems that have plagued the tradition of Islamic philosophy require a new approach to the issue of causality.

The fantasy of third-person science: Phenomenology, ontology and evidence

Dennett’s recent defense in this journal of the heterophenomenological method and its supposed advantages over Husserlian phenomenology is premised on his problematic account of the epistemological and ontological status of phenomenological states. By employing Husserl’s philosophy of science to clarify the relationship between phenomenology and evidence and the implications of this relationship for the empirical identification of ‘real’ conscious states, I argue that the naturalistic account of consciousness Dennett hopes for could be authoritative as a science only by virtue of the very phenomenological evidences Dennett’s method consigns to the realm of fiction. Thus heterophenomenology, qua scientific method, is incoherent.

Pathologies of Desire and Duty: Freud, Ricoeur, and Castoriadis on Transforming Religious Culture

This article emphasizes an underappreciated aspect of Freud’s critique of religion taken up in the writings of Ricoeur and Castoriadis: the degree to which pathologies of desire and duty imbue our relation to shared cultural forms, i.e., narratives, ideals, and values. Both thinkers find in Freud’s anti-religious polemic a valuable attempt to address the intransigence, fanaticism, and violence that can result from an unreflected affirmation of Tradition. Alongside developing a respect and acceptance of other cultures, they argue for the need to establish a critical relation to ‘sacred’meaning structures, one that mirrors interpretive strategies within the psychoanalytic process. Ricoeur and Castoriadis critique Freud’s accentuation of neurosis while extending his thinking into personal-philosophical and social-political contexts.

Everyday Life Reasoning, Possible Worlds and Cultural Processes

Discussing Faiciuc’s paper, I first tackle the problem of fallacies in deductive reasoning showing how, in a possible world theory, non correct forms of reasoning can be useful strategies for discovery, providing these strategies remain at a hypothesis level. Secondly, everyday reasoning and its specificity in comparison to logical-normative one are analyzed. This topic stresses the notion of interpretation and, in this context, the role of the community and of cultural canons shared by the subject. From this point of view, reasoning does not occur, only, in the brain of a person but in everyday exchanges occurring between individuals and the history of their community.

Public and Private Meaning in Hume: Comments on Ted Morris’ “Meaningfulness without Metaphysics: Another Look at Hume’s Meaning-Empiricism”

This paper raises questions concerning Ted Morris’ interpretation of Hume’s notion of meaning and investigates the private and public aspects of Hume’s notion of meaning.