Health Care Reform: What History Doesn’t Teach

The paper begins by tracing the historical development of American medicine as practice, profession, and industry from the eighteenth century to the present. This historical outline emphasizes shifting conceptions of physicians and physician ethics. It lays the basis for showing, in the second section, how contemporary controversies about the physician’s role in managed care take root in medicine’s past. In the final two sections, I revisit both the historical analysis and its application to contemporary debates. I argue that historical narratives can function as “master narratives” that suppress or leave out historical facts. I bring to the surface what is covered up by the master narrative approach, and show its relevance to contemporary ethical debates. I conclude by proposing that preserving the integrity of medicine will require modifying the master narratives we tell about physicians. The integrity of medicine also offers new perspectives for thinking about managed care and the broader topic of health care reform.     

Why Logic Doesn‘t Matter in the (Philosophical) Study of Argumentation

Philosophically, the study of argumentation is important because it holds out the prospect of an interpretation of rationality. For this we need to identify a transcendent perspective on the argumentative interaction. We need a normative theory of argumentation that provides an answer to the question: should the hearer accept the argument of the speaker. In this article I argue that formal logic implies a notion of transcendence that is not suitable for the study of argumentation, because, from a logical point of view, argumentation disappears from sight. We should therefore not expect formal logic to provide an interesting interpretation of the rationality intrinsic in argument and discussion.     

Why Doesn’t He Just Leave Me Alone? Persistent Pursuit: A Critical Review of Theories and Evidence

An integrative review of three theories that explain why some individuals engage in persistent pursuit—coercive control theory, relational goal pursuit, and attachment theory—is presented. The meta-analytic evidence pointing to persistent pursuit as a gendered behavior is reviewed, and coercive control theory is used to explain gender differences. The strong conceptual and empirical overlap between coercive control as a form of intimate partner violence and persistent pursuit is examined. It is suggested that persistent pursuit measures do not adequately assess behaviors that may be used more commonly by women, such as use of physical attractiveness or gossip to damage one’s reputation. Given the promising empirical support for the theories, longitudinal and comparative evaluations, with new methods are needed.     

Why doesn’t feedback correct Vierordt’s law?

Vierordt [(1868). Der zeitsinn nach versuchen. Tübingen: Laupp] observed that participants over-reproduce short durations and under-reproduce long durations within a test range of sample durations (Vierordt’s law). Similar phenomena have been reported for sensory and other processing (e.g. [Helson (1964 Helson, H. (1964). Adaptation-level theory. New York, NY: Harper &; Row. [Google Scholar]). Adaptation-level theory. New York: Harper &; Row; Stevens, and Greenbaum (1966). Regression effect in psychophysical judgment. Perception &; Psychophysics, 1, 439–446]. Performance feedback (knowledge of results) does not correct this performance distortion although it does correct other errors. In Experiment 1, I tested the hypothesis that a random presentation order of the standard durations makes feedback on one trial inappropriate for the next trial preventing correction of the Vierordt effect. In Experiment 2, participants performed two consecutive reproductions after each standard duration. Having the opportunity to immediately utilize the feedback from the first reproduction did not eliminate the Vierordt effect, although participants did attempt to correct the error on the first reproduction. In Experiment 3, the Vierordt effect was reduced in a blocked presentation design. Feedback produced more veridical performance. I conclude that the resistance of the Vierordt effect to correction by feedback may result, in part, from feedback on a given trial being misapplied to correcting performance on the next trial. Ironically, the Vierordt effect, which produced the differing directions and magnitudes of performance errors reported by the feedback, may be what prevents feedback from correcting for the Vierordt effect.     

Why Not Interfere With Nature?

Advocates of an environmental ethic frequently claim that what makes an ethical theory truly and uniquely environmental is its commitment to the principle that environmental wholes such as species, ecosystems, and biotic communities are morally considerable. The prevailing view is that our primary duty towards these wholes is to respect their integrity, stability, and beauty, and that the best way to do this is to leave them alone, not interfere with them, and let nature follow its own course. But is that correct? Why should be refrain from interfering with nature? There are two ways an environmentalist might try to justify an exceptionaless, prima facie principle of noninterference. First, she might claim that there is a contingent but universal connection between human interference and ecosystemic harm. There is also an epistemic variant of this view. When faced with a decision concerning whether to interfere with an ecosystem, there will always be overwhelming reasons for thinking that interference will be harmful, regardless of the specific circumstances. Send, there might be some conceptual connection between interference and harm to ecosystems. For example, if the well-being of an ecosystem is identified with its wildness, and wildness is understood as the absence of human intervention or manipulation, then any human interference necessarily detracts from an ecosystem's wildness and thereby has a detrimental effect on its well-being. In this paper I examine these justifications in detail and argue that none can support an exceptionaless principle of noninterference.     

Making Meaning of Trauma: Trauma Exposure Doesn’t Tell the Whole Story

Although traumatic experiences are relatively common, there is wide variability in individuals’ responses to them. This study examined trauma exposure, meaning making efforts (indexed by post-traumatic cognitions), and post-traumatic stress symptoms (PTS) in a non-clinical volunteer student sample (N = 631). We further examined the moderating role of gender, the importance of trauma type (interpersonal vs. non-interpersonal), and the impact of cumulative traumatic experiences. About 75% of the sample reported past trauma (n = 475). Women reported more interpersonal trauma than did men. For both genders, trauma exposure was associated with more PTS. A dose–response relationship was found between the extent of trauma exposure and negative post-traumatic cognitions. Importantly, post-traumatic cognitions predicted PTS controlling for amount of trauma exposure. It appears that it is not merely exposure to negative events that matters, but how we construe and make sense of these experiences. This study extends our understanding of gender differences, meaning-making, and responses to trauma exposure, and suggests avenues of clinical treatment.     

Why don’t synaesthetic colours adapt away?

Synaesthetes persistently perceive certain stimuli as systematically accompanied by illusory colours, even though they know those colours to be illusory. This appears to contrast with cases where a subject??s colour vision adapts to systematic distortions caused by wearing coloured goggles. Given that each case involves longstanding systematic distortion of colour perception that the subjects recognize as such, how can a theory of colour perception explain the fact that perceptual adaptation occurs in one case but not the other? I argue that these cases and the relationship between them can be made sense of in light of an existing view of colour perception. Understanding colours as ways in which objects and surfaces modify light, perceived through grasping patterns and variations in colour appearances, provides a framework from which the cases and their apparent disanalogy can be predicted and explained. This theory??s ability to accommodate these cases constitutes further empirical evidence in its favour.     

Why can’t I change Bruckner’s Eighth Symphony?

Philosophical Studies - Musical works change. Bruckner revised his Eighth Symphony. Ella Fitzgerald and many other artists have made it acceptable to sing the jazz standard “All the Things...     

Why conceptual competence won’t help the non-naturalist epistemologist

Abstract

Non-naturalist normative realists face an epistemological objection: They must explain how their preferred route of justification ensures a non-accidental connection between justified moral beliefs and the normative truths. One strategy for meeting this challenge begins by pointing out that we are semantically or conceptually competent in our use of the normative terms, and then argues that this competence guarantees the non-accidental truth of some of our first-order normative beliefs. In this paper, I argue against this strategy by illustrating that this competence based strategy undermines the non-naturalist’s ability to capture the robustly normative content of our moral beliefs.     

Why pragmatic justifications of epistemic norms don’t work

Abstract

Pragmatic justifications of epistemic norms tell us to observe these norms as the best means to attaining the things we value. I argue that such justifications do not work, because they harbour an irresolvable tension: their non-alethic character intrinsically conflicts with the truth-aiming character of the epistemic norms they are justifying. We should abandon, then, either epistemic norms or pragmatic justifications of these norms. I therefore argue that we should abandon pragmatic justifications.     

Why it doesn’t matter whether the virtues are truth-conducive

A potential explanation of a fact is a hypothesis such that, if it were true, it would explain the fact in question. Let’s suppose that we become aware of a fact and some potential explanations thereof. Let’s also suppose that we would like to believe the truth. Given this aim, we can ask two questions. First, is it likely that one of these hypotheses is true? Second, given an affirmative answer to the first question, which one is it likely to be? Inference to the best explanation (IBE) offers answers to both questions. To the first, it says ‘Yes’—assuming that at least one of the hypotheses would, if true, provide a satisfactory explanation of the fact under consideration. To the second, it says that the hypothesis most likely to be true is the one that scores best on the explanatory virtues: conservatism, modesty, simplicity, generality, and predictive power. Many philosophers have argued against IBE’s answer to the first question. I am interested in an objection to its answer to the second. Many philosophers seem to think that it is unsustainable: they seem to think that even if we assume that one of the competing hypotheses is true, we should not think that IBE will help us to identify it. Or, more carefully, if these philosophers are doing what they appear to be doing—namely, offering critiques of IBE that don’t depend on assumptions about the field of competing hypotheses—then their claim is that IBE will not help us to identify the truth. I believe that this is mistaken: the argument for believing it assumes a model of IBE that we have no reason to accept.     

Why it doesn’t matter to metaphysics what Mary learns

The Knowledge Argument of Frank Jackson has not persuaded physicalists, but their replies have not dispelled the intuition that someone raised in a black and white environment gains genuinely new knowledge when she sees colors for the first time. In what follows, we propose an explanation of this particular kind of knowledge gain that displays it as genuinely new, but orthogonal to both physicalism and phenomenology. We argue that Mary’s case is an instance of a common phenomenon in which something new is learned as the result of exploiting representational resources that were not previously exploited, and that this results in gaining genuinely new information.     

Why we don’t deserve credit for everything we know

A view of knowledge—what I call the Deserving Credit View of Knowledge(DCVK)—found in much of the recent epistemological literature, particularly among so-called virtue epistemologists, centres around the thesis that knowledge is something for which a subject deserves credit. Indeed, this is said to be the central difference between those true beliefs that qualify as knowledge and those that are true merely by luck—the former, unlike the latter, are achievements of the subject and are thereby creditable to her. Moreover, it is often further noted that deserving credit is what explains the additional value that knowledge has over merely lucky true belief. In this paper, I argue that the general conception of knowledge found in the DCVK is fundamentally incorrect. In particular, I show that deserving credit cannot be what distinguishes knowledge from merely lucky true belief since knowledge is not something for which a subject always deserves credit.     

Why We Shouldn’t Reject Conflicts: A Critique of Tadros

Victor Tadros thinks the idea that in a conflict both sides may permissibly use force should (typically) be rejected. Thus, he thinks that two shipwrecked persons should not fight for the only available flotsam (which can only carry one person) but instead toss a coin, and that a bomber justifiably attacking an ammunitions factory must not be counterattacked by the innocent bystanders he endangers. I shall argue that Tadros’s claim rests on unwarranted assumptions and is also mistaken in the light of the moral reasoning that he himself offers in support of his ‘means principle’.     

Why Bayesians Needn’t Be Afraid of Observing Many Non-black Non-ravens

According to Hempel??s raven paradox, the observation of one non-black non-raven confirms the hypothesis that all ravens are black. Bayesians such as Howson and Urbach (Scientific reasoning: the Bayesian approach, 2nd edn. Open Court, Chicago, 1993) claim that the raven paradox can be solved by spelling out the concept of confirmation in the sense of the relevance criterion. Siebel (J Gen Philos Sci 35:313?C329, 2004) disputes the adequacy of this Bayesian solution. He claims that spelling out the concept of confirmation in the relevance sense lets the raven paradox reappear as soon as numerous non-black non-ravens are observed. It is shown in this paper that Siebel??s objection to the Bayesian solution is flawed. Nevertheless, the objection made by Siebel may give us an idea of how Bayesians can successfully handle situations in which we observe more than one non-black non-raven.