Medical Intellectuals: Resisting Medical Orientalism

In this paper, we propose analogies between medical discourse and Edward Said's Orientalism. Medical discourse, like Orientalism, tends to favor institutional interests and can be similarly dehumanizing in its reductionism, textual representations, and construction of its subjects. To resist Orientalism, Said recommends that critics—intellectuals—adopt the perspective of exile. We apply Said's paradigm of intellectual-as-exile to better understand the work of key physician-authors who cross personal and professional boundaries, who engage with patients in mutually therapeutic relationships, and who take on the public responsibility of representation and advocacy. We call these physician-authors medical intellectuals and encourage others to follow in their path.     

Ein Argumentationsspiel um das Münchhausen-Trilemma

By means of a strategic game the present paper tries to answer the question of whether the so-called trilemma of Münchhausen (H. Albert)as it stands is able to perform the twofold task of both refuting the methodology of foundationalismand of getting us thereby nearer to the methodology of critical rationalism.The formal reconstruction of the argument provides us with four possible versions which however can only be called trilemmas in a wider sense of this term. Moreover, a test shows three of them to be invalid. The subsequent discussion of the only valid one makes clear that in order to save the truth of its premisses as far as possible the latter have to be modified in a way that brings us still farther away from the original trilemma of Münchhausen. But even then it may be doubted whether the remains of the argument can fulfil the above-mentioned twofold task.     

Where “Sex” Is Born(e): Intersexed Births and the Social Urgency of Heterosexuality

Our beloved genders of the present moment are neither universal nor trans-historical presences in the world. The specific gender order which we employ today is the legacy of a particular cultural and political history, and there is still a great deal at stake in preserving it. As a graduate student I stumbled upon the topic of intersexuality a few years ago and found myself enthralled with its implications. Continuing to present itself inspite of all our scientific knowledge about the supposed immutability of female and male, intersexuality disrupts the gender order. The response to this disruption has been swift and terrible: from the intersexed infants who enter our world everyday are carved (literally and figuratively) supposedly normal boys and girls (mostly girls). The following exposition represents a pre-fieldwork (theoretical) stage in my current research and attempts to demonstrate that medical authorities manage intersex cases as they do in order to stabilize the always precarious institution of heterosexuality.     

Positive modal logic

We give a set of postulates for the minimal normal modal logicK ₊ without negation or any kind of implication. The connectives are simply , , , . The postulates (and theorems) are all deducibility statements . The only postulates that might not be obvious are

Emeralds are no chameleons — Why “Grue” is not projectible for induction

The model function for induction of Goodmans's composite predicate Grue was examined by analysis. Two subpredicates were found, each containing two further predicates which are mutually exclusive (green and blue, observed before and after t). The rules for the inductive processing of composite predicates were studied with the more familiar predicate blellow (blue and yellow) for violets and primroses. The following rules for induction were violated by processing grue: From two subpredicates only one (blue after t) appears in the conclusion. As a statement about a future and unobserved condition this subpredicate, however, is not projectible for induction whereas the only suitable predicate (green before t) does not show up in the conclusion. In a disjunction a v b where a is true and b false the disjunction is true. When, however, the only true component is dropped, what remains is necessarily false. An analogous mistake may be observed in the processing of grue, where the only true component (green) was dropped in the conclusion. — As a potent criterion for correct inductions a check of the necessity of the conclusions is recommended.The author is indebted to Prof. Curt Christian for valuable suggestions.     

Clinical interpretation: The hermeneutics of medicine

I argue that clinical medicine can best be understood not as a purified science but as a hermeneutical enterprise: that is, as involved with the interpretation of texts. The literary critic reading a novel, the judge asked to apply a law, must arrive at a coherent reading of their respective texts. Similarly, the physician interprets the text of the ill person: clinical signs and symptoms are read to ferret out their meaning, the underlying disease. However, I suggest that the hermeneutics of medicine is rendered uniquely complex by its wide variety of textual forms. I discuss four in turn: the experiential text of illness as lived out by the patient; the narrative text constituted during history-taking; the physical text of the patient's body as objectively examined; the instrumental text constructed by diagnostic technologies. I further suggest that certain flaws in modern medicine arise from its refusal of a hermeneutic self-understanding. In seeking to escape all interpretive subjectivity, medicine has threatened to expunge its primary subject — the living, experiencing patient.     

Between Science and Nature: Interpreting Lactation Failure in Elizabeth von Arnim's The Pastor's Wife

Interpreting a scene of lactation failure allows us to represent breast-feeding as a contested social practice. This essay reads a novelistic scene of lactation failure in the context of the decline of breast-feeding in the twentieth century. The protagonist's ignorance of the female experiences of pregnancy, childbirth, and lactation is an effect of her objectification within the opposition between science and nature. Unnatural as a woman because she is a natural individual, the pastor's wife exemplifies the dilemmas of breast-feeding as a biosocial practice of maternity in a technological society which features the breakdown of traditional female networks in which knowledge about maternity and breast-feeding are circulated.     

Indeterminiertheit,Iterabilität und Intentionalität

In his recent paper Indeterminacy, empiricism, and the first person John R. Searle tries to refute Willard V. O. Quine's famous indeterminacy of translation thesis by arguing that this thesis is in fact areductio ad absurdum of Quine's own linguistic behaviorism. Searle accuses Quine of being (irrationally) antimentalistic and suggests that the absurdity of Quine's thesis might be avoided if a full-fledged intentionality were tolerated in the debate on meaning. — This anti-Quinean approach in some respects reminds of the improbable debate between Searle and Jacques Derrida ten years ago, when Derrida had split and deferred intentionality by showing that the essential iterability of signs inevitably infects every intentional act with an unremovable non-presence.In this paper it is argued that Searle's attacks on Quine and Derrida have both failed — and that there are structural similarities between these two failures which reveal some interesting parallels between Quine's and Derrida's philosophy.     

The two cultures

Anhand von zwei Unterbereichen der künstlichen Intelligenz — den Expertensystemen und der wissenschaftlichen Entdeckung — wird aufzuzeigen versucht, daß die Beziehung zwischen der formalen und der intuitiven Kultur aus dem Gleichgewicht geraten ist. Dem Bereich der Intuition sollte größere Aufmerksamkeit gewidmet werden.

---

This article is based on a presentation given on a symposium The Art of Science, in Amsterdam, Amolf, 27 May 1987. It was organized to celebrate the 65th birthday of Prof. J. o.     

Some basic problems in the development of the human sciences in China today

Paper read on November 3, 1988 before the Philosophical Society of Fribourg (Switzerland) — In China we use social sciences to refer to all disciplines in the humanities and the social sciences. The expression is juxtaposed to natural sciences. Since I do not discuss such subjects as economics, education, journalism, and other practical fields, I prefer to use here the term human sciences.     

Kripke completeness of some intermediate predicate logics with the axiom of constant domain and a variant of canonical formulas

For each intermediate propositional logicJ, J _* denotes the least predicate extension ofJ. By the method of canonical models, the strongly Kripke completeness ofJ _*+D(=x(p(x)q)xp(x)q) is shown in some cases including:

The homeless and the value of philosophy

Inspired by Robert Ginsberg, The Value of Philosophy: A Dialouge, The Journal of Value Inquiry 24.1 (January 1990): 31–42     

Actual truth,possible knowledge

The well-known argument of Frederick Fitch, purporting to show that verificationism (= Truth implies knowability) entails the absurd conclusion that all the truths are known, has been disarmed by Dorothy Edgington's suggestion that the proper formulation of verificationism presupposes that we make use of anactuality operator along with the standardly invoked epistemic and modal operators. According to her interpretation of verificationism, the actual truth of a proposition implies that it could be known in some possible situation that the proposition holds in theactual situation. Thus, suppose that our object language contains the operatorA — it is actually the case that ... — with the following truth condition: _vA iff _w0, wherew ₀ stands for the designated world of the model — the actual world. Then we can formalize the verificationist claim as follows:

Positive und negative Rückmeldung bei Alternativdiskriminationen

Zusammenfassung Die Untersuchungen befassen sich mit dem Einfluß der verbalen Rückmeldungen richtig und falsch auf das Erlernen von Alternativdiskriminationen in Blank-trial-Experimenten. Dabei wird insbesondere die Wechselwirkung der Rückmeldungskombinationen (richtig/fehlende Rückmeldung vs. falsch/fehlende Rückmeldung) mit der Rückmeldungsproportion untersucht. Die Rückmeldungsproportion ist definiert als das Verhältnis der Anzahl der S-R-Verbindungen einer Lernliste, auf die eine verbale Rückmeldung erfolgt, und der Anzahl der S-R-Verbindungen, bei denen die verbale Rückmeldung fehlt. Die Rückmeldungsproportion wird zwischen 119 und 191 systematisch variiert. Unsere Experimente ergeben u. a., daß bei kleiner Rückmeldungsproportion die Kombination richtig/fehlende Rückmeldung und bei großer Rückmeldungsproportion die Kombination falsch/fehlende Rückmeldung die Lernleistung erhöhen. Dieser Befund wurde nach theoretischen Annahmen über die Lernstrategie der Vpn erwartet. Eine alternative theoretische Interpretation der Befunde wird nach einem Zusatzexperiment verworfen. Insgesamt bestätigen die Untersuchungen, daß (a) die relative Wirksamkeit von Rückmeldungskombinationen stark von den jeweiligen experimentellen Randbedingungen abhängt, daß (b) von einer automatischen Wirksamkeit verbaler Rückmeldung keine Rede sein kann und daß (c) theoretische Annahmen über die kognitive Verarbeitung verbaler Rückmeldungen und über entsprechende Lernstrategien für die Interpretation der untersuchten Lernvorgänge erfolgversprechend sind.

---

Positive and negative feedback in discrimination between alternativesFeedback proportion and learning strategy

Summary This study is concerned with the influence of the verbal feedback modes of right and wrong on the acquisition of alternative discriminations in blank-trial experiments, with special reference to the interaction between the feedback combinations (right/non-feedback as against wrong/non-feedback) and feedback proportion is investigated. Feedback proportion is defined as the ratio of the S-R connections of a learning list succeeded by verbal feedback to the S-R connections succeeded by non-feedback. Feedback proportion was systematically varied between the ratios of 119 and 191.Results showed that at a low feedback proportion learning score is increased with the combination right/non-feedback while in contrast at a high feedback proportion learning score is increased with the combination wrong/non-feedback. These results are in accordance with theoretical expectations on learning strategies of Ss. An alternative interpretation was not confirmed by the results of an additional experiment.In general, our investigations showed that (a) the relative effectiveness of feedback combinations is strongly dependent on the particular experimental conditions; (b) an automatic effect of verbal feedback cannot be assumed; (c) a cognitive interpretation of verbal feedback effects in terms of learning strategies seems very promising.

     

Wissenschaft,technik, lebenswelt

Ohne ZusammenfassungGekürzte und überarbeitete Fassung von Gijutsu to Keiken-Gijutsutetsugaku eno ichi Shiron (Technik und Erfahrung-ein Ansatz zur Phänomenologie der Technik) in Genshogaku to Kaishakugaku (Phänomenologie und Hermeneutik) Bd. 1; Tokyo: Sakei-shoin, 1987. S. 73–110. Ursprünglich vorgetragen anlässlich der Jahrestagung der Japanischen Gesellschaft für Phänomenologie anm 30. November 1986 in Kyoto.     

An extension of the partial credit model with an application to the measurement of change

The partial credit model is considered under the assumption of a certain linear decomposition of the item × category parameters _ih into basic parameters _j. This model is referred to as the linear partial credit model. A conditional maximum likelihood algorithm for estimation of the j is presented, based on (a) recurrences for the combinatorial functions involved, and (b) using a quasi-Newton approach, the so-called Broyden-Fletcher-Goldfarb-Shanno (BFGS) method; (a) guarantees numerically stable results, (b) avoids the direct computation of the Hesse matrix, yet produces a sequence of certain positive definite matricesB _k ,k=1, 2, ..., converging to the asymptotic variance-covariance matrix of the . The practicality of these numerical methods is demonstrated both by means of simulations and of an empirical application to the measurement of treatment effects in patients with psychosomatic disorders.The authors thank one anonymous reviewer for his constructive comments. Moreover, they thankfully acknowledge financial support by the Österreichische Nationalbank (Austrian National Bank) under Grant No. 3720.     

Sosa on knowledge,justification, and aptness

Presented in an author meets critics symposium on Ernest Sosa'sKnowledge in Perspective at the Pacific Division of the American Philosophical Association, March 26, 1993. The other critic was Jonathan Dancy, and Sosa responded.