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.

Internalism and epistemically responsible belief

In section one the deontological (or responsibilist) conception of justification is discussed and explained. In section two, arguments are put forward in order to derive the most plausible version of perspectival internalism, or the position that epistemic justification is a function of factors internal to the believer's cognitive perspective. The two most common considerations put forward in favor of perspectival internalism are discussed. These are the responsibilist conception of justification, and the intuition that two believers with like beliefs and experiences are equally justified in their like beliefs. In section three it is argued that perspectival internalism is false, and that in fact the position is not supported by a responsibilist conception of justification. Section four explicates two other forms of internalism, which are rejected for reasons similar to those presented against perspectival internalism. In section five, an internalist theory of justification is defended which is supported by a responsibilist conception of justification. Roughly stated, the position is that justified belief is belief which arises from the use of correct rules of reasoning. The idea of correctness is explicated, and the position is distinguished from others which are similar to it.     

What we epistemically owe to each other

Philosophical Studies - This paper is about an overlooked aspect—the cognitive or epistemic aspect—of the moral demand we place on one another to be treated well. We care not only how...     

Heidegger and hallucination

Can Heidegger account for hallucination? I argue that while Heidegger does not develop an account of hallucination, he gives us all the resources we need to develop such an account. I first discuss a prominent argument against the very possibility of such an account. I argue that this argument is mistaken. I then discuss Heidegger's brief remarks on hallucination. In analysing a particular case study, Heidegger claims that the subject hallucinates for two reasons. First, he fails to realize the distinction between the different ways entities are present to him. For this reason, he cannot encounter a particular entity as it is present. Second, he is unable to do anything about the fact and manner of the presence of that entity. He is ‘unable to move in his world freely’, as Heidegger puts it. I show how these remarks, when taken in combination with Heidegger's broader ontology, allow us to explain the possibility of hallucination in a distinctively Heideggerian way.     

Taking responsibility for health in an epistemically polluted environment

Proposals for regulating or nudging healthy choices are controversial. Opponents often argue that individuals should take responsibility for their own health, rather than be paternalistically manipulated for their own good. In this paper, I argue that people can take responsibility for their own health only if they satisfy certain epistemic conditions, but we live in an epistemic environment in which these conditions are not satisfied. Satisfying the epistemic conditions for taking responsibility, I argue, requires regulation of this environment. I describe some proposals for such regulation and show that we cannot reject all regulation in the name of individual responsibility. We must either regulate individuals’ healthy choices or regulate the epistemic environment.     

Vehicle-representationalism and hallucination

This paper is a new defense of the view that visual hallucinations lack content. The claim is that visual hallucinations are illusory not because their content is nonveridical, but rather because they seem to represent when they fail to represent anything in the first place. What accounts for the phenomenal character of visual experiences is not the content itself (content-representationalism), but rather the vehicle of content (vehicle-representationalism), that is, not the properties represented by visual experience, but rather the relational properties of experience (or of the brain) of representing singular contents, namely particular instantiations of properties. I argue that the Russellian particular-involving proposition is the only appropriate model for the representational content of visual experience and hence that visual hallucinations are just like failed demonstrations.

     

Context binding and hallucination predisposition

Patients with schizophrenia and current auditory hallucinations exhibit a combination of deficits in context binding and intentional inhibition. Hallucinations also occur in the general population suggesting an underlying continuity of causal mechanisms, however, these experiences may also differ (e.g., in frequency), indicating some differences in aetiology. The aim of this study was to examine the frequency of hallucinatory experiences in healthy young adults and to assess whether difficulties in context binding characterize individuals highly predisposed to hallucinations. A modified version of the Launay–Slade hallucination scale-revised, including an assessment of the frequency of hallucination experiences, was completed by 615 undergraduates from which sub-samples of high (n = 25) and low (n = 27) scorers were drawn. Context memory ability was assessed using a voice–location binding task. The results showed that the frequency of hallucinations in high LSHS-R scorers was much less than that previously reported for individuals with schizophrenia. Furthermore, no group differences in context memory binding were observed, nor any association between hallucination frequency and context binding difficulties. The continuity model of hallucinations may overlook some important differences in hallucinatory experiences in the general population versus psychosis.     

Perception,illusion, and hallucination

Patrick Suppes' set-theoretical approach to the analysis of theories, and Joseph D. Sneed's metatheory are briefly outlined. The notions of observation, illusion and hallucination are reconstructed according to these approaches. It is argued that the terms ‘perception’ and ‘truth’ are theoretical with respect to observation but nontheoretical with respect to illusion and hallucination. Hallucination is construed as a special kind of illusion.     

On the explanatory power of hallucination

Pautz (Perceiving the world , 2010) has argued that the most prominent naive realist account of hallucination—negative epistemic disjunctivism—cannot explain how hallucinations enable us to form beliefs about perceptually presented properties. He takes this as grounds to reject both negative epistemic disjunctivism and naive realism. Our aims are two: First, to show that this objection is dialectically ineffective against naive realism, and second, to draw morals from the failure of this objection for the dispute over the nature of perceptual experience at large.

     

The immersive spatiotemporal hallucination model of dreaming

The paper proposes a minimal definition of dreaming in terms of immersive spatiotemporal hallucination (ISTH) occurring in sleep or during sleep–wake transitions and under the assumption of reportability. I take these conditions to be both necessary and sufficient for dreaming to arise. While empirical research results may, in the future, allow for an extension of the concept of dreaming beyond sleep and possibly even independently of reportability, ISTH is part of any possible extension of this definition and thus is a constitutive condition of dreaming. I also argue that the proposed ISTH model of dreaming, in conjunction with considerations on the epistemic relationship between dreaming and dream reports, raises important questions about the extent to which dreams typically involve a detailed body representation—an assumption that plays an important role in philosophical work on dreaming. As a commonly accepted definition of dreaming is lacking in current dream research, the ISTH model, which integrates conceptual analysis and epistemological considerations with results from empirical research, is an important contribution to this field. By linking dreaming to felt presence, full-body illusions, and autoscopic phenomena such as out-of-body experiences in wakefulness and in the hypnagogic state, the ISTH model of dreaming also helps integrate dream research, both theoretically and experimentally, with the study of other altered states of consciousness involving hallucinations. It makes straightforward and investigable predictions by claiming that all of these experiences have amodal spatiotemporal hallucinations as their common denominator. Finally, it is theoretically relevant for the philosophical discussion on minimal phenomenal selfhood.     

A case of auditory hallucination treated by satiation

Hallucinations can be construed as imagery paralleling obsessional thoughts. Satiation therapy, which has been successful with obsessional thoughts, was used to treat the feared auditory hallucinations of a long-stay mental hospital patient. The patient, treatment and outcome are described. The success of the treatment, suggests the validity of the formulation and the possibility of using other fear-reduction procedures for treating anxiety-provoking hallucinations.