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.

Attempts to prime intellectual virtues for understanding of science: Failures to inspire intellectual effort

Strategies for effectively communicating scientific findings to the public are an important and growing area of study. Recognizing that some complex subjects require recipients of information to take a more active role in constructing an understanding, we sought to determine whether it was possible to increase subjects’ intellectual effort via “priming” methodologies. In particular, we asked whether subconsciously priming “intellectual virtues” (IVs), such as curiosity, perseverance, patience, and diligence might improve participants’ effort and performance on various cognitive tasks. In the first experiment, we found no significant differences in either effort or understanding between IV-primed and neutrally-primed individuals across two different priming techniques. The second experiment measured the effect of IV-priming on intellectual effort in simpler, shorter-duration puzzles and exploration activities; here, we observed an effect, but given its low strength and short duration, we do not believe that priming of IVs is a promising strategy for science communication.     

Character strengths predict resilience over and above positive affect,self-efficacy,optimism, social support,self-esteem,and life satisfaction

The incremental value of character strengths in the prediction of resilience, after the effects of other well-known resilience-related factors (i.e. positive affect, self-efficacy, optimism, social support, self-esteem, life satisfaction) and sociodemographic variables are accounted for, is examined. Using a cross-sectional design, participants (N = 363 adults) completed online measures of character strengths, resilience, and resilience-related factors. A principal component analysis of character strengths was conducted and five factors were extracted, which could be interpreted as emotional, interpersonal, intellectual, restraint, and theological strengths. All strengths factors, except theological strengths, yielded significant positive correlations with resilience. A hierarchical regression showed that strengths predicted an additional 3% of the variance in resilience over and above sociodemographic variables, positive affect, self-efficacy, optimism, social support, self-esteem, and life satisfaction. Emotional strengths and strengths of restraint were significant positive predictors. Implications, limitations, and future research are discussed.     

Fragile X syndrome: Neural network models of sequencing and memory

A comparative framework of memory processes in males with fragile X syndrome (FXS) and typically developing (TYP) mental age-match children is presented. Results indicate a divergence in sequencing skills, such that males with FXS recall sequences similarly to TYP children around five and a half years of age, but the males with FXS recall significantly worse when compared to TYP children around seven and a half years of age. Performance on one working memory measure, an n-back Card Task, is modeled with a neural network. To date, no network models explicate the sequencing and memory processes in those with FXS. Noise was added to various levels (weight matrices) in the FXS model and outputs approximated human FXS performance. Three models were compared: (1) FXS; (2) younger mental age-TYP matches; (3) older reading level-TYP matches. Modeling can help to reify conceptualizations of deficits and to guide in the creation of more valid, science-based remediations. The FXS model suggested that the levels of phonological representation and sequencing in memory were candidates for targeted therapies in males with FXS.     

Is There a Place for Traditional Values and Virtues in Society Today?

This paper argues that rather than looking to the past for a previously developed set of traditional values and virtues we should instead look to the past for ways of thinking about morality and ethics which may be found in the “tradition” and which may also be relevant for the contemporary situation. It examines the causes of the disconnection between traditional ways of thinking and the contemporary situation at two levels: the marginalization of morality and the disarray in ethics. Both aspects are found to be rooted in the emergence of the empirical scientific differentiation of consciousness. The paper then goes on to ask what resources in the tradition may be found to overcome the gap between ancient and modern, or traditional and contemporary, ways of thinking about morality and ethics. The contemporary relevance of the thought of Bernard Lonergan to this issue is examined.     

Higher-order exploratory factor analysis of the Reynolds Intellectual Assessment Scales with a referred sample

The factor structure of the Reynolds Intellectual Assessment Scales (RIAS; [Reynolds, C.R., & Kamphaus, R.W. (2003). Reynolds Intellectual Assessment Scales. Lutz, FL: Psychological Assessment Resources, Inc.]) was investigated with a large (N = 1163) independent sample of referred students (ages 6-18). More rigorous factor extraction criteria (viz., Horn's parallel analysis (HPA); [Horn, J.L. (1965). A rationale and test for the number of factors in factor analysis. Psychometrika, 30, 179-185.], and Minimum Average Partial (MAP) analysis; [Velicer, W.F. (1976). Determining the number of components from the matrix of partial correlations. Psychometrika, 41, 321-327.]), in addition to those used in RIAS development, were investigated. Exploratory factor analyses using both orthogonal and oblique rotations and higher-order exploratory factor analyses using the Schmid and Leiman [Schmid, J., and Leiman, J.M. (1957). The development of hierarchical factor solutions. Psychometrika, 22, 53-61.] procedure were conducted. All factor extraction criteria indicated extraction of only one factor. Oblique rotations resulted in different results than orthogonal rotations, and higher-order factor analysis indicated the largest amount of variance was accounted for by the general intelligence factor. The proposed three-factor solution was not supported. Implications for the use of the RIAS with similarly referred students are discussed.     

Being, Doing, and Knowing: Developing Ethical Competence in Health Care

There is a growing interest in ethical competence-building within nursing and health care practising. This tendency is accompanied by a remarkable growth of ethical guidelines. Ethical demands have also been laid down in laws. Present-day practitioners and researchers in health care are thereby left in a virtual cross-fire of various legislations, codes, and recommendations, all intended to guide behaviour. The aim of this paper was to investigate the role of ethical guidelines in the process of ethical competence-building within health care practice and medical research. A conceptual and critical philosophical analysis of some paragraphs of the Helsinki Declaration and of relevant literature was performed. Three major problems related to ethical guidelines were identified, namely, the interpretation problem (there is always a gap between the rule and the practice, which implies that ethical competence is needed for those who are to implement the guidelines); the multiplicity problem (the great number of codes, declarations, and laws might pull in different directions, which may confuse the health care providers who are to follow them); and the legalisation problem (ethics concerns may take on a legal form, where ethical reflection is replaced by a procedure of legal interpretations). Virtue ethics might be an alternative to a rule based approach. This position, however, can turn ethics into a tacit knowledge, leading to poorly reflected and inconsistent ethical decisions. Ethical competence must consist of both being (virtues) and doing (rules and principles), but also of knowing (critical reflection), and therefore a communicative based model is suggested.     

公正作为德性——亚里士多德公正德性探析

People currently regard justice as the main principle of institutions and society, while in ancient Greek people took it as the virtue of citizens. This article analyzes Aristotle’s virtue of justice in his method of virtue ethics, discussing the nature of virtue, how justice is the virtue of citizens, what kind of virtue the justice of citizens is, and the prospect of the virtue of justice against a background of institutional justice. Since virtue can be said to be a specific individual character, Aristotle also defines the virtue of justice as the character of justice, with which citizens act justly and desire to do what is just. The virtue of justice is also an individual ethical virtue, differing from others for it is at the same time a social ethic. We can call the virtue of justice a “non-individual individual ethical virtue.” It has been explained as between pure altruism and egoism, which is a wrong explanation. John Rawls regards justice as the first virtue of social institutions, challenging Aristotle’s virtue of justice, an assertion which also needs further deliberation. Translated from Zhongguo Renmin Daxue Xuebao 中国人民大学学报 (Journal of Renmin University of China), 2006, (2): 61–69     

Tolerance as a Primary Virtue

The commonly perceived tension between authentic moral and ethical action and action involving tolerance is held to be the illusory product of an unduly individualistic frame of thought. Moral and ethical actions are produced not by independent individuals but by participants in cultural traditions. And even the wholly routine continuation of a single homogeneous tradition must always and invariably involve mutual tolerance: participants must interact not as independent individuals but as tolerant members. Tolerance deserves recognition, accordingly, as a primary virtue, not merely compatible with authentic moral and ethical action, but required by it. An explicit rhetoric enjoining tolerance needs to be understood as performative discourse employed to change, or else to sustain, the systems of tolerances in which all cultures, whether simple or differentiated, homogeneous or diverse, unified or fragmented, invariably consist. This revised version was published online in August 2006 with corrections to the Cover Date.     

The Search for the Source of Epistemic Good

Knowledge has almost always been treated as good, better than mere true belief, but it is remarkably difficult to explain what it is about knowledge that makes it better. I call this "the value problem." I have previously argued that most forms of reliabilism cannot handle the value problem. In this article I argue that the value problem is more general than a problem for reliabilism, infecting a host of different theories, including some that are internalist. An additional problem is that not all instances of true belief seem to be good on balance, so even if a given instance of knowing p is better than merely truly believing p , not all instances of knowing will be good enough to explain why knowledge has received so much attention in the history of philosophy. The article aims to answer two questions: (1) What makes knowing p better than merely truly believing p ? The answer involves an exploration of the connection between believing and the agency of the knower. Knowing is an act in which the knower gets credit for achieving truth. (2) What makes some instances of knowing good enough to make the investigation of knowledge worthy of so much attention? The answer involves the connection between the good of believing truths of certain kinds and a good life. In the best kinds of knowing, the knower not only gets credit for getting the truth but also gets credit for getting a desirable truth. The kind of value that makes knowledge a fitting object of extensive philosophical inquiry is not independent of moral value and the wider values of a good life.