Does the philosophy of medicine exist?

There has been a great deal of discussion, in this journal and others, about obstacles hindering the evolution of the philosophy of medicine. Such discussions presuppose that there is widespread agreement about what it is that constitutes the philosophy of medicine.Despite the fact that there is, and has been for decades, a great deal of literature, teaching and professional activity carried out explicitly in the name of the philosophy of medicine, this is not enough to establish that consensus exists as to the definition of the field. And even if consensus can be obtained as to what constitutes the philosophy of medicine, this does not mean that it exists as a field.     

Commentary on “Can a good philosophical contribution be made just by asking a question?”

This paper explains some of the reasoning behind “Can a Good Philosophical Contribution Be Made Just by Asking a Question?,” a paper which consists solely in its title and which is published in the same issue of the journal as the present paper. The method for explaining that reasoning consists in making available a lightly edited version of a letter the authors sent to the editors when submitting the title-only paper. The editors permitted publication of that paper on the condition that the authors also separately publish a version of that letter; the present paper aims to fulfil that condition.     

Awakening from Descartes' nightmare: On the love of ambiguity in phenomenological approaches to education

This paper is an exploration of the Cartesian paradigms of clarity and univocity and how these inform contemporary educational theory and practice. Phenomenology is discussed as a way of disrupting Descartes' visions of clarity and distinctness as paradigms of knowledge and as a return of inquiry to life as it is actually lived. Analogical discourse is examined as a way of giving a voice to this sort of inquiry. Heidegger's notions of inquiry as obedience and thanksgiving are discussed.     

Towards reflexive practice: Engaging participants as co-researchers or co-analysts in psychological inquiry

This paper considers some of the implications of reflexivity for the practice of psychological research. After a brief consideration of the theoretical background to a concern with reflexivity, the paper goes on to examine how various researchers have attempted to incorporate components of reflexivity in their research practice. While a group of sociologists of science have operationalized reflexivity by self-conscious concern for their own role in the construction of social—scientific knowledge, new paradigm co-operative inquirers interpret a need for reflexivity by including their participants as fully self-reflexive co-researchers. Mulkay's suggestion for a dialogic analytical exchange with one's participants is also considered. The second half of the paper illustrates an attempt at reflexive practice in the authors' own research. This was a project concerned with identity change during the transition to motherhood, and aimed to allow the women a strong hand in helping to shape the project's direction. Preliminary analysis of a woman's data was taken back to her for her comments, and her reflections on the data were incorporated in the final case study. A detailed example of the investigator and participant's discussion of a piece of data is provided.     

Solitude in context: On the role of culture,immigration, and acculturation in the experience of time to oneself

Older adults spend much time in solitude (without social interaction), putting them at risk of loneliness, especially if aging outside their country of origin (e.g., Chinese immigrants to Canada). Yet, cultural contextual factors that may reduce loneliness in moments of solitude are poorly understood. This study sought to disentangle the roles of culture, immigration, and acculturation in solitude-loneliness associations across two countries. Community-dwelling adults aged 51–85 in Vancouver (N = 58 East Asian, N = 37 European/North American) and in Hong Kong (N = 56 East/Southeast Asian) completed approximately 30 ecological momentary assessments over 10 days on their current affect and social situations. Participants in Vancouver spent more time in solitude, desired solitude more, and felt less lonely overall than those in Hong Kong. Multilevel models revealed that moments of solitude felt lonelier than moments spent in social interaction, but only for individuals less acculturated to their host culture or not concurrently desiring solitude. Associations held regardless of host culture, cultural heritage, or immigration status. Findings suggest that solitude need not feel lonely if it happens by choice and if individuals feel connected with their host culture, for both immigrant older adults and those aging in their birth country.     

传统儒家、道家哲学生态观比较

儒家、道家哲学生态观既有共同点,又存在差异。在生态存在论上,两者都是一种生成论世界观,强调人与自然万物的内在联系。不过,道家注重自然运化过程的自然性、一体性,儒家则强调自然运化的生命特征,肯定人与万物的差别;在生态价值论上,道家偏重“自然”的价值．强调自然运化的自然目的性和价值性,肯定人和万物的自然本性的价值。儒家则偏重“人文”价值。它强调人与社会的生存价值．肯定主体德性的价值;在生态实践观上,道家强调“自然无为”的实践原则,“自然无为”体现了对自然自组织、自协调智慧的信任。道家实践观体现在个人生活方式上具有消减性特征,强调慈爱利物、俭啬有度、知和不争。儒家强调发挥人的主体能动性,肯定主体对人与社会、人与自然关系的协调作用。在对农业生产实践的治理上。儒家强调顺应天时、因地制宜和“谨其时禁”。     

The explicit and implicit dance in psychoanalytic change

How the implicit/non-declarative and explicit/declarative cognitive domains interact is centrally important in the consideration of effecting change within the psychoanalytic arena. Stern et al. (1998) declare that long-lasting change occurs in the domain of implicit relational knowledge. In the view of this author, the implicit and explicit domains are intricately intertwined in an interactive dance within a psychoanalytic process. The author views that a spirit of inquiry (Lichtenberg, Lachmann & Fosshage 2002) serves as the foundation of the psychoanalytic process. Analyst and patient strive to explore, understand and communicate and, thereby, create a 'spirit' of interaction that contributes, through gradual incremental learning, to new implicit relational knowledge. This spirit, as part of the implicit relational interaction, is a cornerstone of the analytic relationship. The 'inquiry' more directly brings explicit/declarative processing to the foreground in the joint attempt to explore and understand. The spirit of inquiry in the psychoanalytic arena highlights both the autobiographical scenarios of the explicit memory system and the mental models of the implicit memory system as each contributes to a sense of self, other, and self with other. This process facilitates the extrication and suspension of the old models, so that new models based on current relational experience can be gradually integrated into both memory systems for lasting change.     

Book Reviews

Books reviewed: Joshua I. Miller, Democratic Temperament: The Legacy of William James Ellen Kappy Suckiel, Heaven's Champion: William James's Philosophy of Religion Ruth Anna Putnam (ed), The Cambridge Companion to William James David L. Hall and Roger T. Ames, Democracy of the Dead: Dewey, Confucious, and the Hope for Democracy in China Dale Jacquette, Wittgenstein's Thought in Transition Michael T. Chiselin, Metaphysics and the Origin of Species Richard Swinburne, Is There a God? Evert van der Zweerde, Soviet Historiography of Philosophy Rem B. Edwards (ed), Ethics of Psychiatry: Insanity, Rational Autonomy, and Mental Health Care Jennifer Radden, Divided Minds and Successive Selves: Ethical Issues in Disorders of Identity and Personality     

Affordances can invite behavior: Reconsidering the relationship between affordances and agency

The concept of agency has been central to ecological approaches to psychology. Gibson, one of the founders of this movement, made room for this concept by arguing against the mechanistic conceptions in psychology. In his view, the environment is not a collection of causes that pushes the animal around, but consist of action possibilities, which he coined affordances. In making their way in the world, animals regulate their behavior with respect to these possibilities. Reed later developed this ecological conception of agency, following Gibson in conceiving of affordances as action possibilities. However, drawing upon industrial design, architecture, and phenomenology, we argue that affordances are not mere action possibilities but that they can also invite behavior. We suggest a mutualist perspective on invitations, suggesting that they depend on the animal-environment relationship in multiple dimensions. The implications of this new conception of affordances for the ecological account of agency are explored.