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.     

Envisioning motherhood: Mental-state language in caregiving narratives across the perinatal period

Nancy Suchman's work highlighted the fundamental role of maternal mentalization in maternal addiction, mental health, and caregiving challenges. In this study, we aimed to examine the role of mental-state language (MSL) as a measure of mentalization in prenatal and postnatal narratives and their sentiment in a sample of 91 primarily White mothers from the western United States, followed from the second trimester of pregnancy, through the third trimester, to 4 months postpartum. Specifically, we investigated the use of affective and cognitive MSL in prenatal narratives when mothers visualized caring for their baby and postnatal narratives when mothers compared their prenatal visualization to the current caregiving reality. Results indicated moderate consistency in MSL between the second and third trimesters, but prenatal and postnatal MSL was not significantly correlated. Across all time points, higher use of MSL was related to more positive sentiment, indicating an association between mentalization and positive caregiving representations across the perinatal period. Women used more affective than cognitive MSL in prenatal imagination of caregiving, but this pattern was reversed in their postpartum reflection. Implications on assessing parental mentalization prenatally and considering the relative dominance of affective and cognitive mentalizing are discussed while considering study limitations.     

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.     

Enhancing the care of children with chronic diseases through the narratives of patient,physician, nurse and carer

We tested the hypothesis that a narrative approach may enhance a bio‐psycho‐social model (BPS) in caring for chronically ill children. Forty‐eight narratives were collected from 12 children with six different medical conditions, their mothers, physicians, and nurses. By a textual analysis, narratives were classified on their predominant focus as disease (biological focus), illness (psychologic focus), or sickness (social focus). Sixty‐one percent of narrative’ text were classified as illness, 28% as disease and 11% as sickness. All narratives had a degree of illness focus. Narratives by patients and physicians on the one hand, and nurses’ and mothers’ on the other were disease focused. Narratives were also evaluated with respect to the type of medical condition: Illness was largely prevalent in all but Crohn’s disease and HIV infection, the latter having a predominance of sickness most probably related to stigma. Narrative exploration proved a valuable tool for understanding and addressing the needs of children with complex conditions. Narrative approaches allow identification of the major needs of different patients according to health conditions and story tellers. In the narratives, we found a greater illness and disease focus and surprisingly a low sickness focus, except with HIV stories. Narrative medicine provides a tool to strengthen the BPS model in health care.     

Everything you wanted to know about redemptive stories* (*but were afraid to ask)

Life stories organize personal experiences within broad temporal frameworks. Stories that are redemptive in nature progress from negative beginnings to positive endings. Psychologists have become increasingly interested in the tendency for individuals to both understand their lives using story-based principles and evoke redemptive imagery while so doing. Here, I consider the past (foundations), present (extant literature), and future (directions and controversies) of psychology’s redemptive story. Previously, work on redemptive stories has been informed by several theoretical vantages and analytic approaches. Currently, a sizable literature has emerged examining redemptive stories in relation to a number of processes and outcomes. In future, it will be crucial to explore moderations in these relations as well as redemption’s causal nature.     

Social identity leadership in sport and exercise: Current status and future directions

The social identity approach is fast becoming a prominent framework for understanding effective leadership in sport and exercise contexts. The last five years, in particular, has seen a proliferation of research informed by the identity leadership approach, with a focus on two broad outcomes: performance and health. Using these two key outcomes as an organising framework, we provide a critical narrative review of research that has examined the presence, role, and benefits of identity leadership in sport and exercise contexts, and identify fruitful avenues for future research. Applying a broader lens, we then make five key recommendations for future identity leadership research in sport and exercise contexts. Specifically, we highlight the need for research (a) using more rigorous and varied research designs, (b) using stronger measures, (c) comparing the effects of identity leadership to the effects of other types of leadership, (d) assessing further potential mediators of relationships between identity leadership and key outcomes, and (e) exploring the possible dark side of identity leadership.     

The stranded cinderella and the wandering rascal. Two narratives of female housing exclusion

This article examines the life stories of two young Polish women who have faced severe marginalization and homelessness. The main aim of this article is to investigate how the notions of (in)visibility and (im)mobility are shaping participants' everyday lives and life stories they tell. Using concepts drawn from social sciences, as well as cultural and literary studies, this article attempts to reconstruct the narrative frameworks of their life stories. Marzena's story is a non-linear collection of adventures reminiscent of a picaresque novel, but with fractured agency, which leaves her powerless and restlessly moving around the city. Angelika, on the other hand, is trapped in a two-room dilapidated house with no running water, located in a rural part of Poland. Her narrative resembles a telenovela with melodramatic plot twists, romance and hard-to-believe revelations about the narrator's true self; further, it is a purposeful journey in search for happiness and fortune. Surprisingly, Marzena's mobility makes it unlikely for her to overcome homelessness, while the stranded Angelika finds the resilience necessary to improve her life. The proposed analysis contributes to a deeper understanding of women's experiences of homelessness and demonstrates the need to regard housing exclusion also as a biographical process.