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.     

Evolving research misconduct policies and their significance for physical scientists

Scientific misconduct includes the fabrication, falsification, and plagiarism (FFP) of concepts, data or ideas; some institutions in the United States have expanded this concept to include “other serious deviations (OSD) from accepted research practice.” It is the absence of this OSD clause that distinguishes scientific misconduct policies of the past from the “research misconduct” policies that should be the basis of future federal policy in this area. This paper introduces a standard for judging whether an action should be considered research misconduct as distinguished from scientific misconduct: by this standard, research misconduct must involve activities unique to the practice of science and must have the potential to negatively affect the scientific record. Although the number of cases of scientific misconduct is uncertain (only the NIH and the NSF keep formal records), the costs are high in terms of the integrity of the scientific record, diversions from research to investigate allegations, ruined careers of those eventually exonerated, and erosion of public confidence in science. Existing scientific misconduct policies vary from institution to institution and from government agency to government agency; some have highly developed guidelines that include OSD, others have no guidelines at all. One result has been that the federal False Claims Act has been used to pursue allegations of scientific misconduct. As a consequence, such allegations have been adjudicated in federal courts, rather than judged by scientific peers. The federal government is now establishing a first-ever research misconduct policy that would apply to all research funded by the federal government regardless of which agency funded the research or whether the research was carried out in a government, industrial or university laboratory. Physical scientists, who up to now have only infrequently been the subject of scientific misconduct allegations, must nonetheless become active in the debate over research misconduct policies and how they are implemented since they will now be explicitly covered by this new federal wide policy. Disclaimer: The authors are grateful for the support for conduct of this research provided by the United States Department of Energy (DOE). The views expressed in this paper are solely those of the authors and were formed and expressed without reference to positions taken by DOE or the Pacific Northwest National Laboratory (PNNL). The views of the authors are not intended either to reflect or imply positions of DOE or PNNL.     

The American experience: Lessons learned

This paper discusses ten lessons learned since 1989 about handling allegations of scientific misconduct involving biomedical and behavioral research supported by the U. S. Public Health Service. An earlier version of this paper was presented at a symposium, Scientific Misconduct: An International Perspective, organised by The Medical University of Warsaw, 16 November, 1998. The opinions expressed herein are those of the author and do not necessarily represent the views of the Office of Research Integrity, the U.S. Department of Health and Human Services, or any other federal agency.     

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     

创新和知识经济与促肝细胞生长素的研制

创新是一个民族进步的灵魂,是科研工作的核心,是知识经济对知识的根本要求。促肝细胞生长素是治疗肝炎的有效药物,该药物研制成功的关键在于创新。纵观其研制过程的创新思路与实践,将有助于我们更新科研观念,增加创新意识。