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.     

Making Lemonade out of Lemons: Dialectical Behavior Therapy via Telehealth During a Pandemic

The COVID-19 pandemic has created a burden on healthcare systems and increased demand for mental healthcare at a time when in-person services are limited. Many programs offering dialectical behavior therapy (DBT) for complex clients have pivoted to telehealth in order to increase access to critical mental healthcare. There is, however, limited research on the provision of telehealth treatment for clients with complex psychopathology more broadly, or the telehealth implementation of DBT more specifically. The aim of this study was to examine the use of telehealth services and related clinician attitudes and experiences in the context of DBT. We examined the degree of telehealth platform adoption among DBT clinicians, as well as changes in stress and self-care strategies. A supplemental aim was to gather clinicians’ recommendations for providing DBT via telehealth. Participants included N = 99 DBT practitioners (79.8% female; 20.2% male). Qualitative and quantitative methods were used for data analysis. Findings show that telehealth DBT has been widely adopted among DBT clinicians, and that clinicians’ attitudes to telehealth DBT are cautiously optimistic. Participants described three main areas of stress associated with DBT via telehealth provision, as well as lost and novel self-care strategies.     

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.     

Jungian Constructivism and the Value of Uncertainty

Introducing the basic assumptions of constructivism as a philosophical position, this paper illustrates how Jung's psychology - especially complex, archetype and transcendent function - is consonant with constructivism. Further, the paper explores some clinical implications of constructivism by reviewing the problems of chronic projective-identification in a stalemated analytic case, drawing on the contributions of Winnicott, Ogden and Modell in expanding our understanding of, and facility with, the transcendent function.     

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.     

From dialectic to organization: Bogdanov’s contribution to social theory

This paper situates Bogdanov in the context of social theory generally and socialist theory in particular. It outlines briefly the principal characteristics of his mature system, and assesses the strengths and weaknesses of his approach to the fundamental problems of social thought. The paper devotes particular attention to the problem of just how systems develop from less complex to more complex forms of organization, and evaluates Bogdanov’s solution to this problem against the background of populist, social democratic, and Leninist alternatives.     

Consider the source: One step in assessing premise acceptability

Premise acceptability is conceptually connected to presumption. To say that a premise is acceptable just when there is a presumption in its favor is to give a first approximation to this connection. A number of popular principles of presumption suggest that whether there is a presumption for a premise, belief, or claim depends on the sources which vouch for it. Sources consist of internal belief-generating mechanisms and external testimony. Alvin Plantinga's notion of warrant lays down four conditions upon a source for the belief which it generates to be warranted. We argue that there is a presumption for a premise, belief, or claim if and only if there is a presumption of warrant for that premise,belief or claim. This amounts to the thesis that there is a presumption for a belief from a challenger's point of view if and only if there is a presumption from that person's point of view that her cognitive faculties which have generated the belief have been functioning properly, in an appropriate cognitive environment, in accord with a segment of her design plan aimed at the truth, and that these faculties are reliable. In light of our argument for this thesis, we may legitimately claim that one way to determine that there is a presumption for a belief is to determine that there is a presumption of warrant for that belief, and thus that in determining whether there is a presumption for a belief or premise, we may consider the source.