Given the fact that the history of our brain is a long history of interfaces, connections and exchanges, this text aims to reveal the collective nature of the process involved by and within learning. In fact, the person who learns can only cross-learn: irrespective of the field of learning, he learns across, between and beyond.2 The cross-disciplinary approach suggested in the present study focuses on learning a foreign language.

Collectivist accounts of the ethics of war have traditionally dominated just war theory (Kutz 2005; Walzer 1977; Zohar 1993). These state-based accounts have also heavily influenced the parts of international law pertaining to armed conflict. But over the past ten years, reductive individualism has emerged as a powerful rival to this dominant account of the ethics of war. Reductivists believe that the morality of war is reducible to the morality of ordinary life. War is not a special moral sphere with (...) its own special moral rules. Reductivists typically reject a collectivist approach to the morality of war in favor of an individualist view, according to which individuals (rather than states or other collectives) are the proper focus of moral guidance and evaluation. This view holds that the rules governing killing in war are simply the rules governing killing between individuals, most obviously the rules of self-defense and other-defense (Fabre 2009; Frowe 2014; McMahan 2009; Tadros 2014). -/- This chapter defends reductive individualism against the claim that it is unable to sanction wars of national defense that seek to protect non-vital interests. These non-vital interests include political goods such as the defense of sovereignty—that is, of political and territorial integrity. (shrink)

"Open Democracy envisions what true government by mass leadership could look like."—Nathan Heller, New Yorker How a new model of democracy that opens up power to ordinary citizens could strengthen inclusiveness, responsiveness, and accountability in modern societies To the ancient Greeks, democracy meant gathering in public and debating laws set by a randomly selected assembly of several hundred citizens. To the Icelandic Vikings, democracy meant meeting every summer in a field to discuss issues until consensus was reached. Our contemporary representative (...) democracies are very different. Modern parliaments are gated and guarded, and it seems as if only certain people—with the right suit, accent, wealth, and connections—are welcome. Diagnosing what is wrong with representative government and aiming to recover some of the lost openness of ancient democracies, Open Democracy presents a new paradigm of democracy in which power is genuinely accessible to ordinary citizens. Hélène Landemore favors the ideal of “representing and being represented in turn” over direct-democracy approaches. Supporting a fresh nonelectoral understanding of democratic representation, Landemore recommends centering political institutions around the “open mini-public”—a large, jury-like body of randomly selected citizens gathered to define laws and policies for the polity, in connection with the larger public. She also defends five institutional principles as the foundations of an open democracy: participatory rights, deliberation, the majoritarian principle, democratic representation, and transparency. Open Democracy demonstrates that placing ordinary citizens, rather than elites, at the heart of democratic power is not only the true meaning of a government of, by, and for the people, but also feasible and, today more than ever, urgently needed. (shrink)

As a cornerstone of public health, epidemiology has lately undergone substantial changes enabled by, among other factors, the use of biobank infrastructures. In biobank-related research, the return of results to participants constitutes an important and complex ethical question. In this study, we qualitatively investigated how individuals perceive the results returned following their participation in cohort studies with biobanks. In our semi-structured interviews with 31 participants of two such German studies, we observed that some participants overestimate the nature of the personal (...) information they will receive from the study. Although this misestimation does not seem to jeopardize the validity of the consent provided at recruitment, it may still represent a threat for participants’ trust in research and thus their long-term commitment, crucial for such studies. We argue that such misestimation may have ethical consequences on the principles guiding the reflection on the return of results in biobank research, i.e. autonomy, beneficence, non-maleficence and reciprocity. We suggest that shifting from the idea of directly benefiting participants through the return of research results could help focusing on benefiting society as a whole, thereby increasing research trustworthiness of population-based studies using biobanks. (shrink)

This paper takes stock of a recent but growing movement within the field of deliberative democracy, which normatively argues for the epistemic dimension of democratic authority and positively defends the truth-tracking properties of democratic procedures. Authors within that movement call themselves epistemic democrats, hence the recognition by many of an ‘epistemic turn’ in democratic theory. The paper argues that this turn is a desirable direction in which the field ought to evolve, taking it beyond the ‘fact of disagreement’ that had (...) previously blocked the conceptual road to acknowledging more than intrinsic properties to democratic decision procedures. The paper shows how two authors in particular – Joshua Cohen and David Estlund – have successfully lifted the Rawlsian requirement of epistemic abstinence and defends epistemic democrats and the implications of the epistemic turn in democratic theory against various misconceptions. (shrink)

This entry describes the semiotic thought in the Early Modern Period through three groups of authors: Late Scholastics who developed original theories within a traditional Aristotelian and Augustinian framework; John Locke and the authors of Port-Royal who follow the lines of a linguistic paradigm; Thomas Hobbes, Pierre Gassendi, and Pierre Bayle who built a renewed semiotic theory headed towards epistemology.

This paper argues in favor of the epistemic properties of inclusiveness in the context of democratic deliberative assemblies and derives the implications of this argument in terms of the epistemically superior mode of selection of representatives. The paper makes the general case that, all other things being equal and under some reasonable assumptions, more is smarter. When applied to deliberative assemblies of representatives, where there is an upper limit to the number of people that can be included in the group, (...) the argument translates into a defense of a specific selection mode of participants: random selection. (shrink)

The maze and the masses -- Democracy as the rule of the dumb many? -- A selective genealogy of the epistemic argument for democracy -- First mechanism of democratic reason: inclusive deliberation -- Epistemic failures of deliberation -- Second mechanism of democratic reason: majority rule.

Consensus plays an ambiguous role in deliberative democracy. While it formed the horizon of early deliberative theories, many now denounce it as an empirically unachievable outcome, a logically impossible stopping rule, and a normatively undesirable ideal. Deliberative disagreement, by contrast, is celebrated not just as an empirically unavoidable outcome but also as a democratically sound and normatively desirable goal of deliberation. Majority rule has generally displaced unanimity as the ideal way of bringing deliberation to a close. This article offers an (...) epistemic perspective on this question of consensus versus disagreement. For ensuring the production of better decisions, we argue, the normative appeal of consensus varies depending on the deliberative task – whether it entails problem solving or prediction. We argue that in pure problem-solving contexts, consensus retains a strong normative appeal and forms the ideal deliberative outcome of deliberation. In contrast, on predictive tasks, consensus should generally not be used as a stopping rule noris it likely to be epistemically desirable as an outcome. Instead deliberators may be better served by ending the deliberation with a form of deliberative disagreement we call ‘positive dissensus’, which paves the way for more accurate aggregate predictions. (shrink)

Comment se vivent et s’expérimentent actuellement les relations de parenté dans le Pacifique? Voici le fil conducteur qui relie les onze contributions de ce bel ouvrage dirigé par Christina Toren et Simonne Pauwels. Il actualise l’anthropologie de la parenté des îles du Pacifique, de la Nouvelle-Zélande à la Papouasie-Nouvelle-Guinée, en passant par Fidji, Tonga, Samoa et Taïwan. En introduction, C. Toren et S. Pauwels questionnent la manière dont la parenté constitue dans le Pacifique une t...

This book uncovers and explores the constant tension between the historical and the transcendental that lies at the heart of Michel Foucault's work. In the process, it also assesses the philosophical foundations of his thought by examining his theoretical borrowings from Kant, Nietzsche, and Heidegger, who each provided him with tools to critically rethink the status of the transcendental. Given Foucault's constant focus on the question of the possibility for knowledge, the author argues that his philosophical itinerary can be understood (...) as a series of attempts to historicize the transcendental. In so doing, he seeks to uncover a specific level that would identify these conditions without falling either into an excess of idealism or of materialism. The author concludes that, although this problem does unify Foucault's work and gives it its specifically philosophical dimension, none of the concepts successively provided manages to name these conditions without falling into the pitfalls that Foucault originally denounced as characteristic of the "anthropological sleep"--various forms of confusion between the historical and the transcendental. Although Foucault's work provides us with a highly illuminating analysis of the major problems of post-Kantian philosophies, ultimately it remains aporetic in that it also fails to overcome them. (shrink)

In Insister, Hlne Cixous brings a unique mixture of theoretical speculation, breath-taking textual explication and scholarly erudition to an extremely close reading of Derrida's work, always attentive to the details of his thinking. At the same time, Insister is an extraordinarily poetic meditation, a work of literature and of mourning for Jacques Derrida the person, who was a close friend and accomplice of Cixous's from the beginning of their careers.

ABSTRACTThe idea that the crowd could ever be intelligent is a counterintuitive one. Our modern, Western faith in experts and bureaucracies is rooted in the notion that political competence is the purview of the select few. Here, as in my book Democratic Reason, I defend the opposite view: that the diverse many are often smarter than a group of select elites because of the different cognitive tools, perspectives, heuristics, and knowledge they bring to political problem solving and prediction. In this (...) essay I defend my epistemic argument against proceduralist democrats; the value of model thinking against empiricists; the bracketing of fundamental value diversity against critics who see such diversity as an essential feature of politics; the intelligence of the masses in the face of voter ignorance and systematic biases; and the normative priority of democracy over market mechanisms. I also consider challenges to my use of Hong and Page's formal results, the epistemically proper selection method for representatives, and the role of deliberation in problem solving. I finally chart three avenues for further research. (shrink)

Chronic kidney failure is a serious somatic disease. Addressing the issue of living with a chronic disease means fully considering the patients’ entourage, their families, and those close to them, especially their children and spouses.Objectives: The present paper focuses on the couple’s psychological experience when one of them suffers from a chronic disease, in this instance kidney disease. In particular, how is the spouse affected by the treatment provided? The aim is not only to see how care for sick people (...) can be improved, but also, more specifically, how relatives and especially partners can receive attention.Methodology: A qualitative approach is not only adopted, being based on the psychotherapeutic follow-up of the partners of patients with chronic kidney disease, but also of the patients themselves, addressing the matter of their life as a couple. Three couples were considered, and two case studies are presented here. The issues that cut across these different situations are examined.Results and Discussion: Some couples show considerable resourcefulness. However, over the years, that capacity for adaptation and inventiveness can also be interrupted by the periods of greater suffering and even despair, especially when the somatic pathology becomes chronic. Many spouses talk about how living with a sick partner weighs down on them, causing severe fatigue. Some aspects of the illness can also become traumatic. The disease regularly disrupts the daily life of the couple and the family. This leads to a reworking of family relations. Each couple has its own history with the condition. As it emerges, it can disrupt the bonds of filiation, especially when the illness is hereditary. Making psychological care more accessible to the partners involved constitutes a major challenge for our hospital care systems. (shrink)

"I get up every day with one day more," says Eve, the writer's 97-year-old mother. She is escaping into the New Life and the writer must race to catch up. As things slip away and fall into oblivion, as her mother's world and thus her own relentlessly shrinks, the writer is stunned to see for the first time the vestiges of a prison scene in her beloved Tower of Montaigne, which she has been visiting for fifty years. It represents the (...) story of Cimon and Pero, a daughter's act of charity that saved her father from certain death. How extraordinary that it should only now appear to this other daughter who dreams of nothing less for her parent and thus for herself. A different prison scene draws the writer to reflect on Freud's remark "that the dream of a prisoner can have nothing other than escape as content," a comment he illustrates with Moritz von Schwind's painting _The Prisoner's Dream_. But it is Freud's own dreams of escape from the prison of declining powers in his old age that the writer channels through her telepathic connection to the one she calls her "nuncle." She knows that the worst, worse even than the effects of the disease eating through his body, would have been the obliteration of his dreams upon waking, a sensation of theft that is "like a rug one pulls from beneath the head's feet, bam, bam! like a tapestry of life folded up in a flash." And yet life's tapestry has never seemed more richly colored, more elaborately woven, more abundantly endowed with the gifts of Eve, the mother, the midwife, the irrepressible story-teller, the great escape artist, and the indomitable heroine of this book. (shrink)

Who can say "I am Jewish?" What does "Jew" mean? What especially does it mean for Jacques Derrida, founder of deconstruction, scoffer at boundaries and fixed identities, explorer of the indeterminate and undecidable? In _Portrait of Jacques Derrida as a Young Jewish Saint_, French feminist philosopher Hélène Cixous follows the intertwined threads of Jewishness and non-Jewishness that play through the life and works of one of the greatest living philosophers. Cixous is a lifelong friend of Derrida. They both grew (...) up as French Jews in Algeria and share a "belonging constituted of exclusion and nonbelonging"--not Algerian, rejected by France, their Jewishness concealed or acculturated. In Derrida's family "one never said 'circumcision'but 'baptism,'not 'Bar Mitzvah'but 'communion.'" Judaism cloaked in Catholicism is one example of the undecidability of identity that influenced the thinker whom Cixous calls a "Jewish Saint." An intellectual contemporary of Derrida, Cixous's ideas on writing have an affinity with his philosophy of deconstruction, which sought to overturn binary oppositions--such as man/woman, or Jew/non-Jew--and blur boundaries of exclusion inherent in Western thought. In portraying Derrida, Cixous uses metonymy, alliteration, rhyme, neologisms, and puns to keep the text in constant motion, freeing language from any rigidity of meaning. In this way she writes a portrait of "Derrida in flight," slipping from one appearance to the next, unable to be fixed in one spot, yet encompassing each point he passes. From the circumcision act to family relationships, through Derrida's works to those of Celan, Rousseau, and Beaumarchais, Cixous effortlessly merges biography and textual commentary in this playful portrait of the man, his works, and being (or not being) Jewish. (shrink)

Inequity has been a hallmark of the COVID-19 pandemic in the United States, especially in the sharply disproportionate impacts among people of color. Recent studies have confirmed that t...

Once Apollonius' Conics had been translated from Greek into Arabic, they became a main reference and the principal tool in studying solid problems, algebraic equations of 3rd and 4th degrees, infinitesimal mathematics, etc. Mathematicians of the 9th–10th centuries also studied the conic sections' constructions, as well as their continuous drawing and their drawing by points. Ibrāhīm ibn Sinān, as his grandfather Thābit ibn Qurra, was one of the most active and inventive mathematicians in these fields. Late Hélène Bellosta examined (...) in this article Ibn Sinān's contribution.Une fois les Coniques d'Apollonius traduits en arabe, ces livres sont devenus la référence indispensable et le principal instrument dans l'étude des problèmes solides, des équations algébriques des 3e et 4e degrés, des problèmes des mathématiques infinitésimales, etc. Les mathématiciens des ixe-xe siècles ont également étudié les constructions des sections coniques ainsi que leur tracé par points et leur tracé continu. Ibrāhīm ibn Sinān, comme son grand-père Thābit ibn Qurra, était l'un des mathématiciens les plus actifs et les plus inventifs en ce domaine. Dans cet article, la regrettée Hélène Bellosta a examiné la contribution d'Ibn Sinān.Send article to KindleTo send this article to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle. Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply. Find out more about the Kindle Personal Document Service.DE L'USAGE DES CONIQUES CHEZ IBRĀHĪM IBN SINĀNVolume 22, Issue 1Hélène Bellosta DOI: https://doi.org/10.1017/S0957423911000129Your Kindle email address Please provide your Kindle [email protected]@kindle.com Available formats PDF Please select a format to send. By using this service, you agree that you will only keep articles for personal use, and will not openly distribute them via Dropbox, Google Drive or other file sharing services. Please confirm that you accept the terms of use. Cancel Send ×Send article to Dropbox To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about sending content to Dropbox. DE L'USAGE DES CONIQUES CHEZ IBRĀHĪM IBN SINĀNVolume 22, Issue 1Hélène Bellosta DOI: https://doi.org/10.1017/S0957423911000129Available formats PDF Please select a format to send. By using this service, you agree that you will only keep articles for personal use, and will not openly distribute them via Dropbox, Google Drive or other file sharing services. Please confirm that you accept the terms of use. Cancel Send ×Send article to Google Drive To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about sending content to Google Drive. DE L'USAGE DES CONIQUES CHEZ IBRĀHĪM IBN SINĀNVolume 22, Issue 1Hélène Bellosta DOI: https://doi.org/10.1017/S0957423911000129Available formats PDF Please select a format to send. By using this service, you agree that you will only keep articles for personal use, and will not openly distribute them via Dropbox, Google Drive or other file sharing services. Please confirm that you accept the terms of use. Cancel Send ×Export citation Request permission. (shrink)

In the burgeoning debate about neuroscience’s role in contemporary society, the issue of brain optimization, or the application of neuroscientific knowledge and technologies to augment neurocognitive function, has taken center stage. Previous research has characterized media discourse on brain optimization as individualistic in ethos, pressuring individuals to expend calculated effort in cultivating culturally desirable forms of selves and bodies. However, little research has investigated whether the themes that characterize media dialogue are shared by lay populations. This article considers the relationship (...) between the representations of brain optimization that surfaced in a study of British press coverage between 2000 and 2012 and interviews with forty-eight London residents. Both data sets represented the brain as a resource that could be manipulated by the individual, with optimal brain function contingent on applying self-control in one’s lifestyle choices. However, these ideas emerged more sharply in the media than in the interviews: while most interviewees were aware of brain optimization practices, few were committed to carrying them out. The two data sets diverged in several ways: the media’s intense preoccupation with optimizing children’s brains was not apparent in lay dialogue, while interviewees elaborated beliefs about the underuse of brain tissue that showed no presence in the media. This article considers these continuities and discontinuities in light of their wider cultural significance and their implications for the media–mind relationship in public engagement with neuroscience. (shrink)

Professionals within the mental health services face many ethical dilemmas and challenging situations regarding the use of coercion. The purpose of this study was to evaluate the significance of participating in systematic ethics reflection groups focusing on ethical challenges related to coercion. In 2013 and 2014, 20 focus group interviews with 127 participants were conducted. The interviews were tape recorded and transcribed verbatim. The analysis is inspired by the concept of ‘bricolage’ which means our approach was inductive. Most participants report (...) positive experiences with participating in ethics reflection groups: A systematic and well-structured approach to discuss ethical challenges, increased consciousness of formal and informal coercion, a possibility to challenge problematic concepts, attitudes and practices, improved professional competence and confidence, greater trust within the team, more constructive disagreement and room for internal critique, less judgmental reactions and more reasoned approaches, and identification of potential for improvement and alternative courses of action. On several wards, the participation of psychiatrists and psychologists in the reflection groups was missing. The impact of the perceived lack of safety in reflection groups should not be underestimated. Sometimes the method for ethics reflection was utilised in a rigid way. Direct involvement of patients and family was missing. This focus group study indicates the potential of ethics reflection groups to create a moral space in the workplace that promotes critical, reflective and collaborative moral deliberations. Future research, with other designs and methodologies, is needed to further investigate the impact of ethics reflection groups on improving health care practices. (shrink)

This article furnishes a philosophical background for the current debate about responsibility and culpability for war crimes by referring to ideas from three important just war thinkers: Augustine, Francisco de Vitoria, and Michael Walzer. It combines lessons from these three thinkers with perspectives on current problems in the ethics of war, distinguishes between legal culpability, moral culpability, and moral responsibility, and stresses that even lower-ranking soldiers must in many cases assume moral responsibility for their acts, even though they are part (...) of a military hierarchy and act under orders. The questions addressed in this article are arguably among the hardest and most muddled in military ethics and deserve close philosophical analysis and scrutiny. (shrink)

This article discusses the meanings that motherhood has in the everyday life of women in Sweden and how they practice their mothering. The empirical foundation is qualitative interviews conducted with mothers who live in Sweden. Social constructionist and discursive psychology inspired the article, and according to the analysis three discursive positions were identified. The first position deals with the child-mother relationship and indicates that the child's psychological well-being is dependent on the mother's accessibility. The second discursive position deals with the (...) child-mother-woman relationship. Within this framework, motherhood involves finding contentment in life beyond the child, to be able to convey that well-being to the child. The third discursive position focuses on the mother as a working woman rather than a mother. These three discursive positions are discussed in relation to a pronounced discourse within Swedish society, which centers on an intense politically induced struggle for gender equality. (shrink)

The use of information technology in linguistic research gave rise in the 1950s to what is known as Natural Language Processing, but that framework was created without paying due attention to the need for logical reconstruction of linguistic concepts which were borrowed directly from barely formalised structural linguistics. The Computer-aided Acquisition of Semantic Knowledge project based on the Knowledge Discovery in Databases technology enabled us to interact with computers while gathering and improving our knowledge about languages. Thus, with the help (...) of data mining tools, as a result of revisiting two sorts of generally admitted linguistic theories, we succeeded in improving these local linguistic approaches by proposing to unify the Associative Semantics theory with the Meta-Informative Centering theory. The resulting Distributed Grammar program treats, in addition to the above types of information, the third one, para-information which – despite many studies – had no uniform theoretical background in general linguistics. This DG program aims to lay the foundations for creating the theoretical background of Conceptual Linguistics. (shrink)

This book combines loosely "autobiographical" texts by two of the most influential French intellectuals of our time. "Savoir," by Hélène Cixous is an account of her experience of recovered sight after a lifetime of severe myopia; Jacques Derrida's "A Silkworm of One's Own" muses on a host of motifs, including his varied responses to "Savoir.".

Dans le cadre de la Théorie de la Relation Interlocutive, nous proposons que l’interprétation sémantique et pragmatique de excuse me et sorry, qui ne sont pas, par essence, des marqueurs d’excuse, s’effectue en fonction de deux types de relation interlocutive différents qui conduisent à plusieurs interprétations possibles d’un événement perturbateur. Excuse me est considéré comme marqueur duophonique, c’est-à-dire comme une forme qui impose un désaccord entre un pôle émetteur et un pôle récepteur. On pourra y voir une demande de coopération (...) de l’allocutaire par politesse, pour tenter de réparer un manquement à l’étiquette, ou, bien au contraire, un moyen d’accentuer la nature conflictuelle d’une situation dans un contexte autre qu’un contexte d’excuse. A l’inverse, nous faisons l’hypothèse que sorry est une forme monophonique qui s’emploie pour rétablir l’harmonie interlocutive entre les deux pôles. Avec ce marqueur, la coopération de l’allocutaire est considérée comme acquise, ce qui a pour effet de minimiser le conflit dans des situations d’excuse ou autres. (shrink)

Le livre de Sarah Gutsche-Miller, issu d’une thèse soutenue en 2010, explore l’histoire et l’esthétique du ballet de music-hall dans les trois principaux établissements parisiens, les Folies-Bergère, le Casino de Paris et l’Olympia, entre 1871 et 1913. D’une grande qualité, il va assurément contribuer à combler des lacunes importantes dans l’histoire de la danse et dans celle des music-halls, plus largement dans l’histoire culturelle de Paris à la fin du xixe siècle. Les études sur le music-h...

_Three Steps on the Ladder of Writing_ is a poetic, insightful, and ultimately moving exploration of 'the strange science of writing.' In a magnetic, irresistible narrative, Cixous reflects on the writing process and explores three distinct areas essential for 'great' writing: _The School of the Dead_--the notion that something or someone must die in order for good writing to be born; _The School of Dreams_--the crucial role dreams play in literary inspiration and output; and _The School of Roots_--the importance of (...) depth in the 'nether realms' in all aspects of writing. Cixous's love of language and passion for the written word is evident on every page. Her emotive style draws heavily on the writers she most admires: the Brazilian novelist Clarice Lispector, the Russian poet Marina Tsvetaeva, the Austrian novelists Ingeborg Bachmann and Thomas Bernhard, Dostoyevsky and, most of all, Kafka. (shrink)

This paper is devoted to Ibn Sinn's text deals with two distinct, though closely related, subjects. First he considers the classification of problems, founded on the logical criteria which are the number and degree of indetermination of the solutions and the number of hypotheses and their possible independence. This classification does not replace the Hellenistic one, which remains relevant insofar as it purports to solve geometrical problems, but complements it and has a different frame of reference, applying principally to algebra, (...) that new born science. Ibn Sinn to bestow more importance on the role played by analysis in the course of the proof, the only role left to synthesis being to check that all implications involved in the course of analysis are in fact equivalences. This method will prove to be productive in algebra too, so much so that some algebraists will explicitly identify algebra with analysis. (shrink)

This article engages with medical practice to develop a philosophically informed understanding of epistemic engagement in medicine, and epistemic object relations more broadly. I take my point of departure in the clinical encounter and draw on French psychoanalytical theory to develop and expand a taxonomy already proposed by Karin Knorr-Cetina. In so doing, I argue for the addition of an abject-type object relation; that is, the encounter with objects that transgress frameworks and disrupt further investigation, hence preventing dynamic engagement and (...) negatively shaping our epistemic pathways. This article is primarily theoretical, although partly grounded in qualitative fieldwork. (shrink)