Introduction: Uncertainty is omnipresent in cancer care, including the ambiguity of diagnostic tests, efficacy and side effects of treatments, and/or patients' long-term prognosis. During second opinion consultations, uncertainty may be particularly tangible: doubts and uncertainty may drive patients to seek more information and request a second opinion, whereas the second opinion in turn may also affect patients' level of uncertainty. Providers are tasked to clearly discuss all of these uncertainties with patients who may feel overwhelmed by it. The aim of (...) this study was to explore how oncologists communicate about uncertainty during second opinion consultations in medical oncology.Methods: We performed a secondary qualitative analysis of audio-recorded consultations collected in a prospective study among cancer patients who sought a second opinion in medical oncology. We purposively selected 12 audio-recorded second opinion consultations. Any communication about uncertainty by the oncologist was double coded by two researchers and an inductive analytic approach was chosen to allow for novel insights to arise.Results: Seven approaches in which oncologists conveyed or addressed uncertainty were identified: specifying the degree of uncertainty, explaining reasons of uncertainty, providing personalized estimates of uncertainty to patients, downplaying or magnifying uncertainty, reducing or counterbalancing uncertainty, and providing support to facilitate patients in coping with uncertainty. Moreover, oncologists varied in their choice of words/language to convey uncertainty.Discussion: This study identified various approaches of how oncologists communicated uncertain issues during second opinion consultations. These different approaches could affect patients' perception of uncertainty, emotions provoked by it, and possibly even patients' behavior. For example, by minimizing uncertainty, oncologists may consciously steer patients toward specific medical decisions). Future research is needed to examine how these different ways of communicating about uncertainty affect patients. This could also facilitate a discussion about the desirability of certain communication strategies. Eventually, practical and evidence-based guidance needs to be developed for clinicians to optimally inform patients about uncertain issues and support patients in dealing with these. (shrink)

To carry on reasoning in the face of the implications of skepticism is what Fred Parker calls “sceptical thinking.” Not to be confused with the engineered vacillation leading to a tranquillizing suspense of judgement, it involves the double perspective of someone conducting a life, believing and reasoning as we do, while acutely aware that the whole endeavor is, in a sense, untenable. If, as Sir Philip Sidney famously said, an imaginative writer “nothing affirms, and therefore never lieth,” then the dilemma (...) posed by skepticism might be less embarrassing for that kind of writer than for philosophers. The latter purport to offer tenets valued according to their truth, however variously defined; the former, on the other hand, create “speaking pictures,” or verbal imitations. Skeptically thinking imaginative writers can create speaking pictures of a life in which knowledge is unavailable though people must reason, believe, and act. In a famous letter Keats went so far as to deem a kind of ataraxy to be a condition of the highest art, adducing Shakespeare’s “Negative Capability... of being in uncertainties, Mysteries, doubts, without any irritable reaching after fact & reason”. Parker does not discuss the possibility that negative capability might conduce to the highest flights of literature. He is concerned with the unresolved tensions of skeptical thinking that he sees as complicating key works of literature in the Hanoverian reigns. For their authors and readers, the negativity of skepticism was “disillusioning and destabilizing” if not ameliorated by a humor like Sterne’s or an irony like Hume’s. Humor or irony arises from the oddity that skepticism is put in its place only when we give up and allow nature to reassert itself. Not heroic measures, but backgammon and making merry with friends prevail over doubt. Sometimes, when the confrontation with skepticism gives rise to the precept of following nature, skepticism can result in “a surprising confidence of assertion”. (shrink)

Find out all about dreams and you will know all about insanity. ?Hughlings Jackson.

(1972). Properties and causes: An approach to the problem of hypothesis in the scientific methodology of Sir Isaac Newton. Annals of Science: Vol. 28, No. 3, pp. 217-233.

Для широкого круга читателей (слушателей, аспирантов, преподавателей) интересующихся данной проблемой.

Das Grab des Königs Ninetjer in Saqqara: Architektonische Entwicklung frühzeitlicher Grabanlagen in Ägypten. By Claudia M. Lacher-Raschdorff. Deutsches Archäologisches Institut Kairo, Archäologische Veröffentlichungen, vol. 125. Wiesbaden: Harrassowitz Verlag, 2014. Pp. 295, 44 pls., plans. €247.

This year is the seventieth since the birth of the distinguished Soviet philosopher, M. A. Dynnik. Dynnik is known for his work in the history of philosophy, the history of dialectics, and the critique of contemporary bourgeois philosophy. Dynnik's works are a significant contribution to Marxist philosophy, and to the methodology of research into so important a field as the history of philosophy. Dynnik is also known as a remarkable teacher, whose brilliant lectures are always heard with immense interest.

For 150 years after Galileo's condemnation in 1633, there were many references to the trial, but no sustained, heated or polarized discussions. Then came the thesis that Galileo was condemned not for being a good astronomer but for being a bad theologian (using Scripture to support astronomical hypotheses); it began in 1784-1785 with an apology of the Inquisition by Mallet du Pan in the Mercure de France and the printing in Tiraboschi's Storia della letteratura italiana of an apocryphal letter attributed (...) to Galileo but forged by Onorato Gaetani. This thesis is not only untenable and false but inverts and subverts the truth; it proved to be long-lasting and widely accepted; so it may be labeled a myth. It was held by such writers as . Afterwards, it was generally abandoned, its death knell being pope John Paul II's speeches in 1979-1992. The myth seems to have acted as a catalyst insofar as its creation encouraged the proliferation of pro-clerical accounts and the articulation of pro-Galilean ones, thus making the discussion of Galileo's trial the cause celebre it is today. (shrink)