Despite the ubiquity of healthcare simulation and the humanities in medical education, the two domains of learning remain unintegrated. The stories suffused within healthcare simulation have thus remained unshaped by the developments of narrative medicine and the health humanities. Healthcare simulation, in turn, has yet to utilize concepts like co-construction and narrative competence to enrich learners’ understanding of patient experience alongside their clinical competencies. To create a conceptual bridge between these two fields (including narrative-based inquiry more broadly), we redescribe narrative (...) competence via Ronald Heifetz’s distinction of “technical” and “adaptive” challenges outlined in his adaptive leadership model. Heifetz, we argue, enriches learners’ self-understanding of the unique demands of cultivating narrative competence, which can be both elucidated on the page and tested within the charged yet supportive simulation environment. We introduce Co-constructive Patient Simulation (CCPS) to demonstrate how working with simulated patients can support narrative work by drawing on the clinical vicissitudes of learners in the formulation and enactment of case studies. The three movements of CCPS—resensing, retelling, and retooling—told through learner experiences, describe the affinities and divergences between narrative medicine’s sequence of attention, representation, and affiliation; Montello’s three forms of narrative competence (departure, performance, change), and Heifetz’s three steps (observe, interpret, and intervene) of adaptive leadership. (shrink)

The distinctive nature of pains associated with menstruation and childbirth is used to argue against Klein's version of imperativism.

“If I were a better human being, that person’s voice wouldn’t sound so shrill to me.” Many of us may have had such thoughts. They give voice to the worrying intuition that if we were less affected by sexism and racism, or better at keeping our tempers, our fellow humans would look and sound differently to us. Making sense of this unease requires us to re-think the relation between experiences and standing commitments; to reconsider what we mean by self-control; and (...) to attend to empirical questions about perception, attention, emotion regulation, and tacit cognition. (shrink)

Literature in the epistemology of disagreement has focused on peer disagreement: disagreement between those with shared evidence and equal cognitive abilities. Additional literature focuses on the perspective of amateurs who disagree with experts. However, the appropriate epistemic reaction from superiors who disagree with inferiors remains underexplored. Prima facie, this may seem an uninteresting set of affairs. If A is B’s superior, and A has good reason to believe she is B’s superior, A appears free to dismiss B’s disagreement. However, a (...) closer look will show otherwise. I first distinguish competent from incompetent inferiors and then argue that disagreement from the former often gives superiors reason to adjust credence and reevaluate belief. In other words, epistemic inferiority alone is insufficient grounds for dismissing opinion. More nuanced difficulties arise with incompetent inferiors. When superiors disagree with incompetents, this might provide evidence to bolster belief credence; however, agreement from incompetents can defeat justification. In either instance, inferior opinion carries epistemic weight. Yet, this fails to cover all ground; at times, superiors learn nothing from inferior disagreement. I finish by exploring these uninformative disagreements, how to distinguish them from the informative cases, and the proper epistemic reactions thereof. (shrink)

When a wrongdoing occurs, victims, barring special circumstance, can aptly forgive their wrongdoers, receive apologies, and be paid reparations. It is also uncontroversial, in the usual circumstances, that wronged parties can aptly blame their wrongdoer. But controversy arises when we consider blame from third-parties after the victim has forgiven. At times it seems that wronged parties can make blame inapt through forgiveness. If third parties blame anyway, it often appears the victim is justified in protesting. “But I forgave him!” In (...) other cases, however, forgiveness seems irrelevant: B can forgive A, but it can still seem that third parties can aptly blame A for the wrong against B. This perplexity adds a dimension to ongoing discussion regarding criteria for apt blame and the related issues of standing and fittingness. This paper explores the status of third party blame after forgiveness. I argue that while post forgiveness blame is often inapt, in many other cases forgiveness is irrelevant. This difference is explained by appeal to the various relationships third parties might have to wronged parties, and how these differences affect the ways we blame and thereby blame’s aptness. (shrink)

Conversations with patients and families about the allow-natural-death (AND) order, along with the standard do-not-resuscitate (DNR) order during end-of-life (EOL) decision-making, may create engagement and understanding while promoting care that can be defended using enduring notions of autonomy, beneficence, and professional duty. Ethical, legal, and pragmatic issues surrounding EOL care decision-making seem to suggest discussion of AND orders as one strategy clinicians could consider at the individual practice level and at institutional levels. A discussion of AND orders, along with traditional (...) DNR orders is presented. This is followed by argument and counter-argument focused on ethical, legal, and practical issues germane to EOL care decision-making associated with use of AND orders. (shrink)

The introduction describes the monographic section of Scienza & Politica dedicated to the innovations which postcolonial and feminist studies in Latin America are introducing in the history of political thought as a whole. The fundamental concepts of the following essays are presented here to introduce their historic and critic analysis. It is also highlighted the specific character of continental laboratory which the historic and political reflection is assuming in South American continent and the connections which are occurring with other countries (...) in the global South. (shrink)

Published in the American Journal of Bioethics.

In Part I, this paper argues that Duncan Pritchard’s version of safety is incompatible with closure. In Part II I argue for an alternative theory that fares much better. Part I begins by reviewing past arguments concerning safety’s problems with closure. After discussing both their inadequacies and Pritchard’s response to them, I offer a modified criticism immune to previous shortcomings. I conclude Part I by explaining how Pritchard’s own arguments make my critique possible. Part II argues that most modal theories (...) of knowledge will run into problems similar to those found in Pritchard’s Anti-Luck Virtue Epistemology. I hence offer my own theory grounded in risk assessment and explain why and how it does much better. (shrink)

Bortolotti argues that the irrationality of many delusions is no different in kind from the irrationality that marks many non-pathological states typically treated as beliefs. She takes this to secure the doxastic status of those delusions. Bortolotti’s approach has many benefits. For example, it accounts for the fact that we can often make some sense of what deluded subjects are up to, and helps explain why some deluded subjects are helped by cognitive behavioral therapy. But there is an alternative approach (...) that secures the same benefits as Bortolotti’s account while bringing additional benefits. The alternative approach treats both many delusions and many of the non-pathological states to which Bortolotti compares them as in-between states. Subjects in in-between states don’t fully believe the beliefs which it is sometimes convenient to ascribe to them. This alternative approach to belief and belief-ascription fits well with an independently attractive account of the varied purposes of our ordinary attitude ascriptions. It also makes it easier to make fine-grained distinctions between intentional attitudes of different kinds. (shrink)

Illustrates the similarities between the enslavement of Black people and the enslavement of animals in both the past and the present.

Situations in which patients lack medical decision-making (MDM) capacity raise ethical challenges, especially when the patients decline care that their surrogate decision makers and/or clinicians agree is indicated. These patients are a vulnerable population and should receive treatment that is the standard of care, in line with their the values of their authentic self, just as any other patient would. But forcing treatment on patients who refuse it, even though they lack capacity, carries medical and psychological risks to the patients (...) and the hospital staff. It is also often impractical to force some treatments, especially in the long term. For example, independent of the ethical “should” question, how would one force hemodialysis for the rest of a patient’s life, or force a surgery that requires weeks of post-operative physical therapy? In this article we present a novel algorithm that can help clinicians with ethical and practical decision making, with the goals of achieving the best outcomes for patients and reducing moral distress for their caretakers and clinicians. (shrink)

The dispute on mongrelization starts to play a fundamental role in Latin America inside the modernist debates about the national unity between the end of the XIX century and the beginning of the XX century, to later acquire an unprecedented global diffusion in the eighties and the nineties of the last century. Using the writings of the Bolivian sociologist Silvia River Cusicanqui and of the Argentinian anthropologist, who has long since been active in Brazil, Rita Segato, the essay reconstructs the (...) historic and political happening of metissage in Latin America. The authors show that it is an historical concept which worked as an instance of legitimation both in the period of colonial oppression and later in the epoch of republican modernization. It represents the instrument to hide – if not to delete – the original character of modern State; for this reason it has been able to play a fundamental role in the epoch of liberalism as much as in the neoliberal one. However in mongrelization what is also at stake is that it can express the radically de-colonizing impulse of the differences as forms of litigation which inhabit the complex contemporary Latin American territories. (shrink)

Après le 11 septembre 2001, un ressort essentiel des politiques américaines de renforcement de la « sécurité nationale » a pris la forme d’une insistance quasi paranoïaque sur les menaces potentiellement catastrophiques constituées par le cyber-terrorisme. Un grand nombre de commentateurs politiques, militaires ou économiques, ainsi que d’universitaires et de journalistes, ont envahi..

Herbaria are collections of preserved plant specimens, primarily composed of paper sheets with pressed plants or plant parts attached to them. The most valuable kind of sheet is the holotype specimen. This is the specific plant that was used in describing the species by the person who first identified it. Botanists must reference the holotype when reclassifying or renaming a species. In the past, this meant either borrowing the sheet or visiting the herbarium in which it was housed. With digitization (...) of these sheets, there is much greater and easier access to this information. However, digital images are not substitutes for the sheets themselves. This article will discuss why this is the case, why scanning herbarium sheets is still worthwhile effort, and why the sheets themselves are still necessary to plant research. (shrink)

The imperviousness of delusions to counter-evidence makes it tempting to classify them as imaginings. Bayne and Pacherie argue that adopting a dispositional account of belief can secure the doxastic status of delusions. But dispositionalism can only secure genuinely doxastic status for mental states by giving folk-psychological norms a significant role in the individuation of attitudes. When such norms individuate belief, deluded subjects will not count as believing their delusions. In general, dispositionalism won't confer genuinely doxastic status more often than do (...) competing accounts of belief. (shrink)

Academic dishonesty among students is not confined to the dynamics of the classrooms in which it occurs. The institution has a major role in fostering academic integrity. Ways that institutions can have a significant impact on attitudes toward and knowledge about academic integrity as well as reducing the incidence of academic dishonesty are described. These include the content of an effective academic honesty policy, campus-wide programs designed to foster integrity, and the development of a campus-wide ethos that encourages integrity.

We can increase our understanding of expression by considering an analogy to demonstrative reference. The connections between a demonstrative phrase and its referent, in a case of fully successful communication with that phrase, are analogous to the connections between an expressible state and the behavior that expresses it. The connections in each case serve to maintain a certain status for the connected elements: as actions of persons; or as objects, events, or states significant to persons. The analogy to demonstrative reference (...) helps show that a positive account of expression can make conceptual connections between expressed states and expressive behaviors without courting reductive behaviorism. A general account of expression as marked by these connections is compared to accounts of expression offered by Dorit Bar-On and Mitchell Green. Bar-On’s account turns out to be compatible with the account proposed here, once some of its consequences are fully appreciated. Green’s account rules out, as not expressive, some behaviors like crouching (in fear) that intuitively seem expressive. When Green’s account is altered to allow such behaviors back in, the resulting account also fits the one proposed. (shrink)

From a feminist perspective, unlimited procreative liberty risks treating children as property, distorts understanding of the family, and neglects moral concerns about how we reproduce.

Our behavior doesn't always match the beliefs attributed to us, and sometimes the mismatch raises questions about what our beliefs actually are. I compare two approaches to such cases, and argue in favor of the one which allows some belief-attributions to lack a determinate truth-value. That approach avoids an inappropriate assumption about cognitive activity: namely, that whenever we fail in performing one cognitive activity, there is a distinct cognitive activity at which we succeed. The indeterminacy-allowing approach also meshes well with (...) an attractive view of folk-psychology: that ascriptions can help shape the attitudes they report. (shrink)

There is a close conceptual relation between the notions of religious disenchantment and scientific naturalism. One way of resisting philosophical and cultural implications of the scientific image and the subsequent process of disenchantment can be found in attempts at sketching a reenchanted worldview. The main issue of accounts of reenchantment can be a rejection of scientific results in a way that flies in the face of good reason. Opposed to such reenchantment is scientific naturalism which implies an entirely disenchanted worldview. (...) However, one of the main problems of scientific naturalism are placement problems. A reenchanted worldview does have the conceptual resources to avoid placement problems, yet seems to throw out the baby with the bathwater. A dilemma results: the Scylla of an undesirable scientific naturalism and the Charybdis of a rampant, seemingly prescientific reenchanted worldview. In this article I argue that there is a safe middle passage between these two options, i.e. the recently proposed liberal naturalism which allows for a moderate normative reenchantment. Liberal naturalism lets us have it both ways: avoiding the placement problems while retaining a necessary and reasonable adherence to science, thereby avoiding both an all-too restrictive scientific naturalism. (shrink)

En estas páginas se trata de explicar, a partir de la reflexión de Walter Benjamin (1892-1940), en qué sentido el espacio mercantil puede comprenderse en términos epistemológicos y ontológicos. Más específicamente, constituye un dominio calculable de los objetos propio de la modernidad capitalista. Se persigue enlazar esa problemática con la cuestión filosófica del tiempo y con la teoría crítica de la industria cultural.

Metaphor is a pervasive and significant feature of language. We use metaphor to talk about the world in familiar and innovative ways, and in contexts ranging from everyday conversation to literature and scientific theorizing. However, metaphor poses serious challenges for standard philosophical theories of meaning, because it straddles so many important boundaries: between language and thought, between semantics and pragmatics, between rational communication and mere causal association. ;In this dissertation, I develop a pragmatic theory of metaphorical utterances which reconciles two (...) apparently incompatible intuitions. The first is that metaphors are vehicles for undertaking speech acts with a propositional content distinct from their conventional sentence meaning. The second is that metaphors are tools for inducing the essentially non-propositional effect of 'seeing things in a new light' or under a new aspect. These intuitions seem to be incompatible because it is assumed that only one can capture the essential function of metaphor. I propose instead that non-propositional 'seeing-as' or aspectual thought serves as the means by which speakers intend to accomplish their end of communicating content. This does not imply that speakers are not interested in and even committed to the effects of aspectual thought as well, only that it is not their sole, ultimate intention. ;In order to substantiate this proposal about how metaphor works, I develop an account of the psychological structures on which aspectual thought operates and the changes it engenders; I then show how the content of the speaker's intended speech act is determined by the aspect the sentence generates. By bringing propositional content and non-propositional aspectual thought together in this way, my account can treat the full range of metaphors, from 'ordinary' to 'poetic', within a unified theory. Armed with this account, we have the explanatory resources necessary to acknowledge both that ordinary conversational metaphors are efficient and sometimes essential vehicles for communicating determinate propositional contents, and also that rich, poetic metaphors are invitations to an open-ended contemplation of the subject under discussion. These apparently very different effects turn out to be manifestations of the same basic process of comprehension. (shrink)

Early in the COVID-19 pandemic in the United States, concern that there could be a shortage of ventilators raised the possibility of rationing care. Denying patients life-saving care captures our moral imagination, prompting the demand for a defensible framework of ethical principles for determining who will live and who will die. Behind the moral dilemma posed by the shortage of a particular medical good lies a broad moral geography encompassing important and often unarticulated societal values, as well as assumptions about (...) the nature and purpose of health care and the consequences of long-standing choices about health care as a social good. This article explores what COVID-19 has exposed concerning values and choices around health care in the United States. Employing the lens of Catholic Social Thought, it argues for an approach to rationing that is grounded in respect for human dignity, committed to distributing social goods in light of the common good, and self-conscious about the construction of vulnerability to illness and death. (shrink)

After its publication in 1916, Democracy and Education opened up a global debate about educational thought that is still ongoing. Various translations of Dewey's work, appearing at different times, have aided in introducing his ideas within different conversations and across different cultures. The introduction of Dewey's masterwork through academic, institutional, or political avenues has influenced its reception within contemporary educational scenarios; these avenues need to be taken into account when analyzing the book's reception as well as its impact on the (...) reconstruction of educational discourse. (shrink)

While Wittgenstein’s work has been extensively investigated in relation to many other important and influential philosophers, there is very little scholarly work that positively investigates the relationship between the work of Wittgenstein and Wilhelm Dilthey. To the contrary, some commentators like Hacker (2001a) suggest that Dilthey’s work (and that of other hermeneuticists) simply pales or is obsolete in comparison to Wittgenstein’s own insights. Against such assessments, this article posits that Wittgenstein’s and Dilthey’s thought most crucially intersects at the related topics (...) of scientism on the one hand and scientific and philosophical method on the other. In reconstructing Dilthey’s conceptions of understanding versus explaining and central points of Wittgenstein’s Remarks on Frazer’s Golden Bough, it becomes apparent that they share a staunch rejection of scientism and use the notion of understanding as a means to prevent methodologies from the natural sciences encroaching onto the human sciences (in Dilthey’s case) and philosophy (in Wittgenstein’s case). Notwithstanding a number of central ways in which these thinkers differ, this article closes by suggesting that there is some evidence according to which Wittgenstein, like Dilthey, can reasonably be understood as championing some central tenets of the hermeneutical tradition. (shrink)

Jeffrey Bishop’s The Anticipatory Corpse exposes a functional metaphysics at the root of contemporary medical practice that gives rise to inhumane medicine, especially at the end of life. His critique of medicine argues for alternative spaces and practices in which the communal significance of the body, its telos, can be restored and the meaning of a “good death” enriched. This essay develops an alternative epistemology of the body, drawing from Christian theological accounts of the communal or Eucharistic body and linking (...) liturgical practices to the cultivation of solidarity. It argues for an epistemology of the body that makes visible the invisible bodies at medicine’s margins and illumines the disparate worlds of health care globally. (shrink)

Celebrando os quarenta anos de A Hermenêutica do Sujeito — o curso ministrado por Michel Foucault no Collège de France, em 1982 —, este texto propõe-se a estabelecer conexões, gerais e específicas, entre aquele curso e a Educação. É feita uma discussão acerca da perspectiva analítica não metafísica adotada por Foucault, em contraste com o atual discurso pedagógico interpretativo dominante. São discutidos os sentidos que se pode dar a alguns insights daquele curso, em suas relações com a Educação contemporânea. Propondo-se (...) uma diferenciação entre pedagogia e Pedagogia, destaca-se a função subjetivante das práticas pedagógicas na educação escolarizada. Argumenta-se em favor da ontologia histórica, em oposição à ontologia transcendental e recorre-se ao conceito de frame, de modo a ressaltar sua importância e limitações em estudos como este. Discute-se a inversão moderna que colocou ênfase no preceito do “conhece-te a ti mesmo” (gnôthi seautón), deixando em segundo plano o preceito do “cuida de ti mesmo” (epiméleia heautoû), do que resultou a substituição do ideal antigo do sujeito das ações corretas pelo ideal moderno do sujeito dos saberes verdadeiros. Sugere-se que a Educação possa contribuir para suspender a anunciada morte do sujeito ou, pelo menos, mitigar os seus efeitos. Palavras-chave: Foucault; Subjetivação; Pedagogia; Ontologia histórica. Weaves: between Hermeneutics of the Subject and Education Abstract: Celebrating the forty years of The Hermeneutics of the Subject —the course by Michel Foucault at the Collège de France, in 1982—, this text proposes to establish connections, both general and specific, between that course and Education. A discussion is made about the non-metaphysical analytical perspective adopted by Foucault, in contrast to current dominant interpretive pedagogical discourses. The meanings that can be given to some insights from that course are discussed, in their relations with education. Proposing a differentiation between pedagogy and Pedagogy, the subjectivizing function of pedagogical practices in schools is highlighted. We argue in favor of historical ontology, as opposed to transcendental ontology, and we resort to the concept of frame, in order to emphasize its importance and limitations in foucauldian studies. We discuss the modern inversion that placed emphasis on the precept “know thyself” (gnôthi seautón), leaving in the background the precept “take care of yourself” (epiméleia heautoû), which resulted in the replacement of the ideal of the subject of correct actions by the modern ideal of the subject of true knowledge. We suggest that Education can contribute to suspend the announced death of the subject or, at least, mitigate its effects. Keywords: Foucault; Subjectivizing; Pedagogy; Historical ontology. Tesituras: entre la Hermenéutica del Sujeto y la Educación Resumen: Celebrando los cuarenta años de La Hermenéutica del Sujeto —curso por Michel Foucault en el Collège de France, en 1982—, este texto se propone establecer conexiones generales y específicas, entre ese curso y la Educación. Se discute la perspectiva no-metafísica adoptada por Foucault, en contraste con el actual discurso pedagógico interpretativo dominante. Se problematizan los sentidos que se pueden dar a algunos insigths de aquel curso, en sus relaciones con la educación contemporánea. Se propone una diferenciación entre pedagogía y Pedagogía y se destaca la función de subjetivación de las prácticas pedagógicas en las escuelas. Se argumenta a favor de la ontología histórica, en oposición a la ontología transcendental, y se recurre al concepto de frame, para enfatizar su importancia y limitaciones en estudios foucaultianos. Se discute la idea moderna que puso énfasis en el precepto de “conócete a ti mismo” (gnôthi seautón), dejando en segundo plano el “cuida de ti mismo” (epiméleia heautoû), lo que derivó en la sustitución del ideal antiguo del sujeto de las acciones correctas, por el ideal moderno del sujeto del conocimiento verdadero. Se sugiere que la Educación puede contribuir a suspender la anunciada muerte del sujeto o, al menos, mitigar sus efectos. Palabras clave: Foucault; Subjetivación; Pedagogia; Ontologia histórica. Data de registro: 08/07/2022 Data de aceite: 13/12/2022. (shrink)