Luc Faucher Dans cet article, je soulèverai un problème qui a été négligé jusqu’ici dans les écrits portant sur la philosophie de la psychiatrie au sujet du Research Domain Criteria : le fait que l’initiative découle des priorités de recherche du National Institute of Mental Health et que l’orientation de celles-ci ne permet pas de traiter certains aspects des conditions des patients qui sont jugés essentiels par ceux-ci. Après avoir démontré l’existence de ce problème, je vais tenter de voir par (...) quel moyen on pourrait l’éviter. Pour ce faire, je considérerai un programme, européen cette fois, le Roadmap for Mental Health Research in Europe et sa méthode pour intégrer une diversité de voix, dont celles des patients, dans le processus d’établissement des priorités de recherche. Je me livrerai ainsi à un exercice d’épistémologie sociale comparée en montrant comment certaines caractéristiques organisationnelles d’un des programmes possèdent des vertus épistémiques qui font défaut à l’autre et comment une plus grande justice épistémique pourrait être obtenue par l’implantation de certains mécanismes qui permettent à la voix des patients d’être entendue. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Epistemic Microaggressions and Their HarmsCatherine Sherron (bio)In Microaggressions in Medicine (2024), Lauren Freeman and Heather Stewart raise many philosophical issues undermining, and practical advice for improving, the practice of medicine. Here I offer some thoughts specifically on chapter 4, "Epistemic Microaggressions."Epistemic microaggressions "pertain to our status as knowers" and are "defined as intentional or unintentional verbal or gestural slights made by healthcare professionals that dismiss, ignore, (...) or otherwise fail to recognize knowledge claims made by patients" (Freeman and Stewart 2024, 98). Note that intention is irrelevant; only the impact of how the harm befalls the patient is the focus here. Could there be extenuating circumstances for any particular healthcare professional? Possibly, but the point is to acknowledge the harm and do better both as individual healthcare professionals and within healthcare systems (subsequent chapters of the book point out various specific steps and strategies to address and rectify both individual and systemic shortcomings).Epistemologically, healthcare professionals (hereafter "practitioner") are experts on human medicine, but each patient is generally an expert on their own body. Here I organize some thoughts around specific issues in order to further our thinking about where the knowledge construction goes wrong and see where we might improve.1. Issue 1: Epistemic agencyQuestions in this realm pertain to, for example, who is a knower, whose knowledge counts, and who has epistemic privilege? Epistemologically, subjective knowledge about pain or what is normal for my body is my individual knowledge. While a patient might not have a sufficient vocabulary to accurately describe how it feels to them, the practitioner cannot know better than them. What a practitioner might be able to do is help the patient figure out how to communicate their experience, as well as values, more clearly or effectively. [End Page 147] One way that microaggressions function is by freezing out or shutting down the patient and thus limiting their epistemological contributions to the shared problem.In contrast, building on the work of feminist philosopher of science, Helen Longino (1990), medical knowledge, like scientific knowledge, can be conceived as social knowledge. It is built on the experiences and studies of the scientific and medical communities. The knowledge is held across individuals, not within any one person and no one person can override the community's knowledge. Note that like all scientific knowledge, it is falsifiable or defeasible such that if new evidence arises, the scientific community or subcommunity might need to reassess. In this way, scientific knowledge is dynamic, not static.Returning to the practice of medicine, we would say that is a shared epistemological endeavor across both practitioner and patient. Both parties bring something to the knowledge table, so to speak. But this "table" is not equally welcoming to all people. As we try to understand microaggressions in a US societal context, we would notice that whole groups of people are often not taken seriously by our society as epistemic agents. Most people, including practitioners, hold implicit and explicit racial bias. Statistically, people of color are devalued. Women are consistently devalued, not taken as credible even about their own bodies and experiences (Freeman and Stewart 2024, 114). Specifically in medicine, practitioners consistently have underestimated the claims women make about pain. Freeman and Stewart call this "medical gaslighting" in chapter 5. An additional example to the cases in the book can be found in the 2023 New York Times podcast, The Retrievals, about dozens of women (perhaps as many as 200) undergoing fertility treatment, including egg retrievals that were performed without pain medicine because, as it was later discovered, someone on staff with a drug problem was replacing the fentanyl used for sedation with saline. Even when the women were visibly in pain and requesting more relief, they were told things like "if you want a baby, you have to suffer" and "we are giving you all that we can—you just need to tough it out" (Burton 2023, "The Clinic"). Some of the women reported they felt they were being treated like "hysterical women" (Burton 2023, "The Patients").With a social tendency for people with less power and status to present as less confident, more deferential, and less willing to speak up, we... (shrink)

ABSTRACT I argue that this examination and appreciation for the shift to abductive reasoning should be extended to the intersection of neuroscience and novel brain-computer interfaces too. This paper highlights the implications of applying abductive reasoning to personalized implantable neurotechnologies. Then, it explores whether abductive reasoning is sufficient to justify insurance coverage for devices absent widespread clinical trials, which are better applied to one-size-fits-all treatments. INTRODUCTION In contrast to the classic model of randomized-control trials, often with a large number of (...) subjects enrolled, precision medicine attempts to optimize therapeutic outcomes by focusing on the individual.[i] A recent publication highlights the strengths and weakness of both traditional evidence-based medicine and precision medicine.[ii] Plus, it outlines a tension in the shift from evidence-based medicine’s inductive reasoning style (the collection of data to postulate general theories) to precision medicine’s abductive reasoning style (the generation of an idea from the limited data available).[iii] The paper’s main example is the application of precision medicine for the treatment of cancer.[iv] I argue that this examination and appreciation for the shift to abductive reasoning should be extended to the intersection of neuroscience and novel brain-computer interfaces too. As the name suggests, brain-computer interfaces are a significant advancement in neurotechnology that directly connects someone’s brain to external or implanted devices.[v] Among the various kinds of brain-computer interfaces, adaptive deep brain stimulation devices require numerous personalized adjustments to their settings during the implantation and computation stages in order to provide adequate relief to patients with treatment-resistant disorders. What makes these devices unique is how adaptive deep brain stimulation integrates a sensory component to initiate the stimulation. While not commonly at the level of sophistication as self-supervising or generative large language models,[vi] they currently allow for a semi-autonomous form of neuromodulation. This paper highlights the implications of applying abductive reasoning to personalized implantable neurotechnologies. Then, it explores whether abductive reasoning is sufficient to justify insurance coverage for devices absent widespread clinical trials, which are better applied to one-size-fits-all treatments.[vii] ANALYSIS I. The State of Precision Medicine in Oncology and the Epistemological Shift While a thorough overview of precision medicine for the treatment of cancer is beyond the scope of this article, its practice can be roughly summarized as identifying clinically significant characteristics a patient possesses (e.g., genetic traits) to land on a specialized treatment option that, theoretically, should benefit the patient the most.[viii] However, in such a practice of stratification patients fall into smaller and smaller populations and the quality of evidence that can be applied to anyone outside these decreases in turn.[ix] As inductive logic helps to articulate, the greater the number of patients that respond to a particular therapy the higher the probability of its efficacy. By straying from this logical framework, precision medicine opens the treatment of cancer to more uncertainty about the validity of these approaches to the resulting disease subcategories.[x] Thus, while contemporary medical practices explicitly describe some treatments as “personalized”, they ought not be viewed as inherently better founded than other therapies.[xi] A relevant contemporary case of precision medicine out of Norway focuses on the care of a patient with cancer between the ventricles of the heart and esophagus, which had failed to respond to the standard regimen of therapies over four years.[xii] In a last-ditch effort, the patient elected to pay out-of-pocket for an experimental immunotherapy (nivolumab) at a private hospital. He experienced marked improvements and a reduction in the size of the tumor. Understandably, the patient tried to pursue further rounds of nivolumab at a public hospital. However, the hospital initially declined to pay for it given the “lack of evidence from randomised clinical trials for this drug relating to this [patient’s] condition.”[xiii] In rebuttal to this claim, the patient countered that he was actually similar to a subpopulation of patients who responded in “open‐label, single arm, phase 2 studies on another immune therapy drug” (pembrolizumab).[xiv] Given this interpretation of the prior studies and the patient’s response, further rounds of nivolumab were approved. Had the patient not had improvements in the tumor’s size following a round of nivolumab, then pembrolizumab’s prior empirical evidence in isolation would have been insufficient, inductively speaking, to justify his continued use of nivolumab.[xv] The case demonstrates a shift in reasoning from the traditional induction to abduction. The phenomenon of ‘cancer improvement’ is considered causally linked to nivolumab and its underlying physiological mechanisms.[xvi] However, “the weakness of abductions is that there may always be some other better, unknown explanation for an effect. The patient may for example belong to a special subgroup that spontaneously improves, or the change may be a placebo effect. This does not mean, however, that abductive inferences cannot be strong or reasonable, in the sense that they can make a conclusion probable.”[xvii] To demonstrate the limitations of relying on the abductive standard in isolation, commentators have pointed out that side effects in precision medicine are hard to rule out as being related to the initial intervention itself unless trends from a group of patients are taken into consideration.[xviii] As artificial intelligence (AI) assists the development of precision medicine for oncology, this uncertainty ought to be taken into consideration. The implementation of AI has been crucial to the development of precision medicine by providing a way to combine large patient datasets or a single patient with a large number of unique variables with machine learning to recommend matches based on statistics and probability of success upon which practitioners can base medical recommendations.[xix] The AI is usually not establishing a causal relationship[xx] – it is predicting. So, as AI bleeds into medical devices, like brain-computer interfaces, the same cautions about using abductive reasoning alone should be carried over. II. Responsive Neurostimulation, AI, and Personalized Medicine Like precision medicine in cancer treatment, computer-brain interface technology similarly focuses on the individual patient through personalized settings. In order to properly expose the intersection of AI, precision medicine, abductive reasoning, and implantable neurotechnologies, the descriptions of adaptive deep brain stimulation systems need to deepen.[xxi] As a broad summary of adaptive deep brain stimulation, to provide a patient with the therapeutic stimulation, a neural signal, typically referred to as a local field potential,[xxii] must first be detected and then interpreted by the device. The main adaptive deep brain stimulation device with premarket approval, the NeuroPace Responsive Neurostimulation system, is used to treat epilepsy by detecting and storing “programmer-defined phenomena.”[xxiii] Providers can optimize the detection settings of the device to align with the patient’s unique electrographic seizures as well as personalize the reacting stimulation’s parameters.[xxiv] The provider adjusts the technology based on trial and error. One day machine learning algorithms will be able to regularly aid this process in myriad ways, such as by identifying the specific stimulation settings a patient may respond to ahead of time based on their electrophysiological signatures.[xxv] Either way, with AI or programmers, adaptive neurostimulation technologies are individualized and therefore operate in line with precision medicine rather than standard treatments based on large clinical trials. Contemporary neurostimulation devices are not usually sophisticated enough to be prominent in AI discussions where the topics of neural networks, deep learning, generative models, and self-attention dominate the conversation. However, implantable high-density electrocorticography arrays (a much more sensitive version than adaptive deep brain stimulation systems use) have been used in combination with neural networks to help patients with neurologic deficits from a prior stroke “speak” through a virtual avatar.[xxvi] In some experimental situations, algorithms are optimizing stimulation parameters with increasing levels of independence.[xxvii] An example of neurostimulation that is analogous to the use of nivolumab in Norway surrounds a patient in the United States who was experiencing both treatment-resistant OCD and temporal lobe epilepsy.[xxviii]Given the refractory nature of her epilepsy, implantation of an adaptive deep brain stimulation system was indicated. As a form of experimental therapy, her treatment-resistant OCD was also indicated for the off-label use of an adaptive deep brain stimulation set-up. Another deep brain stimulation lead, other than the one implanted for epilepsy, was placed in the patient’s right nucleus accumbens and ventral pallidum region given the correlation these nuclei had with OCD symptoms in prior research. Following this, the patient underwent “1) ambulatory, patient-initiated magnet-swipe storage of data during moments of obsessive thoughts; (2) lab-based, naturalistic provocation of OCD-related distress (naturalistic provocation task); and (3) lab-based, VR [virtual reality] provocation of OCD-related distress (VR provocation task).”[xxix] Such signals were used to identify when to deliver the therapeutic stimulation in order to counter the OCD symptoms. Thankfully, following the procedure and calibration the patient exhibited marked improvements in their OCD symptoms and recently shared her results publicly.[xxx] In both cases, there is a similar level of abductive justification for the efficacy of the delivered therapy. In the case study in which the patient was treated with adaptive deep brain stimulation, they at least had their neural activity tested in various settings to determine the optimum parameters for treatment to avoid them being based on guesswork. Additionally, the adaptive deep brain stimulation lead was already placed before the calibration trials were conducted, meaning that the patient had already taken on the bulk of the procedural risk before the efficacy could be determined. Such an efficacy test could have been replicated in the first patient’s cancer treatment, had it been biopsied and tested against the remaining immunotherapies in vitro. Yet, in the case of cancer with few options, one previous dose of a drug that appeared to work on the patient may justify further doses. However, as the Norwegian case presents, corroboration with known responses to a similar drug (from a clinical trial) could be helpful to validate the treatment strategy. (It should be noted that both patients were resigned to these last resort options regardless of the efficacy of treatment.) There are some elements of inductive logic seen with adaptive deep brain stimulation research in general. For example, abductively the focus could be that patient X’s stimulation parameters are different from patient Y’s and patient Z’s. In contrast, when grouped as subjects who obtained personalized stimulation, patients X, Y, and Z demonstrate an inductive aspect to this approach’s safety and/or efficacy. The OCD case holds plenty of abductive characteristics in line with precision medicine’s approach to treating cancer and as more individuals try the method, there will be additional data. With the gradual integration of AI into brain-computer interfaces in the name of efficacy, this reliance on abduction will continue, if not grow, over time. Moving forward, if a responsive deep brain stimulation treatment is novel and individualized (like the dose of nivolumab) and there is some other suggestion of efficacy (like clinical similarities to other patients in the literature), then it may justify insurance coverage for the investigative intervention, absent other unrelated reasons to deny it. III. Ethical Implications and Next Steps While AI’s use in oncology and neurology is not yet as prominent as its use in other fields (e.g., radiology), it appears to be on the horizon for both.[xxxi] AI can be found in both the functioning of the neurotechnologies as well as the implementation of precision medicine. The increasing use of AI may serve to further individualize both oncologic and neurological therapies. Given these implications and the handful of publications cited in this article, it is important to have a nuanced evaluation of how these treatments, which heavily rely on abductive justification, ought to be managed. The just use an abductive approach may be difficult as AI infused precision medicine is further pursued. At baseline, such technology relies on a level of advanced technology literacy among the general public and could exclude populations who lack access to basic technological infrastructure or know-how from participation.[xxxii] Even among nations with adequate infrastructure, as more patients seek out implantable neurotechnologies, which require robust healthcare resources, the market will favor patient populations that can afford this complex care.[xxxiii] If patients already have the means to pay for an initial dose/use of a precision medicine product out of pocket, should insurance providers be required to cover subsequent treatments?[xxxiv] That is, if a first dose of a cancer drug or a deep brain stimulator over its initial battery life is successful, patients may feel justified in having the costs of further treatments covered. The Norwegian patient’s experience implies there is a precedent for the idea that some public insurance companies ought to cover successful cancer therapies, however, insurance companies may not all see themselves as obligated to cover neurotechnologies that rely on personalized settings or that are based on precision/abductive research more than on clinical trials. CONCLUSION The fact that the cases outlined above rely on abductive style of reasoning implies that there may not be as strong a justification for coverage by insurance, as they are both experimental and individualized, when compared to the more traditional large clinical trials in which groups have the same or a standardized protocol (settings/doses). If a study is examining the efficacy of a treatment with a large cohort of patients or with different experimental groups/phases, insurance companies may conclude that the resulting symptom improvements are more likely to be coming from the devices themselves. A preference for inductive justification may take priority when ruling in favor of funding someone’s continued use of an implantable neurostimulator. There are further nuances to this discussion surrounding the classifications of these interventions as research versus clinical care that warrant future exploration, since such a distinction is more of a scale[xxxv] than binary and could have significant impacts on the “right-to-try” approach to experimental therapies in the United States.[xxxvi] Namely, given the inherent limitations of conducting large cohort trials for deep brain stimulation interventions on patients with neuropsychiatric disorders, surgically innovative frameworks that blend abductive and inductive methodologies, like with sham stimulation phases, have traditionally been used.[xxxvii] Similarly, for adaptive brain-computer interface systems, if there are no large clinical trials and instead only publications that demonstrate that something similar worked for someone else, then, in addition to the evidence that the first treatment/dose worked for the patient in question, the balance of reasoning would be valid and arguably justify insurance coverage. As precision approaches to neurotechnology become more common, frameworks for evaluating efficacy will be crucial both for insurance coverage and for clinical decision making. ACKNOWLEDGEMENT This article was originally written as an assignment for Dr. Francis Shen’s “Bioethics & AI” course at Harvard’s Center for Bioethics. I would like to thank Dr. Shen for his comments as well as my colleagues in the Lázaro-Muñoz Lab for their feedback. - [i] Jonathan Kimmelman and Ian Tannock, “The Paradox of Precision Medicine,” Nature Reviews. Clinical Oncology 15, no. 6 (June 2018): 341–42, https://doi.org/10.1038/s41571-018-0016-0. [ii] Henrik Vogt and Bjørn Hofmann, “How Precision Medicine Changes Medical Epistemology: A Formative Case from Norway,” Journal of Evaluation in Clinical Practice 28, no. 6 (December 2022): 1205–12, https://doi.org/10.1111/jep.13649. [iii] David Barrett and Ahtisham Younas, “Induction, Deduction and Abduction,” Evidence-Based Nursing 27, no. 1 (January 1, 2024): 6–7, https://doi.org/10.1136/ebnurs-2023-103873. [iv] Vogt and Hofmann, “How Precision Medicine Changes Medical Epistemology,” 1208. [v] Wireko Andrew Awuah et al., “Bridging Minds and Machines: The Recent Advances of Brain-Computer Interfaces in Neurological and Neurosurgical Applications,” World Neurosurgery, May 22, 2024, S1878-8750(24)00867-2, https://doi.org/10.1016/j.wneu.2024.05.104. [vi] Mark Riedl, “A Very Gentle Introduction to Large Language Models without the Hype,” Medium (blog), May 25, 2023, https://mark-riedl.medium.com/a-very-gentle-introduction-to-large-language-models-without-the-hype-5 f67941fa59e. [vii] David E. Burdette and Barbara E. Swartz, “Chapter 4 - Responsive Neurostimulation,” in Neurostimulation for Epilepsy, ed. Vikram R. Rao (Academic Press, 2023), 97–132, https://doi.org/10.1016/B978-0-323-91702-5.00002-5. [viii] Kimmelman and Tannock, 2018. [ix] Kimmelman and Tannock, 2018. [x] Simon Lohse, “Mapping Uncertainty in Precision Medicine: A Systematic Scoping Review,” Journal of Evaluation in Clinical Practice 29, no. 3 (April 2023): 554–64, https://doi.org/10.1111/jep.13789. [xi] Kimmelman and Tannock, “The Paradox of Precision Medicine.” [xii] Vogt and Hofmann, 1206. [xiii] Vogt and Hofmann, 1206. [xiv] Vogt and Hofmann, 1206. [xv] Vogt and Hofmann, 1207. [xvi] Vogt and Hofmann, 1207. [xvii] Vogt and Hofmann, 1207. [xviii] Vogt and Hofmann, 1210. [xix] Mehar Sahu et al., “Chapter Three - Artificial Intelligence and Machine Learning in Precision Medicine: A Paradigm Shift in Big Data Analysis,” in Progress in Molecular Biology and Translational Science, ed. David B. Teplow, vol. 190, 1 vols., Precision Medicine (Academic Press, 2022), 57–100, https://doi.org/10.1016/bs.pmbts.2022.03.002. [xx] Stefan Feuerriegel et al., “Causal Machine Learning for Predicting Treatment Outcomes,” Nature Medicine 30, no. 4 (April 2024): 958–68, https://doi.org/10.1038/s41591-024-02902-1. [xxi] Sunderland Baker et al., “Ethical Considerations in Closed Loop Deep Brain Stimulation,” Deep Brain Stimulation 3 (October 1, 2023): 8–15, https://doi.org/10.1016/j.jdbs.2023.11.001. [xxii] David Haslacher et al., “AI for Brain-Computer Interfaces,” 2024, 7, https://doi.org/10.1016/bs.dnb.2024.02.003. [xxiii] Burdette and Swartz, “Chapter 4 - Responsive Neurostimulation,” 103–4; “Premarket Approval (PMA),” https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpma/pma.cfm?id=P100026. [xxiv] Burdette and Swartz, “Chapter 4 - Responsive Neurostimulation,” 104. [xxv] Burdette and Swartz, 126. [xxvi] Sean L. Metzger et al., “A High-Performance Neuroprosthesis for Speech Decoding and Avatar Control,” Nature 620, no. 7976 (August 2023): 1037–46, https://doi.org/10.1038/s41586-023-06443-4. [xxvii] Hao Fang and Yuxiao Yang, “Predictive Neuromodulation of Cingulo-Frontal Neural Dynamics in Major Depressive Disorder Using a Brain-Computer Interface System: A Simulation Study,” Frontiers in Computational Neuroscience 17 (March 6, 2023), https://doi.org/10.3389/fncom.2023.1119685; Mahsa Malekmohammadi et al., “Kinematic Adaptive Deep Brain Stimulation for Resting Tremor in Parkinson’s Disease,” Movement Disorders 31, no. 3 (2016): 426–28, https://doi.org/10.1002/mds.26482. [xxviii] Young-Hoon Nho et al., “Responsive Deep Brain Stimulation Guided by Ventral Striatal Electrophysiology of Obsession Durably Ameliorates Compulsion,” Neuron 0, no. 0 (October 20, 2023), https://doi.org/10.1016/j.neuron.2023.09.034. [xxix] Nho et al. [xxx] Nho et al.; Erik Robinson, “Brain Implant at OHSU Successfully Controls Both Seizures and OCD,” OHSU News, accessed March 3, 2024, https://news.ohsu.edu/2023/10/25/brain-implant-at-ohsu-successfully-controls-both-seizures-and-ocd. [xxxi] Awuah et al., “Bridging Minds and Machines”; Haslacher et al., “AI for Brain-Computer Interfaces.” [xxxii] Awuah et al., “Bridging Minds and Machines.” [xxxiii] Sara Green, Barbara Prainsack, and Maya Sabatello, “The Roots of (in)Equity in Precision Medicine: Gaps in the Discourse,” Personalized Medicine 21, no. 1 (January 2024): 5–9, https://doi.org/10.2217/pme-2023-0097. [xxxiv] Green, Prainsack, and Sabatello, 7. [xxxv] Robyn Bluhm and Kirstin Borgerson, “An Epistemic Argument for Research-Practice Integration in Medicine,” The Journal of Medicine and Philosophy: A Forum for Bioethics and Philosophy of Medicine 43, no. 4 (July 9, 2018): 469–84, https://doi.org/10.1093/jmp/jhy009. [xxxvi] Vijay Mahant, “‘Right-to-Try’ Experimental Drugs: An Overview,” Journal of Translational Medicine 18 (June 23, 2020): 253, https://doi.org/10.1186/s12967-020-02427-4. [xxxvii] Michael S. Okun et al., “Deep Brain Stimulation in the Internal Capsule and Nucleus Accumbens Region: Responses Observed during Active and Sham Programming,” Journal of Neurology, Neurosurgery & Psychiatry 78, no. 3 (March 1, 2007): 310–14, https://doi.org/10.1136/jnnp.2006.095315. (shrink)

The literature on the epistemology of ignorance already discusses how certain forms of discrimination, such as racism and sexism, are perpetuated by the ignorance of individuals and groups. However, little attention has been given to how speciesism—a form of discrimination on the basis of species membership—is sustained through ignorance_._ Of the few animal ethicists who explicitly discuss ignorance, none have related this concept to speciesism as a form of discrimination. However, it is crucial to explore this connection, I argue, as (...) ignorance is both an integral part of the injustice done to animals as well as an obstacle to improving their treatment. In order to adequately criticize sustained structural speciesism and injustices towards animals, I develop an epistemological account of ‘speciesist ignorance’. I begin by defining and distinguishing between individual and group-based accounts of speciesist ignorance. I argue that humans, taken as a group, enjoy a position of privilege, which allows them to comfortably remain ignorant of their participation in collective wrongdoings towards animals. Additionally, I point out that speciesist ignorance is structurally encouraged and thereby maintains the dominant view that the human-animal-relationship, as it stands, is just. In sum, this article lays the groundwork for a social epistemology of speciesist ignorance. In particular, it informs further debate about individual and institutional epistemic duties to inquire into speciesism and to inform the public, about the moral culpability of ignorant actions, and about effective animal advocacy and policy which actively rejects speciesist ignorance. (shrink)

In recent decades, philosophers of science have become increasingly concerned with the social dimensions of scientific knowledge. Philosophers such as Helen Longino, Philip Kitcher, Miriam Solomon, Heather Douglas, and Janet Kourany have sought to incorporate the social aspects of science, while retaining the normative commitments of philosophy of science. Some of the major theoretical approaches in social epistemology of science, however, tend to ignore or underestimate the role that the current state of (...) class='Hi'>science organization plays in the production of scientific knowledge.1 The world has changed significantly in recent decades, and science has changed with it. The.. (shrink)

This essay defends the view that “modern science,” as with modernity in general, is a polycentered phenomenon, something that appears in different forms at different times and places. It begins with two ideas about the nature of rational scientific inquiry: Karin Knorr Cetina's idea of “epistemic cultures,” and Philip Kitcher's idea of science as “a system of public knowledge,” such knowledge as would be deemed worthwhile by an ideal conversation among the whole public under conditions of mutual (...) engagement. This account of the nature of scientific practice provides us with a new perspective from which to understand key elements in the philosophical project of Jaina logicians in the seventh, eighth, and ninth centuries c.e. Jaina theory seems exceptionally well targeted onto two of the key constituents in the ideal conversation—the classification of all human points of view and the representation of end states of the deliberative process. The Buddhist theory of the Kathāvatthu contributes to Indian epistemic culture in a different way: by supplying a detailed theory of how human dialogical standpoints can be revised in the ideal conversation, an account of the phenomenon Kitcher labels “tutoring.” Thus science in India has its own history, one that should be studied in comparison and contrast with the history of science in Europe. In answer to Joseph Needham, it was not ‘modern science’ which failed to develop in India or China but rather non-well-ordered science, science as unconstrained by social value and democratic consent. What I argue is that this is not a deficit in the civilisational histories of these countries, but a virtue. (shrink)

The dominant conception of delusion in psychiatry (in textbooks, research papers, diagnostic manuals, etc.) is predominantly epistemic. Delusions are almost always characterized in terms of their epistemic defects, i.e., defects with respect to evidence, reasoning, judgment, etc. However, there is an individualistic bias in the epistemic conception; the alleged epistemic defects and abnormalities in delusions relate to individualistic epistemic processes rather than social epistemic processes. We endorse the social epistemological turn in recent (...) philosophical epistemology, and claim that a corresponding turn is needed in the study of delusions. It is a turn from the (purely) individualistic conception, which characterizes delusions only by individualistic epistemic defects and abnormalities, to the (partially) social epistemic conception, which characterizes delusions by individualistic as well as social epistemic defects and abnormalities. This paper is intended as an initial step toward such a social epistemological turn. In particular, we will develop a new model of the development of delusions according to which testimonial abnormalities, including testimonial isolation and testimonial discount, are a causal factor in the development of delusions. (shrink)

When one wants to use citizen input to inform policy, what should the standards of informedness on the part of the citizens be? While there are moral reasons to allow every citizen to participate and have a voice on every issue, regardless of education and involvement, designers of participatory assessments have to make decisions about how to structure deliberations as well as how much background information and deliberation time to provide to participants. After assessing different frameworks for the relationship (...) between science and society, we use Philip Kitcher's framework of Well-Ordered Science to propose an epistemic standard on how citizen deliberations should be structured. We explore what potential standards follow from this epistemic framework focusing on significance versus scientific and engineering expertise. We argue that citizens should be tutored on the historical context of why scientific questions became significant and deemed scientifically and socially valuable, and if citizens report that they are capable of weighing in on an issue then they should be able to do so. We explore what this standard can mean by looking at actual citizen deliberations tied to the 2014 NASA ECAST Asteroid Initiative Citizen forums. We code different vignettes of citizens debating alternative approaches for Mars exploration based upon what level of information seemed to be sufficient for them to feel comfortable in making a policy position. The analysis provides recommendations on how to design and assess future citizen assessments grounded in properly conveying the historical value context surrounding a scientific issue and trusting citizens to seek out sufficient information to deliberate. (shrink)

Building, restoring and maintaining well-placed trust between scientists and the public is a difficult yet crucial social task requiring the successful cooperation of various social actors and institutions. Kitcher’s takes up this challenge in the context of liberal democratic societies by extending his ideal model of “well-ordered science” that he had originally formulated in his. However, Kitcher nowhere offers an explicit account of what it means for the public to invest epistemic trust in (...) science. Yet in order to understand how his extended model and its implementation in the actual world address the problem of trust as well as to evaluate it critically, an explicit account of epistemic public trust in science needs to be given first. In this article we first present such an account and then scrutinize his project of building public trust in science in light of it. We argue that even though Kitcher’s ideal model and his proposals for its implementation in the real world face a number of problems, they can be addressed with the resources of our account. (shrink)

To anyone vaguely aware of Feyerabend, the title of this paper would appear as an oxymoron. For Feyerabend, it is often thought, science is an anarchic practice with no discernible structure. Against this trend, I elaborate the groundwork that Feyerabend has provided for the beginnings of an approach to organizing scientific research. Specifically, I argue that Feyerabend’s pluralism, once suitably modified, provides a plausible account of how to organize science. These modifications come from C.S. Peirce’s account of the (...) economics of theory pursuit, which has since been corroborated by empirical findings in the social sciences. I go on to contrast this approach with the conception of a ‘well-ordered science’ as outlined by Kitcher (Science, truth, and democracy, Oxford University Press, New York, 2001), Cartwright (Philos Sci 73(5):981–990, 2006), which rests on the assumption that we can predict the content of future research. I show how Feyerabend has already given us reasons to think that this model is much more limited than it is usually understood. I conclude by showing how models of resource allocation, specifically those of Kitcher (J Philos 87:5–22, 1990), Strevens (J Philos 100(2):55–79, 2003) and Weisberg and Muldoon (Philos Sci 76(2):225–252, 2009), unwittingly make use of this problematic assumption. I conclude by outlining a proposed model of resource allocation where funding is determined by lottery and briefly examining the extent to which it is compatible with the position defended in this paper. (shrink)

The goal of this dissertation is to reconstruct, critically evaluate, and apply the pluralism of Paul Feyerabend. I conclude by suggesting future points of contact between Feyerabend’s pluralism and topics of interest in contemporary philosophy of science. I begin, in Chapter 1, by reconstructing Feyerabend’s critical philosophy. I show how his published works from 1948 until 1970 show a remarkably consistent argumentative strategy which becomes more refined and general as Feyerabend’s thought matures. Specifically, I argue that Feyerabend develops a (...) persuasive case against rationalism, or the thesis that there exist normative and exclusive rules of scientific rationality. In Chapter 2, I reconstruct Feyerabend’s pluralism and detail its relationship to his humanitarianism and epistemological anarchism. I understand Feyerabend’s pluralism as the combination of the principles of proliferation and tenacity. I show the evolution and justification of these principles from Feyerabend’s early papers until the late 1970s. In Chapter 3, I defend Feyerabend’s pluralism from its most prominent criticisms. I then clarify that Feyerabend’s pluralism amounts to a conception of the logic of theory pursuit and modify his view using insights from C.S. Peirce, Pierre Duhem, and Michael Polanyi. From Peirce, I show how economic, sociological, and value-laden features of theory pursuit may be used to constrain proliferation and tenacity. From Duhem and Polanyi, I try to show the proper role of tacit knowledge within a Feyerabendian framework. Finally, I show what implications Feyerabend’s pluralism has for models of distributing funds within scientific communities. I contend that it provides a more promising model that the ‘well-ordered science’ proposal advanced by numerous philosophers and social scientists. Specifically, I aim to understand what taking Feyerabend’s pluralism seriously entails for principles of balancing funding allocation decisions and the role of peer-review in evaluating the potential success of research proposals. I conclude by suggesting future lines of research for further analyzing and applying Feyerabend’s pluralism. (shrink)

In this paper, I address a question in social epistemology about the unity of a scientic community to- wards its inner groups (teams, labs...). I investigate the reasons why these groups might want to \go it alone", working among themselves and hiding their discoveries from other groups. I concentrate on the intermediate results of a longer project, where the first steps can help to achieve a more advanced result. I study to what extent the isolation of research groups might (...) be damaging to the epistemic progress of the whole community. In order to get an idea of the reason why scientists might not share their intermediate results with others, consider for example Schawlow and Townes in the summer of 1958 (the historical material is drawn from Broberg, 1991, chap. 3): together they had just designed the principle of functioning of what would be known as the laser, with the intention of constructing the rst laser, relying on their theoretical ideas. Should they have published their theoretical discovery, or rather taken advantage of their advance on possible oppo- nents and start the experimental work? They chose to publish their theoretical ideas in a scientic journal, and they also led a patent application. On the one hand, it was a valuable choice: the patent was granted and their paper was published, making them soon famous. Further- more, another scientist called Gould was to le a simi- lar patent application a few months later, in March 1959; it was refused, because of the priority of Schawlow and Townes. If the latter had not submitted their idea in 1958, the patent would certainly have been acknowl- edged to Gould. In this sense, publishing their intermediate result was a worthy strategy. On the other hand, history showed that their publication had also some drawbacks for them. Schawlow and Townes' publication triggered a race among many American laboratories for the rst experimental construction of the laser. In addition to bringing them competitors, their publication helped these competitors in crucial ways; so much so that it was another scientist, Maiman, and not Schawlow and Townes, who was able to build the rst working laser, in May 1960, and to publish the result. If Schawlow and Townes had not published their theoretical idea, there are chances that they would have been the first ones to build a laser. Their publication of the first theoretical result certainly prevented them from getting the second experimental one. In short, the best publishing strategy about an intermediate result is no easy question for a scientist. Consider now the whole community, concerned with the results available to all and with the pace of the epistemic progress. Schawlow and Townes' publication enabled the rst laser to be built quicker, as other teams could rely on their theoretical work. More generally, being able to reuse other's works seems to be a rm basis of scientic progress. Thus, for the whole community, it seems that there are only benets if intermediate results are published. As this is not necessarily the best strategy for those who reach these intermediate results, there might be a conflict between the interests of individuals and those of the whole community. The question Schawlow and Townes faced was whether they should make their discovery publicly known, or keep it for themselves to progress alone. This alternative can also arise for an entire lab, when competing with other labs on some long-run project: should it make its discoveries known to its opponents, or only share them internally among its members? At a higher level still, this question arises for what can be called scientic schools, which are groups of labs sharing some particular approach|methodological, experimental or interpre- tational, for example. At each level within the scientic community, there are competitive groups of scientists which may decide to go it alone and to prevent their results from being accessible to others. If they had good reasons for doing so, there would be dramatic consequences for the whole community: other groups would not be able to reuse their results, labour force would be wasted in achieving them again, and the progress of the eld would be slowered. 9 The aim of this paper is to investigate this risk of division: to assess the conditions under which it may oc- cur, its damage for the community, and to draw the limit of an acceptable pluralism. The reasoning with benets and drawbacks which has been sketched for Schawlow and Townes seems to be implicitly an informal economic argument. In order to clarify and to rene such an argument, I will investigate it in a rational decision framework, supposing some utility or preferences for the groups of scientists, and I will propose a formal model, in game theory. In social epistemology of science, formal models have been proposed for various questions (for example, Kitcher 1990, 1993, Goldman 2009, Strevens 2003, 2006, Weisberg and Muldoon, forthcoming, Zollman 2007, 2008, 2009, 2010), but not for the question of the division of the scientic community. I will concentrate on the normative aspect of the question, ignoring the descriptive and historical question of whether groups do go it alone or not. The model I propose is sequential: two groups are competing on a research program, which consists of several results which have to be obtained in order. The groups always carry out some research for the next result, which they reach with some probability per unit of time. When a group, say A, reaches a result, it can either make it public for the other group, or continue its research. After a result is made public, the competitor B can start from it so as to continue its own research. Thus, when A publishes it loses its lead, and its competitor will be able to compete with it in the near future. But it is also recognized as the rst to reach this step. I consider two dierent cases, one in which the number of steps is limited, another where the limit concerns the number of temporal intervals. In both cases, assuming that all steps are equally dicult and equally rewarding, it turns out that the best strategy for a group concerned with its own reward is to make public every step it takes. Thus, there is no risk that groups might separate: a scientist, whatever its group, will publish for all. Finally, I turn to more complex situations, where results have varying size or diculty: there, groups can indeed be better o going it alone. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Editorial changes at PPPWelcomes and ThanksJohn Z. Sadler, MDAfter 30 years of co-editing (with Bill Fulford) and editing Philosophy, Psychiatry, & Psychology, I thought it was time for me to step down, and last fall the Association for the Advancement of Philosophy and Psychiatry Executive Council assembled an international search team to select a new Editor-in-Chief. This thoughtful and efficient group, led by Robyn Bluhm, completed the search and (...) selection in a matter of a few months! All of us in the field are grateful to the search committee members for their congenial, disciplined, and fruitful work: Derek Bolton, David Crepaz-Keay, Anthony Fernandez, Brent Kious, Guilherme Messas, and Michael Wong. We are excited about the future of the journal with our new Editor-in-Chief, Professor Werdie van Staden. Briefly, Werdie is the Nelson Mandela Professor of Philosophy and Psychiatry and Director of the Centre for Ethics and Philosophy of the Health Sciences, the University of Pretoria, South Africa.Students, trainees, and early career scholars in our field often ask about how senior scholars found their way to, and through, the field of philosophy/psychiatry. The reading of Werdie's biography, in chronological order, would befuddle a reader trying to predict where he would end up by 2024. In the youth of his adulthood, Werdie was heading toward a career in music, collecting several degrees in music theory, composition, and performance. Indeed, music would occupy a big piece of his life over the decades. Dr. van Staden has continued his musical career as a composer of two symphonies, a concerto, as well as multiple choral and chamber works. He has performed as a flautist for the Pretoria Symphony Orchestra since 2006, and was the Principal for 8 years.However, he was also an individual directed toward service to his fellow human beings. He completed his MBChB medical degree in 1990 and went on to several degree qualifications in medicine, psychiatry, and philosophy. Most significant for us was his early experience with Bill Fulford's master's degree program in the Philosophy of Mental Health at the University of Warwick, later completing a doctoral degree. His Mandela Professorship at Pretoria was the first endowed Professorship in our philosophy/psychiatry multidisciplinary field. Since then his intellectual work has ranged over clinical and research ethics, philosophy of language and psychopathology, Ubuntu virtue theory, person-centered medicine, medical education, and many more areas, making him a most versatile scholar. Over the past three [End Page 91] decades he has functioned as a practicing clinician, a department chair, a clinical trialist, a partner to Bill Fulford in developing and disseminating the Values-Based Practice approach to clinical medicine, a leader in many professional organizations, an editor of the South African Journal of Psychiatry, not to overlook serving as an author, reviewer, and Senior Editor at PPP at various points since the journal's inception. His professional and intellectual activities and accomplishments are too numerous to recount; suffice to say we are delighted to have him bring his vision, creativity, and vigor to us by adding PPP to his to-do list!We congratulate and thank Professor Nancy Potter on her retirement from academia as well as one of our first Senior Editors of PPP. Nancy's path to philosophy/psychiatry was by way of work in the correctional system in her youth, followed by philosophical field work in the emergency psychiatry department at the University of Louisville Hospital, with her psychiatrist colleague Rafi El-Mallakh, MD. However, philosophy has been her first priority, with work in feminist theory, philosophy of peace, virtue theory, and standpoint/social epistemology over her career. Never satisfied with armchair philosophy, Dr. Potter has immersed herself in settings, traditions, and practices to understand them from inside as well as out. As a PPP Senior Editor, Nancy was instrumental in developing the service-user voice, as well as diversifying our authorship in many other ways. I will miss her even-tempered, yet rigorous editorial voice in the journal.My last appointment of a Senior Editor turned out to be one of Dr. van Staden's students. I welcome Dr. Mohammed Abouelleil Rashed as our newest... (shrink)

ABSTRACT What, if anything, should we do when someone says they don’t believe in anthropogenic climate change? Or that they worry that a COVID-19 vaccine might be dangerous? We argue that in general, we face an epistemic duty to object to such assertions, qua instances of science denial and science sceptical discourse, respectively. Our argument builds on recent discussions in social epistemology, specifically surrounding the idea that we ought to speak up against (epistemically) problematic assertions so (...) as to fulfil an important epistemic obligation – namely, preventing epistemic harms in others. We show that both science denial (SD) and vaccine hesitant (VH) discourses are harmful in a distinctively epistemic sense, and as such generate an especially strong duty to voice our disagreement. As we also argue, this obligation is nonetheless defeasible: depending on the situational features of those involved, voicing an objection to VH discourse may actually end up doing more harm than good. We conclude by tracing what seems like a promising path towards restoring well-placed public trust in scientific testifiers. Doing so is key in order to guarantee equitable access to warranted beliefs about important subject matters, such as the safety of vaccines, to all segments of society. (shrink)

Coercion is still highly prevalent in contemporary psychiatry. Qualitative research indicates, however, that patients and psychiatric staff have different understandings of what they mean by ‘coercion’. Psychiatric staff primarily employ the concept as referring to instances of formal coercion regulated by law, such as involuntary hospital admission or treatment. Patients, on the other hand, use a broader concept, which also understands many instances of informal psychological pressure as coercive. We point out that the predominance of a narrow concept of coercion (...) in psychiatry can have negative consequences for patients, and argue that this difference in how the concept ‘coercion’ is used is both grounded in epistemic oppression and reinforces such oppression. Epistemic oppression, as defined by Dotson, refers to the persistent epistemic exclusion of members of marginalized groups from participation in practices of knowledge production. We first demonstrate how patients may experience inferential inertia when communicating their experiences of coercion. We then show that the resulting predominance of a narrow concept of coercion in psychiatry can be described as a case of hermeneutical injustice in a context shaped by institutional hermeneutical ignorance. We argue for a change in institutional practices in psychiatry that allows for the adequate consideration of patients’ perspectives on coercion. (shrink)

With twentieth- and twenty-first-century philosophy of science’s unfolding acceptance of the nature of scientific inquiry being value-laden, the persistent worry has been that there are no means for legitimate negotiation of the social or non-epistemic values that enter into science. The rejection of the value-free ideal in science has thereby been coupled with the spectres of indiscriminate relativism and bias in scientific inquiry. I challenge this view in the context of recently expressed concerns regarding Canada's (...) death of evidence controversy. The worry, raised by Stathis Psillos, is that as constructivist accounts of science demoted the previously secure status of evidence for drawing justified conclusions in science, we were left with no rational delineation between the right and wrong values for science. The implication for the death of evidence controversy is that we may have no rational grounds for claiming that the Canadian Government is wrong to interfere with scientific enterprise. But he does offer another avenue for reaching the conclusion that the wrong social values are directing the current stifling of some sectors of Canadian science. Psillos draws from standpoint epistemologies to devise a salient defence of ‘valuing evidence’ as a universalizable social value. That is, government bodies ought to enable scientific research via adequate funding as well as political non-interference. In this paper, I counter that non-epistemic values can be rationally evaluated and that standpoint epistemology’s universalizable standpoint provides an inadequate framework for negotiating social values in science. Regarding, I draw from the evidence-based medicine debate in philosophy of medicine and from feminist empiricist investigations into the science–values relationship in order to make the argument for empirically driven value arbitration. If social values can be rationally chosen in the context of justification, then we can have grounds for charging the Canadian leadership with being ‘at war with science’. I further argue that my recommended empiricist methodology is preferable to Psillos’s search for universalizable perspectives for negotiating social values in science because the latter method permits little more than the trivial conclusion that evidence is valuable to science. (shrink)

The papers collected in this book share a common motivation: All respond to certain kinds of injustice that unfairly and unreasonably prevent the insights and intellectual abilities of vulnerable and stigmatized groups from being given their due recognition. Most people are opposed to injustice in principle, and do not want to have mistaken views about others. But research in the social sciences reveals a disturbing truth: Even people who intend to be fair-minded and unprejudiced are influenced by unconscious biases (...) and stereotypes, as well as social structures and institutions that lead to unjust judgments. We may sincerely want to be epistemically just, but we frequently fail, and simply thinking harder about it will not fix the problem. -/- This volume collects 17 new essays that draw from cutting-edge social science research, to suggest how we can better manage our own unjust reactions, as well as resist patterns of epistemic injustice that we may face. The volume concludes with an afterward by Miranda Fricker, reflecting on these new lines of research and potential future directions to explore. (shrink)

This paper provides an argument for a more socially relevant philosophy of science (SRPOS). Our aims in this paper are to characterize this body of work in philosophy of science, to argue for its importance, and to demonstrate that there are significant opportunities for philosophy of science to engage with and support this type of research. The impetus of this project was a keen sense of missed opportunities for philosophy of science to have a broader (...) class='Hi'>social impact. We illustrate various ways in which SRPOS can provide social benefits, as well as benefits to scientific practice and philosophy itself. Also, SRPOS is consistent with some historical and contemporary goals of philosophy of science. We’re calling for an expansion of philosophy of science to include more of this type of work. In order to support this expansion, we characterize philosophy of science as an epistemic community and examine the culture and practices of philosophy of science that can help or hinder research in this area. (shrink)

This paper challenges the exclusion of patients from epistemic practices in psychiatry by examining the creation and revision processes of the Diagnostic and Statistical Manual of Mental Disorders (DSM), a document produced by the American Psychiatric Association that identifies the properties of mental disorders and thereby guides research, diagnosis, treatment, and various administrative tasks. It argues there are epistemic—rather than exclusively social/political—reasons for including patients in the DSM revision process. Individuals with mental disorders are indispensable resources to (...) enhance psychiatric epistemology, especially in the context of the crisis, controversy, and uncertainty surrounding mental health research and treatment. (shrink)

Positivism has had a tremendous impact on the development of the social sciences over the past two centuries. It has deeply influenced method and theory, and has seeped deeply into our broader understandings of the nature of the social sciences. Postmodernism has attempted to loosen the grip of positivism on our thinking, and while it has not been without its successes, postmodernism has worked more to deconstruct positivism than to construct something new in its place. Psychologists today perennially (...) wrestle to find and retain their intellectual balance within the methodological, theoretical, and epistemological struggles between positivism and postmodernism. In the process, pre-postmodern criticisms of positivism have been largely forgotten. Although they remain deeply buried at the core of psychology, these early alternatives to positivism are rarely given explicit hearing today. The current piece explores some of the early critiques of positivism, particularly of its scientism, as well as early suggestions to tip the scales (back) in favor ofsapientia(“wisdom”). This third option, largely overlooked within mainstream psychology, is of tremendous value today as it is both deconstructive and constructive relative to the shortcomings of positivism. It avoids the overly reductionistic “trivial order” of positivism, as well as the deeply unsatisfying and disorienting “barbaric vagueness” of postmodernism, while simultaneously embracing important core elements of both currents of thought. (shrink)

Expert knowledge regularly informs personal and civic-decision making. To decide which experts to trust, lay publics —including policymakers and experts from other domains—use different epistemic and non-epistemic cues. Epistemic cues such as honesty, like when experts are forthcoming about conflicts of interest, are a popular way of understanding how people evaluate and decide which experts to trust. However, many other epistemic cues, like the evidence supporting information from experts, are inaccessible to lay publics. Therefore, lay publics (...) simultaneously use second-order social cues in their environment to inform decisions to trust. These second-order social cues, or ‘social indicators of trust’, prevent lay publics from having to trust blindly. Social indicators of trust therefore inform lay publics’ epistemic vigilance, or constant low level-monitoring of testimony from experts. This special issue examines the nature, acquisition and application of social indicators of trust for scientific experts and institutions. It also raises questions about the types of trust asked of lay publics and challenges traditional normative assumptions about the relationship between science and lay publics through study of attitudes, values, and experiences. The issue descriptively re-examines the structure of institutions, their role and methods for ferrying information, as well as how social indicators operate in times of crisis. In this collection of works, we bridge history, science, philosophy of science, science and technology studies, science communication and social epistemology, to broaden the discourse on trust in experts and more accurately reflect the imperfect yet indispensable endeavour that trusting is. (shrink)

It is common to note that social environment and cultural formation shape mental disorders. The details of this claim are, however, not well understood. The paper takes a look at the claim that culture has an impact on psychiatry from the perspective of metaphysics and the philosophy of science. Its aim is to offer, in a general fashion, partial explications of some significant versions of the thesis that culture and social environment shape mental disorders and to (...) highlight some of the consequences social constructionism about psychiatry has for psychiatric explanation. In particular, it will be argued that the alleged dependence of facts about particular mental disorders and about the second order property of being a mental disorder on social facts amounts to a robust form of constructivism, whereas the view that clinician–patient interaction is influenced by cultural facts is perfectly compatible with an anti-constructivist stance. (shrink)

This paper examines the conditions of trustworthy science advice mechanisms, in which scientists have a mandated role to inform public policymaking. Based on the literature on epistemic trust and public trust in science, we argue that possession of relevant expertise, justified moral and political considerations, as well as proper institutional design are conditions for trustworthy science advice. In order to assess these conditions further, we explore the case of temporary advisory committees in Norway. These committees (...) exemplify a de facto trusted and seemingly well-functioning science advice mechanism. Still, this mechanism turns out to poorly realize some central conditions of trustworthy science advice. From this we draw three lessons. Firstly, it remains crucial to distinguish between well-placed and de facto trust. Secondly, some conditions of trustworthy science advice seem more significant than others and there are thresholds for realizing each condition. Thirdly, not only does the institutional design and organization of science advice matter more than often recognized; the trust and trustworthiness of the broader social and political context and institutional environment make a difference as well. (shrink)

Since the early 1980s, private, for-profit corporations have become increasingly involved in all aspects of scientific research, especially of biomedical research. In this essay, I argue that there are dangerous epistemic consequences of this trend, which should be more thoroughly examined by social epistemologists. In support of this claim, I discuss a recent episode of pharmaceutical research involving the painkiller Vioxx. I argue that the research on Vioxx was epistemically problematic and that the primary cause of these inadequacies (...) was faulty institutional arrangements. More specifically, the research was organized in such a way as to allow short-term commercial interests to compromise epistemic integrity. Thus, the Vioxx case study, in conjunction with numerous case studies developed elsewhere, provides strong reasons for believing that the privatization of the biomedical sciences is epistemically worrisome, and it suggests that the primary response to this situation should be a social, or organizational, one. What kind of organizational response would be most beneficial? I briefly discuss two prominent social epistemological proposals for how scientific research should be organized - namely those of Philip Kitcher and Helen Longino - and I suggest that they are incapable of dealing with the phenomenon of privatization. I then draw upon the Vioxx episode in order to outline an alternative suggestion for reorganizing certain aspects of pharmaceutical research. (shrink)

The place of social epistemology within contemporary philosophy, as well as its relation to other academic disciplines, is the topic of an ongoing debate. One camp within that debate holds that social epistemology should be pursued strictly from within the perspective of individualistic analytic epistemology. In contrast, a second camp holds that social epistemology is an interdisciplinary field that should be given priority over traditional analytic epistemology, with the specific aim of radically transforming the latter to (...) fit the results and methodology of the former. We are rather suspicious of this apparent tension, which we believe can be significantly mitigated by paying attention to certain recent advances within philosophy of mind and cognitive science. Accordingly, we attempt to explain how extended knowledge, the result of combining active externalism from contemporary philosophy of mind with contemporary epistemology, can offer an alternative conception of the future of social epistemology. (shrink)

The aim of this paper is to investigate how we can reunite social philosophy and philosophy of science to address problems in science and technology. First, referring to Don Howard?s, George Reisch?s, and Philip Mirowski?s works, I shall briefly explain how philosophy of science was depoliticised during the cold war. Second, I shall examine Steve Fuller?s criticism of Thomas Kuhn. Third, I shall scrutinise Philip Kitcher?s view of well-ordered science. Fourth, I shall emphasise (...) the importance of autonomy and argue that philosophy of science needs to cultivate a critical attitude towards authority. Fifth, drawing upon Ian Jarvie?s social reading of Karl Popper, I shall argue that Popper?s philosophy can be a model for reuniting social philosophy and philosophy of science. (shrink)

This paper reviews current debates in social epistemology about the relations ‎between ‎knowledge ‎and consensus. These relations are philosophically interesting on their ‎own, but ‎also have ‎practical consequences, as consensus takes an increasingly significant ‎role in ‎informing public ‎decision making. The paper addresses the following questions. ‎When is a ‎consensus attributable to an epistemic community? Under what conditions may ‎we ‎legitimately infer that a consensual view is knowledge-based or otherwise ‎epistemically ‎justified? Should consensus be the aim of scientific (...) inquiry, and if so, what ‎kind of ‎consensus? How should dissent be handled? It is argued that a legitimate inference ‎that a ‎theory is correct from the fact that there is a scientific consensus on it requires taking ‎into ‎consideration both cognitive properties of the theory as well as social properties of ‎the ‎consensus. The last section of the paper reviews computational models of ‎consensus ‎formation.‎. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Can The Psychopathologized Speak?Notes on Social Objectivity and Psychiatric ScienceAwais Aftab*, MD (bio)In "Exclusion of Psychopathologized Standpoints Due to Hermeneutical Ignorance Undermines Psychiatric Objectivity" (2022), Bennett Knox offers a compelling argument that failure of psychiatric community to engage with the "psychopathologized" in processes such as the revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM) constitutes a form of epistemic injustice and threatens the (...) class='Hi'>social objectivity of psychiatric science. I find myself in agreement with the central thesis and I am glad to see it articulated so well by Knox. While it is clear that the exclusion of psychopathologized standpoints in psychiatric science cannot be justified, there are issues that arise that require further clarification, and may generate disagreements, when we consider the complexities of how this inclusion is to take place, what requirements can be imposed on this process of inclusion, and the relationship between the DSM and psychiatric science broadly when it comes to social objectivity.The Methodological Objectivity of the DSM Does Not Exhaust the Methodological Objectivity of Psychiatric ScienceThe DSM is a nosological project within a particular historical context, operating with a certain set of assumptions (Aftab & Ryznar, 2021). The DSM has limitations in terms of what sorts of perspectives it can meaningfully incorporate, but the limitations of the DSM are not the limitations of psychiatric science. This is because psychiatric science is a pluralistic domain and includes many different methodologies and perspectives (Jerotic & Aftab, 2021). As one example, the DSM is poorly equipped to capture the phenomenology of psychiatric conditions. It is not something that it sets out to do. This, however, only becomes a serious problem if we adopt the attitude "if it's not in the DSM then it doesn't really count." Unfortunately, many in the psychiatric community have [End Page 267] adopted this sort of attitude, at least implicitly, resulting in a serious neglect of phenomenology (and various other perspectives, including those of the psychopathologized), leading Nancy Andreasen to bemoan the "death of phenomenology." (Andreasen, 2007) The DSM is methodologically limited by design; there are things that it will fail to do. The appropriate response is to acknowledge these inherent limitations. Other perspectives such as neurodiversity or Hearing Voices Movement also bring their own sets of assumptions and limitations. The DSM is simply one element, one perspective, one methodology in a scientific field that is capable of and ought to adopt a plurality of perspectives and methodologies. This is worth pointing out because Knox appears to assume that if it proves difficult or impossible for the DSM to include radically diverse perspectives, then "all the worse for psychiatry's objectivity." If it is impossible for the DSM, that does not mean that it is also impossible for psychiatric science.1In Determining What Counts as Inappropriate Exclusion, What Is the Role of Scientific Expertise?Longino herself brings up this question: "in determining what counts as inappropriate exclusion of dissenting perspectives, does it matter what kind of issue is involved? Are the duties of inclusion different when the question is, Should we be trying to learn about such and such, for example, atomic fission? than when it is, Is atomic fission a controllable or uncontrollable process?" (Longino, 2002, p. 133) The danger that needs to be averted here is that of trivializing expertise and placing experts on an equal footing with non-experts, a danger that is strikingly illustrated by our social response to the coronavirus disease 2019 pandemic.Take an example from medicine. Individuals with lung cancer have a lot to offer when it comes to the treatment of lung cancer, including their experiences of care, and choice of, say, aggressive chemotherapy vs palliative comfort care, etc. but how much do they have to contribute on the matter of the histopathological classification of lung cancer? Consider the Hierarchical Taxonomy of Psychopathology (HiTOP) (Kotov et al., 2021). This quantitative nosological project has a very specific aim: to determine the patterns of covariation among psychiatric symptoms using statistical techniques such as factor analysis. This... (shrink)

Background and Objectives: In this research article, the researcher addresses the issue of creating public understanding in a democratic society about the progress of science, with an emphasis on pluralism from philosophers of science. The idea that there is only one truth and that there are just natural laws awaiting discovery by scientists has historically made it difficult to explain scientific progress. This belief motivates science to develop theories that explain the unity of science, and it (...) is thought that diversity in the way different ideas presented by scientists is a problem that results in time being wasted in search of the most accurate theory. Some scientists perceive a benefit in having a range of scientific hypotheses, though. One benefit that is frequently cited is that scientific diversity as a whole contributes to the development of a democratic society that permits the expression of a range of viewpoints. The road to accountable scientific pluralism is fraught with difficulties, though. Therefore, it is crucial to take into account both pluralism's advantages and disadvantages. This research aims at: 1. analyzing in an epistemological way the interpretation of scientific theories and the progress of science from the perspectives of scientific pluralists; 2. analyzing the relationship between science and democracy in explaining scientific significance and progress; and 3. synthesizing new knowledge on epistemic dependentism and to argue that it plays a significant role in evaluating research issues related to scientific pluralism. Methodology: The research methodology involves the application of documentary investigation along with philosophical discourse. The method of philosophical argumentation involves analyzing the lines of arguments found in relevant academic publications in order to assess their validity and soundness. Main Results: One key argument of the pluralists is the use of the concept of theoretical pluralism, which suggests that scientific knowledge is created from a variety of perspectives according to the social and cultural context of knowledge creation. It is found that part of Longino's argument is based on the negation of rational/social dichotomy. Moreover, her theory is a departure from philosopher of science Philip Kitcher, who advocates the creation of scientific knowledge and the evaluation of scientific progress through the means of democratic society. He explains that these procedures will lead to "well-ordered science" in democratic society. Discussions: The researcher examines the underlying ideas accepted by these two philosophers of science and finds that although their opinions differ, they have common ground in the acceptance of consensus. However, the views of both philosophers still lack weight in explaining the knowledge itself. The researcher argues that the acceptance of pluralism as a way of understanding scientific progress necessarily lends itself to dependentism, which points to interdependence in comparisons of superiority/inferiority between scientific theories. It is undeniable that the situation has emerged all the time, even though the success of the scientific theories being compared to each other comes from different social and cultural grounds of thought. Conclusions: Some popular models of scientific pluralism in the philosophy of science still lack a compelling justification, particularly on the epistemic grounds. By elucidating the epistemic significance of the interdependence of these things, scientific pluralism can be strengthened by incorporating the notion of epistemic dependentism into the analysis of scientific progress. (shrink)

The current regulatory regime for pharmaceuticals is criticized from a libertarian perspective for imposing the same risk–benefit analysis on all patients. The critics call for the abandonment of market access regulations. But the regulatory regime is also criticized by philosophers of science for applying too low epistemic standards, who call for stricter regulation. This article aims to engage the debate in a less polarized way, first by advancing the libertarian alternative to the current regime through an approach I (...) call Certified Capitalism for Pharmaceuticals (CCP), without endorsing this view in the end; second, by developing an argument against all regulatory regimes without market access regulations, including CCP, based on the possibility that the pharmaceutical industry could bend pharmaceutical science to its interests in such a regime. Whether this argument is successful, or whether CCP is able to circumvent it, cannot be decided on the basis of the empirical information currently available. Third, these arguments lead to two further insights for a philosophy of science that takes the social embeddedness of science seriously: Market access regulations limit the bending of research by industry by limiting epistemic diversity. The patent system can be seen as the thread of a well-functioning scientific system because it can give some agents enough resources to bend science through industrial selection. (shrink)

Much feminist epistemology has liberatory political objectives; therefore it is activist. Its non‐ideal theorizing reveals how social differences and power affect knowers, knowing, knowledge, and epistemological theorizing to sustain conditions of oppression, and articulates how norms and practices of knowing, in daily life and in the sciences, ought to change to enable social transformations. It articulates and promotes new, more inclusive, expansive, and nuanced epistemic norms and practices that produce knowledge and understanding needed to overcome structures of (...) oppression and to equitably promote well‐being. Such work in feminist epistemology may plausibly be considered applied philosophy. (shrink)

The National Science Foundation (NSF) in the United States, like many other funding agencies all over the globe, has made large investments in interdisciplinary research in the sciences and engineering, arguing that interdisciplinary research is an essential resource for addressing emerging problems, resulting in important social benefits. Using NSF as a case study for problem that might be relevant in other contexts as well, I argue that the NSF itself poses a significant barrier to such research in (...) not sufficiently appreciating the value of the humanities as significant interdisciplinary partners. This essay focuses on the practices of philosophy as a highly valuable but currently under-appreciated partner in achieving the goals of interdisciplinary research. This essay advances a proposal for developing deeper and wider interdisciplinary research in the sciences through coupled ethical-epistemological research. I argue that this more robust model of interdisciplinary practice will lead to better science by providing resources for understanding the types of value decisions that are entrenched in research models and methods, offering resources for identifying the ethical implications of research decisions, and providing a lens for identifying the questions that are ignored, under-examined, and rendered invisible through scientific habit or lack of interest. In this way, we will have better science both in the traditional sense of advancing knowledge by building on and adding to our current knowledge as well as in the broader sense of science for the good of, namely, scientific research that better benefits society. (shrink)

From social media to search engines to Wikipedia, the internet is thoroughly embedded in how we produce, locate, and share knowledge around the world. Who Should We Be Online? provides an account of online knowledge that takes seriously the role of sexist, racist, transphobic, colonial, and capitalist forms of oppression. Frost-Arnold argues against analyzing internet users as a collection of identical generic people with smartphones. The novel epistemology developed in this book recognizes that we are differently embodied beings interacting (...) within systems of dominance. Our social identities and global inequalities shape who we are, who we can be online, and what we know. Tackling problems of online content moderation, fake news, and hoaxes, Frost-Arnold shows that oppressive online structures and practices help fuel ignorance. But she also reveals how the internet provides opportunities for marginalized people and activists to share knowledge online. Drawing on feminist accounts of objectivity, veritistic social epistemology, epistemologies of ignorance, virtue epistemology, and the epistemic injustice literature, this book argues for a social epistemology that values truth and objectivity, while recognizing that inequalities shape our collective ability to attain these goals. Timely and interdisciplinary, Who Should We Be Online? weaves together internet studies scholarship from across the humanities, social sciences, and computer science. Presenting case studies of moderators, imposters, tricksters, fakers, and lurkers, this book both explains the problems with our current internet ecosystem and imagines liberatory online futures. (shrink)

Scientists regularly make possibility claims. While philosophers of science are well aware of the distinction between epistemic and objective notions of possibility, we believe that they often fail to apply this distinction in their analyses of scientific practices that employ modal concepts. We argue that heeding this distinction will help further progress in current debates in the philosophy of science, as it shows that the debaters talk about different things, rather than disagree on the same issue. (...) We first discuss how the two notions differ with respect to their epistemology and show that these differences are sometimes ignored in the philosophy of science. We then revisit four current philosophy of science debates about modelling, that are framed in modal terms, to showcase how the distinction significantly clarifies these debates and thereby helps advance them. (shrink)

Context: Philosophy of science is the branch of philosophy that deals with methods, foundations, and implications of science. It is a theory of how to create scientific knowledge. Presently, there is widespread agreement on how to do science, namely conjectures, ideally in the form of a mathematical model, and refutations, testing the model using empirical evidence. Problem: Many social scientists are using a conception of science created for the physical sciences. Expanding philosophy of science (...) so that it more successfully encompasses social systems would create new avenues of inquiry. Two dimensions could be added to philosophy of science: the amount of attention paid to the observer and the amount of impact of a theory on the system described. Method: My approach is to illuminate underlying assumptions. I claim that there are at least three epistemologies and that they can be combined to form a more robust conception of knowledge and of how to do research. There are at least four models and four basic elements being used by scientists. Results: The article identifies the logical propositions underlying second-order science. It suggests strategies for developing second-order science. And it describes several methods that can be used to practice second-order science, including how past theories have not only described but also changed the phenomenon being studied. Implications: The task for members of the scientific community, particularly social scientists, is to practice second-order science and to develop further its theories and methods. A practical implication is to accept methods for acting as well as theories as a contribution to science, since methods explicitly define the role of an observer/ participant. Constructivist content: The paper is an extension of the work of Heinz von Foerster and other second-order cyberneticians. (shrink)

Photo ID 222412412 © US Navy Medicine | Dreamstime.com ABSTRACT In a non-military setting, the answer is clear: it would be unethical to treat someone based on non-medical considerations such as nationality. We argue that Battlefield Triage is a moral tragedy, meaning that it is a situation in which there is no morally blameless decision and that the demands of justice cannot be satisfied. INTRODUCTION Medical resources in an austere environment without quick recourse for resupply or casualty evacuation are often (...) limited. The shortage extends not only to supplies like blood products and drugs, but physicians and other medical personnel. In the midst of a mass casualty scenario, such as a battle that includes intense ground fighting, the medical staff will stretch scarce resources and triage casualties according to specific criteria. Typically, they proceed by providing care for the most severely wounded first, referred to here as conventional triage. At times, though, the staff may reverse the triage so that soldiers with minor wounds can return to the fight. In a mass casualty situation, when medical personnel apply conventional triage and treat casualties from opposing forces, a dilemma may arise. We argue that it can be permissible for military physicians to prioritize their own soldiers over enemy combatants in a mass casualty triage, where reverse triage does not apply. The case we will focus on is as follows: Battlefield Triage: During combat operations on a remote island in the Pacific Ocean, a compatriot soldier and an enemy combatant arrive at the compatriot soldier country’s medical treatment facility. Both have similar gunshot wounds to the abdomen, and they arrive with similar conditions. Both have low oxygen saturation and excessive blood loss. The sole physician only has enough time to stabilize one person. The scenario is brief, and we are aware that medical rules of eligibility will most often dictate how the physician proceeds,[1] but this scenario is useful in setting up the question we focus on in this paper: would it be wrong to favor the stabilization of a soldier just because the soldier is the physician’s compatriot? In other words, can nationality serve as an ethically justified tiebreaker in a situation such as Battlefield Triage?[2] In a non-military setting, the answer is clear: it would be unethical to treat someone based on non-medical considerations such as nationality. The AMA’s Code of Medical Ethics asserts that physicians have “ethical obligations to place patients’ welfare above their self-interest and above obligations to other groups.”[3] The World Medical Association’s Declaration of Tokyo affirms that “no motive, whether personal, collective or political, shall prevail against this higher purpose” of alleviating distress.[4] Physicians are taught early on that triage decisions must be medically indicated and made without consideration of factors such as race, ethnicity, religion, social status, and nationality. They are taught that public trust and obligations of justice grounded in equality demand that only medical indications be considered. But military physicians in a military setting are beholden to obligations, duties, and responsibilities as members of the military, and when these obligations, duties, and responsibilities conflict, as they do in Battlefield Triage, which loyalties win out and why?[5] Critics of partiality on national grounds argue that partiality undermines public trust in medicine and justice because everyone should be treated equally regardless of nationality.[6] Proponents of partiality argue that military obligations supersede equality and that justice requires partiality in such cases.[7] Despite the critics’ disagreement, both agree that there is a morally right, perhaps even blameless, course of action. Drawing on insights from virtue ethics, we argue that Battlefield Triage is a moral tragedy in which justice is unattainable and there is no action without moral cost. The assumption that there is a morally right choice is flawed. We argue that while no decision in this scenario is free from moral blame, there are reasons to favor treating one’s soldiers over enemy combatants. I. The Case Against Partiality There is a common assumption that there is a morally right or just decision in Battlefield Triage. A number of organizations and scholars claim that it is wrong for military physicians to favor their own soldiers on the grounds of nationality or some form of ‘group membership.’ (In a conflict involving service members from multiple nations working as a coalition, a soldier from an allied country may receive the same priority as the US service member due to ‘group membership.’) The World Medical Association’s WMA Declaration of Lisbon on the Rights of the Patient, which was reaffirmed in 2015, posits that, “[i]n circumstances where a choice must be made between potential patients for a particular treatment that is in limited supply, all such patients are entitled to a fair selection procedure for that treatment. That choice must be based on medical criteria and made without discrimination.”[8] This echoes what was set forth in Article 12 of the Geneva Conventions, which states that “[o]nly urgent medical reasons will authorize priority in the order of treatment to be administered.”[9] The argument for impartiality in Battlefield Triage is that every person is morally equal, and equality entails that medical distribution is, “based on a combination of medical need and urgency.”[10] This is in keeping with the bioethical principles that are generally applied.[11] II. The Case for Partiality On the other side, there are arguments that favoritism is the ethically right decision in Battlefield Triage.[12] The argument asserts that members of the military form a morally significant community of friends and participation in these relationships demands partiality. Just as parents have strong ethical duties to their children and not just any children, military personnel have ethical duties to their group, a group that involves an affirmation of mutual aid and support. Some have termed these ‘associative duties. According to Michael Gross, obligations of friendship, care, and solidarity “leave very little room for generally applicable principles of justice that would obligate a medic to treat enemy or non-compatriot wounded ahead of their compatriots.”[13] This is true in Battlefield Triage, but it may also be true even if the enemy’s soldier were more seriously wounded: “the ethics of small group cohesion, largely an ethics of care, mostly replaces the demands of impartial justice.”[14] In a more recent article, Gross explains that preferential treatment is ethically justified based on fighting capability and “the special obligations people owe friends, family, and, no less, comrades-in-arms.”[15] To not show partiality to the US soldier would be morally wrong on the grounds of friendship and mutual care.[16] III. The Moral Tragedy of Battlefield Triage Defenders and critics of Battlefield Triage favoritism based on nationality both frame their position as just or fair. For example, Justin List argues that physicians are “bound to practice medical neutrality,”[17] Marcus Adams denies that physicians “possess special ethical obligations” to enemy combatants because of their profession.[18] These perspectives assume that there is a morally right decision and that justice is attainable. The assumption that there is or can be a morally right Battlefield Triage decision, and we need to put our heads together to figure it out, remains strongly entrenched. However, the facts of the situation should give us pause; there are too many people and too few resources, and this demands a decision-making process that determines who will receive scarce resources. By its very nature, a battlefield triage decision has to be made based on some characteristic or value, a characteristic or value that will inevitably favor some at the expense of others. This is precisely why competing analyses “in the military context struggle to resolve these conflicts satisfactorily.”[19] Drawing on the insights of virtue ethics, we suggest that Battlefield Triage is a moral tragedy. Virtue ethics suggests that morality is about acting virtuously, which is to say that we should do what a virtuous person would do in the situation. Ethics is about figuring out how a just, wise, compassionate, loving, and fair person would act, and then doing that, as one grows in virtue. But life is not always clear cut, and it is possible that virtuous people may find themselves in a moral tragedy, a situation in which, through no fault of one’s own, a person must make a morally objectionable decision. After the action the virtuous person “emerges having done a terrible thing, the very sort of thing that the callous, dishonest, unjust, or in general vicious agent would characteristically do.”[20] Stated differently, a moral tragedy presents a virtuous person with two or more courses of action, all of which have a moral cost.[21] In Battlefield Triage, no matter how the physician goes about deciding, there is going to be defensible concern from those not saved. The fact that there are more people than can be helped fosters competing values in battlefield triage: maximize lives saved, treat people equally, treat the worse off, and support the war effort. Treating people equally may create tension between treating the worse off, maximizing lives saved, and supporting the war effort. Reverse triage is a case in point, as supporting the war effort conflicts with treating the worse off first, as is a fair lottery system since deploying a lottery may not maximize lives saved or support the war effort. There can be reasons why one person is selected over another, to be sure. Yet, there are reasons for making a decision, and that the decision is subject to legitimate moral concern is another. To recognize the moral tragedy of Battlefield Triage is to recognize the impossibility of acting blamelessly in the situation. In this situation, the virtuous military physician is going to have to sacrifice important values such as justice, compassion, and respect for others, even with a defensible criterion in hand. The physician will grieve this sacrifice accordingly. The physician may find her decision difficult or stressful, and rightly so, because of what her circumstances require of her. This kind of moral tragedy results “in actions which betray and violate the rights of persons to whom there may be a strong duty of care. When this happens, it properly triggers an appropriate moral emotion since our moral integrity has been violated and this affects how we think of ourselves and what we have become.”[22] Rather than view her triage decision as the morally superior choice, the virtuous military physician will view her decisions in these circumstances in a different light: it is the least bad option in a terrible situation, and she did something ethically problematic, something that is contrary to her moral character. She deeply regrets the circumstances in which she had to act. IV. Virtue Ethics A virtue ethicist has insight into how one should go about deciding what to do in a moral tragedy, although virtue ethics may not be as helpful as one may hope. The goal of the virtuous military physician in Battlefield Triage is to adopt the best course of action or the action that she feels she ought to do, all things considered. This does not make her choice devoid of serious wrongdoing—a decision must be made, but that does not make it just. The virtuous military physician will approach the situation with courage, responsibility, and insight. She will think about the decision carefully, wisely, and conscientiously; she will weigh the goods and harms of the choices before her, in conjunction with a proper conception of the good life, human worth, and understanding of her obligations to others—including chain of command, fellow soldiers, and the medical community. She is attuned to the value of human life and has a reasonable idea of the various ways her decisions will affect others. She recognizes that she is in this non-ideal situation through no fault of her own: she is not the one fighting in battles; she is serving her country as a physician, whose job it is to save lives, treat everyone justly, and promote military objectives. She regrets the decision she is forced to make in battlefield triage, acting “with immense regret and pain,” Hursthouse explains, “instead of indifferently or gladly.”[23] This is because, no matter what decision is made, the virtuous military physician “does something terrible or horrible,” something she otherwise would not do and is contrary to her values.[24] V. A Resolvable Moral Tragedy Instead of asking whether there is a morally right decision, in which a decision is morally blameless and above reproach, the virtue ethicist asks whether there is a decision with a convincing rationale, knowing that a decision can have a clear rationale but still be morally tragic. It is perfectly reasonable to think that different virtuous persons will arrive at different courses of action: “two virtuous agents, in the same situation,” Hursthouse writes, “may act differently” in irresolvable moral tragedies, in cases in which there is no clear course of action.[25] Because a person must act in a moral tragedy, one goal is to identify reasons for choosing the chosen action. Some decisions are clearly indefensible—treating neither the compatriot soldier nor the enemy combatant in Battlefield Triage would be wrong—and some decisions are more problematic than others. If the military physician selects to treat the soldier because she does not like the enemy combatant’s skin color, such a reason would be deeply problematic. But much of the debate over how to act in a moral tragedy is not over clearly indefensible or problematic criteria. Instead, the literature is largely about different standards or implementations of justice. Some scholars defend nation-impartial triage as right, while others defend nation-aware triage as right, and each argues that the other side is promoting an unjust or otherwise wrong solution to Battlefield Triage. We suggest that Battlefield Triage is a resolvable moral tragedy and that virtue ethics offers convincing reasons to prefer the treatment of the compatriot soldier rather than the enemy combatant on the grounds of national identity. Virtues are integral to living a good life, a flourishing life, but as Aristotle observed long ago, human beings are inherently social, interdependent and interconnected in profound ways.[26] This goes beyond the obvious fact that we need each other to survive day to day (one person makes clothes, another farms, and another makes tools); the claim is that a good or flourishing life depends in large part on one’s social network or community. This is why many of Aristotle’s moral virtues are other facing: justice, friendship, generosity, and magnanimity, to name a few. Courage, a typically self-facing virtue, is understood by Aristotle to be the virtue that regards one’s fear of death in battle, a battle fought on behalf of one’s city.[27] All of this remains true today. Namely, there is an important sense in which our community matters to our lives: it is easier to live a good, flourishing life if one is part of a good, flourishing community. Our community is made up of smaller groups, and it is more accurate to say that we are simultaneous members of different groups within a broader community. A person may be part of a family, friend group, research team, large state university, city, state, and nation. Groups can function well or not, as we all have experienced, and this suggests that there are virtues or excellences that groups can instantiate. Good groups are unified in purpose, with each member doing their duty alongside others for the attainment of that purpose. Good groups manifest solidarity among their members. Although Aristotle does not list solidarity as a virtue, a number of modern-day virtue ethicists have begun examining how group solidarity can be a virtue that contributes to a good or flourishing life.[28] Solidarity is not conceptualized as an individual virtue, a virtue possessed by a person in isolation of others; instead, it is a collective virtue, a virtue that is shared among members of a defined group with particular ends.[29] “A group has solidarity to the extent that its members are disposed to: (1) share values, aims, or goals; (2) care about those values, aims, or goals; (3) act in accordance with those values, aims, or goals; (4) trust the testimony of other group members with respect to those values, aims, and goals; and (5) feel a sense of belonging to the group.”[30] The virtue of collective or group solidarity involves individuals having special concern for each other, shared aims and values, trust, loyalty, and a sense of belonging with these specific others. There is a oneness to the group in the pursuit of a definite goal or purpose, involving mutual support and affirmation of each member. As such, the group has ends and goods above and beyond the good of each individual person. Sometimes solidarity requires personal sacrifice for the collective (for example, a father sacrificing food so his child can eat). The virtue of collective or group solidarity is important to the military and medical community at every level, and for clear reasons. In the military, there is a clear hierarchy of command, unity of purpose and end, mutual trust and support in complex settings, and so on. Soldiers need to know they can count on one another, and solidarity grounds a soldier’s ability to trust others and be assured of mutual aid. In medicine, solidarity maintains self-regulation of the profession, shared values and goals, as well as public support, not to mention that day-to-day operations require physician trust, engagement, and effort toward the ends of clinical care. Physicians need to work together, along with others, in pursuit of health, and disunity is sowed when there is mistrust, selfishness, or disengagement among the healthcare team and organization. Importantly, just as we are all members of various groups and hence may manifest group solidarity in different settings, the virtuous military physician instantiates collective solidarity with both the medical profession and the military. Her dual loyalty contributes to the moral difficulty of acting in Battlefield Triage. The military physician has competing obligations to distinct groups and cannot satisfy all obligations in Battlefield Triage. Solidarity with the military supports the consideration of favoring the soldier for reasons of national identity, whereas solidarity with the medical community does not. Something has to give, which is why it is a moral tragedy. The virtuous military physician, therefore, must weigh the costs of each course of action. To fulfill her obligations to the medical community would require that she does not use nationality and other non-medical considerations in Battlefield Triage. Since the soldier and enemy combatant are equally injured, justice would demand a random process, perhaps a flip of the coin. Although this may satisfy obligations the military physician has to the medical community, this would be costly to the physician’s military group. If word gets out that the physician decides who to treat based on a coin toss, soldiers, families, and citizens may become frustrated and angry. Soldier morale may go down if it becomes known that a coin flip led to the preventable death of a soldier and the saving of an enemy combatant who had killed (or attempted to kill) other soldiers. As Gross highlights, military solidarity involves a mutual aid promise that military personnel promise to help one another.[31] A military physician is part of the military and, as such, is part of the mutual aid promise, which would appear to be violated if the physician flips a coin. Treating a member of one’s own team may be psychologically more beneficial than treating an enemy combatant and may lead to less moral distress.[32] Finally, treating soldiers rather than enemy combatants promotes broader military and social aims, including returning soldiers to health, maintaining unity of purpose, and minimizing community suffering from a soldier’s death. Favoring members of one’s group, that is, triage based on nationality in Battlefield Triage, would fulfill obligations of military group loyalty, which is contrary to the values and duties of medicine. It does not seem as though showing favoritism in this particular situation is very costly to the medical community or general public, but this is because there is recognition that the physician is in the military. Medicine is impartial to non-medical indications partly because of fairness and to promote public trust in medicine. However, Battlefield Triage is unique, as medicine is being practiced in a non-public, wartime setting. In ordinary circumstances, a patient’s identity is irrelevant, and physicians ought not play favorites. Since Battlefield Triage is not an ordinary circumstance, decisions based on patient identity may not undermine public trust in medicine. In addition, it is contestable that fairness in Battlefield Triage requires that no consideration be paid to one’s nationality. Fairness is about giving each person their due, what is owed to them, and the case can be made that soldiers who place themselves in danger for the sake of the common good or a just cause are owed special attention when they suffer harm in the line of duty. In other words, soldiers voluntarily undergo risk to themselves for the greater good, and society owes them for this sacrifice. This plausibly includes preferential treatment in a situation such as Battlefield Triage. So, while the medical community affirms justice demands non-preferential treatment, the military community can affirm the opposite. The demands of fairness are unclear at best or in conflict in this situation: demands of physician justice decry favoritism, while demands of military justice support favoritism. Triage not based on nationality is arguably unfair and triage based on nationality may not undermine public trust, after all. All things considered, there is a clear rationale for favoring nationality-based preferential treatment in Battlefield Triage. Adopting a nationality-based preference in this situation is more defensible than not. This does not make such a decision ethically right or just. Preference based on nationality is the least bad decision, but it is not morally blameless. It involves one in a serious moral wrong, a wrong otherwise avoided and contrary to one’s character. The virtuous military physician is in a situation in which obligations conflict, and we disagree with Gross, who posits that care of fellow soldiers “is important to the near exclusion of all else.”[33] Gross fails to appreciate the collective virtue of solidarity as applied to those in medicine. The military physician has duties to fellow soldiers but also to fellow physicians, to the medical community, and humanity. To favor a soldier on grounds of nationality violates her duties and responsibilities to this latter group. She is involved in a moral tragedy and can only seek the most just action given the circumstances, yet, at least in virtue ethics, the action remains far from blameless. CONCLUSION We argue that Battlefield Triage is a moral tragedy, meaning that it is a situation in which there is no morally blameless decision and that the demands of justice cannot be satisfied. As such, the virtuous military physician incurs a moral cost to acting as she does—there is a moral residue. However, despite being a moral tragedy, there are clear reasons to act in favor of treating one’s own, considering group solidarity. As such, these kinds of tragedies are resolvable: virtuous military physicians should favor treatment of their own, although they would do so with sorrow. - [1] Militaries set forth medical rules of eligibility or guidelines used to determine whether a person qualifies for specific medical interventions or treatments in certain circumstances, and these guidelines are binding for a military physician. For example, despite opposition from medical organizations, militaries have adopted reverse triage guidelines for military physicians to follow. For ethical discussion, see Falzone, Elisabeth, P. Pasquier, C. Hoffmann, O. Barbier, M. Boutonnet, A. Salvadori, A. Jarrassier, J. Renner, B. Malgras, and S. Mérat. "Triage in military settings." Anaesthesia Critical Care & Pain Medicine 36, no. 1 (2017): 43-51. https://doi.org/10.1016/j.accpm.2016.05.004 [2] There are issues that are related to this, including the triage of civilians and allied soldiers. We set related issues aside for purposes of this paper [3] American Medical Association, Code of Medical Ethics: Current Opinions with Annotations, 2004–2005 ed. (Chicago, IL: AMA, 2004), 300. [4] American Medical Association, Code of Medical Ethics: Current Opinions with Annotations, 2004–2005 ed. (Chicago, IL: AMA, 2004), 300. [5] This is termed the “dual loyalty” dilemma in military medicine and has been described at length elsewhere: Institute of Medicine (US) Board on Health Sciences Policy. Military Medical Ethics: Issues regarding Dual Loyalties: Workshop Summary. Washington (DC): National Academies Press (US); 2008. Toward a Framework for Resolving Dual Loyalties. Available from: https://www.ncbi.nlm.nih.gov/books/NBK214853/ [6] See Kenneth G. Swan and K.G. Swan, Jr., “Triage: The Past Revisited,” Military Medicine 161:8 (1996): 448–452. https://doi.org/10.1093/milmed/161.8.448; Jerome A. Singh, “American Physicians and dual loyalty obligations in the ‘war on terror,’” BMC Medical Ethics 4.4 (2003): 1–10. https://doi.org/10.1186/1472-6939-4-4; Beam, Thomas E. "Medical Ethics on the Battlefield." Military Medical Ethics: Sect. IV. Medical ethics in the military. Medical ethics on the battlefield: the crucible of military medical ethics 2 (2003): 369-402; Hereth, Blake. "Health justice for unjust combatants." Journal of Military Ethics 20, no. 1 (2021): 67-81. https://doi.org/10.1080/15027570.2021.1949782. [7] See Adams, Marcus P. "Triage priorities and military physicians." In Physicians at war: The dual-loyalties challenge, pp. 215-236. Dordrecht: Springer Netherlands, 2008. Gross, Michael L. "Comradery, community, and care in military medical ethics." Theoretical medicine and bioethics 32 (2011): 337-350. https://doi.org/10.1007/s11017-011-9189-6. Gross, Michael L. "The limits of impartial medical treatment during armed conflict." In Military medical ethics for the 21st century, pp. 71-84. Routledge, 2016. [8] World Medical Association, WMA Declaration of Lisbon on the Rights of the Patient. 5 December 2022, https://www.wma.net/policies-post/wma-declaration-of-lisbon-on-the-rights-of-the-patient/ [9] Geneva Convention for the Amelioration of the Condition of Wounded, Sick in Armed Forces in the Field. 12 August 1949. https://www.un.org/en/genocideprevention/documents/atrocity-crimes/Doc.30_GC-I-EN.pdf. [10] List, Justin M. "Medical neutrality and political activism: physicians' roles in conflict situations." In Physicians at war: The dual-loyalties challenge, pp. 237-253. Dordrecht: Springer Netherlands, 2008. 240 [11] Beauchamp, T., and J. Childress. 2013. Principles of Biomedical Ethics, 7th ed. Oxford, United Kingdom: Oxford University Press. [12] Adams, Marcus P. "Triage priorities and military physicians." In Physicians at war: The dual-loyalties challenge, pp. 215-236. Dordrecht: Springer Netherlands, 2008. [13] Gross, "Comradery, community, and care in military medical ethics," 347. [14] Gross, “Comradery, community, and care in military medical ethics,” 349. [15] Gross, Michael L. "When medical ethics and military ethics collide." Narrative inquiry in bioethics 13, no. 3 (2023): 199-204. 202 https://dx.doi.org/10.1353/nib.2023.a924191 [16] Our argument draws on virtue ethics, from which care ethics derives, and it is worth clarifying how our argument relates to Gross’s. We do not think that the virtue of friendship grounds triage decisions, for we think it is unlikely that the physician and wounded soldier are friends. Instead, as explained below, we think the collective virtue of group solidarity better captures the moral significance of group loyalty and that Gross would agree with us. But since military physicians are part of distinct groups, with competing obligations, the military physician will be forced to sacrifice a value in battlefield triage cases. In other words, we think Gross downplays the dual group membership of a military physician. [17] List,”Medical neutrality and political activism,” 250. [18] Adams,”Triage priorities and military physicians,” 235. [19] London, Leslie, Leonard S. Rubenstein, Laurel Baldwin-Ragaven, and Adriaan Van Es. "Dual loyalty among military health professionals: human rights and ethics in times of armed conflict." Cambridge Quarterly of Healthcare Ethics 15, no. 4 (2006): 381-391. 383. [20] Hursthouse, R. On Virtue Ethics. OUP 1999. 74 [21] Nussbaum, Martha C. "The costs of tragedy: Some moral limits of cost-benefit analysis." The Journal of Legal Studies 29, no. S2 (2000): 1005-1036, 1007. [22] De Wijze, S. (2005). Tragic-remorse–the anguish of dirty hands. Ethical theory and moral practice, 7(5), 453-471, 457. https://doi.org/10.1007/s10677-005-6836-x [23] Hursthouse, 73 [24] Hursthouse, 81 [25] Hursthouse, 72 [26] Aristotle, Politics 1253a8. Reeve, C. D. C., Indianapolis: Hackett Publishing Co., 2017 [27] Aristotle, Nicomachean Ethics. III.6.114a, 34-35. 2002, Nicomachean Ethics, Christopher Rowe (trans.), Oxford: Oxford University Press [28] Byerly, T. Ryan, and Meghan Byerly. "Collective virtue." The Journal of Value Inquiry 50, no. 1 (2016): 33-50. https://doi.org/10.1007/s10790-015-9484-y; Federico, Veronica. "Conclusion: solidarity as a public virtue." Solidarity as a Public Virtue (2018): 495-542. https://doi.org/10.5771/9783845290058. Rehg, William. "Solidarity and the common good: An analytic framework." Journal of Social Philosophy 38, no. 1 (2007): 7-21. https://doi.org/10.1111/j.1467-9833.2007.00363.x [29] Byerly and Byerly. "Collective virtue." 43 [30] Battaly, Heather. "Solidarity: Virtue or vice?." In Social virtue epistemology, pp. 303-324. Routledge, 2022. 304 [31] Ibid., 2011: 341 [32] It might be thought that displaying altruism by helping an enemy combatant at the expense of one’s fellow soldier may be psychologically satisfiying. For evidence that military physicians find it difficult to treat enemy combatants, see Lundberg, Kristina, Sofia Kjellström, Anders Jonsson, and Lars Sandman. "Experiences of Swedish military medical personnel in combat zones: adapting to competing loyalties." Military medicine 179, no. 8 (2014): 821-826. https://doi.org/10.7205/MILMED-D-14-00038. Lamblin, Antoine, Clément Derkenne, Marion Trousselard, and Marie-Ange Einaudi. "Ethical challenges faced by French military doctors deployed in the Sahel (Operation Barkhane): a qualitative study." BMC Medical Ethics 22 (2021): 1-13. https://doi.org/10.1186/s12910-021-00723-2 [33] Ibid., 2011: 344. (shrink)

The aim of the present thesis is to reconcile two opposing intuitions; one originating from mainstream individualistic epistemology and the other one from social epistemology. In particular, conceiving of knowledge as a cognitive phenomenon, mainstream epistemologists focus on the individual as the proper epistemic subject. Yet, clearly, knowledge-acquisition many times appears to be a social process and, sometimes, to such an extent—as in the case of scientific knowledge—that it has been argued there might be knowledge that is (...) not possessed by any individual alone. In order to make sense of such contradictory claims, I combine virtue reliabilism in mainstream epistemology with two hypotheses from externalist philosophy of mind, viz., the extended and distributed cognition hypotheses. Reading virtue reliabilism along the lines suggested by the hypothesis of extended cognition allows for a weak anti-individualistic understanding of knowledge, which has already been suggested on the basis of considerations about testimonial knowledge: knowledge, many times, has a dual nature; it is both social and individual. Provided, however, the possibility of distributed cognition and group agency, we can go even further by making a case for a robust version of antiindividualism in mainstream epistemology. This is because knowledge may not always be the product of any individual’s cognitive ability and, thereby, not creditable to any individual alone. Knowledge, instead, might be the product of an epistemic group agent’s collective cognitive ability and, thus, attributable only to the group as a whole. Still, however, being able—on the basis of the hypothesis of distributed cognition—to recognize a group as a cognitive subject in itself allows for proponents of virtue reliabilism to legitimately apply their individualistic theory of knowledge to such extreme cases as well. Put another way, mainstream individualistic epistemologists now have the means to make sense of the claim that p is known by S, even though it is not known by any individual alone. (shrink)

Any experimental field consists of preparing special conditions for examining interesting objects for research. So naturally, the particular ways in which scientists prepare their objects determine the kind and the content of knowledge produced. This book provides a framework for the analysis of experimental practices - the Social Epistemology of Experiment - that incorporates both the ‘material’ and the ‘social’ dimensions of knowledge production. The Social Epistemology of Experiment is applied to experimental economics and in so doing, (...) it introduces the epistemic role of the participation of human subjects in experiments and the causal efficacy of institutions in constraining and enabling human behaviour. It also develops the role of the social and socially established practices in overcoming the methodological difficulties associated with experimenting with humans subjects in the social sciences as well as the effect of scientists’ interventions in the laboratory worlds. This book provides an historical and contextualized account of the emergence of experimental economics, the methodological discussions that have informed and constituted it, its main research programmes, and stylized facts. The analysis of its three main research programmes – market experiments, game theory experiments and individual decision-making experiments – shows how economics experiments are particularly tailored to produce knowledge about market institutions and individual behaviour in contexts where there might be conflicts of individual and social goals, and also about the processes of individual decision-making. (shrink)

Contemporary analytic epistemology exhibits an individualistic bias. The standard analyses of knowledge found in current epistemological discussions assume that the only epistemic agents worthy of philosophical consideration are individual cognizers. The idea that collectives could be genuine knowers has received little, if any, serious consideration. This individualistic bias seems to be motivated by the view that epistemology is about things that go on inside the head. In this paper I challenge this type of epistemic individualism by arguing that (...) certain groups are intentional agents and that cognition occurs at the level of groups. In section I, I extend a plausible and well-defended account of individual intentionality to organizations. In section II, I appeal to research on distributed cognition in order to challenge the view that cognition occurs exclusively in the individual mind-brain. Having established that groups can be believers and cognizers, I turn to the issue of the justification of group belief. In section III, consider whether a reliabilist account of justification can be extended to groups. (shrink)

In this paper the phenomenon of pluralistic ignorance is discussed and it is argued why it is of relevance for epistemic logic and social psychology. Roughly put, pluralistic ignorance is the case when a group of interacting agents all experience a discrepancy between their private opinions and the perceived opinions of the others. After introducing the phenomenon, numerous features of pluralistic ignorance that are of interest for epistemic logic and social epistemology, are discussed. This discussion serves (...) two purposes: It recaps the existing research on pluralistic ignorance within epistemic logic and social epistemology, while at the same time stating open problems for social epistemology and epistemic logic that pertains to the study of pluralistic ignorance. Finally, it is argued that the features of pluralistic ignorance of interest to epistemic logic and social epistemology relate to general features of information dynamics in situations of social interaction. (shrink)

ABSTRACT This paper takes Lee McIntyre’s argument for post-truth and uses it to explain the contemporary rise of bad faith and bullshitting social actors. The paper then posits the critical realist metatheoretical framework of ontological realism, epistemic relativity, and judgemental rationality as a means of understanding the societal placement and the operation of bullshit and bad faith. Utilizing the CR concept of alethic truth enables epistemologies to be judged on a standard of truth separate from the epistemology itself. (...) Using this separation of truth from truth seeking techniques, the social processes inherent in epistemic communities and their translation into social epistemology are then examined in order put bullshit in its social place. The conclusion then discusses some suggested actions to begin to bolster epistemic communities and their associated institutional forms, as well as supporting the production and use of individuals’ judgmental rationality. (shrink)

The aim of this essay is to elaborate philosophical and ethical underpinnings of posthumous diagnosis of famous historical figures based on literary and artistic products, or commonly called retrospective diagnosis. It discusses ontological and epistemic challenges raised in the humanities and social sciences, and attempts to systematically reply to their criticisms from the viewpoint of clinical medicine, philosophy of medicine, particularly the ontology of disease and the epistemology of diagnosis, and medical ethics. The ontological challenge focuses on the (...) doubt about the persistence of a disease over historical time, whereas the epistemic challenge disputes the inaccessibility of scientific verification of a diagnosis in the past. I argue that the critics are in error in conflating the taxonomy of disease and the act of diagnosing a patient. Medical diagnosis is fundamentally a hypothesis-construction and an explanatory device that can be generated under various degrees of uncertainty and limited amount of information. It is not an apodictic judgment as the critics presuppose, but a probabilistic judgment with varying degrees of plausibility under uncertainty. In order to avoid this confusion, I propose that retrospective diagnosis of a historical figure be syndromic without identifying underlying disease, unless there is justifiable reason for such specification. Moreover it should be evaluated not only from the viewpoint of medical science but also in a larger context of the scholarship of the humanities and social sciences by its overall plausibility and consistency. On the other hand, I will endorse their concerns regarding the ethics and professionalism of retrospective diagnosis, and call for the need for situating such a diagnosis in an interdisciplinary scope and the context of the scholarship of the historical figure. I will then enumerate several important caveats for interdisciplinary retrospective diagnosis using an example of the retrospective diagnosis of Socrates for his life-long intermittent neurologic symptoms. Finally, I will situate the present argument in a larger context of the major debate among the historians of medicine and paleopathologists, and discuss the similarities and differences. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Religion, Psychiatry, and “Radical” Epistemic InjusticesRosa Ritunnano, MD (bio) and Ian James Kidd, PhD (bio)Hermeneutical injustice as a concept has evolved since its original formulation by Miranda Fricker (2007). The concept has been taken up in psychiatry, with its moral, epistemic and clinical premium on the interpretation of extremely complex and difficult experiences (Kidd et al., 2022). There are many varieties of hermeneutical injustice with different forms, (...) sources, degrees, effects, and interpersonal and socio-structural aspects (Medina, 2017). José Eduardo Porcher has proposed the addition of a new form of ‘radical’ hermeneutical injustice, with a case study of psychotic symptoms involving religious content.He offers different characterizations of this injustice:a particularly radical form of injustice, namely, having their own interpretation of their experiences unjustifiably undermined.a form of hermeneutical injustice that occurs when a patient diagnosed with psychosis is denied the opportunity of interpreting their own experiences within their own religious framework.These are different things. Denying someone the opportunity to interpret their experiences in their own, preferred framework is one way of undermining their interpretations. Another is forcing someone to use your own preferred framework and then belittling their own, which seems doubly wrong. Misusing some preferred interpretive framework can be as unjust as not using it. The two definitions could be combined, but then much will depend on what it means to undermine someone’s interpretation of an experience. We think there is a form of radical hermeneutical injustice—different to the one described by Porcher. Some interpretations of kinds of experience with religious content can be undermined if one is committed to a metaphysical naturalism. In these cases, one person cannot regard someone’s interpretive framework as coherent or intelligible (one that involves supernatural entities, for instance).Most discussions of hermeneutical injustice focus on social structures. Fricker notes structural dimensions to hermeneutical injustice. In a standard case, a group has unequal participation in collective practices for making and using interpretive resources (Ritunnano, 2022). In a rich analysis, José Medina describes four ‘axes’ or dimensions for distinguishing forms of hermeneutical injustice [End Page 235] (Medina, 2017). The source of these injustices can be semantic or performative. The dynamics may be structural or interpersonal, or both. Moreover, there are different degrees of breadth and depth, defined here in terms of the ‘reach’ of the injustice across one’s life, and the depth of damage to one’s hermeneutic agency, respectively (Medina, 2017, p. 45). On this model, what might count as ‘radical’ hermeneutical injustices? Deep and broad hermeneutical injustices can be radical when they are very broad in scope and very deeply damaging. This might be what Porcher has in mind. But we think there is a further option, relevant to his case study.Porcher focuses on a case where individuals experience unusual beliefs and perceptions with religious content receive a ‘psychosis’ diagnosis. The alleged injustice is that the possibility of a genuine religious experience is not recognized and validated. The example is Femi, a young man with Christian background, who enters the mental health system following the onset of psychotic ‘symptoms’. After being found “disoriented and depleted in public” – tired and undernourished—Femi is compulsorily admitted to hospital, explaining he undertook fasting and isolation in response to orders from God. During this time, Femi devoted himself to Bible reading and stopped going to work. In hospital, where the authenticity of God’s voice is challenged by clinicians, Femi is treated for acute psychosis with pharmacotherapy. While remission of symptoms follow, there is no functional recovery, and Femi is described as “unmotivated and apathetic”.Femi interpreted his experiences in religious terms, but this interpretation is not accepted or pursued by the clinicians. Is this a hermeneutical injustice? If so, is it a ‘radical’ one? Granted, Femi’s religious interpretation may be psychologically adaptive—enhancing his sense of life as meaningful (Ritunnano & Bortolotti, 2022). But this is consistent with it being a hermeneutical injustice. Plus, a religious framing may be conducive to his functional recovery after being discharged, especially in conjunction with a supportive religious community, able to help him articulate, understand, and respond to those religious experiences (see Cottingham, 2005; Wynn, 2005). However, none of... (shrink)

continent. 1.1 : 3-13. / 0/ – Introduction I want to propose, as a trajectory into the philosophically weird, an absurd theoretical claim and pursue it, or perhaps more accurately, construct it as I point to it, collecting the ground work behind me like the Perpetual Train from China Mieville's Iron Council which puts down track as it moves reclaiming it along the way. The strange trajectory is the following: Kant's critical philosophy and much of continental philosophy which has followed, (...) has been a defense against horror and madness. Kant's prohibition on speculative metaphysics such as dogmatic metaphysics and transcendental realism, on thinking beyond the imposition of transcendental and moral constraints, has been challenged by numerous figures proceeding him. One of the more interesting critiques of Kant comes from the mad black Deleuzianism of Nick Land stating, “Kant’s critical philosophy is the most elaborate fit of panic in the history of the Earth.” And while Alain Badiou would certainly be opposed to the libidinal investments of Land's Deleuzo-Guattarian thought, he is likewise critical of Kant's normative thought-bureaucracies: Kant is the one author for whom I cannot feel any kinship. Everything in him exasperates me, above all his legalism—always asking Quid Juris? Or ‘Haven’t you crossed the limit?’—combined, as in today’s United States, with a religiosity that is all the more dismal in that it is both omnipresent and vague. The critical machinery he set up has enduringly poisoned philosophy, while giving great succour to the academy, which loves nothing more than to rap the knuckles of the overambitious [….] That is how I understand the truth of Monique David-Menard’s reflections on the properly psychotic origins of Kantianism. I am persuaded that the whole of the critical enterprise is set up to to shield against the tempting symptom represented by the seer Swedenborg, or against ‘diseases of the head’, as Kant puts it. An entire nexus of the limits of reason and philosophy are set up here, namely that the critical philosophy not only defends thought from madness, philosophy from madness, and philosophy from itself, but that philosophy following the advent of the critical enterprise philosophy becomes auto-vampiric; feeding on itself to support the academy. Following Francois Laruelle's non-philosophical indictment of philosophy, we could go one step further and say that philosophy operates on the material of what is philosophizable and not the material of the external world. [1] Beyond this, the Kantian scheme of nestling human thinking between our limited empirical powers and transcendental guarantees of categorical coherence, forms of thinking which stretch beyond either appear illegitimate, thereby liquefying both pre-critical metaphysics and the ravings of the mad in the same critical acid. In rejecting the Kantian apparatus we are left with two entities – an unsure relation of thought to reality where thought is susceptible to internal and external breakdown and a reality with an uncertain sense of stability. These two strands will be pursued, against the sane-seal of post-Kantian philosophy by engaging the work of weird fiction authors H.P. Lovecraft and Thomas Ligotti. The absolute inhumanism of the formers universe will be used to describe a Shoggothic Materialism while the dream worlds of the latter will articulate the mad speculation of a Ventriloquil Idealism. But first we must address the relation of philosophy to madness as well as philosophy to weird fiction. /1/ – Philosophy and Madness There is nothing that the madness of men invents which is not either nature made manifest or nature restored. Michel Foucault. Madness and Civilization. The moment I doubt whether an event that I recall actually took place, I bring the suspicion of madness upon myself: unless I am uncertain as to whether it was not a mere dream. Arthur Schopenhauer. The World as Will and Idea, Vol. 3. Madness is commonly thought of as moving through several well known cultural-historical shifts from madness as a demonic or otherwise theological force, to rationalization, to medicalization psychiatric and otherwise. Foucault's Madness and Civilization is well known for orientating madness as a form of exclusionary social control which operated by demarcating madness from reason. Yet Foucault points to the possibility of madness as the necessity of nature at least prior to the crushing weight of the church. Kant’s philosophy as a response to madness is grounded by his humanizing of madness itself. As Adrian Johnston points out in the early pages of Time Driven pre-Kantian madness meant humans were seized by demonic or angelic forces whereas Kantian madness became one of being too human. Madness becomes internalized, the external demonic forces become flaws of the individual mind. Foucault argues that, while madness is de-demonized it is also dehumanized during the Renaissance, as madmen become creatures neither diabolic nor totally human reduced to the zero degree of humanity. It is immediately clear why for Kant, speculative metaphysics must be curbed – with the problem of internal madness and without the external safeguards of transcendental conditions, there is nothing to formally separate the speculative capacities for metaphysical diagnosis from the mad ramblings of the insane mind – both equally fall outside the realm of practicality and quotidian experience. David-Menard's work is particularly useful in diagnosing the relation of thought and madness in Kant's texts. David-Menard argues that in Kant's relatively unknown “An Essay on the Maladies of the Mind” as well as his later discussion of the Seer of Swedenborg, that Kant formulates madness primarily in terms of sensory upheaval or other hallucinatory theaters. She writes: “madness is an organization of thought. It is made possible by the ambiguity of the normal relation between the imaginary and the perceived, whether this pertains to the order of sensation or to the relations between our ideas” Kant's fascination with the Seer forces Kant between the pincers of “aesthetic reconciliation” – namely melancholic withdrawal – and “a philosophical invention” – namely the critical project. Deleuze and Guattari's schizoanalysis is a combination and reversal of Kant's split, where an aesthetic over engagement with the world entails prolific conceptual invention. Their embrace of madness, however, is of course itself conceptual despite all their rhizomatic maneuvers. Though they move with the energy of madness, Deleuze and Guattari save the capacity of thought from the fangs of insanity by imbuing materiality itself with the capacity for thought. Or, as Ray Brassier puts it, “Deleuze insists, it is necessary to absolutize the immanence of this world in such a way as to dissolve the transcendent disjunction between things as we know them and as they are in themselves”. That is, whereas Kant relied on the faculty of judgment to divide representation from objectivity Deleuze attempts to flatten the whole economy beneath the juggernaut of ontological univocity. Speculation, as a particularly useful form of madness, might fall close to Deleuze and Guattari’s shaping of philosophy into a concept producing machine but is different in that it is potentially self destructive – less reliant on the stability of its own concepts and more adherent to exposing a particular horrifying swath of reality. Speculative madness is always a potential disaster in that it acknowledges little more than its own speculative power with the hope that the gibbering of at least a handful of hysterical brains will be useful. Pre-critical metaphysics amounts to madness, though this may be because the world itself is mad while new attempts at speculative metaphysics, at post-Kantian pre-critical metaphysics, are well aware of our own madness. Without the sobriety of the principle of sufficient reason we have a world of neon madness: “we would have to conceive what our life would be if all the movements of the earth, all the noises of the earth, all the smells, the tastes, all the light – of the earth and elsewhere, came to us in a moment, in an instant – like an atrocious screaming tumult of things”. Speculative thought may be participatory in the screaming tumult of the world or, worse yet, may produce its spectral double. Against theology or reason or simply commonsense, the speculative becomes heretical. Speculation, as the cognitive extension of the horrorific sublime should be met with melancholic detachment. Whereas Kant's theoretical invention, or productivity of thought, is self -sabotaging, since the advent of the critical project is a productivity of thought which then delimits the engine of thought at large either in dogmatic gestures or non-systematizable empirical wondrousness. The former is celebrated by the fiction of Thomas Ligotti whereas the latter is espoused by the tales of H.P. Lovecraft. /2/ – Weird Fiction and Philosophy. Supernatural horror, in all its eerie constructions, enables a reader to taste treats inconsistent with his personal welfare. Thomas Ligotti Songs of a Dead Dreamer. I choose weird stories because they suit my inclination best—one of my strongest and most persistent wishes being to achieve,momentarily, the illusion of some strange suspension or violation of the galling limitations of time, space, and natural law which forever imprison us and frustrate our curiosity about the infinite cosmic spaces beyond the radius of our sight and analysis H.P. Lovecraft. “Notes on Writing Weird Fiction” Lovecraft states that his creation of a story is to suspend natural law yet, at the same time, he indexes the tenuousness of such laws, suggesting the vast possibilities of the cosmic. The tension that Lovecraft sets up between his own fictions and the universe or nature is reproduced within his fictions in the common theme of the unreliable narrator; unreliable precisely because they are either mad or what they have witnessed questions the bounds of material reality. In “The Call of Cthulhu” Lovecraft writes: The most merciful thing in the world, I think, is the inability of the human mind to correlate all its contents. We live on a placid island of ignorance in the midst of black seas of infinity, and it was not meant that we should voyage far. The sciences, each straining in its own direction, have hitherto harmed us little; but some day the piecing together of dissociated knowledge will open up such terrifying vistas of reality, and of our frightful position therein, that we shall either go mad from the revelation or flee from the deadly light into the peace and safety of a new dark age. Despite Lovecraft's invocations of illusion, he is not claiming that his fantastic creations such as the Old Ones are supernatural but, following Joshi, are only ever supernormal. One can immediately see that instead of nullifying realism Lovecraft in fact opens up the real to an unbearable degree. In various letters and non-fictional statements Lovecraft espoused strictly materialist tenets, ones which he borrowed from Hugh Elliot namely the uniformity of law, the denial of teleology and the denial of non-material existence. Lovecraft seeks to explore the possibilities of such a universe by piling horror upon horror until the fragile brain which attempts to grasp it fractures. This may be why philosophy has largely ignored weird fiction – while Deleuze and Guattari mark the turn towards weird fiction and Lovecraft in particular, with the precursors to speculative realism as well as contemporary related thinkers have begun to view Lovecraft as making philosophical contributions. Lovecraft's own relation to philosophy is largely critical while celebrating Nietzsche and Schopenhauer. This relationship of Lovecraft to philosophy and philosophy to Lovecraft is coupled with Lovecraft's habit of mercilessly destroying the philosopher and the figure of the academic more generally in his work, a destruction which is both an epistemological destruction and an ontological destruction. Thomas Ligotti's weird fiction which he has designated as a kind of “confrontational escapism” might be best described in the following quote from one of his shortstories, “The human phenomenon is but the sum of densely coiled layers of illusion each of which winds itself on the supreme insanity. That there are persons of any kind when all there can be is mindless mirrors laughing and screaming as they parade about in an endless dream”. Whereas Lovecraft's weirdness draws predominantly from the abyssal depths of the uncharted universe, Ligotti's existential horror focuses on the awful proliferation of meaningless surfaces that is, the banal and every day function of representation. In an interview, Ligotti states: We don't even know what the world is like except through our sense organs, which are provably inadequate. It's no less the case with our brains. Our whole lives are motored along by forces we cannot know and perceptions that are faulty. We sometimes hear people say that they're not feeling themselves. Well, who or what do they feel like then? This is not to say that Ligotti sees nothing beneath the surface but that there is only darkness or blackness behind it, whether that surface is on the cosmological level or the personal. By addressing the implicit and explicit philosophical issues in Ligotti's work we will see that his nightmarish take on reality is a form of malevolent idealism, an idealism which is grounded in a real, albeit dark and obscure materiality. If Ligotti's horrors ultimately circle around mad perceptions which degrade the subject, it takes aim at the vast majority of the focus of continental philosophy. While Lovecraft's acidic materialism clearly assaults any romantic concept of being from the outside, Ligotti attacks consciousness from the inside: Just a little doubt slipped into the mind, a little trickle of suspicion in the bloodstream, and all those eyes of ours, one by one, open up to the world and see its horror [...] Not even the solar brilliance of a summer day will harbor you from horror. For horror eats the light and digests it into darkness. Clearly, the weird fiction of Lovecraft and Ligotti amount to a anti-anthrocentric onslaught against the ramparts of correlationist continental philosophy. /3/ – Shoggothic Materialism or the Formless Formless protoplasm able to mock and reflect all forms and organs and processes—viscous agglutinations of bubbling cells—rubbery fifteen-foot spheroids infinitely plastic and ductile—slaves of suggestion, builders of cities—more and more sullen, more and more intelligent, more and more amphibious, more and more imitative—Great God! What madness made even those blasphemous Old Ones willing to use and to carve such things? H.P. Lovecraft. “At the Mountains of Madness” On the other hand, affirming that the universe resembles nothing and is only formless amounts to saying that the universe is something like a spider or spit. Georges Bataille. “Formless”. The Shoggoths feature most prominently in H.P. Lovecraft's shortstory “At the Mountains of Madness” where they are described in the following manner: It was a terrible, indescribable thing vaster than any subway train – a shapeless congeries of protoplasmic bubbles, faintly self -luminous, and with myriads of temporary eyes forming and un-forming as pustules of greenish light all over the tunnel-filling front that bore down upon us, crushing the frantic penguins and slithering over the glistening floor that it and its kind had swept so evilly free of all litter. The term is a litmus test for materialism itself as the Shoggoth is an amorphous creature. The Shoggoths were living digging machines bio engineered by the Elder Things, and their protoplasmic bodies being formed into various tools by their hypnotic powers. The Shoggoths eventually became self aware and rose up against their masters in an ultimately failed rebellion. After the Elder Ones retreated into the oceans leaving the Shoggoths to roam the frozen wastes of the Antarctic. The onto-genesis of the Shoggoths and their gross materiality, index the horrifyingly deep time of the earth a concept near and dear to Lovecraft's formulation of horror as well as the fear of intelligences far beyond, and far before, the ascent of humankind on earth and elsewhere. The sickly amorphous nature of the Shoggoths invade materialism at large, where while materiality is unmistakably real ie not discursive, psychological, or otherwise overly subjectivist, it questions the relation of materialism to life. As Eugene Thacker writes: The Shoggoths or Elder Things do not even share the same reality with the human beings who encounter them—and yet this encounter takes place, though in a strange no-place that is neither quite that of the phenomenal world of the human subject or the noumenal world of an external reality. Amorphous yet definitively material beings are a constant in Lovecraft's tales. In his tale “The Dream-Quest of Unknown Kadatth” Lovecraft describes Azathoth as, “that shocking final peril which gibbers unmentionably outside the ordered universe,” that, “last amorphous blight of nethermost confusion which blashphemes and bubbles at the centre of all infinity,” who, “gnaws hungrily in inconceivable, unlighted chambers beyond time”. Azathoth's name may have multiple origins but the most striking is the alchemy term azoth which is both a cohesive agent and a acidic creation pointing back to the generative and the decayed. The indistinction of generation and degradation materially mirrors the blur between the natural and the unnatural as well as life and non-life. Lovecraft speaks of the tension between the natural and the unnatural is his short story “The Unnameable.” He writes, “if the psychic emanations of human creatures be grotesque distortions, what coherent representation could express or portray so gibbous and infamous a nebulousity as the spectre of a malign, chaotic perversion, itself a morbid blasphemy against Nature?”. Lovecraft explores exactly the tension outlined at the beginning of this chapter, between life and thought. At the end of his short tale Lovecraft compounds the problem as the unnameable is described as “a gelatin—a slime—yet it had shapes, a thousand shapes of horror beyond all memory”. Deleuze suggests that becoming-animal is operative throughout Lovecraft's work, where narrators feel themselves reeling at their becoming non-human or of being the anomalous or of becoming atomized. Following Eugene Thacker however, it may be far more accurate to say that Lovecraft's tales exhibit not a becoming-animal but a becoming-creature. Where the monstrous breaks the purportedly fixed laws of nature, the creature is far more ontologically ambiguous. The nameless thing is an altogether different horizon for thought. The creature is either less than animal or more than animal – its becoming is too strange for animal categories and indexes the slow march of thought towards the bizarre. This strangeness is, as aways, some indefinite swirling in the category of immanence and becoming. Bataille begins “The Labyrinth” with the assertion that being, to continue to be, is becoming. More becoming means more being hence the assertion that Bataille's barking dog is more than the sponge. This would mean that the Shoggotth is altogether too much being, too much material in the materialism. Bataille suggests that there is an immanence between the eater and the eaten, across the species and never within them. That is, despite the chaotic storm of immanence there must remain some capacity to distinguish the gradients of becoming without reliance upon, or at least total dependence upon, the powers of intellection to parse the universe into recognizable bits, properly digestible factoids. That is, if we undo Deleuze's aforementioned valorization of sense which, for his variation of materialism, performed the work of the transcendental, but refuse to reinstate Kant's transcendental disjunction between thing and appearance, then it must be a quality of becoming-as-being itself which can account for the discernible nature of things by sense. In an interview with Peter Gratton, Jane Bennett formulates the problem thusly: What is this strange systematicity proper to a world of Becoming? What, for example, initiates this congealing that will undo itself? Is it possible to identify phases within this formativity, plateaus of differentiation? If so, do the phases/plateaus follow a temporal sequence? Or, does the process of formation inside Becoming require us to theorize a non-chronological kind of time? I think that your student’s question: “How can we account for something like iterable structures in an assemblage theory?” is exactly the right question. Philosophy has erred too far on the side of the subject in the subject-object relation and has furthermore, lost the very weirdness of the non-human. Beyond this, the madness of thought need not override. /4/ - Ventriloquial Idealism or the Externality of Thought My aim is the opposite of Lovecraft's. He had an appreciation for natural scenery on earth and wanted to reach beyond the visible in the universe. I have no appreciation for natural scenery and want the objective universe to be a reflection of a character. Thomas Ligotti. “Devotees of Decay and Desolation.” Unless life is a dream, nothing makes sense. For as a reality, it is a rank failure [….] Horror is more real than we are. Thomas Ligotti. “Professor Nobody's Little Lectures on Supernatural Horror”. Thomas Ligotti's tales are rife with mannequins, puppets, and other brainless entities which of replace the valorized subject of philosophy – that of the free thinking human being. His tales such as “The Dream of the Manikin” aim to destroy the rootedness of consciousness. James Trafford has connected the anti-egoism of Ligotti to Thomas Metzinger – where the self is at best an illusion and we plead desperately for someone else to acknowledge that we are real. Trafford has stated it thus, “Life is played out as an inescapable puppet show, an endless dream in which the puppets are generally unaware that they are trapped within a mesmeric dance of whose mechanisms they know nothing and over which they have no control”. An absolute materialism, for Ligotti, implies an alienation of the idea which leads to a ventriloquil idealism. As Ligotti notes in an interview, “the fiasco and nightmare of existence, the particular fiasco and nightmare of human existence, the sense that people are puppets of powers they cannot comprehend, etc.” And then further elaborates that,“[a]ssuming that anything has to exist, my perfect world would be one in which everyone has experienced the annulment of his or her ego. That is, our consciousness of ourselves as unique individuals would entirely disappear”. The externality of the idea leads to the unfortunate consequence of consciousness eating at itself through horror which, for Ligotti, is more real than reality and goes beyond horror-as-affect. Beyond this, taking together with the unreality of life and the ventriloquizing of subjectivity, Ligotti's thought becomes an idealism in which thought itself is alien and ultimately horrifying. The role of human thought and the relation of non-relation of horror to thought is not completely clear in Ligotti's The Conspiracy Against the Human Race. Ligotti argues in his The Conspiracy Against the Human Race,that the advent of thought is a mistake of nature and that horror is being in the sense that horror results from knowing too much. Yet, at the same time, Ligotti seems to suggest that thought separates us from nature whereas, for Lovecraft, thought is far less privileged – mind is just another manifestation of the vital principal, it is just another materialization of energy. In his brilliant “Prospects for Post-Copernican Dogmatism” Iain Grant rallies against the negative definition of dogmatism and the transcendental, and suggests that negatively defining both over-focuses on conditions of access and subjectivism at the expense of the real or nature. With Schelling, who is Grant's champion against the subjectivist bastions of both Fichte and Kant, Ligotti's idealism could be taken as a transcendental realism following from an ontological realism. Yet the transcendental status of Ligotti's thought move towards a treatment of the transcendental which may threaten to leave beyond its realist ground. Ligotti states: Belief in the supernatural is only superstition. That said, a sense of the supernatural, as Conrad evidenced in Heart of Darkness, must be admitted if one's inclination is to go to the limits of horror. It is the sense of what should not be- the sense of being ravaged by the impossible. Phenomenally speaking, the super-natural may be regarded as the metaphysical counterpart of insanity, a transcendental correlative of a mind that has been driven mad. Again, Ligotti equates madness with thought, qualifying both as supernatural while remaining less emphatic about the metaphysical dimensions of horror. The question becomes one of how exactly the hallucinatory realm of the ideal relates to the black churning matter of Lovecraft's chaos of elementary particles. In his tale “I Have a Special Plan for This World” Ligotti formulates thus: A: There is no grand scheme of things. B: If there were a grand scheme of things, the fact – the fact – that we are not equipped to perceive it, either by natural or supernatural means, is a nightmarish obscenity. C: The very notion of a grand scheme of things is a nightmarish obscenity. Here Ligotti is not discounting metaphysics but implying that if it does exist the fact that we are phenomenologically ill-equipped to perceive that it is nightmarish. For Ligotti, nightmare and horror occur within the circuit of consciousness whereas for Lovecraft the relation between reality and mind is less productive on the side of mind. It is easier to ascertain how the Kantian philosophy is a defense against the diseases of the head as Kant armors his critical enterprise from too much of the world and too much of the mind. The weird fiction of both Lovecraft and Ligotti demonstrates that there is too much of both feeding into one another in a way that corrodes the Kantian schema throughly, breaking it down into a dead but still ontologically potentiated nigredo. The haunting, terrifying fact of Ligotti's idealism is that the transcendental motion which brought thought to matter, while throughly material and naturalized, brings with it the horror that thought cannot be undone without ending the material that bears it either locally or completely. Thought comes from an elsewhere and an elsewhen being-in-thought. The unthinkable outside thought is as maddening as the unthought engine of thought itself within thought which doesn't exist except for the mind, the rotting décor of the brain. /5/ - Hyperstitional Transcendental Paranoia or Self -Expelled Thought Weird fiction has been given some direct treatment in philosophy in the mad black Deleuzianism of Nick Land. Nick Land along with others in the 1990s created the Cyber Culture Research Unit as well as the research group Hyperstition. The now defunct hyperstitional website, an outgrowth of the Cyber Culture Research Unit, defined hyperstition in the following fourfold: 1-Element of effective culture that makes itself real. 2-Fictional quantity functional as a time-traveling device. 3-Coincidence intensifier. 4-Call to the Old Ones. The distinctively Lovecraftian character of hyperstition is hard to miss as is its Deleuzo-Guattarian roots. In the opening pages of A Thousand Plateaus Deleuze and Guattari write, “We have been criticized for over-quoting literary authors. But when one writes, the only question is which other machine the literary machine can be plugged into”. The indisinction of literature and philosophy mirrors the mess of being and knowing as post-correlationist philosophy, where philosophy tries to make itself real where literature, especially the weird, aims itself at the brain-circuit of horror. The texts of both Lovecraft and Ligotti work through horror as epistemological plasticity meeting with proximity as well as the deep time of Lovecraft and the glacially slow time of paranoia in Ligotti. Against Deleuze, and following Brassier, we cannot allow the time of consciousness, the Bergsonian time of the duree, to override natural time, but instead acknowledge that it is an unfortunate fact of existence as a thinking being. Horror-time, the time of consciousness, with all its punctuated moments and drawn out terrors, cannot compare to the deep time of non-existence both in the unreachable past and the unknown future. The crystalline cogs of Kant's account of experience as the leading light for the possibility of metaphysics must be throughly obliterated. His gloss of experience in Prolegomena to any Future Metaphysics could not be more sterile: Experience consists of intuitions, which belong to the sensibility, and of judgments, which are entirely a work of the understanding. But the judgments which the understanding makes entirely out of sensuous intuitions are far from being judgments of experience. For in the one case the judgment connects only the perceptions as they are given in sensuous intuition [....] Experience consists in the synthetic connection of appearances in consciousness, so far as this connection is necessary. Here it is difficult to dismiss the queasiness that Kant's legalism induces upon sight for both Badiou and David-Menard. Kant's thought becomes, as Foucault says when reflecting on Sade's text in relation to nature, “the savage abolition of itself”. For Badiou, Kant's philosophy simply closes off too much of the outside, freezing the world of thought in an all too limited formalism. Critical philosophy is simply the systematized quarantine on future thinking, on thinking which would threaten the formalism which artificially grants thought its own coherency in the face of madness. Even the becoming-mad of Deleuze, while escaping the rumbling ground, makes grounds for itself, mad grounds but grounds which are thinkable in their affect. The field of effects allows for Deleuze's aesthetic and radical empiricism, in which effects and/or occasions make up the material of the world to be thought as a chaosmosis of simulacra. Given a critique of an empiricism of aesthetics, of the image, it may be difficult to justify an attack on Kantian formalism with the madness of literature, which does not aim to make itself real but which we may attempt to make real. That is, how do Lovecraft's and Ligotti's materials, as materials for philosophy to work on, differ from either the operative formalisms of Kant or the implicitly formalized images of Deleuzian empiricism? It is simply that such texts do not aim to make themselves real, and make claims to the real which are more alien to us than familiar, which is why their horror is immediately more trustworthy. This is the madness which Blanchot discusses in The Infinite Conversation through Cervantes and his knight – the madness of book-life, of the perverse unity of literature and life a discussion which culminates in the discussion of one of the weird's masters, that of Kafka. The text is the knowing of madness, since madness, in its moment of becoming-more-mad, cannot be frozen in place but by the solidifications of externalizing production. This is why Foucault ends his famous study with works of art. Furthermore extilligence, the ability to export the products of our maligned brains, is the companion of the attempts to export, or discover the possibility of intelligences outside of our heads, in order for philosophy to survive the solar catastrophe. To borrow again from Deleuze, writing is inseparable from becoming. The mistake is to believe that madness is reabsorbed by extilligence, by great works, or that it could be exorcised by the expelling of thought into the inorganic or differently organic. Going out of our heads does not guarantee we will no longer mean we cannot still go out of our minds. This is simply because of the outside, of matter, or force, or energy, or thing-in-itself, or Schopenhauerian Will. In Lovecraft’s “The Music of Erich Zahn” an “impoverished student of metaphysics” becomes intrigued by strange viol music coming from above his room. After meeting the musician the student discovers that each night he plays frantic music at a window in order to keep some horridness at bay, some “impenetrable darkness with chaos and pandemonium”. The aesthetic defenses provided by the well trained brain can bear the hex of matter for so long, the specter of unalterability within it which too many minds obliterate, collapsing everything before the thought of thought as thinkable or at least noetically mutable on our own terms. Transcendental paranoia is the concurrent nightmare and promise of Paul Humphrey's work, of being literally out of our minds. It is the gothic counterpart of thinking non-conceptually but also of thinking never belonging to any instance of purportedly solid being. As Bataille stated, “At the boundary of that which escapes cohesion, he who reflects within cohesion realizes there is no longer any room for him” Thought is immaterial only to the degree that it is inhuman, it is a power that tries, always with failure, to ascertain its own genesis. Philosophy, if it can truly return to the great outdoors, if it can leave behind the dead loop of the human skull, must recognize not only the non-priority of human thought, but that thought never belongs to the brain that thinks it, thought comes from somewhere else. To return to the train image from the beginning “a locomotive rolling on the surface of the earth is the image of continuous metamorphosis” this is the problem of thought, and of thinking thought, of being no longer able to isolate thought, with only a thought-formed structure. [1] One of the central tenets of Francois Laruelle's non-philosophy is that philosophy has traditionally operated on material already presupposed as thinkable instead of trying to think the real in itself. Philosophy, according to Laruelle, remains fixated on transcendental synthesis which shatters immanence into an empirical datum and an a prori factum which are then fused by a third thing such as the ego. For a critical account of Laruelle's non-philosophy see Ray Brassier's Nihil Unbound. (shrink)

While positive appraisals of testimonial knowledge by Enlightenment thinkers have recently begun to receive more attention, such discussions often operate at a very general level, leaving out much of the context and dynamics of specific types of testimonial interactions. Drawing on extended passages from Georg Friedrich Meier and Immanuel Kant, the present paper looks at the specific case of scholarly testimony and the various epistemic dangers that can befall the interaction between scholars (or, in modern parlance, ‘experts’) and lay (...) audiences. While Kant recognises the imperfections of many expert testifiers (and pays special attention to the figure of the ‘pedant’), he is keenly aware of the – greater – risk of what may be called ‘epistemic populism’, which seeks ‘to make imperceptible the blatantly obvious inequality between loquacious ignorance and thorough science’ (AA, XI, 141). Furthermore, Kant suggests, those with superior epistemic authority can justifiably disengage from interactions with those who, as laypersons, arrogate to themselves equal epistemic standing and are unwilling to appreciate the rational force of evidence and argumentation. Prolonging interaction in such a scenario would be futile and may well be ‘contrary to the dignity of reason’ (AA, XI, 143). (shrink)

Epistemic burdens – the nature and extent of our ignorance (that and how) with respect to various courses of action – serve to determine our incentive structures. Courses of action that seem to bear impossibly heavy epistemic burdens are typically not counted as options in an actor’s menu, while courses of action that seem to bear comparatively heavy epistemic burdens are systematically discounted in an actor’s menu relative to options that appear less epistemically burdensome. That ignorance serves (...) to determine what counts as an option means that epistemic considerations are logically prior to moral, prudential, and economic considerations: in order to have moral, prudential, or economic obligations, one must have options, and epistemic burdens serve to determine our options. One cannot have obligations without doing some epistemic work. We defend this claim on introspective grounds. We also consider how epistemic burdens distort surrogate decision-making. The unique epistemology of surrogate cases makes the priority of the epistemic readily apparent. We then argue that anyone who accepts a principle similar to ought implies can is committed to the logical priority of the epistemic. We also consider and reject several possible counterarguments. -/- . (shrink)

In this paper, I identify a form of epistemic insensitivity that occurs when someone fails to make proper use of the epistemic tools at their disposal in order to bring their beliefs in line with epistemically relevant evidence that is available to them. I call this kind of insensitivity agential insensitivity because it stems from the epistemic behavior of an individual agent. Agential insensitivity can manifest as a failure to either attend to relevant and available evidence, or (...) appropriately interpret evidence that is attended to. The concept of agential insensitivity allows us to conceptualize the kind of not-knowing involved in forms of ignorance that are cultivated and maintained by individual agents, especially when this ignorance is enabled or encouraged by social structures. I use the skepticism about racial disparities in policing practices that is displayed by many white Americans as a lens for exploring this connection. Understanding agential insensitivity thus provides insight into both social and epistemic phenomena. (shrink)

How should we conceive of policymakers for the purposes of political analysis? In particular, if we wish to explain and predict political decisions and their consequences, if we wish to ensure that political action is as effective as it can be, how should we think of policymakers? Should we think of them as they are commonly conceived in traditional political analysis, i.e., as uniquely knowledgeable and as either altruistic (i.e., as motivated to realize goals associated with their constituents’ interests) or (...) knavish (i.e., as motivated to realize goals associated with their own personal interests), or should we treat them as possibly ignorant with respect to their political tasks? -/- It is always an open question whether policymakers possess the knowledge required to realize some policy objective. It should never be assumed a priori that policymaker knowledge is adequate to the policy tasks with which policymakers are charged. Politicians need knowledge concerning the causes of social phenomena adequate to control events sufficiently well to ensure the success of their policies. No argument has ever been offered for the standard, if only implicit, assumption that policymakers, somehow automatically, possess this knowledge. In many contexts, there is no reason to believe that policymakers possess or can acquire this knowledge. Indeed, a bit of reflection reveals how unlikely it is that and how rare the circumstances must be in which policymakers meet this condition, which political philosophers, theorists, economists, and other political thinkers have traditionally assumed as a matter of course. -/- The main purpose of the book is to encourage a conversation among scholars and students of political inquiry (in philosophy and political theory, political science, economics and political economy) concerning the best way to conceive of policymakers for the purposes of such inquiry. -/- The book defends an alternative, more realistic, method of political analysis. The book argues against the false assumption that policymakers are epistemically privileged. The book presents and defends the alternative assumption that, with respect to the knowledge required to discharge their political tasks effectively, policymakers are at least as ignorant as constituents. -/- The book further argues that whether policymakers are altruistic or knavish is, in the first instance, a function of the nature and extent of their ignorance with regard to constituent-minded policy goals. Policymakers who possess the knowledge required to be effectively altruistic are more likely to be altruistic, other things the same, than policymakers who are ignorant of the knowledge that successful altruism requires. -/- This being said, my goal is more to leave readers thinking about and inclined to debate these profound issues than to prescribe a particular methodological conclusion (even less to advocate a particular political conclusion). The book is a heuristic for spurring further conversation. It makes of readers fellow interlocutors partnered with the characters (and the author!) of the dialogue. -/- The vehicle for this analysis is a conversation between four friends, philosophy graduate students, with different interests, different levels and kinds of experience, and different political preferences. The four friends consider how politicians should be conceived for the purposes of analyzing political decision-making and its consequences. -/- In his famous Dialogues concerning Natural Religion, David Hume concluded that the assumption of an all-knowing and all-powerful God was neither necessary nor sufficient to explain natural phenomena. Dialogues concerning Natural Politics does for social science what Hume did for natural science. Both books undermine the assumption that some epistemically privileged being – God in the case of natural phenomena and God-like politicians in the case of social phenomena – must be invoked to explain relevant phenomena. (shrink)

One of the most challenging issues, essential for the actual state of science, is the search for a fragile balance between scientific normativity, openness, methodological proliferation and other key concepts, associated with the modern world of research. Paul Feyerabend understood science not as a detached and hermetic self-sufficient reality, but as a structural part of the social world, liable to politicization, discrepancies and inconsistency. His analysis of science, its strategies and institutions involved and, in a way, (...) undermined a long living concept of science as an objective, rational and neutral domain. Following his discoveries, today researchers in general, philosophers of science and social epistemologists in particular, face the problem of corrupted practices, which jeopardize the acquisition of true knowledge. According to the ideas of professor S. Turner, there are two strategies of approaching epistemic coercion: conformity or resistance. Aimed at scientific progress and sustainable development the scientists strive to overcome obstacles of technological, organizational and administrative nature. It presents the case of epistemic resistance. In other circumstances, when the mechanisms of epistemic coercion function without recognition and impediment, the epistemic environment conforms. Professor S. Turner’s article gives an in-depth analysis of epistemic coercion as a ubiquitous phenomenon, pervading intellectual and institutional practices of science and public life. Having stated the existence of the new instruments of epistemic control, he also sheds light on the requirement of the new forms of resistance. In the following article the author consequently scrutinizes the types of epistemic coercion offered by S. Turner. In order to highlight a technological perspective on all three types of epistemic coercion (information deprivation, normalizing/stigmatizing, legitimating/delegitimizing), the author places the emphasis on algorithm – based practices as a distinctive type of information deprivation. Presented from the standpoint of technological design, an algorithm could be seen as a technologically embodied form of epistemic coercion. Further on, the author argues that some of the means of resistance, given by prof. S. Turner, are more suitable to perform epistemic coercion, rather than resisting it. For instance, transparency has compromised itself as an untrustworthy concept put in use to conceal more information than to reveal. Tribalism is proven to be another arguable means of resistance because of its limiting effect on practices of open internal and external scientific communication. Finally, the author augments the list of means of epistemic coercion with construction of ignorance and coercive effect of expertise. (shrink)

The cultural and epistemic status of science is under attack. Social and cultural studies of science are widely perceived to offer evidence and arguments in support of an anti-science campaign. They portray science as a mundane social endeavour, akin to religion and politics, with no privileged access to truthful information about the real world. Science is under threat and needs defence. Old philosophical legitimations have lost their bite. Alarm bells ring, new troops (...) have to be mobilised. Call economics, the good old friend of the status quo depicting it as a generally beneficial social order while accommodating a rather mundane picture of human behaviour. In contrast to constructivist and relativist sociology of scientific knowledge, economic accounts of science seek to provide a rigorous defence of the cultural and epistemic legitimacy of science by accommodating plausible elements in the sociological accounts and by embedding them in invisible-hand arguments about the functioning of some market-like structure within science. Viewed through economic spectacles, science re-emerges from the ashes as stronger and more beautiful than ever. A spectator raises an innocent question: is economics itself strong and beautiful enough to offer such alleviating services? In order to examine the emerging issue of disciplinary credibility, we need to look at economics itself more closely, and we need to address traditional issues in the philosophy of science as well as less traditional issues of reflexivity. We will see that the above caricature concerning the role of economics in the science wars calls for heavy qualifications if not wholesale rejection. (shrink)