Effective person-centred care requires recognition of the personhood not only of patients but of practitioners. This chapter explores the consequences of this recognition for major debates in medical epistemology, regarding clinical reasoning and the relationship between research and practice. For too long these debates have been dominated by false dichotomies - subjectivity versus objectivity, judgement versus evidence, reason versus emotion. Based on flawed understandings of such core concepts as “objectivity” and “engagement”, this distorted dissection of the subject-object relationship has served (...) to depersonalise practice. The costs of this depersonalisation include over-regulation and micromanagement of healthcare processes by administrators and payers at the same time that information from clinical research remains under-utilized and the personhood of patients risks being ignored. Science is a human practice, founded in a broader conception of human reasoning, ontologically dependent on human beings living and engaging with the world in social, emotional and ethical contexts. After looking at different conceptions of epistemic hierarchies and their uses in the analysis and evaluation of reasoning in a range of practice contexts, we propose a “nested hierarchy” that effectively turns upside-down the flawed evidence hierarchies that have helped to depersonalise care. T.S. Eliot’s “wisdom, knowledge, information” scheme (to which we add “data” below “information”) provides a model for a person-centred epistemic hierarchy. This crucial, person-centred inversion represents levels of awareness that characterise more or less developed thinking and judgement on the part of the particular practitioner. (shrink)

Cutting God in Half argues that, in order to tackle climate change, world poverty, extinction of species and our other global problems rather better than we are doing at present we need to bring about a revolution in science, and in academia more generally. We need to put our problems of living – personal, social, global – at the heart of the academic enterprise. How our human world, imbued with meaning and value, can exist and best flourish embedded in the (...) physical universe is, the book argues, our basic problem. It is our fundamental philosophical problem, our fundamental problem of knowledge and understanding, and our fundamental practical problem of living. It is this problem that we fail, at present, to recognize as fundamental – to our cost. It can be understood to arise as a result of cutting God in half – severing the God of Cosmic Power from the God of Value. The first is Einstein’s God, the underlying unity in the physical universe that determines how events occur. The second is what is of most value associated with human life – and sentient life more generally. Having cut God in half in this way, the problem then becomes to see how the two halves can be put together again. This book tackles outstanding aspects of this problem, and in doing so throws out original ideas about science, education, religion, evolutionary theory, free will, quantum theory, and how we should go about tackling our impending global crises. It transpires that bringing our basic problem into sharp focus has revolutionary implications. It becomes clear how and why many aspects of our social and cultural world urgently need to be transformed. Cutting God in Half is written in a lively, accessible style, and ought to be essential reading for anyone concerned about ultimate questions – the nature of the universe, the meaning of life, the future of humanity. (shrink)

In the philosophy of perception, representationalism is the view that all phenomenological differences among mental states are representational differences, in other words, differences in content. In this paper I defend an alternative view which I call external sortalism, inspired by traditional adverbialism, and according to which experiences are not essentially representational. The central idea is that the external world serves as a model for sorting, conceptualizing, and reasoning surrogatively about perceptual experience. On external sortalism, contents are construed as a kind (...) of gloss on experiences themselves. We can retain what is attractive about representationalism, namely, that perceptual experiences can be evaluated for accuracy, without problematic commitment to the idea that they bear a substantive, representational relation to external objects and properties and that this relation determines the phenomenal character of experience. (shrink)

The aim of the present paper is to suggest an alternative view to the conventional distinction between ontology and epistemology, thereby reconstituting the relationship between the cognitive self and the real world. More specifically, we will criticize the distinction by shedding light on a peculiar character of the body, which can provide a critical perspective against Cartesian dualism. Furthermore, we will give a sketchy description of the philosophy of touch, and propose the notion of skin-self, or self-manifesting self, as a (...) radical alternative to the modern conception of self. (shrink)

In this paper I sketch a liberal studies course designed to explore our fundamental problem of thought and life: How can our human world exist and best flourish embedded as it is in the physical universe? The fundamental character of this problem provides one with the opportunity to explore a wide range of issues. What does physics tell us about the universe and ourselves? How do we account for everything physics leaves out? How can living brains be conscious? If everything (...) occurs in accordance with physical law, what becomes of free will? How does Darwin's theory of evolution contribute to the solution to the fundamental problem? What is the history of thought about this problem? What is of most value associated with human life? What kind of civilized world should we seek to help create? Why is the fundamental problem not a part of standard education in schools and universities? What are the most serious global problems confronting humanity? Can humanity learn to make progress towards as good a world as possible? These are some of the questions that can be tackled as an integral part of exploring the fundamental problem. But the course does not merely wander at random from one issue to another. Taking the fundamental problem as central provides the course with a coherent structure. The course would be conducted as a seminar, and it would respond to queries and suggestions from students. (shrink)