The evidence-based practice and evidence-based medicine movements have promoted standardization through guideline development methodologies based on systematic reviews and meta-analyses of best available research. EBM has challenged clinicians to question their reliance on practical reasoning and clinical judgement. In this paper, we argue that the protagonists of EBM position their mission as reducing uncertainty through the use of standardized methods for knowledge evaluation and use. With this drive towards uniformity, standardization and control comes a suspicion towards intuition, creativity and uncertainty (...) as integral parts of medical practice. We question the appropriateness of attempts to standardize professional practice through a discussion of the importance of uncertainty. Greenhalgh’s taxonomy of uncertainty is used to inform an analysis of the clinical reasoning occurring in a potentially life threatening emergency situation with a young patient. The case analysis is further developed by the use of the Canadian philosopher Bernard Lonergan’s theory about understanding and objective knowing. According to Lonergan it is not by getting rid of or even by reducing uncertainty, but by attending systematically to it and by relating to it in a self-conscious way, that objective knowledge can be obtained. The paper concludes that uncertainty is not a regrettable and unavoidable aspect of decision making but a productive component of clinical reasoning. (shrink)

Philosophy becomes speculative when it raises questions about the ultimate nature of being and thought. What does it mean to be? What does it mean to think? How are being and thought related? What does it mean to ask these questions? These questions have occupied a central place in philosophy throughout history, but have led a shadow existence in twentieth-century thought, which has cut the tie between reason and these fundamental questions, leaving the questions in the twilight, and reason instrumentalised. (...) A.N. Whitehead (1861-1947), one of the founders of analytic philosophy and co-author (with Bertrand Russell) of Principia Mathematica, is one of the few contemporary thinkers to have developed an explicit speculative philosophy. Unsurprisingly, his philosophy has played a marginal role in academic debates. In this study, the methodological foundation of Whitehead’s speculative thought is reconstructed. On the basis of a systematic and historical examination of the nature of the question of being, Whiteheads ontology of the event as the passage into novelty emerges in its full scope, allowing the reader to understand why and to what extent Whitehead has walked a different path than other contemporary thinkers. His philosophy contains a conception of reason that is not alien to newness and creativity while being more than procedural or pragmatic, and a mode of understanding existence that brings out the acuteness of freedom, value and legitimacy, as well as the unity of things, of thought and nature. In order to show what is really happening in this philosophy, the received interpretation of Whitehead’s ontology is radically dismantled. The central thought, that to be means to happen, is explained in a process of reiteration and gradual clarification, examining traditional philosophical problems in metaphysics and epistemology (on topics like: nature and matter, knowledge, categorical structure, freedom and necessity, truth and meaning, modality) from its perspective. What emerges is a philosophy in which the temporality of being, when taken seriously, changes the status of familiar problems and dualisms and offers possibilities for thought, which previously did not exist. Whitehead “hears” the classical questions of philosophy in a new way. Beyond the trenches of twentieth-century philosophy, Whitehead’s speculative thinking contains many elements that will be of value to those studying the foundations of thought today and looking for new directions. In a time when the dualism of nature and man is maintained cynically in our economies and dismantled, but only in a biologistic fashion and therefore only seemingly, as a cover-up, in science and philosophy, Whitehead’s new and creative way of hearing, and answering, old questions about ultimate concerns, when understood properly, is more up to date than ever before. (shrink)

After a review of terminology, I identify—in addition to Margaret Battin’s list of five primary arguments for and against aid-in-dying—the argument from functional equivalence as another primary argument. I introduce a novel way to approach this argument based on Bernard Lonergan’s generalized empirical method. Then I proceed on the basis of GEM to distinguish palliative sedation, palliative sedation to unconsciousness when prognosis is less than two weeks, and foregoing life-sustaining treatment from aid-in-dying. I conclude that aid-in-dying must be justified on (...) its own merits and not on the basis of these well-established palliative care practices; and that societies must decide, in weighing the merits of aid-in-dying, whether or not to make the judgment that no life is better than life-like-this part of their operative value structure. (shrink)

The classical notion of scientific objectivity is a property of propositional truth. It is the property of being open to testing and inspection, in principle, by all men, although in practice perhaps, the testing of a scientific claim is restricted to the members of a community of professional experts. It is, moreover, the property of being stable in time, true eternally as it were; for objective truth is thought to express what is so independently of human interests, initiatives, bias, social (...) circumstances and historical environment. Often there is the added connotation that what is so is pictured not in its relationship to man, but absolutely, as it were, in itself, or in its relations to the rest of nature, where nature is taken to have an essence independently of the meaning conferred on nature by Dasein. All this is expressed as truth-invariance relative to synchronous communities of knowers whether sympatric or allopatric : truth-invariance relative to allochronous communities of knowers, and truth-invariance relative to the physical transformations and substitutions which define the objective content of a scientific law or theory. (shrink)

What is perception doing in mathematical reasoning? To address this question, I discuss the role of perception in geometric reasoning. Perception of the shape properties of concrete diagrams provides, I argue, a surrogate consciousness of the shape properties of the abstract geometric objects depicted in the diagrams. Some of what perception is not doing in mathematical reasoning is also discussed. I take issue with both Parsons and Maddy. Parsons claims that we perceive a certain type of abstract object. Maddy claims (...) (at least at one time claimed) that perception provides the basis for intuition of mathematical sets. 1 Mathematical reasoning with diagrams 2 Do we perceive abstract objects? 3 Do we perceive mathematical sets? (shrink)

Muchas propuestas de filosofía contemporánea convierten la filosofía primera en mera historiografía, o en un análisis del lenguaje, sus dimensiones y sus contextos histórico-sociales, o en un mero recorrido por la historia de un problema y sus diversos desarrollos. El artículo, nombrando esta situación como un estar en el laberinto intenta establecer otra base a la filosofía primera entrando en diálogo con dos propuestas muy diversas, aun partiendo del método común de Husserl, su creador : la búsqueda de una fundamentación (...) en una subjetividad trascendental que opera ya desde el mundo de la vida que realiza Husserl en la crisis de las ciencias europeas y la propuesta de la actualidad de la realidad en el acto intelectivo sentiente de Zubiri con su noología. (shrink)

El objetivo del presente artículo es múltiple. Primero, pondera una serie de razones por las cuales la mística aún es relevante para el análisis de la condición humana del hombre actual. Segundo, propone a la promesa y a la ausencia como dispositivos de la mística. Tercero, expone, desde la lectura que hacen Alois Haas y Amador Vega de algunos sermones alemanes del Maestro Eckhart y de El peregrino querúbico de Angelus Silesius, los planteamientos fundamentales de la mística de estos autores, (...) a saber: el vaciamiento del alma, el coengendramiento, el abismo de Dios y la unión mística. Al mismo tiempo esboza cómo el pensamiento de Eckhart y Silesius, además de ser estudiado, produce ecos en algunas de las formulaciones filosóficas más importantes del siglo XX. The aim of this article is multiple. First, it weighs a series of reasons for which mysticism is still relevant for the analysis of man’s current human condition. Second, it proposes promise and absence as the devices of mysticism. Third, it exhibits, according to the reading of Alois Haas and Amador Vega of some of Meister Eckhart’s German sermons and Angelus Silesius’ The Cherubic Wanderer, the fundamental expositions of these authors’ mysticism, namely: voidance of the soul, co-conceivement, God’s abyss and mystical union. At the same time it outlines how the thought of Eckhart and Silesius, besides being studied, produces echoes in some of the most important philosophical formulations of the 20th century. (shrink)

The unfinished nature of Beauchamp and Childress’s account of the common morality after 34 years and seven editions raises questions about what is lacking, specifically in the way they carry out their project, more generally in the presuppositions of the classical liberal tradition on which they rely. Their wide-ranging review of ethical theories has not provided a method by which to move beyond a hypothetical approach to justification or, on a practical level regarding values conflict, beyond a questionable appeal to (...) consensus. My major purpose in this paper is to introduce the thought of Bernard Lonergan as offering a way toward such a methodological breakthrough. In the first section, I consider Beauchamp and Childress’s defense of their theory of the common morality. In the second, I relate a persisting vacillation in their argument regarding the relative importance of reason and experience to a similar tension in classical liberal theory. In the third, I consider aspects of Lonergan’s generalized empirical method as a way to address problems that surface in the first two sections of the paper: (1) the structural relation of reason and experience in human action; and (2) the importance of theory for practice in terms of what Lonergan calls “common sense” and “general bias.”. (shrink)