In the domain of medical science, factual evidence is usually considered as the criterion on which to base decisions and construct hypotheses. Evidence-based medicine is the translation of this approach into the field of patient care, and it means providing only the type of care that is based on evidence that proves its effectiveness and appropriateness. However, while the literature has focused on the types and force of evidence used to establish the recommendation and treatment guidelines, the problem of how (...) evidence is used in doctor–patient interactions to motivate, or refuse, treatment or habit change has been almost completely neglected. In this specific context, characterized by the epistemic unbalance between the interlocutors and a specific conversational goal, the scientific categories of evidence are often irrelevant. The goal of this paper is to address this challenge by analyzing the role evidence plays in doctor–patient interactions in diabetes care. After introducing an analytical distinction between the epistemic and the pragmatic aspect of evidence, we will propose a classification of the types and functions of evidence in chronic care communication, and illustrate its possible uses through its application to our corpus of diabetes-care consultations. From our qualitative analyses, it is possible to observe how in this communicative context a crucial role is played by the conflicts of evidence, in which providers correct patients’ uses of evidence leading them to using less defeasible levels of evidence. (shrink)

There is much to like about the idea that justification should be understood in terms of normality or normic support (Smith 2016, Goodman and Salow 2018). The view does a nice job explaining why we should think that lottery beliefs differ in justificatory status from mundane perceptual or testimonial beliefs. And it seems to do that in a way that is friendly to a broadly internalist approach to justification. In spite of its attractions, we think that the normic support view (...) faces two serious challenges. The first is that it delivers the wrong result in preface cases. These cases suggest that the view is either too sceptical or too externalist. The second is that the view struggles with certain kinds of Moorean absurdities. It turns out that these problems can easily be avoided. If we think of normality as a condition on *knowledge*, we can characterise justification in terms of its connection to knowledge and thereby avoid the difficulties discussed here. The resulting view does an equally good job explaining why we should think that our perceptual and testimonial beliefs are justified when lottery beliefs cannot be. Thus, it seems that little could be lost and much could be gained by revising the proposal and adopting a view on which it is knowledge, not justification, that depends directly upon normality. (shrink)

Epistemic permissivism is the thesis that the evidence can rationally permit more than one attitude toward a proposition. Pascal’s wager is the idea that one ought to believe in God for practical reasons, because of what one can gain if theism is true and what one has to lose if theism is false. In this paper, I argue that if epistemic permissivism is true, then the defender of Pascal’s wager has powerful responses to two prominent objections. First, I argue that (...) if permissivism is true, then permissivism is true about theistic belief. Second, I show how epistemic permissivism about theistic belief dispels two objections to Pascal’s wager: the objection that wagering is impossible, and the objection that wagering is epistemically impermissible. (shrink)

Defined narrowly, epistemology is the study of knowledge and justified belief. As the study of knowledge, epistemology is concerned with the following questions: What are the necessary and sufficient conditions of knowledge? What are its sources? What is its structure, and what are its limits? As the study of justified belief, epistemology aims to answer questions such as: How we are to understand the concept of justification? What makes justified beliefs justified? Is justification internal or external to one's own mind? (...) Understood more broadly, epistemology is about issues having to do with the creation and dissemination of knowledge in particular areas of inquiry. This article will provide a systematic overview of the problems that the questions above raise and focus in some depth on issues relating to the structure and the limits of knowledge and justification. (shrink)