In "What Minds Can Do" (1997), Pierre Jacob argues for the cognitive turn in the philosophy of mind. He formulates this in contrast with the linguistic turn, which privileges linguistic semanticity over mental semanticity. Jacob argues that the order of privilege should be the other way around. I argue for a third option, which I call the ecological turn, which dissolves the bifurcation explored by Jacob.

First, I argue that the narrow content of a thought cannot be identical with the linguistic meaning of the sentence used to express it. Secondly, I argue that the distinction between narrow content and linguistic meaning is not fatal to content-dualism. Thirdly I argue for the view that the proposition contributed by the clause prefixed by "that" is an interpretation of the believer's thought. Finally, I use this insight to provide an individualist account of Burge's thought-experiments such that recognition that (...) the truth-conditions of belief-ascriptions include aspects of the believer's environment does not entail that those environmental aspects are thereby parts of the contents of the person's thoughts. (shrink)

Tyler Burge has argued that an incorrect understanding of a word can be sufficient for possessing the concept the word literally expresses. His well-known 'arthritis' case involves a patient who understands 'arthritis' incorrectly, but who nevertheless, according to Burge, possesses the concept arthritis. Critics of Burge have objected that there is an alternative concept that best matches the patient's understanding and that this, therefore, is the patient's concept. The paper first argues that Burge's response to this objection is unconvincing. A (...) better response is then developed. It is argued that there is no alternative concept that matches the incorrect understanding, since the patient thinks he has a partial understanding. This, together with points about ordinary psychological explanation and modes of presentations of concepts, establish that it is impossible to undermine Burge's social externalism by appealing to the idea that an alternative concept matches the incorrect understanding. (shrink)

Tyler Burge has in many writings distinguished between mental content externalism based on incorrect understanding and mental content externalism based on partial but not incorrect understanding. Both and have far-reaching implications for analyses of communication and concept possession in various expert-layperson relations, but Burge and his critics have mainly focused on . This article first argues that escapes the most influential objection to . I then raise an objection against Burge’s argument for . The objection focuses on Burge’s claim that (...) a person with a partial understanding of a term in our community expresses our standard concept because he is willing to defer to our standard understanding, while his “Putnamian” twin in a counterfactual community does not. The problem with Burge’s argument for this claim is that he does not consider the possibility that the person in our community and the twin would defer to the same understanding if they were presented with the same alternatives. Drawing from widespread dispositional assumptions about meaning, I argue that Burge must accept that they express the same concept if they would defer to the same understanding. The article closes with an examination on various ways the externalist may attempt to avoid this problem and concludes that none of them succeeds. (shrink)

The article uses a producer-consumer theory from philosophy of mind and language to analyse the meaning of basic health concepts like disease, illness and sickness. The core idea of the producer-consumer perspective is that a person who has an incomplete understanding of a term can associate it with the same concept as a linguistic expert, if both of them are willing to defer to the same contextual or general norms of meaning. Using “disease” as an example, the article argues that (...) the producer-consumer theory implies that if patients were normally willing to defer to a standard expert concept of disease, it would be reasonable to assume that the concept of disease is this concept. However, it is empirically well documented that many patients are not willing to defer to health workers’ understanding of lay health concepts like “disease”. This means that the overall conceptual analysis of disease and other lay health concepts should be pluralistic—the concepts belong within what Wittgenstein calls different language-games. This conceptual pluralism is inconsistent with assumptions many theorists have made when attempting to develop general definitions of basic concepts of ill health. Furthermore, the pluralistic analysis has striking implications for how conceptions of meaning should be accepted as sound; participants in health discourses are entitled to use basic health terms like “health” and “illness” in accordance with their own language-games, and health workers should therefore acknowledge a diversity of meaning in patient communication. Nevertheless, health professionals can often secure a communicative platform of shared concepts by understanding patients’ language games, and by achieving contextual aims of agreement about meaning. (shrink)

It is fundamental assumption in nursing theory that it is important for nurses to understand how patients experience states of ill health. This assumption is often related to aims of empathic understanding, but normative principles of social interpretation can have an important action‐guiding role whenever nurses seek to understand patients’ subjective horizons on the basis of active or passive expressions of meaning. The aim of this article is to present a philosophical theory of concept possession and to argue that it (...) can shed light on how nurses should seek to understand patients’ subjective perspectives on the meaning of illness. The two basic ideas in the theory are that patients’ beliefs and thoughts about their experiences involve concepts and that concepts can be communicated on the basis of shared implicit conceptions of what they mean. These conditions of understanding have a striking application: nurse‐patient communication is limited by many contextual factors, but it is often possible for nurses to detect shared implicit conceptions of the meaning of concepts of disease and illness. Furthermore, by acting as sympathetic linguistic experts and creating an atmosphere for dialogue, nurses can make patients feel comfortable about deferring to medical explanations of meaning that can constitute a communicative platform. The last part of the article uses a number of cases studies to show how these implications can be implemented as conceptual tools for securing meaningful communication about illness experiences in patient dialogue. (shrink)

Influential holistic analyses of patient perspectives assume that the concepts that patients associate with medical terms are formed by their total social and cultural contexts. Holistic analyses presuppose conceptual role semantics in the sense that they imply that a medical term must have the same role for a nurse and a patient in order for them to associate the same concept with the term. In recent philosophy of mind, social externalism has emerged as a non‐holistic alternative to conceptual role theories. (...) According to social externalism, a nurse and a patient express the same concept by a term if they both have a minimal or better understanding of the term. Three arguments in favour of social externalism are presented in connection with nurse–patient interaction. The first concerns successful communication, the second focuses on belief reports made by patients and the third centres on the need for including medical terms in medical discourse. Finally, the practical implications of the arguments are clarified. The most important of these is that, in cases of misunderstanding, a nurse should not conform to a patient's idiosyncratic understanding, but instead correct the mistaken applications of the term in question. (shrink)