In recent years, virtue theories have enjoyed a renaissance of interest among general and medical ethicists. This book offers a virtue-based ethic for medicine, the health professions, and health care. Beginning with a historical account of the concept of virtue, the authors construct a theory of the place of the virtues in medical practice. Their theory is grounded in the nature and ends of medicine as a special kind of human activity. The concepts of virtue, the virtues, and the virtuous (...) physician are examined along with the place of the virtues of trust, compassion, prudence, justice, courage, temperance, and effacement of self-interest in medicine. The authors discuss the relationship between and among principles, rules, virtues, and the philosophy of medicine. They also address the difference virtue-based ethics makes in confronting such practical problems as care of the poor, research with human subjects, and the conduct of the healing relationship. This book woith the author's previous volumes, A Philosophical Basis of Medical Practice and For the Patient's Good, are part of their continuing project of developing a coherent moral philosophy of medicine. (shrink)

Dreyfus's model of expert skill acquisition is philosophically important because it shifts the focus on expertise away from its social and technical externalization in STS, and its relegation to the historical and psychological context of discovery in the classical philosophy of science, to universal structures of embodied cognition and affect. In doing so he explains why experts are not best described as ideologues and why their authority is not exclusively based on social networking. Moreover, by phenomenologically analyzing expertise from a (...) first person perspective, he reveals the limitations of, and sometimes superficial treatment that comes from, investigating expertise from a third person perspective. Thus, he shows that expertise is a prime example of a subject that is essential to science but can only be fully elaborated with the aid of phenomenological tools. However, both Dreyfus's descriptive model and his normative claims are flawed due to the lack of hermeneutical sensitivity. He assumes an expert's knowledge has crystallized out of contextual sensitivity plus experience, and that an expert has shed, during the training process, whatever prejudices, ideologies, hidden agendas, or other forms of cultural embeddedness, that person might have begun with. One would never imagine, from Dreyfus's account, that society could possibly be endangered by experts, only how society's expectations and actions could endanger experts. The stories of actual controversies not only shows things do not work the way Dreyfus claims, but also that it would be less salutary if they did. Such stories amount to counterexamples to Dreyfus's normative claims, and point to serious shortcomings in his arguments. (shrink)

ABSTRACTEvidence-based practice in psychology is ordinarily understood to demarcate between legitimate and illegitimate psychotherapy practice, based upon the epistemic demarcation distingui...

Suitable for students and scholars, this title challenges the assumption that skepticism, rather than established belief, lies at the heart of scientific discovery.

In this groundbreaking book, psychiatrist and ethicist Mona Gupta analyzes the basic assumptions of Evidence-based medicine (EBM), and critically examines their applicability to psychiatry. Highlighting ethical tensions between psychiatry and EBM, she asks the controversial question - should psychiatrists practice evidence-based medicine at all?

The philosophy of evidence-based medicine -- What is EBM? -- What is good evidence for a clinical decision? -- Ruling out plausible rival hypotheses and confounding factors : a method -- Resolving the paradox of effectiveness : when do observational studies offer the same degree of evidential support as randomized trials? -- Questioning double blinding as a universal methodological virtue of clinical trials : resolving the Philip's paradox -- Placebo controls : problematic and misleading baseline measures of effectiveness -- Questioning (...) the methodological superiority of "placebo" over "active" controlled trials -- Examining the paradox that traditional roles for mechanistic reasoning and expert -- Judgment have been up-ended by EBM -- A qualified defence of the EBM stance on mechanistic reasoning -- Knowledge that versus knowledge how : situating the EBM position on expert clinical judgment -- Moving EBM forward. (shrink)