This paper argues that self-consciousness and moral agency depend crucially on both embodied and social aspects of human existence, and that the capacity for practical wisdom, phronesis, is central to moral personhood. The nature of practical wisdom is elucidated by drawing on rival analyses of expertise. Although ethical expertise and practical wisdom differ importantly, they are alike in that we can acquire them only in interaction with other persons and through habituation. The analysis of moral agency and practical wisdom is (...) framed by Dennett's proposal that moral personhood requires satisfaction of six conditions, including self-consciousness. (shrink)

This essay argues that while we have examined clinical ethics quite extensively in the literature, too little attention has been paid to the complex question of how clinical ethics is learned. Competing approaches to ethics pedagogy have relied on outmoded understandings of the way moral learning takes place in ethics. It is argued that the better approach, framed in the work of Aristotle, is the idea of phronesis, which depends on a long-term mentorship in clinical medicine for either medical students (...) or clinical ethics students. Such an approach is articulated and defended. (shrink)

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

Modern medicine faces fundamental challenges that various approaches to the philosophy of medicine have tried to address. One of these approaches is based on the ancient concept of phronesis. This paper investigates whether this concept can be used as a moral basis for the challenges facing modern medicine and, in particular, analyses phronesis as it is applied in the works of Pellegrino and Thomasma. It scrutinises some difficulties with a phronesis-based theory, specifically, how it presupposes a moral community of professionals. (...) It is argued that Pellegrino and Thomasma's concept of phronesis corresponds to a Hippocratic concept of t�chn�, and that this latter concept seems to address many of the challenging issues Pellegrino and Thomasma also address. Thus, if modern medicine is to find its philosophical model in ancient concepts, it appears that the Hippocratic t�chn� is closer to the ancient concept of medicine than the Aristotelian phronesis, and that it might avoid many of the pitfalls of a phronesis-based approach. (shrink)

Rationality in medicine is frequently construed as hypotheticodeductive. This article argues that such a model gives a distorted view of the rational character of an enterprise that makes judgments about individual human well-being. Medicine as a science is a practical human science. Seen as such, its rational orientation is one that applies general knowledge to particular situations. It is argued that such an orientation is not deductive but interpretative. The Aristotelian concept of practical wisdom (‘phron sis’) is used as a (...) model of the rational orientation of clinical judgment. Keywords: clinical judgment, rationality, human sciences CiteULike Connotea Del.icio.us What's this? (shrink)

Originally published: New York: Random House, 1972.

The Phenomenological Mind is the first book to properly introduce fundamental questions about the mind from the perspective of phenomenology. Key questions and topics covered include: What is phenomenology? naturalizing phenomenology and the empirical cognitive sciences phenomenology and consciousness consciousness and self-consciousness, including perception and action time and consciousness, including William James intentionality the embodied mind action knowledge of other minds situated and extended minds phenomenology and personal identity Interesting and important examples are used throughout, including phantom limb syndrome, blindsight (...) and self-disorders in schizophrenia, making The Phenomenological Mind an ideal introduction to key concepts in phenomenology, cognitive science and philosophy of mind. (shrink)

Intuition in medical and moral reasoning -- Moral intuitionism -- The place of Aristotelian phronesis in clinical reasoning -- Aristotle's practical syllogism: accounting for the individual through a theory of action and cognition -- Individual and statistical physiognomy: the art and science of making the invisible visible -- Clinical intuition versus statistical reasoning -- Contingency and correlation: the significance of modeling clinical reasoning on statistics -- Abduction: the intuitive support of clinical induction -- Conclusion: medical ethics beyond ontology.

When it comes to understanding the nature of social cognition, we have—according to the standard view—a choice between the simulation theory, the theory-theory or some hybrid between the two. The aim of this paper is to argue that there are, in fact, other options available, and that one such option has been articulated by various thinkers belonging to the phenomenological tradition. More specifically, the paper will contrast Lipps' account of empathy—an account that has recently undergone something of a revival in (...) the hands of contemporary simulationists—with various accounts of empathy found in the phenomenological tradition. I discuss the way Lipps was criticized by Scheler, Stein and Husserl, and outline some of the core features of their, at times divergent, alternatives. I then proceed by considering how their basic take on empathy and social cognition was taken up and modified by Schutz—a thinker whose contribution to the analysis of interpersonal understanding has been unjustly neglected in recent years. (shrink)

This paper is an attempt to reframe the debate of whether medicine is an art or a science in the Aristotelian sense. The recent book of Pellegrino and Thomasma, A Philosophical Basis of Medical Practice, serves as the starting point. Taking clinical interaction as the distinctive feature of medicine, the resemblances of medicine with the characteristics of practical reasoning in the Aristotelian sense are further explored. This comparison proves especially useful in discussing the special status of medical knowledge. Clinical reasoning, (...) resulting in clinical judgments, shows strong similarities with practical reasoning. The application of general principles, instead of deduction from them as in science is essential to both. The ancient concept of practical rationality may therefore be more appropriate while trying to ascribe rationality to medicine than the modern concept of rationality, associated solely with scientific reasoning. (shrink)

Recent imaging results suggest that individuals automatically share the emotions of others when exposed to their emotions. We question the assumption of the automaticity and propose a contextual approach, suggesting several modulatory factors that might influence empathic brain responses. Contextual appraisal could occur early in emotional cue evaluation, which then might or might not lead to an empathic brain response, or not until after an empathic brain response is automatically elicited. We propose two major roles for empathy; its epistemological role (...) is to provide information about the future actions of other people, and important environmental properties. Its social role is to serve as the origin of the motivation for cooperative and prosocial behavior, as well as help for effective social communication. (shrink)

The evidence-based medicine movement advocates basing all medical decisions on certain types of quantitative research data and has stimulated protracted controversy and debate since its inception. Evidence-based medicine presupposes an inaccurate and deficient view of medical knowledge. Michael Polanyi’s theory of tacit knowledge both explains this deficiency and suggests remedies for it. Polanyi shows how all explicit human knowledge depends on a wealth of tacit knowledge which accrues from experience and is essential for problem solving. Edmund Pellegrino’s classic treatment of (...) clinical judgment is examined, and a Polanyian critique of this position demonstrates that tacit knowledge is necessary for understanding how clinical judgment and medical decisions involve persons. An adequate medical epistemology requires much more qualitative research relevant to the clinical encounter and medical decision making than is currently being done. This research is necessary for preventing an uncritical application of evidence-based medicine by health care managers that erodes good clinical practice. Polanyi’s epistemology shows the need for this work and provides the structural core for building an adequate and robust medical epistemology that moves beyond evidence-based medicine. (shrink)

When it comes to understanding the nature of social cognition, we have— according to the standard view—a choice between the simulation theory, the theory-theory or some hybrid between the two. The aim of this paper is to argue that there are, in fact, other options available, and that one such option has been articulated by various think- ers belonging to the phenomenological tradition. More specifically, the paper will con- trast Lipps’ account of empathy—an account that has recently undergone something of (...) a revival in the hands of contemporary simulationists—with various accounts of empa- thy found in the phenomenological tradition. I discuss the way Lipps was criticized by Scheler, Stein and Husserl, and outline some of the core features of their, at times diver- gent, alternatives. I then proceed by considering how their basic take on empathy and social cognition was taken up and modified by Schutz—a thinker whose contribution to the analysis of interpersonal understanding has been unjustly neglected in recent years. (shrink)

Social cognitive neuroscience examines social phenomena and processes using cognitive neuroscience research tools such as neuroimaging and neuropsychology. This review examines four broad areas of research within social cognitive neuroscience: (a) understanding others, (b) understanding oneself, (c) controlling oneself, and (d) the processes that occur at the interface of self and others. In addition, this review highlights two core-processing distinctions that can be neurocognitively identified across all of these domains. The distinction between automatic versus controlled processes has long been important (...) to social psychological theory and can be dissociated in the neural regions contributing to social cognition. Alternatively, the differentiation between internally-focused processes that focus on one's own or another's mental interior and externally-focused processes that focus on one's own or another's visible features and actions is a new distinction. This latter distinction emerges from social cognitive neuroscience investigations rather than from existing psychological theories demonstrating that social cognitive neuroscience can both draw on and contribute to social psychological theory. (shrink)

There has been a growing interest in casuistry since the ground breaking work of Jonsen and Toulmin. Casuistry, in their view, offers the possibility of securing the moral agreement that policy makers desire but which has proved elusive to theory driven approaches to ethics. However, their account of casuistry is dependent upon the exercise of phronesis. As recent discussions of phronesis make clear, this requires attention not only to the particulars of the case, but also to the substantive goods at (...) stake in the case. Without agreement on these goods attention to cases is unlikely to secure the productive consensus that Jonson and Toulmin seek. (shrink)

This paper suggests that certain traditional ways of analysing the self start off in situations that are abstract or detached from normal experience, and that the conclusions reached in such approaches are, as a result, inexact or mistaken. The paper raises the question of whether there are more contextualized forms of self- consciousness than those usually appealed to in philosophical or psychological analyses, and whether they can be the basis for a more adequate theoretical approach to the self. First, we (...) develop a distinction between abstract and contextualized actions and intentions by drawing on evidence from studies of rehabilitation after brain damage, and we introduce the notion of intentional attitude. Second, we discuss several interesting conclusions drawn from theoretically and experimentally abstract approaches. These conclusions raise some important issues about both the nature of the self and reflexive consciousness. At the same time they indicate the serious limita- tions concerning what we can claim about self and self-consciousness within such abstract frameworks. Such limitations motivate the question of whether it is possible to capture a sense of self that is more embedded in contextualized actions. Specifically, our concern is to focus on first-person approaches. We identify two forms of self-consciousness, eco- logical self-awareness and embedded reflection, that (1) function within the kinds of contextualized activity we have indicated, and (2) can be the basis for a theoretical account of the self. Both forms of self-consciousness are closely tied to action and promise to provide a less abstract basis for developing a theoretical approach to the self. (shrink)