The values of nursing arise from a concern with human flourishing. If the desire to become a nurse is a reflection of an aspiration to care for others in need then we should anticipate that those who choose to nurse have a tendency towards the values we would normally associate with a caring profession (care, compassion, perhaps altruism, and so on). However, these values require a secure base if they are not to succumb to the corrupting pressures of the increasingly (...) instrumental nature of the values of the institutions in which healthcare in general and nursing in particular takes place. One way of securing a base for withstanding the corrupting influences of the institution is to understand nursing as a practice in the sense in which Alasdair MacIntyre uses that term. In this brief paper I will outline ways in which the managerial imperative of meeting targets is both distorting practice and undermining nursing’s values. I conclude that understanding nursing as a MacIntyrean practice provides a refuge from what might otherwise be overwhelming pressures for nurses to adopt instrumental values to the detriment of professional caring values. (shrink)

This paper explores the notion of ‘expert’ health care practitioner in the context of critical thinking and health care education where scientific rather than philosophical inquiry has been the dominant mode of thought. A number of factors have forced are appraisal in this respect: the challenge brought about by the identification of complex ethical issues in clinical situations; medicine's `solving' of many of the simple health problems; the recognition that uncertainty is a common and perhaps innate feature of clinical practice; (...) debate about the concepts of illness and disease; plus insights from psychology,sociology and medical anthropology. Together these have prompted alternative ways of thinking which have the aim of identifying the best rather than the right decision (where best equates to good and right equates to correct in the sense of true or approved). It is argued that phronesis adds a necessary corrective dimension to modern Western medicine's over-emphasis on techne and is one of the factors that differentiates novice from expert practitioner. However, this attracts certain conflicts of interest: phronesis can only be gained and assessed from experience of praxis; agencies with legitimate interests in medicine such as government and professional registering bodies require more substantive criteria. (shrink)

When trying to assess the implications of recent deep shifts in the philosophy of science for the broader arena of medicine, the theme that most readily comes to mind is underdetermination . In scientific research one always hopes for determination: that the world should determine the observations we make of it; that evidence should determine the theories we adopt; that the practice of science should determine results independent of the sort of society in which that practice takes place. In this (...) essay, doubts cast on each of these ideas by recent work in philosophy of science will be discussed and the consequences for philosophy of medicine will be indicated. Keywords: Underdetermination, retroduction, Kuhn, observation as theoryladen, realism, theory appraisal, values in science, social dimensions of science CiteULike Connotea Del.icio.us What's this? (shrink)

After a quarter of a century in print, Capra's groundbreaking work still challenges and inspires. This updated edition of The Tao of Physics includes a new preface and afterword in which the author reviews the developments of the twenty-five years since the book's first publication, discusses criticisms the book has received, and examines future possibilities for a new scientific world.

This study is based on a critique of Western medicine derived from the proposition that any system of medicine must necessarily embody a mysterious quality. What is meant by mystery is an all encompassing element of indeterminancy and so of uncertainty in both the theory and practice of medicine.

While much discussion in bioethics, philosophy of science, and philosophy of medicine concerns the proper handling and uses of value considerations, there has been little discussion about how to identify or recognize values in medical/scientific discourse. This article presents a heuristic method for identifying values in such discourses. Values are defined as descriptions or conditions that guide human action and are praise- or blameworthy. Values manifest themselves in discourses in one or more of three dimensions: linguistic, causal, and descriptive; each (...) with distinctive “subtypes”. By recognizing the various ways that values manifest in discourses, a “values scholar” can ask relevant questions of the discourse and thereby come to recognize potential evaluative meanings in the discourse. Numerous examples are provided from the author's own research program. Strengths, limitations, and paths to developing the model are briefly discussed. (shrink)