Clinical judgement, expertise and skilled coping

Medicine involves specific practical expertise as well as more general context-independent medical knowledge. This raises the question, what is the nature of the expertise involved? Is there a model of clinical judgement or understanding that can accommodate both elements? This paper begins with a summary of a published account of the kinds of situation-specific skill found in anaesthesia. It authors claim that such skills are often neglected because of a prejudice in favour of the ‘technical rationality’ exemplified in evidence-based medicine but they do not themselves offer a general account of the relation of practical expertise and general medical knowledge. The philosopher Hubert Dreyfus provides one model of the relation of general knowledge to situation-specific skilled coping. He claims that the former logically depends on the latter and provides two arguments, which I articulate in the second section, for this. But he mars those arguments by building in the further assumption that such situation-specific responses must be understood as concept-free and thus mindless. That assumption is held in place by three arguments all of which I criticize in the next section to give a unified account of clinical judgement as both practical and conceptually structured and thus justified in the face of a prejudice in favour of ‘technical rationality’

Why general education?: Peters, Hirst and history

Richard Peters argued for a general education based largely on the study of truth-seeking subjects for its own sake. His arguments have long been acknowledged as problematic. There are also difficulties with Paul Hirst's arguments for a liberal education, which in part overlap with Peters'. Where justification fails, can historical explanation illuminate? Peters was influenced by the prevailing idea that a secondary education should be based on traditional, largely knowledge-orientated subjects, pursued for intrinsic as well as practical ends. Does history reveal good reasons for this view? The view itself has roots going back to the 16th century and the educational tradition of radical Protestantism. Religious arguments to do with restoring the image of an omniscient God in man made good sense, within their own terms, of an encyclopaedic approach to education. As these faded in prominence after 1800, old curricular patterns persisted in the drive for ‘middle-class schools’, and new, less plausible justifications grew in salience. These were based first on faculty psychology and later on the psychology of individual differences. The essay relates the views of Peters and Hirst to these historical arguments, asking how far their writings show traces of the religious argument mentioned, and how their views on education and the development of mind relate to the psychological arguments

Pragmatist Ethics and Climate Change [preprint]

This chapter explores some features of pragmatic pluralism as an ethical perspective on climate change. It is inspired in part by Andrew Light’s work on climate diplomacy as U.S. Assistant Secretary of Energy for International Affairs, and by Bryan Norton’s environmental pragmatism, while drawing more explicitly than Light or Norton from classical pragmatist sources such as John Dewey. The primary aim of the chapter is to characterize, differentiate, and advance a general pragmatist approach to climate ethics. The main line of argument is that we are suffering culturally from a sort of “moral jetlag” due in part to “moral fundamentalist” habits, and that a critical focus on pragmatic pluralism—in moral theory generally and climate ethics particularly—would be salutary for our recovery if philosophers are to speak more effectively to “wicked problems” in a way that aids public deliberation and social learning. Moral fundamentalist habits, and the monistic one-way assumption that unintentionally—but not blamelessly—exercises and unduly reinforces them, are obstacles to fostering habits of moral and political inquiry better suited to dealing with predicaments rapidly transforming our warming planet

Theoretical virtues and theological construction

Theist and critic alike typically assume rather traditional, Medieval, understandings of God, thereby masking certain complexities in their disputes. Drawing on the practices of both scientific and theological theory construction, it is argued that traditional theologies should be seen as negotiable in certain ways. In the light of this, standard attempts at refutations of Christianity have significantly less force than is usually appreciated. Some pitfalls of both strong and weak commitments to any particular theological framework are discussed

Interdisciplinary Perspectives on Behavioral Economics, 22-23 May

Report of the Conference "Economics and/or Psychology: Interdisciplinary Perspectives on Behavioral Economics"

Embodied cognition: A field guide

The nature of cognition is being re-considered. Instead of emphasizing formal operations on abstract symbols, the new approach foregrounds the fact that cognition is, rather, a situated activity, and suggests that thinking beings ought therefore be considered first and foremost as acting beings. The essay reviews recent work in Embodied Cognition, provides a concise guide to its principles, attitudes and goals, and identifies the physical grounding project as its central research focus