Coping with uncertainty in public health: the use of heuristics

The observation that experts and lay people use cognitive shortcuts or heuristics to arrive at judgements about complex problems is certainly not new. But what is new is the finding that a group of reasoning strategies, which have been maligned by philosophers and logicians alike, have demonstrable value in helping members of the public come to a judgement about public health problems. These problems, which span food safety crises, immunization scares and risks associated with exposure to environmental toxins, presuppose knowledge and expertise which falls outside of the epistemic and technical competence of most members of the public. Notwithstanding the complexity of these problems, they are not perceived by lay people to be wholly unintelligible or incomprehensible. This short communication reports on the findings of a questionnaire-based investigation into the use of these reasoning strategies by 879 members of the public. The results reveal a rational competence on the part of lay people which has been hitherto unexamined, and which may be usefully exploited in all aspects of public health work

Is Mental Illness an Access Barrier to Seeking and Receiving Abortion Services?

This study examines the relationship between one’s mental health status and access to abortion services. A review of the literature confirms that no prior research has been completed to determine whether or not mental health status is a barrier to seeking and/or receiving abortion services. A qualitative study using professionals from the mental health and abortion service fields was conducted to explore this relationship. Findings suggest that there are implications for some individuals experiencing mental illness. Another finding concludes that mental illness may be a secondary access barrier if one’s health insurance is provided by governmental funds. An implication for future research pertains to examining the degree to which mental illness may be a primary barrier to accessing abortion services

Circles and analogies in public health reasoning

The study of the fallacies has changed almost beyond recognition since Charles Hamblin called for a radical reappraisal of this area of logical inquiry in his 1970 book Fallacies. The “witless examples of his forbears” to which Hamblin referred have largely been replaced by more authentic cases of the fallacies in actual use. It is now not unusual for fallacy and argumentation theorists to draw on actual sources for examples of how the fallacies are used in our everyday reasoning. However, an aspect of this move towards greater authenticity in the study of the fallacies, an aspect which has been almost universally neglected, is the attempt to subject the fallacies to empirical testing of the type which is more commonly associated with psychological experiments on reasoning. This paper addresses this omission in research on the fallacies by examining how subjects use two fallacies – circular argument and analogical argument – during a reasoning task in which subjects are required to consider a number of public health scenarios. Results are discussed in relation to a view of the fallacies as cognitive heuristics that facilitate reasoning in a context of uncertainty

The use of "no evidence" statements in public health

Public health communication makes extensive use of a linguistic formulation that will be called the "no evidence" statement. This is a written or spoken statement of the form "There is no evidence that P" where P stands for a proposition that typically describes a human health risk. Danger lurks in these expressions for the hearer or reader who is not logically perspicacious, as arguments that use them are only warranted under certain conditions. The extent to which members of the public are able to determine what those conditions are will be considered by examining data obtained from 879 subjects. The role of "no evidence" statements as cognitive heuristics in public health reasoning is considered

Pragmatic disorders and their social impact

Pragmatic disorders in children and adults have been the focus of clinical investigations for approximately 40 years. In that time, clinicians and researchers have established a diverse range of pragmatic phenomena that are disrupted in these disorders. Pragmatic deficits include problems with the use and understanding of speech acts, the processing of non-literal language, failure to adhere to Gricean maxims in conversation and discourse deficits. These deficits are found in several clinical populations including individuals with autistic spectrum disorders, schizophrenia, traumatic brain injury and right-hemisphere damage. However, what is less often investigated is the social impact of pragmatic disorders on the children and adults who are affected by them. In this paper, I examine what is known about pragmatic disorders in these clinical groups. I then consider the wider social consequences of these disorders, where consequences are broadly construed to include factors that act as indicators of social adjustment

On Pain of Death

On Pain of Death is a fictional retelling of the story of Sir Pelleas, who, in Thomas Malory’s Le Morte D’Arthur, is depicted as a noble knight with unrequited love for Lady Ettarde. He follows her for weeks, repeatedly declaring his love for her, despite her clear rejections. In rewriting this story, I hope to draw attention to the fact that, by today’s standards, what he is doing is clear-cut stalking. By introducing a character with a periphery perspective, I hope to call into question how “romantic” these stories of unrequited love really are

Establishing diagnostic criteria: the role of clinical pragmatics

The study of pragmatic disorders is of interest to speech-language pathologists who have a professional responsibility to assess and treat communication impairments. However, these disorders, it will be argued in this paper, have a significance beyond the clinical management of clients with communication impairments. Specifically, pragmatic disorders can now make a contribution to the diagnosis of a range of clinical conditions in which communication is adversely affected. These conditions include attention deficit hyperactivity disorder (ADHD), the autistic spectrum disorders, schizophrenia and the dementias. Pragmatic disorders are already among the criteria used to diagnose some of these conditions (e.g. ADHD), although they are not described in these terms. In other conditions (e.g. the dementias), pragmatic disorders have potential diagnostic value in the absence of reliable biomarkers markers of these conditions and similar initial presenting symptoms. Using clinical data, and the findings of empirical studies, the case is made for the inclusion and/or greater integration of pragmatic disorders in the formal classificatory systems that are used to diagnose a range of disorders. A previously unrecognised role for pragmatic impairments in the nosology and diagnosis of clinical disorders is thereby established