What do "epistemics" and "ethics" entail and how are these topics related?
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Topic Summary
Epistemic thinking refers to a cognitive and metacognitive process by which we reason about ‘knowledge’. Here, we aim to discuss the necessary and sufficient features of ‘knowledge’ insofar as they connect with our relational ethics (or ‘how we interact with others in practice’).
What constitutes knowledge?
How is it generated?
Do specific social agents (i.e individuals) possess more epistemic authority?
Why? Why not?
What attributes of epistemic reasoning (in other words, what epistemic attitudes or higher order epistemic constructs) are conducive to identifying theories or ideas of relevance?
What are the limitations of ‘knowledge’ and thinking about how we think about what constitutes ‘knowledge’?
What ethical implications do epistemics and meta-epistemics have in connection to professional domains and/or to everyday living?
What implications does high ‘medical uncertainty’ have in the context of a healthcare system where providers–who seek to identify information about people–have implicitly more “epistemic status” and more decision-making power than the clients whom they serve?
In the mental health domain, where–not only are the DSM constructs lacking in reliability and predictive validity pointing to problematic flaws in the categorical structure of the taxonomy itself, but the detection of disorder can implicitly undermine personhood, what kind of ethical implications does this have for ‘practitioner-client’ interactions? Are sufficient ethical principles really underlying the evaluation and treatment of clients at this time? Or do we have some problems that we need to address? Is the evaluation and treatment process more likely to be driven by the institutional desire to manage risk rather than to relationally engage ? Is it ethical to make such diagnostic claims in light of such statistical and epistemic information gaps? If a diagnosis must be made for practical reasons (insurance), then how should a ‘diagnosis’ be communicated? To be clear, we are not implying that all professionals are behaving unethically during the act of diagnosis: not only is the purpose of this practice, to shed light on the pathophysiology of disorder in order to reverse engineer the problem (though, we could certainly debate the extent to which this process does or does not function in this way), many clients seek closure and comfort in such declarations. The needs of stakeholders are critically important; however, what if an excessive need for closure, undermines one’s capacity for balanced communication and/or appraisal? What if a pervasive psychological intolerance of uncertainty undermines our individual and collective capacities for sense-making?
Barring clear structural damage (you know, shattered bones, dead tissue, etc), most health information is rarely so simple and unidimensional . Appraising ‘diagnosis’ as ‘predictive prognosis’ might be a comforting crutch, but is this not epistemically dishonest to an extent? Perhaps the point at which scientific and medical information is communicated, is where we need to consider an ethic of ambiguity upon which to deploy the use of appropriate language that would allow us to express and receive messages about the limitations of our knowledge. Maybe it is in light this honest ‘unknowing’, that we could learn to find meaning, value, and maybe even some conceptually creative solutions, to our continuous problems.
Han, Paul K. J. 2013. “Conceptual, Methodological, and Ethical Problems in Communicating Uncertainty in Clinical Evidence.” Medical Care Research and Review : MCRR 70 (1 0): 14S-36S. https://doi.org/10.1177/1077558712459361.
Birrell, Pamela J., and Cindy M. Bruns. 2016. “Ethics and Relationship: From Risk Management to Relational Engagement.” Journal of Counseling & Development 94 (4): 391–97. https://doi.org/10.1002/jcad.12097.
@article{brodrick_free_2020,
title = {Free to {Choose}: {A} {Moral} {Defense} of the {Right}-to-{Try} {Movement}},
volume = {45},
issn = {0360-5310},
shorttitle = {Free to {Choose}},
url = {https://academic.oup.com/jmp/article/45/1/61/5700356},
doi = {10.1093/jmp/jhz028},
abstract = {Abstract. The claim that individuals legitimately differ with respect to their values seems to be uncontroversial among bioethicists, yet many bioethicists nev},
language = {en},
number = {1},
urldate = {2020-08-12},
journal = {The Journal of Medicine and Philosophy: A Forum for Bioethics and Philosophy of Medicine},
author = {Brodrick, Michael},
month = jan,
year = {2020},
note = {ZSCC: 0000001
Publisher: Oxford Academic},
pages = {61--85},
}
Abstract. The claim that individuals legitimately differ with respect to their values seems to be uncontroversial among bioethicists, yet many bioethicists nev
@article{han_tolerating_2019,
title = {Tolerating uncertainty about conceptual models of uncertainty in health care},
volume = {25},
issn = {1365-2753},
url = {https://onlinelibrary.wiley.com/doi/abs/10.1111/jep.13110},
doi = {10.1111/jep.13110},
language = {en},
number = {2},
urldate = {2020-10-24},
journal = {Journal of Evaluation in Clinical Practice},
author = {Han, Paul K. J. and Djulbegovic, Benjamin},
year = {2019},
note = {ZSCC: 0000004
\_eprint: https://onlinelibrary.wiley.com/doi/pdf/10.1111/jep.13110},
pages = {183--185},
}
@article{holliman_visual_2019,
title = {Visual {Entropy} and the {Visualization} of {Uncertainty}},
url = {http://arxiv.org/abs/1907.12879},
abstract = {Background: It is possible to find many different visual representations of data values in visualizations, it is less common to see visual representations that include uncertainty, especially in visualizations intended for non-technical audiences. Objective: our aim is to rigorously define and evaluate the novel use of visual entropy as a measure of shape that allows us to construct an ordered scale of glyphs for use in representing both uncertainty and value in 2D and 3D environments. Method: We use sample entropy as a numerical measure of visual entropy to construct a set of glyphs using R and Blender which vary in their complexity. Results: A Bradley-Terry analysis of a pairwise comparison of the glyphs shows participants (n=19) ordered the glyphs as predicted by the visual entropy score (linear regression R2 {\textgreater}0.97, p{\textless}0.001). We also evaluate whether the glyphs can effectively represent uncertainty using a signal detection method, participants (n=15) were able to search for glyphs representing uncertainty with high sensitivity and low error rates. Conclusion: visual entropy is a novel cue for representing ordered data and provides a channel that allows the uncertainty of a measure to be presented alongside its mean value.},
urldate = {2020-10-14},
journal = {arXiv:1907.12879 [cs, math]},
author = {Holliman, Nicolas S. and Coltekin, Arzu and Fernstad, Sara J. and Simpson, Michael D. and Wilson, Kevin J. and Woods, Andrew J.},
month = jul,
year = {2019},
note = {ZSCC: 0000002
arXiv: 1907.12879},
keywords = {Computer Science - Graphics, Computer Science - Human-Computer Interaction, Computer Science - Information Theory},
}
Background: It is possible to find many different visual representations of data values in visualizations, it is less common to see visual representations that include uncertainty, especially in visualizations intended for non-technical audiences. Objective: our aim is to rigorously define and evaluate the novel use of visual entropy as a measure of shape that allows us to construct an ordered scale of glyphs for use in representing both uncertainty and value in 2D and 3D environments. Method: We use sample entropy as a numerical measure of visual entropy to construct a set of glyphs using R and Blender which vary in their complexity. Results: A Bradley-Terry analysis of a pairwise comparison of the glyphs shows participants (n=19) ordered the glyphs as predicted by the visual entropy score (linear regression R2 \textgreater0.97, p\textless0.001). We also evaluate whether the glyphs can effectively represent uncertainty using a signal detection method, participants (n=15) were able to search for glyphs representing uncertainty with high sensitivity and low error rates. Conclusion: visual entropy is a novel cue for representing ordered data and provides a channel that allows the uncertainty of a measure to be presented alongside its mean value.
@article{elsner_beyond_2019,
title = {Beyond {Medical} {Paternalism}: {Undoing} the {Doctor}-{Patient} {Relationship} in {Simone} de {Beauvoir}'s {A} {Very} {Easy} {Death}},
volume = {37},
issn = {1080-6571},
shorttitle = {Beyond {Medical} {Paternalism}},
url = {https://muse.jhu.edu/article/745344},
doi = {10.1353/lm.2019.0019},
abstract = {In A Very Easy Death Simone de Beauvoir documents the illness, hospitalization, and death of her mother Françoise. Critics in the fields of bioethics and the medical humanities have concentrated on the text’s paternalistic doctor-patient encounter, which culminates in the withholding of the cancer diagnosis from Beauvoir’s mother and entails an unnecessary medical intervention to which the patient never consents. Reviewing the text’s reception, this article argues that a focus on the ways in which it depicts breaches of several tenets of medical ethics have decontextualized A Very Easy Death and occluded the key role Beauvoir plays in the doctor-patient relationship. By situating the text within Beauvoir’s œuvre and debates in French philosophy of medicine at the time of publication, this article proposes that Beauvoir’s part in the withholding of the cancer diagnosis emerges less as a submission to medical paternalism than as a form of maternal caregiving.},
language = {en},
number = {2},
urldate = {2020-03-25},
journal = {Literature and Medicine},
author = {Elsner, Anna Magdalena},
month = dec,
year = {2019},
note = {ZSCC: 0000000
Publisher: Johns Hopkins University Press},
pages = {420--441},
}
In A Very Easy Death Simone de Beauvoir documents the illness, hospitalization, and death of her mother Françoise. Critics in the fields of bioethics and the medical humanities have concentrated on the text’s paternalistic doctor-patient encounter, which culminates in the withholding of the cancer diagnosis from Beauvoir’s mother and entails an unnecessary medical intervention to which the patient never consents. Reviewing the text’s reception, this article argues that a focus on the ways in which it depicts breaches of several tenets of medical ethics have decontextualized A Very Easy Death and occluded the key role Beauvoir plays in the doctor-patient relationship. By situating the text within Beauvoir’s œuvre and debates in French philosophy of medicine at the time of publication, this article proposes that Beauvoir’s part in the withholding of the cancer diagnosis emerges less as a submission to medical paternalism than as a form of maternal caregiving.
@article{roulston_qualitative_2018,
title = {Qualitative interviewing and epistemics},
volume = {18},
issn = {1468-7941, 1741-3109},
url = {http://journals.sagepub.com/doi/10.1177/1468794117721738},
doi = {10.1177/1468794117721738},
abstract = {Work on epistemics in conversation analysis (CA) has demonstrated how speakers attend closely to the knowledge claims they and others make and how this shapes interaction. This paper uses work on epistemics in CA to explore how interviewers and interviewees orient to knowledge claims involving the asking and answering of questions. Since research participants are recruited to represent a category identified by the researcher, interviewees are assumed to have greater knowledge relative to the research topic as compared to interviewers, who typically work to demonstrate that they are eager learners about others’ experiences, perceptions and beliefs and so forth. This paper examines sequences from research interviews to focus on the fine-grained work involved in asking questions and making knowledge claims within interviews. Epistemics provides a powerful tool to examine how speakers’ orientations to others’ knowledge claims is central to the interactional work of conducting interviews.},
language = {en},
number = {3},
urldate = {2020-03-12},
journal = {Qualitative Research},
author = {Roulston, Kathryn},
month = jun,
year = {2018},
pages = {322--341},
}
Work on epistemics in conversation analysis (CA) has demonstrated how speakers attend closely to the knowledge claims they and others make and how this shapes interaction. This paper uses work on epistemics in CA to explore how interviewers and interviewees orient to knowledge claims involving the asking and answering of questions. Since research participants are recruited to represent a category identified by the researcher, interviewees are assumed to have greater knowledge relative to the research topic as compared to interviewers, who typically work to demonstrate that they are eager learners about others’ experiences, perceptions and beliefs and so forth. This paper examines sequences from research interviews to focus on the fine-grained work involved in asking questions and making knowledge claims within interviews. Epistemics provides a powerful tool to examine how speakers’ orientations to others’ knowledge claims is central to the interactional work of conducting interviews.
@article{pekrun_measuring_2017,
title = {Measuring emotions during epistemic activities: the {Epistemically}-{Related} {Emotion} {Scales}},
volume = {31},
issn = {0269-9931, 1464-0600},
shorttitle = {Measuring emotions during epistemic activities},
url = {https://www.tandfonline.com/doi/full/10.1080/02699931.2016.1204989},
doi = {10.1080/02699931.2016.1204989},
abstract = {Measurement instruments assessing multiple emotions during epistemic activities are largely lacking. We describe the construction and validation of the EpistemicallyRelated Emotion Scales, which measure surprise, curiosity, enjoyment, confusion, anxiety, frustration, and boredom occurring during epistemic cognitive activities. The instrument was tested in a multinational study of emotions during learning from conflicting texts (N = 438 university students from the United States, Canada, and Germany). The findings document the reliability, internal validity, and external validity of the instrument. A seven-factor model best fit the data, suggesting that epistemically-related emotions should be conceptualised in terms of discrete emotion categories, and the scales showed metric invariance across the North American and German samples. Furthermore, emotion scores changed over time as a function of conflicting task information and related significantly to perceived task value and use of cognitive and metacognitive learning strategies.},
language = {en},
number = {6},
urldate = {2020-04-02},
journal = {Cognition and Emotion},
author = {Pekrun, Reinhard and Vogl, Elisabeth and Muis, Krista R. and Sinatra, Gale M.},
month = aug,
year = {2017},
note = {ZSCC: 0000077},
pages = {1268--1276},
}
Measurement instruments assessing multiple emotions during epistemic activities are largely lacking. We describe the construction and validation of the EpistemicallyRelated Emotion Scales, which measure surprise, curiosity, enjoyment, confusion, anxiety, frustration, and boredom occurring during epistemic cognitive activities. The instrument was tested in a multinational study of emotions during learning from conflicting texts (N = 438 university students from the United States, Canada, and Germany). The findings document the reliability, internal validity, and external validity of the instrument. A seven-factor model best fit the data, suggesting that epistemically-related emotions should be conceptualised in terms of discrete emotion categories, and the scales showed metric invariance across the North American and German samples. Furthermore, emotion scores changed over time as a function of conflicting task information and related significantly to perceived task value and use of cognitive and metacognitive learning strategies.
@article{noauthor_cultivating_2017,
title = {Cultivating {Humility} and {Diagnostic} {Openness} in {Clinical} {Judgment}},
volume = {19},
issn = {2376-6980},
url = {https://journalofethics.ama-assn.org/article/cultivating-humility-and-diagnostic-openness-clinical-judgment/2017-10},
doi = {10.1001/journalofethics.2017.19.10.ecas1-1710},
abstract = {In this case, a physician rejects a patient’s concerns that tainted water is harming the patient and her community. Stereotypes and biases regarding socioeconomic class and race/ethnicity, constraining diagnostic frameworks, and fixed first impressions could skew the physician’s judgment. This paper narratively illustrates how cultivating humility could help the physician truly hear the patient’s suggestions. The discussion builds on the multifaceted concept of cultural humility as a lifelong journey that addresses not only stereotypes and biases but also power inequalities and community inequities. Insurgent multiculturalism is a complementary concept. Through epistemic humility—which includes both intellectual and emotional components—and admitting uncertainty, physicians can enhance patients’ and families’ epistemic authority and health agency.},
language = {en},
number = {10},
urldate = {2020-03-20},
journal = {AMA Journal of Ethics},
month = oct,
year = {2017},
pages = {970--977},
}
In this case, a physician rejects a patient’s concerns that tainted water is harming the patient and her community. Stereotypes and biases regarding socioeconomic class and race/ethnicity, constraining diagnostic frameworks, and fixed first impressions could skew the physician’s judgment. This paper narratively illustrates how cultivating humility could help the physician truly hear the patient’s suggestions. The discussion builds on the multifaceted concept of cultural humility as a lifelong journey that addresses not only stereotypes and biases but also power inequalities and community inequities. Insurgent multiculturalism is a complementary concept. Through epistemic humility—which includes both intellectual and emotional components—and admitting uncertainty, physicians can enhance patients’ and families’ epistemic authority and health agency.
@article{leal-soto_three-factor_2017,
title = {Three-factor structure for {Epistemic} {Belief} {Inventory}: {A} cross-validation study},
volume = {12},
issn = {1932-6203},
shorttitle = {Three-factor structure for {Epistemic} {Belief} {Inventory}},
url = {https://dx.plos.org/10.1371/journal.pone.0173295},
doi = {10.1371/journal.pone.0173295},
abstract = {Research on epistemic beliefs has been hampered by lack of validated models and measurement instruments. The most widely used instrument is the Epistemological Questionnaire, which has been criticized for validity, and it has been proposed a new instrument based in the Epistemological Questionnaire: the Epistemic Belief Inventory. The Spanishlanguage version of Epistemic Belief Inventory was applied to 1,785 Chilean high school students. Exploratory and confirmatory factor analyses in independent subsamples were performed. A three factor structure emerged and was confirmed. Reliability was comparable to other studies, and the factor structure was invariant among randomized subsamples. The structure that was found does not replicate the one proposed originally, but results are interpreted in light of embedded systemic model of epistemological beliefs.},
language = {en},
number = {3},
urldate = {2020-03-12},
journal = {PLOS ONE},
author = {Leal-Soto, Francisco and Ferrer-Urbina, Rodrigo},
editor = {Lozano, Sergi},
month = mar,
year = {2017},
pages = {e0173295},
}
Research on epistemic beliefs has been hampered by lack of validated models and measurement instruments. The most widely used instrument is the Epistemological Questionnaire, which has been criticized for validity, and it has been proposed a new instrument based in the Epistemological Questionnaire: the Epistemic Belief Inventory. The Spanishlanguage version of Epistemic Belief Inventory was applied to 1,785 Chilean high school students. Exploratory and confirmatory factor analyses in independent subsamples were performed. A three factor structure emerged and was confirmed. Reliability was comparable to other studies, and the factor structure was invariant among randomized subsamples. The structure that was found does not replicate the one proposed originally, but results are interpreted in light of embedded systemic model of epistemological beliefs.
@article{leblanc_toward_2016,
title = {Toward {Epistemic} {Justice}: {A} {Critically} {Reflexive} {Examination} of ‘{Sanism}’ and {Implications} for {Knowledge} {Generation}},
volume = {10},
issn = {1911-4788},
shorttitle = {Toward {Epistemic} {Justice}},
url = {https://journals.library.brocku.ca/index.php/SSJ/article/view/1324},
doi = {10.26522/ssj.v10i1.1324},
abstract = {The dominance of medicalized “psy” discourses in the West has marginalized alternative perspectives and analyses of madness, resulting in the underinclusion (or exclusion) from mainstream discourse of the firsthand experiences and perspectives of those who identify as Mad. We argue that this marginalization of firsthand knowledge(s) demands closer critical scrutiny, particularly through the use of critical reflexivity. This paper draws on Fricker’s concept of epistemic injustice, whereby a person is wronged in his or her capacity as a knower, as a useful framework for interrogating the subjugation of Mad knowledge(s). Also examined is the problem of sanism, a deeply embedded system of discrimination and oppression, as an underlying component of epistemic injustice. Sanism assumes a pathological view of madness, which can be attributed to what Rimke has termed psychocentrism: the notion that pathologies are rooted in the mind and/or body of the individual, rather than the product of social structures, relations, and problems. The paper examines how sanism marginalizes the knowledge(s) of Mad persons and contributes to epistemic injustice, and considers possibilities for advancing social justice using Mad epistemological perspectives.},
language = {en},
number = {1},
urldate = {2020-04-02},
journal = {Studies in Social Justice},
author = {LeBlanc, Stephanie and Kinsella, Elizabeth Anne},
month = aug,
year = {2016},
note = {ZSCC: 0000044},
pages = {59--78},
}
The dominance of medicalized “psy” discourses in the West has marginalized alternative perspectives and analyses of madness, resulting in the underinclusion (or exclusion) from mainstream discourse of the firsthand experiences and perspectives of those who identify as Mad. We argue that this marginalization of firsthand knowledge(s) demands closer critical scrutiny, particularly through the use of critical reflexivity. This paper draws on Fricker’s concept of epistemic injustice, whereby a person is wronged in his or her capacity as a knower, as a useful framework for interrogating the subjugation of Mad knowledge(s). Also examined is the problem of sanism, a deeply embedded system of discrimination and oppression, as an underlying component of epistemic injustice. Sanism assumes a pathological view of madness, which can be attributed to what Rimke has termed psychocentrism: the notion that pathologies are rooted in the mind and/or body of the individual, rather than the product of social structures, relations, and problems. The paper examines how sanism marginalizes the knowledge(s) of Mad persons and contributes to epistemic injustice, and considers possibilities for advancing social justice using Mad epistemological perspectives.
@article{domen_ethics_2016,
title = {The {Ethics} of {Ambiguity}: {Rethinking} the {Role} and {Importance} of {Uncertainty} in {Medical} {Education} and {Practice}},
volume = {3},
issn = {2374-2895, 2374-2895},
shorttitle = {The {Ethics} of {Ambiguity}},
url = {http://journals.sagepub.com/doi/10.1177/2374289516654712},
doi = {10.1177/2374289516654712},
abstract = {Understanding and embracing uncertainty are critical for effective teacher–learner relationships as well as for shared decisionmaking in the physician–patient relationship. However, ambiguity has not been given serious consideration in either the undergraduate or graduate medical curricula or in the role it plays in patient-centered care. In this article, the author examines the ethics of ambiguity and argues for a pedagogy that includes education in the importance of, and tolerance of, ambiguity that is inherent in medical education and practice. Common threads running through the ethics of ambiguity are the virtue of respect, and the development of a culture of respect is required for the successful understanding and implementation of a pedagogy of ambiguity.},
language = {en},
urldate = {2020-03-12},
journal = {Academic Pathology},
author = {Domen, Ronald E.},
month = aug,
year = {2016},
keywords = {ambiguity, ethics, medical education, patient-centered care,, professionalism, respect, uncertainty},
pages = {237428951665471},
}
Understanding and embracing uncertainty are critical for effective teacher–learner relationships as well as for shared decisionmaking in the physician–patient relationship. However, ambiguity has not been given serious consideration in either the undergraduate or graduate medical curricula or in the role it plays in patient-centered care. In this article, the author examines the ethics of ambiguity and argues for a pedagogy that includes education in the importance of, and tolerance of, ambiguity that is inherent in medical education and practice. Common threads running through the ethics of ambiguity are the virtue of respect, and the development of a culture of respect is required for the successful understanding and implementation of a pedagogy of ambiguity.
@article{sandoval_understanding_2016,
title = {Understanding and {Promoting} {Thinking} {About} {Knowledge}: {Origins}, {Issues}, and {Future} {Directions} of {Research} on {Epistemic} {Cognition}},
volume = {40},
issn = {0091-732X, 1935-1038},
shorttitle = {Understanding and {Promoting} {Thinking} {About} {Knowledge}},
url = {http://journals.sagepub.com/doi/10.3102/0091732X16669319},
doi = {10.3102/0091732X16669319},
language = {en},
number = {1},
urldate = {2020-03-12},
journal = {Review of Research in Education},
author = {Sandoval, William A. and Greene, Jeffrey A. and Bråten, Ivar},
month = mar,
year = {2016},
pages = {457--496},
}
@incollection{probst_epistemological_2015,
address = {Cham},
title = {Epistemological {Issues} in {Diagnosis} and {Assessment}},
isbn = {978-3-319-17773-1 978-3-319-17774-8},
url = {http://link.springer.com/10.1007/978-3-319-17774-8_2},
abstract = {This book begins with a thoughtful exploration of two fundamental questions that underlie all clinical decisions. First, what exactly is a “mental disorder,” as opposed to other kinds of suffering or maladaptive behavior that we would call non-mental disorders? What makes a disorder specifically mental? And second, on what do we base these definitions and distinctions? What do we consider reliable (and unreliable) sources of knowledge, and what are some of the pitfalls in our assumptions about what we “know” and how we’ve come to “know” it? Common cognitive errors are explored, along with their consequences. These include circular reasoning, the difficulty of determining threshold or cut-off point, assumptions about causality, and the problems inherent in mental heuristics such as anchoring and availability. The chapter then explores the role of labels and labeling theory, the aims and limitations of classification systems such as the DSM, and the challenge of trying to develop a way to think about mental disorder that is useful for both general purposes (to make predictions based on shared characteristics) and specific aims (to understand and help particular individuals).},
language = {en},
urldate = {2020-03-12},
booktitle = {Critical {Thinking} in {Clinical} {Assessment} and {Diagnosis}},
publisher = {Springer International Publishing},
author = {Probst, Barbara},
editor = {Probst, Barbara},
year = {2015},
doi = {10.1007/978-3-319-17774-8_2},
pages = {15--44},
}
This book begins with a thoughtful exploration of two fundamental questions that underlie all clinical decisions. First, what exactly is a “mental disorder,” as opposed to other kinds of suffering or maladaptive behavior that we would call non-mental disorders? What makes a disorder specifically mental? And second, on what do we base these definitions and distinctions? What do we consider reliable (and unreliable) sources of knowledge, and what are some of the pitfalls in our assumptions about what we “know” and how we’ve come to “know” it? Common cognitive errors are explored, along with their consequences. These include circular reasoning, the difficulty of determining threshold or cut-off point, assumptions about causality, and the problems inherent in mental heuristics such as anchoring and availability. The chapter then explores the role of labels and labeling theory, the aims and limitations of classification systems such as the DSM, and the challenge of trying to develop a way to think about mental disorder that is useful for both general purposes (to make predictions based on shared characteristics) and specific aims (to understand and help particular individuals).
@article{han_conceptual_2013,
title = {Conceptual, {Methodological}, and {Ethical} {Problems} in {Communicating} {Uncertainty} in {Clinical} {Evidence}},
volume = {70},
issn = {1077-5587},
url = {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4238424/},
doi = {10.1177/1077558712459361},
abstract = {The communication of uncertainty in clinical evidence is an important endeavor that poses difficult conceptual, methodological, and ethical problems. Conceptual problems include logical paradoxes in the meaning of probability and “ambiguity”— second-order uncertainty arising from the lack of reliability, credibility, or adequacy of probability information. Methodological problems include questions about optimal methods for representing fundamental uncertainties and for communicating these uncertainties in clinical practice. Ethical problems include questions about whether communicating uncertainty enhances or diminishes patient autonomy and produces net benefits or harms. This article reviews the limited but growing literature on these problems and efforts to address them and identifies key areas of focus for future research. It is argued that the critical need moving forward is for greater conceptual clarity and consistent representational methods that make the meaning of various uncertainties understandable, and for clinical interventions to support patients in coping with uncertainty in decision making.},
number = {1 0},
urldate = {2020-07-01},
journal = {Medical care research and review : MCRR},
author = {Han, Paul K. J.},
month = feb,
year = {2013},
pmid = {23132891},
pmcid = {PMC4238424},
note = {ZSCC: 0000114 },
pages = {14S--36S},
}
The communication of uncertainty in clinical evidence is an important endeavor that poses difficult conceptual, methodological, and ethical problems. Conceptual problems include logical paradoxes in the meaning of probability and “ambiguity”— second-order uncertainty arising from the lack of reliability, credibility, or adequacy of probability information. Methodological problems include questions about optimal methods for representing fundamental uncertainties and for communicating these uncertainties in clinical practice. Ethical problems include questions about whether communicating uncertainty enhances or diminishes patient autonomy and produces net benefits or harms. This article reviews the limited but growing literature on these problems and efforts to address them and identifies key areas of focus for future research. It is argued that the critical need moving forward is for greater conceptual clarity and consistent representational methods that make the meaning of various uncertainties understandable, and for clinical interventions to support patients in coping with uncertainty in decision making.
@article{logue_politics_2013,
title = {The {Politics} of {Unknowing} and the {Virtues} of {Ignorance}: {Toward} a {Pedagogy} of {Epistemic} {Vulnerability}},
language = {en},
journal = {PHILOSOPHY OF EDUCATION},
author = {Logue, Jennifer},
year = {2013},
pages = {10},
}
@article{schraw_conceptual_2013,
title = {Conceptual {Integration} and {Measurement} of {Epistemological} and {Ontological} {Beliefs} in {Educational} {Research}},
volume = {2013},
issn = {2090-8652},
url = {https://www.hindawi.com/archive/2013/327680/},
doi = {10.1155/2013/327680},
abstract = {This paper examines the conceptualization and measurement of epistemological and ontological phenomena and makes recommendations for improving the conceptual framework and methodological assessment of these phenomena. I discuss the ways educational researchers have studied beliefs and how this research can be improved through a comprehensive conceptual framework and better measurement. This paper provides definitions of epistemological and ontological beliefs and world views, discusses six complementary strategies for assessing these beliefs, compares the strengths of these strategies, and provides examples of how they have been used in the research literature. This paper discusses challenges related to the development of a comprehensive theoretical framework for beliefs, as well as ways to improve measurement of these beliefs and summarizes six emergent themes.},
language = {en},
urldate = {2020-03-12},
journal = {ISRN Education},
author = {Schraw, Gregory},
year = {2013},
pages = {1--19},
}
This paper examines the conceptualization and measurement of epistemological and ontological phenomena and makes recommendations for improving the conceptual framework and methodological assessment of these phenomena. I discuss the ways educational researchers have studied beliefs and how this research can be improved through a comprehensive conceptual framework and better measurement. This paper provides definitions of epistemological and ontological beliefs and world views, discusses six complementary strategies for assessing these beliefs, compares the strengths of these strategies, and provides examples of how they have been used in the research literature. This paper discusses challenges related to the development of a comprehensive theoretical framework for beliefs, as well as ways to improve measurement of these beliefs and summarizes six emergent themes.
@article{han_varieties_2011,
title = {Varieties of {Uncertainty} in {Health} {Care}: {A} {Conceptual} {Taxonomy}},
volume = {31},
issn = {0272-989X},
shorttitle = {Varieties of {Uncertainty} in {Health} {Care}},
url = {https://doi.org/10.1177/0272989X10393976},
doi = {10.1177/0272989X10393976},
abstract = {Uncertainty is a pervasive and important problem that has attracted increasing attention in health care, given the growing emphasis on evidence-based medicine, shared decision making, and patient-centered care. However, our understanding of this problem is limited, in part because of the absence of a unified, coherent concept of uncertainty. There are multiple meanings and varieties of uncertainty in health care that are not often distinguished or acknowledged although each may have unique effects or warrant different courses of action. The literature on uncertainty in health care is thus fragmented, and existing insights have been incompletely translated to clinical practice. This article addresses this problem by synthesizing diverse theoretical and empirical literature from the fields of communication, decision science, engineering, health services research, and psychology and developing a new integrative conceptual taxonomy of uncertainty. A 3-dimensional taxonomy is proposed that characterizes uncertainty in health care according to its fundamental sources, issues, and locus. It is shown how this new taxonomy facilitates an organized approach to the problem of uncertainty in health care by clarifying its nature and prognosis and suggesting appropriate strategies for its analysis and management.},
language = {en},
number = {6},
urldate = {2020-10-14},
journal = {Medical Decision Making},
author = {Han, Paul K. J. and Klein, William M. P. and Arora, Neeraj K.},
month = nov,
year = {2011},
note = {ZSCC: 0000425
Publisher: SAGE Publications Inc STM},
pages = {828--838},
}
Uncertainty is a pervasive and important problem that has attracted increasing attention in health care, given the growing emphasis on evidence-based medicine, shared decision making, and patient-centered care. However, our understanding of this problem is limited, in part because of the absence of a unified, coherent concept of uncertainty. There are multiple meanings and varieties of uncertainty in health care that are not often distinguished or acknowledged although each may have unique effects or warrant different courses of action. The literature on uncertainty in health care is thus fragmented, and existing insights have been incompletely translated to clinical practice. This article addresses this problem by synthesizing diverse theoretical and empirical literature from the fields of communication, decision science, engineering, health services research, and psychology and developing a new integrative conceptual taxonomy of uncertainty. A 3-dimensional taxonomy is proposed that characterizes uncertainty in health care according to its fundamental sources, issues, and locus. It is shown how this new taxonomy facilitates an organized approach to the problem of uncertainty in health care by clarifying its nature and prognosis and suggesting appropriate strategies for its analysis and management.
@article{murray_toward_2011,
title = {Toward {Post}-metaphysical {Enactments}: {On} {Epistemic} {Drives}, {Negative} {Capability}, and {Indeterminacy} {Analysis}},
volume = {7},
abstract = {Various approaches and interpretations of post-metaphysics are described, followed by an exploration of methods and approaches to enacting a post-metaphysical attitude toward beliefs, and in particular beliefs commonly held within the community of integral theory and practice. Integral Post-metaphysics is described in context with the larger trend of post-metaphysical thought. Along the way several concepts and themes are introduced, including the epistemic turn in reasoning, misplaced concreteness, epistemic drives, and negative capability.},
language = {en},
number = {2},
author = {Murray, Tom},
year = {2011},
note = {ZSCC: 0000010},
pages = {34},
}
Various approaches and interpretations of post-metaphysics are described, followed by an exploration of methods and approaches to enacting a post-metaphysical attitude toward beliefs, and in particular beliefs commonly held within the community of integral theory and practice. Integral Post-metaphysics is described in context with the larger trend of post-metaphysical thought. Along the way several concepts and themes are introduced, including the epistemic turn in reasoning, misplaced concreteness, epistemic drives, and negative capability.
@article{cann_core_2010,
title = {The {Core} {Beliefs} {Inventory}: a brief measure of disruption in the assumptive world},
volume = {23},
issn = {1061-5806, 1477-2205},
shorttitle = {The {Core} {Beliefs} {Inventory}},
url = {http://www.tandfonline.com/doi/abs/10.1080/10615800802573013},
doi = {10.1080/10615800802573013},
language = {en},
number = {1},
urldate = {2020-03-12},
journal = {Anxiety, Stress \& Coping},
author = {Cann, Arnie and Calhoun, Lawrence G. and Tedeschi, Richard G. and Kilmer, Ryan P. and Gil-Rivas, Virginia and Vishnevsky, Tanya and Danhauer, Suzanne C.},
month = jan,
year = {2010},
pages = {19--34},
}
@article{guilfoyle_therapeutic_2005,
title = {From {Therapeutic} {Power} to {Resistance}?: {Therapy} and {Cultural} {Hegemony}},
volume = {15},
issn = {0959-3543, 1461-7447},
shorttitle = {From {Therapeutic} {Power} to {Resistance}?},
url = {http://journals.sagepub.com/doi/10.1177/0959354305049748},
doi = {10.1177/0959354305049748},
abstract = {Four ideas are used to conceptually link local therapeutic practices with macro sociocultural arrangements, and to question the feasibility of therapeutically derived resistances against them: power as a productive force; the power–knowledge integration; the power–resistance relationship; and power in context. Narrative therapy is presented as an example of a ‘therapy of resistance’, which at a micro level challenges the therapist–client power relation and privileges clients’ local knowledges, and hence, at a macro level, promotes resistance against dominant discourses and practices. However, at least two fundamental problems face therapies advocating resistance. At a macro level, they are vulnerable to neutralization when they engage in broader power relations. And at a micro level, they cannot escape the institutionalized therapist–client power imbalance, which renders ethically problematic the use of the therapeutic encounter to promote resistance. Strategies for addressing these problems are discussed.},
language = {en},
number = {1},
urldate = {2020-06-24},
journal = {Theory \& Psychology},
author = {Guilfoyle, Michael},
month = feb,
year = {2005},
note = {ZSCC: 0000075},
pages = {101--124},
}
Four ideas are used to conceptually link local therapeutic practices with macro sociocultural arrangements, and to question the feasibility of therapeutically derived resistances against them: power as a productive force; the power–knowledge integration; the power–resistance relationship; and power in context. Narrative therapy is presented as an example of a ‘therapy of resistance’, which at a micro level challenges the therapist–client power relation and privileges clients’ local knowledges, and hence, at a macro level, promotes resistance against dominant discourses and practices. However, at least two fundamental problems face therapies advocating resistance. At a macro level, they are vulnerable to neutralization when they engage in broader power relations. And at a micro level, they cannot escape the institutionalized therapist–client power imbalance, which renders ethically problematic the use of the therapeutic encounter to promote resistance. Strategies for addressing these problems are discussed.
@book{arp_bonds_2001,
title = {The {Bonds} of {Freedom}: {Simone} de {Beauvoir}'s {Existentialist} {Ethics}},
isbn = {978-0-8126-9442-0},
shorttitle = {The {Bonds} of {Freedom}},
abstract = {"The Bonds of Freedom is the first full-scale analysis of Beauvoir's existentialist ethics, as laid out in her important work, The Ethics of Ambiguity, written in 1946. Kristana Arp traces the central themes of Beauvoir's ethics back to her earlier philosophical essays and to literary works such as The Blood of Others and All Men Are Mortal. Drawing from the thought of Husserl, Heidegger, Sartre, and Merleau-Ponty, Beauvoir developed her own distinctive version of existentialism throughout these works."--BOOK JACKET.},
language = {en},
publisher = {Open Court Publishing},
author = {Arp, Kristana},
year = {2001},
keywords = {Philosophy / Movements / Existentialism},
}
"The Bonds of Freedom is the first full-scale analysis of Beauvoir's existentialist ethics, as laid out in her important work, The Ethics of Ambiguity, written in 1946. Kristana Arp traces the central themes of Beauvoir's ethics back to her earlier philosophical essays and to literary works such as The Blood of Others and All Men Are Mortal. Drawing from the thought of Husserl, Heidegger, Sartre, and Merleau-Ponty, Beauvoir developed her own distinctive version of existentialism throughout these works."–BOOK JACKET.
@article{schommer_effects_1990,
title = {Effects of beliefs about the nature of knowledge on comprehension.},
volume = {82},
number = {3},
journal = {Journal of educational psychology},
author = {Schommer, Marlene},
year = {1990},
note = {Publisher: American Psychological Association},
pages = {498},
}
![Free to Choose: A Moral Defense of the Right-to-Try Movement [link]](http://bibbase.org/img/filetypes/link.svg "Paper")
