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.

Bibliography

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.

Relevant References

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