Epistemic thinking refers to a cognitive and metacognitive process that involves reasoning about ‘knowledge’. Here, we aim to discuss the nature of ‘knowledge’ insofar as it connects with our ethics and how our perception of ‘knowledge’ affects how we interact with each other in the world.

  • What constitutes knowledge?
    • In what ways do we conceptualize ‘information’?
    • How is it generated and transferred?
  • Do specific social agents (individuals) inherently possess more epistemic value?
    • Why? Why not?
  • What attributes of our epistemic reasoning (in other words, what ways of thinking about knowledge, arguments, evidence, and truth) are conducive to identifying theories or ideas of relevance?
  • What are the limitations of ‘knowledge’ and how we think about it?
  • What ethical implications do epistemics and meta-epistemics have in connection to fields where providers possess more power than consumers, such as healthcare, STEM, and education?
  • What ethical issues are implicit in social systems where some individuals agents have more decision-making power than those whom they serve?

Let’s look at a specific example: take the field of ‘mental wellness & illness’.

Translational Issues in Psychiatry As A Case Study

How issues in theory mediate issues in practice : How epistemological issues mediate ethical issues

DSM categories lack theoretical-conceptual reliability and predictive validity. The widespread unawareness of the limitations of our most popular ontological model of mental illness, is problematic because if we cannot reliably and precisely characterize such problematic states of being, how are we to effectively treat them?

Additionally, how can [mis]perceptions about the character of “mental disorder” unfairly influence our perception of the legitimacy of the ideas/propositions that those afflicted may generate?

So, what kind of ethical implications does this have for patient-provider interactions? At a time when diagnoses still lack sufficient prognostic utility, what are our ethics around evaluation, treatment, and communication with clients? Do we have some questions that we need to address with respect to how we conceptualize and implement diagnostic practices?

Do you think the evaluation and treatment process (at large) is more likely to be driven by the institutional desire to manage risk rather than to relationally engage ? Is it ethical to make such diagnostic determinations in light of such conceptual & empirical gaps?

If a diagnosis must be made for practical reasons (insurance, for instance), then how should a ‘diagnosis’ be communicated?  To be clear, we are not saying that professionals who engage in the act of diagnosis are behaving unethically: not only is the intent of diagnosis to shed light on the pathophysiology of disorder in order to identify and implement ways to lessen the harmful dysfunction (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 diagnoses. The needs of providers and client stakeholders are critically important; however, what if an excessive psychological need for closure, actually undermines the capacity for critical thinking & balanced analysis? What if a pervasive psychological intolerance of uncertainty undermines individual and collective capacities for sense-making? The problem that presents when diagnostic claims are made in the absence of enough information to support them and when they are framed using inaccurate abstractions, is a conceptual pain point that could be tipping a downstream cascade of mis and disinformation.

Barring clear structural damage (you know, shattered bones, dead tissue, etc), most health phenomena are rarely so simple and unidimensional . Appraising ‘diagnosis’ as ‘predictive prognosis’ might be a comforting crutch, but should it be normative to prioritize psychological safety over epistemic validity? 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 receive, integrate, and express messages about the strengths & limitations of our knowledge.

Maybe, it is in the light such an honest ‘unknowing’, that we could learn to find meaning and value –even some creative solutions– to our continuous problems.

References

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.

 

Zotero Library: Epistemic Thinking & Ethics

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