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Epistemic humility

Yael Peled
Contemporary realities of global population movement increasingly bring to the fore the challenge of quality and equitable health provision across language barriers. While this linguistic challenge is not unique to immigration contexts and is likewise shared by health systems responding to the needs of aboriginal peoples and other historical linguistic minorities, the expanding multilingual landscape of receiving societies renders this challenge even more critical, owing to limited or even non-existing familiarity of modern and often monolingual health systems with the particular needs of new linguistic minorities...
May 9, 2018: Bioethics
Alistair M C Isaac
Psychophysics measures the attributes of perceptual experience. The question of whether some of these attributes should be interpreted as more fundamental, or "real," than others has been answered differently throughout its history. The operationism of Stevens and Boring answers "no," reacting to the perceived vacuity of earlier debates about fundamentality. The subsequent rise of multidimensional scaling (MDS) implicitly answers "yes" in its insistence that psychophysical data be represented in spaces of low dimensionality...
October 2017: Studies in History and Philosophy of Science
John R Stone
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...
October 1, 2017: AMA Journal of Ethics
Judith H Danovitch, Megan Fisher, Hans Schroder, David Z Hambrick, Jason Moser
This study explored developmental and individual differences in intellectual humility (IH) among 127 children ages 6-8. IH was operationalized as children's assessment of their knowledge and willingness to delegate scientific questions to experts. Children completed measures of IH, theory of mind, motivational framework, and intelligence, and neurophysiological measures indexing early (error-related negativity [ERN]) and later (error positivity [Pe]) error-monitoring processes related to cognitive control. Children's knowledge self-assessment correlated with question delegation, and older children showed greater IH than younger children...
September 18, 2017: Child Development
Anita Ho
In this issue of the Hastings Center Report, Joshua Rager and Peter Schwartz suggest using opioid treatment agreements as public health monitoring tools to inform patients about "the requirements entailed by undergoing opioid therapy," rather than as contractual agreements to alter patients' individual behavior or to benefit them directly. Because Rager and Schwartz's argument presents suspected OTA violations as a justification to stop providing opioids yet does not highlight the broader epistemic and systemic context within which clinicians prescribe these medications, their proposal may perpetuate a climate of distrust and stigmatization without correcting systemic factors that may have placed patients and others at risk in the first place...
May 2017: Hastings Center Report
Daniel Z Buchman, Anita Ho, Daniel S Goldberg
Trust is central to the therapeutic relationship, but the epistemic asymmetries between the expert healthcare provider and the patient make the patient, the trustor, vulnerable to the provider, the trustee. The narratives of pain sufferers provide helpful insights into the experience of pain at the juncture of trust, expert knowledge, and the therapeutic relationship. While stories of pain sufferers having their testimonies dismissed are well documented, pain sufferers continue to experience their testimonies as being epistemically downgraded...
March 2017: Journal of Bioethical Inquiry
Ian James Kidd
This paper offers an epistemological framework for the debate about whether the results of scientific enquiry are inevitable or contingent. I argue in Sections 2 and 3 that inevitabilist stances are doubly guilty of epistemic hubris--a lack of epistemic humility--and that the real question concerns the scope and strength of our contingentism. The latter stages of the paper-Sections 4 and 5-address some epistemological and historiographical worries and sketch some examples of deep contingencies to guide further debate...
February 2016: Studies in History and Philosophy of Science
Daniel Z Buchman, Anita Ho, Judy Illes
OBJECTIVE: Past research has demonstrated that trust is central to an effective therapeutic relationship, but the role of trust in chronic pain management is not well understood. The objective of this study was to provide an in-depth examination of how adults living with chronic pain negotiate trust and demonstrate trustworthiness with clinicians in therapeutic encounters. METHODS: This qualitative study focused on adults living in an urban setting in British Columbia, Canada...
August 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Patrick J Connolly
This paper offers a new approach to an old debate about superaddition in Locke. Did Locke claim that some objects have powers that are unrelated to their natures or real essences? The question has split commentators. Some (Wilson, Stuart, Langton) claim the answer is yes and others (Ayers, Downing, Ott) claim the answer is no. This paper argues that both of these positions may be mistaken. I show that Locke embraced a robust epistemic humility. This epistemic humility includes ignorance of the real essences of bodies, of the causal processes underlying the production of natural phenomena, and of God's method of creation...
June 2015: Studies in History and Philosophy of Science
Michel C F Shamy, Frank W Stahnisch, Michael D Hill
The ethical principle of 'equipoise', introduced in 1974, represents the most widely influential justification for the enrollment of patients into randomized clinical trials. However, definitions of equipoise vary, and its terms are not universally accepted. In this paper, we suggest a new way of approaching the ethics of clinical trial enrollment, which we call fallibility. The principle of fallibility argues that all physician opinions are sufficiently uncertain to warrant investigation, and that the ethical justification for any trial becomes a question of its epistemic validity, by which we mean the strength of its hypotheses and methods...
January 2015: International Journal of Stroke: Official Journal of the International Stroke Society
Alistair Wardrope
Many critics of medicalization (the process by which phenomena become candidates for medical definition, explanation and treatment) express concern that the process privileges individualised, biologically grounded interpretations of medicalized phenomena, inhibiting understanding and communication of aspects of those phenomena that are less relevant to their biomedical modelling. I suggest that this line of critique views medicalization as a hermeneutical injustice--a form of epistemic injustice that prevents people having the hermeneutical resources available to interpret and communicate significant areas of their experience...
August 2015: Medicine, Health Care, and Philosophy
Daniel Z Buchman, Anita Ho
Prescription opioid abuse (POA) is an escalating clinical and public health problem. Physician worries about iatrogenic addiction and whether patients are 'drug seeking', 'abusing' and 'diverting' prescription opioids exist against a backdrop of professional and legal consequences of prescribing that have created a climate of distrust in chronic pain management. One attempt to circumvent these worries is the use of opioid contracts that outline conditions patients must agree to in order to receive opioids. Opioid contracts have received some scholarly attention, with trust and trustworthiness identified as key values and virtues...
October 2014: Journal of Medical Ethics
Abraham Schwab
Physicians and other medical practitioners make untold numbers of judgments about patient care on a daily, weekly, and monthly basis. These judgments fall along a number of spectrums, from the mundane to the tragic, from the obvious to the challenging. Under the rubric of evidence-based medicine, these judgments will be informed by the robust conclusions of medical research. In the ideal circumstance, medical research makes the best decision obvious to the trained professional. Even when practice approximates this ideal, it does so unevenly...
February 2012: Journal of Medicine and Philosophy
A Ho
The notions of "expert" and "expertise" imply that some people have more credibility than others on certain matters. While expert authority is often taken for granted, there are questions as to whether expert power in some cases can be a form of epistemic oppression. Informed by bedside disagreements between family and clinicians as well as feminist discussions of epistemic oppression, this paper argues for a commitment to epistemic humility and the adoption of a two-way collaborative approach between clinicians and families that can help to enhance professionals' own understanding of their theoretical framework and also promote responsive patient care...
August 2009: Journal of Medical Ethics
James A Marcum
Today, modern Western medicine is facing a quality-of-care crisis that is undermining the patient-physician relationship. In this paper, a notion of the epistemically virtuous clinician is proposed in terms of both the reliabilist and responsibilist versions of virtue epistemology, in order to help address this crisis. To that end, a clinical case study from the literature is first reconstructed. The reliabilist intellectual virtues, including the perceptual and conceptual virtues, are then discussed and applied to the case study...
2009: Theoretical Medicine and Bioethics
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