VMST 2018: 8TH ANNUAL VALUES IN MEDICINE, SCIENCE, AND TECHNOLOGY CONFERENCE 2018
PROGRAM FOR SATURDAY, MAY 19TH
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09:30-11:00 Session 14: Publics, Politics, and Science
Chair:
Matthew J. Brown (The University of Texas at Dallas, United States)
09:30
Eric Martin (Baylor University, United States)
Criticizing and inspiring science: the case of Richard Lewontin
SPEAKER: Eric Martin

ABSTRACT. In the polarized “science wars” of the 1990s, Science Studies scholarship acquired a reputation for hostility to science. Often this reputation was based on mischaracterization or misunderstanding, but even some within the field thought that STS was lacking a proper esteem for science and its social significance. Evelyn Fox Keller, for example, believes that entrenched habits of critical scholarship have left the community with an “urgent crisis,” unable to defend the claims of climate scientists. More recently, Bruno Latour and Harry Collins have wondered whether they were part of academic trends that have lent themselves to a denigration of natural sciences. Now that such denigration is associated with corporate unaccountability, anti-intellectualism, and the political right, scholars face the challenge of articulating the proper measures of scientific critique and defense.

STS scholars therefore have a renewed interest in the defense of science, and recent trends have encouraged a rush to defend science. I argue that such defense is vital but should not be understood as replacement for the critique of science.

In this paper I use a case study to emphasize successful lessons in this goal of measured critique of science. Richard Lewontin was an evolutionary biologist who enjoyed a broad reputation for simultaneously defending and questioning science. Indeed, he was often critiquing the very science he had himself advanced. Lewontin’s high-profile critiques of science, though, were not seen as anti-science. His contributions to population genetics are beyond dispute, and he attracted many students into his field and into his laboratory.

Lewontin had a keen sense for both the powers and the limitations of biological science and its limitations. Briefly, a few of those lessons on the nature of science include the claims that: -Science is shaped by metaphors and permeated by values -Because science is value-laden there is room for ideological critique of science -Science is a collection of piecemeal problem-solving activities; not a single universal method of discovery -Novel scientific tools have the potential to occlude scientific understanding if they are invested with too much significance

In this paper I elucidate these lessons and show how they support the goal of measured critique of science.

09:50
Sharyn Clough (Phronesis Lab, OSU, United States)
Rorty, Science, and Peace Literacy
SPEAKER: Sharyn Clough

ABSTRACT. In previous work I have argued that feminist and other political values can function as empirical claims, and that where relevant and well-supported by evidence, political values can increase the empirical strength of particular scientific theories. In this paper I shift focus to show not only that political values can have evidential support, but also to show how evidential deliberations about political values can be effective in science contexts, i.e., articulating the conditions and skills required for effective deliberation. I now focus on the importance of skills like empathy and epistemic humility in science, modeled on Rorty’s notions of liberal irony, and explicated in terms of peace literacy—a new kind of phronesis or practical wisdom, borrowed from Paul K. Chappell.

I show the importance of adopting an ironical commitment to our own political values—that we need to recognize the contingency, the fallibility, of our values—and the importance of subjecting those values to critical scrutiny. It is dogmatism about our values, rather than the presence of the values themselves, that is the main cause for concern in science. Following Rorty, I encourage scientists and those who study science to embrace pragmatic inquiry, and muddle through with our always fallible and contingent processes of data collection and analysis —these are the best practices we’ve got, in science as in politics, and perhaps especially in politically-informed science.

The recognition of fallibilism and contingency respects the properly persuasive power of empirical evidence, while extending the range of what counts as empirical, and recognizing the contingency of even the strongest evidence claims available at any given moment. Through the promotion of skills like humility and empathy, liberal irony involves a commitment to the phronesis of peace-making in our daily lives as scientists and citizens.

10:10
Cristian Larroulet Philippi (CU Boulder, United States)
Democratizing Well-ordered Science

ABSTRACT. One area of scientific practice that has significant consequences for the collective good is the decision-making procedures behind science’s research agenda (SRA). These significant consequences entail that SRA is a public issue (M.J. Brown 2013). But which is that collective good that SRA should promote? Philip Kitcher (2001, 2011) has provided an ideal account of how social values should guide SRA: well-ordered science (WOS). WOS has been criticized regarding both its capacity for guiding action (Kitcher 2002; M.B. Brown 2004) and its democratic legitimacy (Keren 2015). Against the first criticism, Kitcher claims that this concern confuses ‘ideals’ and the ways to arrive at them (2002, 2011). No defense has been given against the second. In this essay, I start by distinguishing between normative ideals that provide an ideal answer to the normative question at stake (e.g. Rawls’ [1999] principles of justice) and those that provide an idealized procedure for answering the question (e.g. the ideal of ‘free and fair elections’). Kitcher’s understanding of WOS as a “hypothetical procedure”, the answers of which we should aim at, classifies WOS an ‘ideal answer’. Given this, Kitcher’s response to the action-guiding problem fails. Why? Ideal answers may guide action, but only if the answers (as in Rawls’ case) are known. But, given the detail-oriented task at hand for ideal deliberators, I argue that the answers of WOS as a “hypothetical procedure” cannot be known. Thus, there are no ideal answers for our science’s agenda to compare with, so no guiding. However, this is not the case if we read WOS as an ‘ideal procedure’, that is, taking its idealized procedures (rather than its unknown answers) as that which we should aim at regarding science’s agenda. Under this understanding, WOS can provide a benchmark for assessing science’s agendas, and therefore be action-guiding. Furthermore, drawing from the literature on instrumental versus intrinsic justifications of democratic decision-making procedures, this reading of WOS allows me to reject Keren’s criticisms regarding its democratic legitimacy. Therefore, both concerns can be dealt with once WOS is understood procedurally.

11:30-12:15 Session 15: Lightning Talks
Chair:
Matthew J. Brown (The University of Texas at Dallas, United States)
11:30
Marina Dimarco (University of Pittsburgh, United States)
Kareem Khalifa (Middlebury College, United States)
Prediction Tickets: Values, Pursuit, and Underdetermination

ABSTRACT. In this paper, we offer a new account of the role of values in theory choice. Specifically, we argue that non-epistemic values sometimes serve as ‘prediction tickets,’ i.e. as motivating the pursuit of questions, such that the answers to these questions provide evidence favoring one hypothesis over another. While others working on science and values have noted the role of non-epistemic values in the context of pursuit, they have tended to conceive of the objects of pursuit on a large scale, e.g. as theories or as research programs. By contrast, prediction tickets concern the pursuit of smaller scale questions that arise in response to relatively local (and routine) kinds of research problems and disagreements within a scientific community. Prediction tickets’ functions are especially salient in cases of transient underdetermination. In particular, while transient underdetermination is understood to have different epistemic implications in the short and long run, recent work in science and values has neglected to assign a similar temporal dimension to the values themselves. Prediction tickets are one way of filling this lacuna. In an example from evolutionary biology, we show that in addition to traditional cognitive values like accuracy, non-epistemic values can motivate pursuing questions in the short run, and the answers to these questions alleviate transient underdetermination in the long run. Importantly, because evidence, rather than the non-epistemic values themselves, ultimately determines theory choice, prediction tickets are compatible with an ideal of value-free science. That is, while non-epistemic values motivate pursuit, epistemic considerations are the only rational determinants of beliefs about hypotheses. Moreover, our account can uphold this aspect of the value-free ideal while replicating many advantages claimed by critics of the value-free ideal, most notably those advantages claimed by inductive risk theorists.

11:35
Parysa Mostajir (University of Chicago, United States)
A Pragmatist Reintegration of Science and Ethics

ABSTRACT. Science’s relationship to ethics is frequently framed in terms of the points at which two distinct arenas intersect and influence each other. This framework presumes a conceptual and practical distinction that is not only a contingent, historical development, but a political one. The separation, in scientific-ethical discourse, between internal or inherent properties of scientific inquiry, and external or accidental properties of its application or reception, is already to assume a dichotomy that requires examination.

To critique this separation, I appropriate a pragmatist postulate that, in the broadest sense, the purpose for undertaking any inquiry directly emerges from a desire to improve our circumstances in everyday life, or in ‘the realm of common sense’. Scientific inquiry organically emerges from the problems of lived experience with an eye to enriching the latter, and has earned its prestige by virtue of its improvement of conditions and quality of life, via its capacity to allow greater control of our material environment. We no longer must structure our daily routines around the rising and setting sun, for example; we use electric lights to illuminate our activities at any time of day. The ethical and political properties of scientific inquiry are written into the practice from the beginning, since they are written into the quotidian affairs from which inquiries arise as tools for potential solutions. The consequences that science, or an associated technology, has on wider society, are therefore not afterthoughts or externalities, but constitutive concerns, even raisons d’etre, of the practices themselves.

The assumption of a conceptual and discursive separation of scientific practices from the societies in which they are embedded is an artifice that should be deconstructed via a conscientious philosophical examination of the functional role of inquiry in human life. The dogmatic or lazy reification of this separation plays a pernicious role in silencing legitimate political claims to consider the socio-ethical consequences of scientific and technological practices, and to regulate them accordingly.

John Dewey, 1938. Logic, The Theory of Inquiry. Henry Holt, New York. Langdon Winner, 1980. 'Do Artifacts Have Politics?', Daedalus, 109(1).

11:40
Sindhuja Bhakthavatsalam (CSUN, United States)
Values in Science Education: A Critical Appraisal of ‘Nature of Science’ in the Next Generation Science Standards

ABSTRACT. Nature of Science (NOS) deals with general, overarching features of scientific knowledge and practices. At least since John Dewey scholars have been underscoring the importance of incorporating NOS in school science. In 2013, several states in the US adopted the Next Generation Science Standards (NGSS) – a document enlisting ‘performance expectations’ for a number of science topics – for K-12 science. This was based on the National Research Council’s A Framework for Science Education: Practices, Crosscutting Concepts, and Core Ideas – referred to as the three ‘dimensions’ of science. While the rationale behind the Framework – that science education should closely mirror science as it is actually practiced by scientists – is laudable, one area where the NGSS is lacking is NOS, which does not appear in the performance expectations but has instead been relegated to an appendix. The NGSS does a particularly bad job of covering one aspect of NOS, the role of social and ethical values in science. That science is influenced by society is a key point in the recent philosophical literature on ‘Values in Science’ (VIS). This point hardly finds a place in the NGSS, which only mentions in passing, values in relation to engineering and technology. Worse, it goes on to say, “Science knowledge indicates what can happen in natural systems—not what should happen. The latter involves ethics, values, and human decisions about the use of knowledge.” Teaching that there is a sharp division between scientific and ethical realms can be naïve and problematic since in practice, science and ethics are often inextricably tied. Here I a) argue that the NGSS is inadequate and inaccurate with respect to VIS by drawing on the philosophical literature, and b) make recommendations for ways in which the NGSS can appropriately and accurately incorporate VIS and integrate it with the aforementioned three dimensions.

11:45
Frederick Grinnell (UT Southwestern Medical Center, United States)
Insights from Philosophy of Science Fair about the Source of Uncertainty in Practice of Science

ABSTRACT. The current framework for science education developed in the United States is called Next Generation Science Standards (NGSS). NGSS describes student experience of practice of science as a key dimension of science education. Science fair brings together many of the elements of practice of science -- problem selection, experimental design and implementation, data analysis, and communication of research findings. This paper suggests that the philosophy of science fair focuses on the scientific method rather than on practice of science. These two terms frequently are used interchangeably, but the philosophy of science fair clearly distinguishes between them through its answer to the pragmatic question, Is it ok to change one’s hypothesis to fit the data? Unlike practice of science, in which case the answer is “yes,” in science fair, the answer is “no.” Science fair rules dictate that the student’s goal is to confirm or refute a starting hypothesis, the traditional view of what the scientific method accomplishes. This paper will explore the assumptions underlying the two difference answers. In particular, science fair assumes that the hypothesis is fixed and that the method to test the hypothesis is adequate to the task. Practice of science does not accept either of these assumptions. Indeed, practice of science accepts the uncertainty of the hypothesis, the methodology, and the data itself. Managing this uncertainty is one of the most important sources of discovery in science.

11:50
Anna Wani (UT Southwestern, United States)
To Sleep or not to sleep
SPEAKER: Anna Wani

ABSTRACT. In the early morning hours of Saturday morning, I received a call from the pediatric sleep lab. A young otherwise healthy, obese seven year old boy had been notes to have severe obstructive sleep apnea with significant hypoxia and hypercapnia. He had met emergent criteria to initiate treatment with continuous positive airway pressure, which had not been adequate in improving his hypoxia or hypercapnia and had only minimally improved the number of obstructions an hour. Given that the primary treatment for pediatric sleep apnea is adenotonsillectomy, the sleep tech who performed the study was calling to ask me if I preferred to admit this patient for an emergent surgery.

I decided to admit this patient to the hospital to have surgery to remove his tonsils and adenoids, thereby removing the obstruction causing the sleep apnea in his case. He was admitted on Saturday night, and was placed on positive pressure therapy at night until his surgery was performed on Monday.

He still went to sleep for two nights with profound hypoxia and hypercapnia, and was that ok? Because he was in the hospital, being watched? Or would the better approach have been to not admit the patient at all since resources are scarce in a Children’s hospital during flu season and just have the patient be emergently evaluated by ENT to do the surgery as an outpatient on Monday, especially since these symptoms have been present for months at least?

This small case highlights the bigger problem in our healthcare system. Health care delays. When is a delay acceptable and when is not?

In the case of this young boy, he had had symptoms of sleep disordered breathing, which had been evaluated and he had been referred for a routine sleep study. Some weeks had passed, prior to the uncovering of the severity of his problem, but now that we knew how severe it was, we could not just stand by and do nothing? Or could we?

I would like to host a round table discussion on the ethical obligations we have in case like this, and similar themes run through other medical specialties throughout health care.

11:55
Jesse Saloom (University of Louisiana at Lafayette, United States)
The Effect of Medical Progress on the Ethics of Organ Sales
SPEAKER: Jesse Saloom

ABSTRACT. Legalizing the sale of kidneys has been an ongoing discussion in bioethics. It has been argued that once organs can successfully be cloned and transplanted, the ethics of kidney sales will no longer be relevant. Yet there is reason to question this notion, since a certain system that allows kidney sales might be preferable to transplanting cloned kidneys.

This paper will consider the benefits transplanting cloned kidneys could have over kidneys from live vendors. Most notably, transplanting clones gets around problems concerning exploitation to vendors. This paper will also consider less obvious benefits—alongside more obvious detriments— to a single-payer system that facilitates sales from live vendors. These benefits and detriments will be considered from the current state of medicine.

However, many of the ethical arguments rest upon issues such as risk, which are determined by the current state of medicine. As the state of medicine changes, the strength of the arguments changes. For this reason, it is worth analyzing these arguments from the future of medical science. Therefore, ethical arguments regarding the sale of kidneys will not only be analyzed from the current state of medical science, but from its future as well.

12:00
Daniel Hicks (University of California, Davis, United States)
The Triple Movement of Research Metrics
SPEAKER: Daniel Hicks

ABSTRACT. The use of research metrics has been highly controversial. Proponents of these metrics argue that they allow scarce resources to be allocated efficiently and encourage socially-relevant research. Critics argue that metrics prioritize quantity over quality, and associate the use of research metrics with the commodification of research and the "neoliberal university."

This paper analyses this controversy, drawing on work by Nancy Fraser and Karl Polanyi on the politics of economic-technological change. In his analysis of industrialization, Polanyi identified a "double movement": changes to the system of production were driven by elites, while popular movements fought to protect people from the harms of an unrestricted free market (Polanyi 1944 [2001]). However, Fraser argued that Polanyi neglected the differences between two kinds of popular responses to industrialization (Fraser 2014). The status quo is not simply two groups — capitalists vs. workers — but instead involves mutually reinforcing hierarchies — such as gender and race. Changes to the system of production disrupt these other hierarchies as well. Traditionalists or reactionaries resist both liberal and egalitarian changes to the status quo. Egalitarians use new economic opportunities to challenge both traditional and capitalist hierarchies. Thus, according to Fraser, there are three important social groups involved in the politics of economic-technological change: capitalist-liberals, reactionaries, and egalitarians. Fraser refers to this dynamic as the "triple movement."

A triple movement analysis can be applied to the research metrics controversy. The arguments in favor of metrics often reflect capitalist-liberal assumptions. And critics of metrics are often explicitly traditionalist. The third, egalitarian possibility is often overlooked: developing and using research metrics to challenge both traditional academic power structures and the movement towards commodification. Egalitarian uses of metrics are illustrated with a brief review of bibliometric analyses of gender hierarchies in peer review, research funding, and faculty career development.

References

Fraser, Nancy. 2014. “Can Society Be Commodities All the Way down? Post-Polanyian Reflections on Capitalist Crisis.” Economy and Society 43 (4):541–58.

Polanyi, Karl. 1944 [2001]. The Great Transformation. Beacon Press.

12:05
Elyse Purcell (SUNY Oneonta, United States)
Animal Research, Interspecies Relationships and the Moral Community
SPEAKER: Elyse Purcell

ABSTRACT. Should non-human animals be granted the same protections as human subjects in medical research? Answering this question has proven to be a longstanding challenge in moral philosophy. Certain philosophers have argued that there are unique capacities that are distinctive in humans and this distinction justifies certain medical practices – practices that may induce pain, discomfort, suffering and death – for non-human animals if those medical practices better the human community. In other words, human subjects are granted a higher moral consideration in medical research than non-human animals such as chimpanzees, dogs, and rabbits because human subjects retain capacities unique to their membership in the human species or moral community. In contrast to this view, other philosophers have argued that, although most humans do posses different capacities from non-human animals, these different capacities do not provide a justification for inflicting pain and suffering on non-human animals for the sake of medical advancement. In response to the cruel treatment of non-human animals in medical research, William Russell and Rex Burch developed the moral principles of reduction, refinement and replacement in animal use (1959). Known as the “3 Rs,” these principles encouraged researchers to reduce the number of animals used in medical experiments, refine or limit the distress and pain animals suffer, and to replace the use of animals with non-animal alternatives whenever possible. However, although Russell and Burch’s approach gained significant attention, the number of animals used in medical research and testing has continued to increase. This increase raises significant ethical questions for philosophers and the medical community. The aim of this essay is to provide a thick conception of interspecies relationships in order to grant stronger moral protections for non-human animals used in medical research. This thick concept circumscribes a boundary for animals used in medical research and creates a form of membership in the moral community through our interspecies relations for those (i.e., animals) that have been traditionally excluded.

12:10
J Britt Holbrook (New Jersey Institute of Technology, United States)
AAAS Statement on Scientific Freedom and Responsibility

ABSTRACT. The Board of Directors of the American Association for the Advancement of Science (AAAS), the world’s largest general scientific society and publisher of Science magazine, officially adopted the AAAS Statement on Scientific Freedom and Responsibility on October 12, 2017. In full, the statement reads:

Scientific freedom and scientific responsibility are essential to the advancement of human knowledge for the benefit of all. Scientific freedom is the freedom to engage in scientific inquiry, pursue and apply knowledge, and communicate openly. This freedom is inextricably linked to and must be exercised in accordance with scientific responsibility. Scientific responsibility is the duty to conduct and apply science with integrity, in the interest of humanity, in a spirit of stewardship for the environment, and with respect for human rights.

This paper will present the statement from the perspective of one of the members of the AAAS Committee on Scientific Freedom and Responsibility, which developed the statement. It will give a short history of the statement, describing both why and how it was developed. The main point of the presentation will be to spark a discussion about the statement, with particular focus on how it might be used to advance ethics and values in science and technology, as well as in a policy context.

13:30-14:30 Session 16: Health and Medicine I
Chair:
Peter Park (The University of Texas at Dallas, United States)
13:30
Sarah Miller (The Pennsylvania State University, United States)
On the Possibilities and Limitations of Epistemic Collaboration in Maternal-Fetal Medicine
SPEAKER: Sarah Miller

ABSTRACT. This paper analyzes the role that values play in the generation of knowledge in maternal-fetal medicine by drawing on recent literature in feminist social epistemology to offer an epistemic-ethical analysis of the obstetric patient-practitioner relationship. In the first half of the paper, I analyze the epistemic risks involved for obstetric patients by introducing the idea of epistemic moral injury, a hybrid concept arising through the work of Jean Hampton and Miranda Fricker. I also consider how some aspects of the obstetric patient-practitioner relationship can benefit women by bolstering their reproductive autonomy and self-trust. In the second half of the paper, I examine the role of epistemic credibility in the patient-practitioner relationship. I analyze patterns of credibility excess and deficit promoted by the use of certain reproductive technologies. I also identify possible tensions that can arise between visually-informed medical expertise and the somatically-informed expertise of obstetric patients. In response to the identification of such tensions, I propose a way they might be addressed while specifically avoiding the harm of epistemic moral injury: a collaborative epistemic model of expertise to which both patient and practitioner contribute. Throughout the paper, I conduct an intersectional analysis designed to capture the multi-factor impact of different vectors of identity on perceived excesses and deficits of epistemic credibility. While gender is obviously a vitally important factor in such considerations, so, too, are race, class, national origin, and sexual orientation. Thus, the ultimate aim of the paper is to conduct an analysis of epistemic credibility and epistemic injustice in the obstetric patient-practitioner relationship.

13:50
Benjamin Chin-Yee (University of Toronto, Canada)
Ross Upshur (University of Toronto, Canada)
Jonathan Fuller (University of Toronto, Canada)
On the Very Idea of an Algorithm: Three Problems with Big Data and Machine Learning in Medicine

ABSTRACT. Machine learning technologies fuelled by ‘big data’ are finding growing applications in medicine, from interpretation of diagnostic tests and imaging to disease prognostication and drug development. An exponential rise in articles on these topics is seen in the literature, including endorsements in prominent medical journals with proponents claiming that “much of the diagnostic and monitoring functions performed by physicians today can be offset to computers and algorithms” [Topol et al. JAMA 2015;313(4):353-4]. Amid this enthusiasm, the philosophical assumptions that underlie the big data and machine learning movement in medicine are rarely questioned. Our presentation examines some of these assumptions, exploring their implications for clinical medicine at the intersection between epistemology and ethical practice. We highlight three interrelated problems that confront big data and machine learning in medicine: (i) the problem of data, and how particular epistemic values and the ‘theory-ladenness of observation’ impact what counts as data; (ii) the problem of measurement, and how big data’s overreliance on quantitative measures risks reification and misrepresentation of clinical phenomena; and, lastly, (iii) the problem of algorithms, and how formal systems face inherent limitations in capturing the complexity and irreducible uncertainties that arise in clinical practice. We demonstrate the epistemic and ethical implications of these problems through a series of clinical case examples. These problems reveal implicit positivist, reductionist, and (often) deterministic assumptions which are commonplace in the big data analytics movement. We characterize these biases in order to better understand the limitations of these tools and to enable the development of technologies that are more sensitive to particular patients’ values and contexts. We conclude by arguing that—despite claims from big data proponents—these approaches do not offer a complete account of clinical practice, which ultimately requires a pluralistic epistemology that interprets and integrates these tools alongside other legitimate ‘ways of knowing.’

15:00-16:00 Session 17: Dissertations in Progress
Chair:
Matthew J. Brown (The University of Texas at Dallas, United States)
15:00
Christopher Choglueck (Indiana University Bloomington, United States)
Drug Facts and Value-laden Labels: the Pill, Informed Consent, and the FDA’s New Patient Inserts

ABSTRACT. The US Food and Drug Administration (FDA) uses drug labels to communicate information to patients/consumers and their providers. What might seem like a straight-forward transfer of information presents serious epistemic and ethical problems. For one, because medical knowledge can be laden with ethical and politics values, regulators must consider patients’ own values for the information to be epistemically fitting. Furthermore, knowledge itself has the political and economic potential to enable certain actions and disable others, so it can contribute to injustice by undermining patients’ agency when their rights and interests are ignored.

Reproductive health has been one site where regulators at the FDA have struggled to handle the values and interests of patients/consumers. The thalidomide tragedy in the 1950s and ‘60s catalyzed safety reforms after this morning-sickness treatment killed and deformed thousands of children exposed during early pregnancy. High-dose-estrogen oral contraceptives, once associated with blood clots, transformed the role of patients by resulting in detailed leaflets of risks for women. More recently, the morning-after pill has created controversy when anti-abortionists used the FDA’s drug label in court to refuse contraceptive coverage for their female employees (Sebelius v. Hobby Lobby 2014).

These controversies at the intersection of science, regulation, and reproductive health present an opportunity to investigate how values and politics constitute knowledge in regulatory science.  My talk will focus on proposed strategies of risk management related to informed consent for the association of blood clots with high-dose-estrogen oral contraceptives in the 1970 at the Nelson Senate Hearings, particularly the challenges of understanding hormonal contraceptives as a “treatment” and the novelty of informed consent beyond the interpersonal level of doctor and patient.

15:20
Margaret Greta Turnbull (Boston College, United States)
Dinosaur Bones and Disagreement: What Paleobiologists Can Teach Epistemologists of Disagreement

ABSTRACT. In the second chapter of my dissertation, I consider a case of disagreement in the practice of contemporary paleobiology. Paleobiologists, I’ll argue, can help us to see that reasonable disagreement between peers is possible. In the first section, I articulate a widely discussed view in the epistemology of disagreement, first proposed by Richard Feldman, which claims that “mutually recognized reasonable disagreement” is impossible. In the second section, I explicate a case of disagreement in the practice of paleobiology which concerns the function of bizarre dinosaurian structures. In the third section, I note an interesting feature of this disagreement. The paleobiologists involved disagree not merely about the proposition under debate but also about which items of empirical data serve as evidence for and against that proposition. In the fourth section, I argue that this feature changes the locus of rationality of concern to the view that reasonable disagreement is impossible. In the fifth section, I provide an explanation and a defense of the view that under a Bayesian framework, both sides of the debate in paleobiology can behave rationally simultaneously and can recognize each other as behaving rationally in their disagreement. I conclude that this disagreement between paleobiologists can teach philosophers how peers may rationally disagree.

 

16:30-17:30 Session 18: Mental Health
Chair:
Elyse Purcell (SUNY Oneonta, United States)
16:30
Susan Hawthorne (St. Catherine University, United States)
Anne Williams-Wengerd (St. Catherine University, United States)
‘Effective’ is a Weasel Word: On Effective Intervention in Serious Mental Illness
SPEAKER: unknown

ABSTRACT. “Effective” is a weasel word. It seems obvious that effectiveness is desirable—as in developing effective interventions for serious mental illness (SMI). Yet the term’s blandness allows its use without the explanation it needs. Effective at what, exactly? Why that goal? Digging into those questions reveals the goals and values embedded in intervention research, practices of intervention, and policy; not digging in allows obfuscation in each area. In some ways, the need for specificity is recognized. Researchers distinguish between “efficacy” research (effective within the study’s controls) and “effectiveness” research (effective in real-world settings). More generally, researchers define “effectiveness” through operationalization. Providers tacitly establish standards for effectiveness by setting therapeutic goals. Still, “effectiveness” often stands in for more than the research or intervention promises, as it is interpreted by both professionals and nonprofessionals in ways not consonant with a particular operationalization or intervention. For example, antipsychotics are effective according to narrow criteria. But they are not effective at helping people who experience SMI reach other goals, such as finding housing. Oversimplifications allowed by the weasel word contribute to poor practices and policies around SMI, such as prioritizing antipsychotics while letting social interventions languish. The term “effectiveness” stamps approval on whatever goal is set, and it commends achievement itself. A proposed pragmatist solution for “weaseling” asks for specification and justification of the intended goals and the values that underwrite them. Users of “effectiveness” should be ready to answer—and debate—the questions, “Effective at what?,” “Why that goal?,” and “Is effectiveness (versus, say, process or progress) the right framing?”1,2 This proposal is compatible with the “untidy pluralism” of knowledge-building practices in medicine,3 and with pluralism in approaches to SMI. Specifying the values may help research, intervention practice, and policy better focus on significant need around SMI than they do at present.

Selected References 1. Carlier, I.V.E., et al., Routine outcome monitoring and feedback on physical or mental health status: evidence and theory. Journal of Evaluation in Clinical Practice 2012; 18(1): 104-110 2. Berg, H. and R. Slaattelid, Facts and values in psychotherapy—A critique of the empirical reduction of psychotherapy within evidence‐based practice. Journal of Evaluation in Clinical Practice 2017; 23: 1075-1080 3. Solomon, M., Making medical knowledge. Oxford, Oxford University Press, 2015

16:50
Claudia Murphy (Independent Scholar, United States)
Displacing the Addiction Paradigms--Addiction and Oppression, The Tale of an Alcoholic

ABSTRACT. Standard philosophical models of addiction fail to place the phenomena of addiction within the social matrices of domination and oppression. I will start by arguing that the two models of addiction –the disease model and the weakness of will model each ignore the institutional context in which addictions operate. Neither model appreciates the social structure and institutional context which frames addictive behavior. Following a line of thought about displaced paradigms developed by Iris Young, I will argue that each of the aforementioned models also mistakenly thinks of addiction as being something located within an individual and fails to see that addiction is actually a social relationship. Both the disease model and the weakness of will model represent addiction as a static property of an individual instead of as a function of social being in its environment. For the remainder of my presentation I will be focusing on the example of alcoholism. I am not making the claim that all addictions are the same, or that my comments will apply equally no matter the example in front of us. Overall my argument will be for the conclusion that addiction to alcohol is a tool of oppression, and is not an effective liberation strategy. I will be discussing the relationships between victimization, control and liberation. As the title of the presentation suggests I will be using some personal history in the development of my argument. References: 1. Bartky, Sandra, "Foucault, Femininity and the Modernization of Patriarchal Power," Femininity and Domination, Routledge, 1990 1. Foddy, Bennett and Savulescu, Julian, “A liberal Account of Addiction,” Philosophy, Psychiatry and Psychology, Volume 17 Number 1, March 2010 2. Kennett, Jeanette “Just Say No? Addiction and the Elements of Self Control,” Addiction and Self-Control: Perspectives from Philosophy, Psychology and Neuroscience, Oxford University Press, 2013/2017 3. Jaggar, Alison M “Love and Knowledge: Emotion in Feminist Epistemology” Inquiry, Volume 32, 1989 4. Young, Iris Marion, “The Distributive Paradigm,” in Justice and the Politics of Difference, Princeton University Press, 1990