There appears to be a fundamental inconsistency between research which shows that some minority groups consistently receive lower quality healthcare and the literature indicating that healthcare workers appear to hold equality as a core personal value. Recent evidence using Implicit Association Tests suggests that these disparities in outcome may in part be due to social biases that are primarily unconscious. In some individuals the activation of these biases may be also facilitated by the high levels of cognitive load associated with clinical practice. However, a range of measures, such as counter-stereotypical stimuli and targeted experience with minority groups, have been identified as possible solutions in other fields and may be adapted for use within healthcare settings. We suggest that social bias should not be seen exclusively as a problem of conscious attitudes which need to be addressed through increased awareness. Instead the delivery of bias free healthcare should become a habit, developed through a continuous process of practice, feedback and reflection.
In 2011 the Prime Minister of the UK David Cameron during a Commons debate told the then shadow Chief Secretary to the Treasury Angela Eagle to "calm down, dear". His words were widely taken to be sexist, patronising and arrogant. They betrayed a fairly transparent attempt to rely on stereotypes about women's judgement being clouded by emotion in order to undermine or deflate the credibility of her questioning of his policies. 1 They also were an attempt to silence her. Cameron did not intend literally to prevent her from speaking by physically closing her mouth or by interrupting her, although he may have done the latter. Rather, he wanted her attempts to describe what she saw as the failures of his policies, not to have, in the eyes of the other present members of the Commons, the status of assertions. He attempted to achieve this by feigning that he had not recognised her intentions. By saying to her to calm down, he was insinuating that because of her emotional state it was impossible to surmise what she may be saying. He was telling their audience that her speech did not constitute an input to rational debate because her intentions could not be recognised. His gambit did not pay off, as it was transparently disingenuous, but it was an attempt to silence his opponent by causing her assertions to misfire. 2 Intellectual arrogance is a very common and varied phenomenon. The fairly recent episode mentioned above is only one example; but arrogance is encountered in all walks of life. 3 It is exhibited by individuals who do not respect their turn in conversation, who interrupt others, who take up an unfair share of the available time. It shows up when a person boasts about his achievements, never admits to a mistake, publicly puts other 1 On deflating credibility as a kind of testimonial injustice see, Miranda Fricker's ground-breaking Epistemic Injustice (2007). 2 As a matter of fact the gambit backfired because it was widely interpreted as indicating an inability to remain cool under pressure. By telling Eagle to calm down, Cameron had shown that he was flustered and unable to address the content of her challenge. I shall explain the nature of illocutionary disablement or silencing by causing a speech act to misfire below. For reporting of this episode see http://www.theguardian.com/ politics/2011/apr/27/david-cameron-calm-down-dear [accessed on 30 July 2015]. The locus classicus on illocutionary silence is Rae Langton (1993) see also her (2009). 3 For reasons of brevity in the rest of this paper I use 'arrogance' as a shorthand for 'intellectual arrogance'. Whenever arrogance in general is intended, this fact is indicated explicitly.2 people "in their place", or thinks that he is always right. 4 It is also manifested by excessive risk takers, by people who do not tolerate dissent, by those who try to intimidate others into agreeing with them.Despite its prevalence intellectual arrogance has not received the detailed philosophical attention that it deserves. To my knowledge very little has been written in r...
Virtue ethicists and epistemologists have generally presumed that virtue and vices are real psychological states or traits amenable to empirical study. There is, however, no agreement on the psychological constructs that may play this role. This chapter introduces the apparatus of attitude psychology that, in the author’s view, supplies a theoretical framework suitable to understand those intellectual vices which in Chapter 2 have been described as defects in epistemic agency. The approach throws light on the affective, motivational, and cognitive dimensions of the vices which are under scrutiny in this book. The chapter provides an overview of key concepts in attitude psychology including that of an attitude as a summary evaluation of its object. It makes a case that attitudes are the causal bases of intellectual virtues and vices. It concludes by addressing various objections to the framework and briefly addresses the questions raised by the situationist criticism of virtue epistemology.
Intellectual humility, I argue in this paper, is a cluster of strong attitudes (as these are understood in social psychology) directed toward one's cognitive make-up and its components, together with the cognitive and affective states that constitute their contents or bases, which serve knowledge and value-expressive functions. In order to defend this new account of humility I first examine two simpler traits: intellectual self-acceptance of epistemic limitations and intellectual modesty about epistemic successes. The position defended here addresses the shortcomings of both ignorance and accuracy based accounts of humility. 7 This notion of an attitude is the central construct of social psychology. See Banaji & Heiphetz (2010). It is not to be confused with that of an attitude toward a proposition. ALESSANDRA TANESINI
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