Virtue, progress and practice

Reasoning, evidence, and clinical decision‐making: The great debate moves forward

“…The strict dichotomy between evidence and value—the former concerned with objective fact and the latter invariably reduced to matters of subjective “preference”—suggests a clear philosophical dividing line between epistemic questions (concerning knowledge, empirical data, and reason) and questions of an evaluative or moral nature (concerning what should be the case, what is preferable, matters of emotion and personal commitment). While this dichotomy may well have played an important role in intellectual progress and the development of numerous scientific specialisms, it is also possible that its influence now inhibits progress …”

“…All thinking and all decision‐making concerning the care of persons take place against the background of conceptual frameworks that may only occasionally be made the subject of critical scrutiny, but which are by no means necessary and may not be universally shared. There is no such thing as atheoretical thinking and practice, and it is a definitive feature of the reasonable person, and indeed of the autonomous practitioner, that she spends some time identifying and interrogating the preconceptions that frame her practice. Far from being an activity somehow disconnected from practice, it is a precondition of adequate theorising that it enables practitioners to make sense of what they actually do .…”

Reason and value: making reasoning fit for practice

“…If we are serious about the need to promote dialogue between professionals and academics from a broad range of backgrounds, then these basic organizational questions about how to facilitate such dialogue need addressing. As we have argued previously [2] and as the foregoing account of the papers in this issue of the JECP illustrates, such a dialogue is essential for progress both in practice and in our theoretical understanding. It serves the dual purpose of equipping practitioners to question the conceptual basis of their practices and enabling intellectuals to ground their thinking in a profound engagement with some of the most important realities of contemporary life.…”

“…Discussions about the nature of evidence, the proper goals of practice or the nature, scope and limitations of clinical reasoning, can appear intractable because we bring to them assumptions that may typically lie in the background, rarely subjected to critical scrutiny [1]. It can initially come as something of a shock to discover that other apparently rational persons do not share assumptions that may have slipped so far into the background as to strike us as sheer common sense [2]. Even so, if we are to say something on such important matters that is at once substantive (going beyond platitudes) and defensible (justifiable in principle to other reasonable people) -if we are even to understand the nature of our disagreements, let alone find realistic ways to resolve them -then we cannot avoid doing philosophy in this sense.…”

Explanation, understanding, objectivity and experience

“…This edition closes with a report of a 1‐day interdisciplinary workshop on ‘bodies and minds in medicine’, hosted by the Centre for the Humanities and Health at King's College, London . As discussed in previous editions [32,34], the journal enthusiastically supports this sort of intellectually serious, interdisciplinary exchange of ideas. The report published here is useful in a number of ways.…”