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Javier E

Functional medicine: Is it the future of healthcare or just another wellness trend? - I... - 0 views

www.independent.ie/...r-wellness-trend-37437566.html

functional medicine healthcare future wellness health science research

shared by Javier E on 26 Dec 22 - No Cached
  • Functional Medicine is the alternative medicine Bill Clinton credits with giving him his life back after his 2004 quadruple heart by-pass surgery. Its ideology is embraced by Oprah and regularly features on Gwyneth Paltrow's Goop.
  • Developed in 1990 by Dr Jeffrey Bland, who in 1991 set up the Institute of Functional Medicine with his wife Susan, today the field is spearheaded by US best-selling author Dr Mark Hyman, adviser to the Clintons and co-director of the controversial Cleveland Clinic for Functional Medicine.
  • "Functional Medicine is not about a test or a supplement or a particular protocol," he adds. "It's really a new paradigm of disease and how it arises and how to restore health. Within it there are many approaches that are effective, it's not exclusive, it doesn't exclude traditional medications, it includes all modalities depending on what's right for that patient."
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  • Functional Medicine isn't a protected title and a medical qualification isn't a prerequisite to practice. The result is an unregulated and disparate field, with medical doctors, nutritionists, naturopaths and homeopaths among the many practitioners.
  • Some other chronic illnesses the field claims to treat include heart disease, type 2 diabetes, irritable bowel syndrome, ulcerative colitis, depression, anxiety and arthritis
  • ll kinds of different reasons, some might have gluten issues, gut issues, others might have a deficiency causing neurological issues, MS is a symptom."
  • "There are components of Functional Medicine that absolutely lack an evidence base and there are practitioners of what they call Functional Medicine, they charge people for intravenous nutritional injections, they exaggerate claims, and that is professionally inappropriate, unethical and it lacks evidence.
  • On Dr Mark Hyman's view of MS he says, "there are a lot of terms put together there, all of which individually make a lot of sense, but put together in that way they do not.
  • "What does FM actually mean? It means nothing. It's a gift-gallop of words thrown together. It's criticised by advocates of evidence-based medicine because it's giving a veneer of scientific legitimacy to ideas that are considered pseudoscientific. For example, it'll take alternative medicine modalities like homeopathy and then call them 'bio-infusions' or something similar, rebranding it as something that works.
  • "It's a redundant name, real medicine is functional."
  • Next month the third annual Lifestyle and Functional Medical conference will take place in Salthill, Galway on November 3. Last year's event was attended by more than 500 people and featured a keynote address by honorary consultant cardiologist Dr Aseem Malhotra, author of bestselling The Pioppi Diet (which was named one of the top five worst celebrity diets to avoid in 2018 by the British Dietetic Foundation).
  • Dr David Robert Grimes is physicist and visiting fellow of Oxford and QUB. His research into cancer focuses on modelling tumour metabolism and radiation interactions. For Dr Grimes, the lack of definition, or "double-speak" as he puts it, in FM is troubling.
  • As well as the cost of appointments, FM practitioners commonly charge extra for tests. An omega finger prick test is around €100. A vitamin D test can cost upwards of €60, full thyroid panel more than €150 and a gut function test €400. Prices vary between practitioners.
  • "If I, as a GP, engaged in some of these behaviours I would be struck off." Specifically? "If I was recommending treatments that lacked an evidence base, or if I was promoting diagnostic tests which are expensive and lack an evidence base.
  • GPs engage every year in ongoing continuous professional development, I spend my evenings and my weekends outside of working hours attending educational events, small-group learning, large-group learning, engaging in research. This is an accusation that was levelled at the profession 30 years ago and then it was correct, but the profession has caught up…
  • "Obviously promoting wellness and healthy diet is very welcome but going beyond that and stating that certain aspects of 'functional medicine' can lead to reduced inflammation or prevent cancer, we have to be very careful about those claims.
  • Often the outcome of such tests are seemingly 'benign' prescriptions of vitamins or cleanses. However, dietitian Orla Walsh stresses that even these can have potentially harmful effects, especially on "vulnerable" patients, if not prescribed judiciously.
  • FM has five basic principles. 1. We are all genetically and biochemically unique so it treats the individual, not the disease. 2. It's science-based. 3. The body is intelligent and has the capacity for self-regulation. 4. The body has the ability to heal and prevent nearly all the diseases of ageing. 5. Health is not just the absence of disease, but a state of immense vitality.
  • She began her Functional Medicine career while training as a medical doctor and now travels the world working with high-profile clients. Dr McHale charges €425 for an initial consultation and €175 for follow-up appointments. Straightforward lab tests are €250 to €750, for complex cases testing fees can be up to €2,000.
  • "The term [Functional Medicine] tends to be bandied around quite a bit. Other things people say, such as 'functional nutritionist', can be misleading as a term. Many people are Functional Medicine practitioners but don't have any real medical background at all... I think regulation is always probably the best way forward."
  • "There's an awful lot to it in terms of biochemistry and physiology," she says. "You do need to have a very solid and well ingrained bio-chemistry background. A solely clinical background doesn't equip you with the knowledge to read a test.
  • "Evidence-base is the cornerstone of medicine and that has to be maintained. It becomes problematic in this area because you are looking at personalised medicine and that can be very difficult to evidence-base."
  • GP Christine Ritter travelled from England to attend the Galway conference last year with a view to integrating Functional Medicine into her practice.
  • "It was very motivating," she says. "Where it wasn't perhaps as strong was to find the evidence. The Functional Medicine people would say, 'we've done this study and this trial and we've used this supplement that was successful', but they can't show massive research data which might make it difficult to bring it into the mainstream.
  • "I also know the rigorous standard of trials we have in medicine they're not usually that great either, it's often driven by who's behind the trial and who's paying for it.
  • "Every approach that empowers patient to work on their destiny [is beneficial], but you'd have to be mindful that you're not missing any serious conditions."
  • Dr Hyman is working to grow the evidence-base for Functional Medicine worldwide. "The future is looking very bright," he says. "At the Cleveland Centre we're establishing a research base, building educational platforms, fellowships, residency programmes, rotations. We're advancing the field that's spreading across the world. We're seeing in China the development of a programme of Functional Medicine, South Africa, the UK, in London the Cleveland Clinic will hopefully have a Functional Medicine centre."
  • For Dr Mark Murphy regulation is a moot point as it can only apply once the field meets the standards of evidence-based medicine.
  • "Despite well intentioned calls for regulation, complementary and alternative medical therapies cannot be regulated," he says. "Only therapies that possess an evidence-base can enter our standard regulatory processes, including the Irish Medical Council, the Health Products Regulatory Authority and Irish advertising standards. In situations where complementary and alternative therapies develop an evidence base, they are no longer 'complementary and alternative', but in effect they become part of mainstream 'Medicine'.
  • l What are the principles?
  • "There's a huge variation between therapists, some are brilliant and some are okay, and some are ludicrous snake oil salesmen."
  • He is so concerned that patients' health and wealth are being put at risk by alternative therapies that earlier this year he joined Fine Gael TD Kate O'Connell and the Irish Cancer Society in introducing draft legislation earlier this year making it illegal to sell unproven treatments to cancer patients. Violators face jail and heavy fines.
  • Dr Grimes says criticism of variations in the standards of traditional medical research can be fair, however due to the weight of research it is ultimately self-correcting. He adds, "The reality is that good trials are transparent, independent and pre-registered.
  • "My involvement in shaping the Bill came from seeing first-hand the exploitation of patients and their families. Most patients undergoing treatment will take some alternative modalities in conjunction but a significant portion are talked out of their conventional medicine and seduced by false promises
sissij

There Is No Such Thing as Alternative Medicine | Big Think - 1 views

bigthink.com/...-thing-as-alternative-medicine

alternative medicine science bias

shared by sissij on 28 Feb 17 - No Cached
  • Unfortunately for Hahnemann his philosophy—the less of an active ingredient remains the more powerful a remedy is (once you reach 13c on the homeopathic scale there is no longer any active ingredient left)—is nonsense.
  • This does not stop the irrational stream of unproven (or disproven) therapies arising from the holistic and wellness sphere.
  • Distrust in one doctor should not imply blind faith in another.
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  • Yet a growing suspicion of corporate and political interests in the sixties inspired a new wave of holism that’s gaining strength a half-century later. We’re right to be wary of corporate agendas and political mismanagement when it comes to healthcare.
  • The reality is the most basic advice—move often and diversely; eat a balanced, whole foods diet—is boring in an age of immediate gratification.
  • The alternative is suffering, something many companies and hucksters willfully champion at a time when we can all use less of it.
  • sissij on 28 Feb 17
     
    People have been searching for more powerful and more efficient medicines. All sorts of weird ideas pop up as people try out different possibilities. Although people believe in science today, they are still willing to try out different things. Alternative medicine is where people like to spend their money on. When it comes to health, people are likely to be superstitious. Many people don't go to the doctors until the last minute. They tends to rely more on their own senses and perception when it comes to their life. I think it's because going to doctor is like trusting another person with your life, which is very hard for people. Seeking for alternative medicine give people a feeling that they can avoid the doctors. Like the medicine of eternity back in time, the alternative medicine today uses the same flaws in our reasoning. --Sissi (2/28/2017)
Javier E

A Place For Placebos « The Dish - 0 views

dish.andrewsullivan.com/...a-place-for-placebos

placebo ritual stress science mindfulness meditation

shared by Javier E on 31 Dec 13 - No Cached
  • there’s virtually no scientific evidence that alternative medicine (anything from chiropractic care to acupuncture) has any curative benefit beyond a placebo effect. … However, there is one area where alternative medicine often trumps traditional medicine: stress reduction. And stress reduction can, of course, make a huge impact on people’s health. …
  • Maybe each of these activities (listening to high end audio gear, drinking high end wine, having needles inserted into your chakras) is really about ritualizing a sensory experience. By putting on headphones you know are high quality, or drinking expensive wine, or entering the chiropractor’s office, you are telling yourself, “I am going to focus on this moment. I am going to savor this.” It’s the act of savoring, rather than the savoring tool, that results in both happiness and a longer life.
Javier E

The Dangers of Pseudoscience - NYTimes.com - 0 views

opinionator.blogs.nytimes.com/...the-dangers-of-pseudoscience

pseudoscience science demarcation

shared by Javier E on 11 Oct 13 - No Cached
  • the “demarcation problem,” the issue of what separates good science from bad science and pseudoscience (and everything in between). The problem is relevant for at least three reasons.
  • The first is philosophical: Demarcation is crucial to our pursuit of knowledge; its issues go to the core of debates on epistemology and of the nature of truth and discovery.
  • The second reason is civic: our society spends billions of tax dollars on scientific research, so it is important that we also have a good grasp of what constitutes money well spent in this regard.
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  • Third, as an ethical matter, pseudoscience is not — contrary to popular belief — merely a harmless pastime of the gullible; it often threatens people’s welfare,
  • It is precisely in the area of medical treatments that the science-pseudoscience divide is most critical, and where the role of philosophers in clarifying things may be most relevant.
  • some traditional Chinese remedies (like drinking fresh turtle blood to alleviate cold symptoms) may in fact work
  • There is no question that some folk remedies do work. The active ingredient of aspirin, for example, is derived from willow bark, which had been known to have beneficial effects since the time of Hippocrates. There is also no mystery about how this happens: people have more or less randomly tried solutions to their health problems for millennia, sometimes stumbling upon something useful
  • What makes the use of aspirin “scientific,” however, is that we have validated its effectiveness through properly controlled trials, isolated the active ingredient, and understood the biochemical pathways through which it has its effects
  • In terms of empirical results, there are strong indications that acupuncture is effective for reducing chronic pain and nausea, but sham therapy, where needles are applied at random places, or are not even pierced through the skin, turn out to be equally effective (see for instance this recent study on the effect of acupuncture on post-chemotherapy chronic fatigue), thus seriously undermining talk of meridians and Qi lines
  • Asma at one point compares the current inaccessibility of Qi energy to the previous (until this year) inaccessibility of the famous Higgs boson,
  • But the analogy does not hold. The existence of the Higgs had been predicted on the basis of a very successful physical theory known as the Standard Model. This theory is not only exceedingly mathematically sophisticated, but it has been verified experimentally over and over again. The notion of Qi, again, is not really a theory in any meaningful sense of the word. It is just an evocative word to label a mysterious force
  • Philosophers of science have long recognized that there is nothing wrong with positing unobservable entities per se, it’s a question of what work such entities actually do within a given theoretical-empirical framework. Qi and meridians don’t seem to do any, and that doesn’t seem to bother supporters and practitioners of Chinese medicine. But it ought to.
  • what’s the harm in believing in Qi and related notions, if in fact the proposed remedies seem to help?
  • we can incorporate whatever serendipitous discoveries from folk medicine into modern scientific practice, as in the case of the willow bark turned aspirin. In this sense, there is no such thing as “alternative” medicine, there’s only stuff that works and stuff that doesn’t.
  • Second, if we are positing Qi and similar concepts, we are attempting to provide explanations for why some things work and others don’t. If these explanations are wrong, or unfounded as in the case of vacuous concepts like Qi, then we ought to correct or abandon them.
  • pseudo-medical treatments often do not work, or are even positively harmful. If you take folk herbal “remedies,” for instance, while your body is fighting a serious infection, you may suffer severe, even fatal, consequences.
  • Indulging in a bit of pseudoscience in some instances may be relatively innocuous, but the problem is that doing so lowers your defenses against more dangerous delusions that are based on similar confusions and fallacies. For instance, you may expose yourself and your loved ones to harm because your pseudoscientific proclivities lead you to accept notions that have been scientifically disproved, like the increasingly (and worryingly) popular idea that vaccines cause autism.
  • Philosophers nowadays recognize that there is no sharp line dividing sense from nonsense, and moreover that doctrines starting out in one camp may over time evolve into the other. For example, alchemy was a (somewhat) legitimate science in the times of Newton and Boyle, but it is now firmly pseudoscientific (movements in the opposite direction, from full-blown pseudoscience to genuine science, are notably rare).
  • The verdict by philosopher Larry Laudan, echoed by Asma, that the demarcation problem is dead and buried, is not shared by most contemporary philosophers who have studied the subject.
  • the criterion of falsifiability, for example, is still a useful benchmark for distinguishing science and pseudoscience, as a first approximation. Asma’s own counterexample inadvertently shows this: the “cleverness” of astrologers in cherry-picking what counts as a confirmation of their theory, is hardly a problem for the criterion of falsifiability, but rather a nice illustration of Popper’s basic insight: the bad habit of creative fudging and finagling with empirical data ultimately makes a theory impervious to refutation. And all pseudoscientists do it, from parapsychologists to creationists and 9/11 Truthers.
  • The borderlines between genuine science and pseudoscience may be fuzzy, but this should be even more of a call for careful distinctions, based on systematic facts and sound reasoning. To try a modicum of turtle blood here and a little aspirin there is not the hallmark of wisdom and even-mindedness. It is a dangerous gateway to superstition and irrationality.
Javier E

How Tech Can Turn Doctors Into Clerical Workers - The New York Times - 0 views

www.nytimes.com/...with-data-driven-medicine.html

medicine health care doctor

shared by Javier E on 18 May 18 - No Cached
  • what I see in my colleague is disillusionment, and it has come too early, and I am seeing too much of it.
  • In America today, the patient in the hospital bed is just the icon, a place holder for the real patient who is not in the bed but in the computer. That virtual entity gets all our attention. Old-fashioned “bedside” rounds conducted by the attending physician too often take place nowhere near the bed but have become “card flip” rounds
  • My young colleague slumping in the chair in my office survived the student years, then three years of internship and residency and is now a full-time practitioner and teacher. The despair I hear comes from being the highest-paid clerical worker in the hospital: For every one hour we spend cumulatively with patients, studies have shown, we spend nearly two hours on our primitive Electronic Health Records, or “E.H.R.s,” and another hour or two during sacred personal time.
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  • The living, breathing source of the data and images we juggle, meanwhile, is in the bed and left wondering: Where is everyone? What are they doing? Hello! It’s my body, you know
  • Our $3.4 trillion health care system is responsible for more than a quarter of a million deaths per year because of medical error, the rough equivalent of, say, a jumbo jet’s crashing every day.
  • I can get cash and account details all over America and beyond. Yet I can’t reliably get a patient record from across town, let alone from a hospital in the same state, even if both places use the same brand of E.H.R
  • the leading E.H.R.s were never built with any understanding of the rituals of care or the user experience of physicians or nurses. A clinician will make roughly 4,000 keyboard clicks during a busy 10-hour emergency-room shift
  • In the process, our daily progress notes have become bloated cut-and-paste monsters that are inaccurate and hard to wade through. A half-page, handwritten progress note of the paper era might in a few lines tell you what a physician really thought
  • so much of the E.H.R., but particularly the physical exam it encodes, is a marvel of fiction, because we humans don’t want to leave a check box empty or leave gaps in a template.
  • For a study, my colleagues and I at Stanford solicited anecdotes from physicians nationwide about patients for whom an oversight in the exam (a “miss”) had resulted in real consequences, like diagnostic delay, radiation exposure, therapeutic or surgical misadventure, even death. They were the sorts of things that would leave no trace in the E.H.R. because the recorded exam always seems complete — and yet the omission would be glaring and memorable to other physicians involved in the subsequent care. We got more than 200 such anecdotes.
  • The reason for these errors? Most of them resulted from exams that simply weren’t done as claimed. “Food poisoning” was diagnosed because the strangulated hernia in the groin was overlooked, or patients were sent to the catheterization lab for chest pain because no one saw the shingles rash on the left chest.
  • I worry that such mistakes come because we’ve gotten trapped in the bunker of machine medicine. It is a preventable kind of failure
  • How we salivated at the idea of searchable records, of being able to graph fever trends, or white blood counts, or share records at a keystroke with another institution — “interoperability”
  • The seriously ill patient has entered another kingdom, an alternate universe, a place and a process that is frightening, infantilizing; that patient’s greatest need is both scientific state-of-the-art knowledge and genuine caring from another human being. Caring is expressed in listening, in the time-honored ritual of the skilled bedside exam — reading the body — in touching and looking at where it hurts and ultimately in localizing the disease for patients not on a screen, not on an image, not on a biopsy report, but on their bodies.
  • What if the computer gave the nurse the big picture of who he was both medically and as a person?
  • a professor at M.I.T. whose current interest in biomedical engineering is “bedside informatics,” marvels at the fact that in an I.C.U., a blizzard of monitors from disparate manufacturers display EKG, heart rate, respiratory rate, oxygen saturation, blood pressure, temperature and more, and yet none of this is pulled together, summarized and synthesized anywhere for the clinical staff to use
  • What these monitors do exceedingly well is sound alarms, an average of one alarm every eight minutes, or more than 180 per patient per day. What is our most common response to an alarm? We look for the button to silence the nuisance because, unlike those in a Boeing cockpit, say, our alarms are rarely diagnosing genuine danger.
  • By some estimates, more than 50 percent of physicians in the United States have at least one symptom of burnout, defined as a syndrome of emotional exhaustion, cynicism and decreased efficacy at work
  • It is on the increase, up by 9 percent from 2011 to 2014 in one national study. This is clearly not an individual problem but a systemic one, a 4,000-key-clicks-a-day problem.
  • The E.H.R. is only part of the issue: Other factors include rapid patient turnover, decreased autonomy, merging hospital systems, an aging population, the increasing medical complexity of patients. Even if the E.H.R. is not the sole cause of what ails us, believe me, it has become the symbol of burnou
  • burnout is one of the largest predictors of physician attrition from the work force. The total cost of recruiting a physician can be nearly $90,000, but the lost revenue per physician who leaves is between $500,000 and $1 million, even more in high-paying specialties.
  • I hold out hope that artificial intelligence and machine-learning algorithms will transform our experience, particularly if natural-language processing and video technology allow us to capture what is actually said and done in the exam room.
  • as with any lab test, what A.I. will provide is at best a recommendation that a physician using clinical judgment must decide how to apply.
  • True clinical judgment is more than addressing the avalanche of blood work, imaging and lab tests; it is about using human skills to understand where the patient is in the trajectory of a life and the disease, what the nature of the patient’s family and social circumstances is and how much they want done.
  • Much of that is a result of poorly coordinated care, poor communication, patients falling through the cracks, knowledge not being transferred and so on, but some part of it is surely from failing to listen to the story and diminishing skill in reading the body as a text.
  • As he was nearing death, Avedis Donabedian, a guru of health care metrics, was asked by an interviewer about the commercialization of health care. “The secret of quality,” he replied, “is love.”/•/
Javier E

MacIntyre | Internet Encyclopedia of Philosophy - 0 views

www.iep.utm.edu/mac-over

rationality morality relativism perspectivism science community historicism tradition modernity Enlightenment Thomism aristotle

shared by Javier E on 24 Dec 19 - No Cached
  • For MacIntyre, “rationality” comprises all the intellectual resources, both formal and substantive, that we use to judge truth and falsity in propositions, and to determine choice-worthiness in courses of action
  • Rationality in this sense is not universal; it differs from community to community and from person to person, and may both develop and regress over the course of a person’s life or a community’s history.
  • So rationality itself, whether theoretical or practical, is a concept with a history: indeed, since there are also a diversity of traditions of enquiry, with histories, there are, so it will turn out, rationalities rather than rationality, just as it will also turn out that there are justices rather than justice
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  • Rationality is the collection of theories, beliefs, principles, and facts that the human subject uses to judge the world, and a person’s rationality is, to a large extent, the product of that person’s education and moral formation.
  • To the extent that a person accepts what is handed down from the moral and intellectual traditions of her or his community in learning to judge truth and falsity, good and evil, that person’s rationality is “tradition-constituted.” Tradition-constituted rationality provides the schemata by which we interpret, understand, and judge the world we live in
  • The apparent problem of relativism in MacIntyre’s theory of rationality is much like the problem of relativism in the philosophy of science. Scientific claims develop within larger theoretical frameworks, so that the apparent truth of a scientific claim depends on one’s judgment of the larger framework. The resolution of the problem of relativism therefore appears to hang on the possibility of judging frameworks or rationalities, or judging between frameworks or rationalities from a position that does not presuppose the truth of the framework or rationality, but no such theoretical standpoint is humanly possible.
  • MacIntyre finds that the world itself provides the criterion for the testing of rationalities, and he finds that there is no criterion except the world itself that can stand as the measure of the truth of any philosophical theory.
  • MacIntyre’s philosophy is indebted to the philosophy of science, which recognizes the historicism of scientific enquiry even as it seeks a truthful understanding of the world. MacIntyre’s philosophy does not offer a priori certainty about any theory or principle; it examines the ways in which reflection upon experience supports, challenges, or falsifies theories that have appeared to be the best theories so far to the people who have accepted them so far. MacIntyre’s ideal enquirers remain Hamlets, not Emmas.
  • history shows us that individuals, communities, and even whole nations may commit themselves militantly over long periods of their histories to doctrines that their ideological adversaries find irrational. This qualified relativism of appearances has troublesome implications for anyone who believes that philosophical enquiry can easily provide certain knowledge of the world
  • According to MacIntyre, theories govern the ways that we interpret the world and no theory is ever more than “the best standards so far” (3RV, p. 65). Our theories always remain open to improvement, and when our theories change, the appearances of our world—the apparent truths of claims judged within those theoretical frameworks—change with them.
  • From the subjective standpoint of the human enquirer, MacIntyre finds that theories, concepts, and facts all have histories, and they are all liable to change—for better or for worse.
  • MacIntyre holds that the rationality of individuals is not only tradition-constituted, it is also tradition constitutive, as individuals make their own contributions to their own rationality, and to the rationalities of their communities. Rationality is not fixed, within either the history of a community or the life of a person
  • The modern account of first principles justifies an approach to philosophy that rejects tradition. The modern liberal individualist approach is anti-traditional. It denies that our understanding is tradition-constituted and it denies that different cultures may differ in their standards of rationality and justice:
  • Modernity does not see tradition as the key that unlocks moral and political understanding, but as a superfluous accumulation of opinions that tend to prejudice moral and political reasoning.
  • Although modernity rejects tradition as a method of moral and political enquiry, MacIntyre finds that it nevertheless bears all the characteristics of a moral and political tradition.
  • If historical narratives are only projections of the interests of historians, then it is difficult to see how this historical narrative can claim to be truthful
  • For these post-modern theorists, “if the Enlightenment conceptions of truth and rationality cannot be sustained,” either relativism or perspectivism “is the only possible alternative” (p. 353). MacIntyre rejects both challenges by developing his theory of tradition-constituted and tradition-constitutive rationality on pp. 354-369
  • How, then, is one to settle challenges between two traditions? It depends on whether the adherents of either take the challenges of the other tradition seriously. It depends on whether the adherents of either tradition, on seeing a failure in their own tradition are willing to consider an answer offered by their rival (p. 355)
  • how a person with no traditional affiliation is to deal with the conflicting claims of rival traditions: “The initial answer is: that will depend upon who you are and how you understand yourself. This is not the kind of answer which we have been educated to expect in philosophy”
  • MacIntyre focuses the critique of modernity on the question of rational justification. Modern epistemology stands or falls on the possibility of Cartesian epistemological first principles. MacIntyre’s history exposes that notion of first principle as a fiction, and at the same time demonstrates that rational enquiry advances (or declines) only through tradition
  • MacIntyre cites Foucault’s 1966 book, Les Mots et les choses (The Order of Things, 1970) as an example of the self-subverting character of Genealogical enquiry
  • Foucault’s book reduces history to a procession of “incommensurable ordered schemes of classification and representation” none of which has any greater claim to truth than any other, yet this book “is itself organized as a scheme of classification and representation.”
  • From MacIntyre’s perspective, there is no question of deciding whether or not to work within a tradition; everyone who struggles with practical, moral, and political questions simply does. “There is no standing ground, no place for enquiry . . . apart from that which is provided by some particular tradition or other”
  • Three Rival Versions of Moral Enquiry (1990). The central idea of the Gifford Lectures is that philosophers make progress by addressing the shortcomings of traditional narratives about the world, shortcomings that become visible either through the failure of traditional narratives to make sense of experience, or through the introduction of contradictory narratives that prove impossible to dismiss
  • MacIntyre compares three traditions exemplified by three literary works published near the end of Adam Gifford’s life (1820–1887)
  • The Ninth Edition of the Encyclopaedia Britannica (1875–1889) represents the modern tradition of trying to understand the world objectively without the influence of tradition.
  • The Genealogy of Morals (1887), by Friedrich Nietzsche embodies the post-modern tradition of interpreting all traditions as arbitrary impositions of power.
  • The encyclical letter Aeterni Patris (1879) of Pope Leo XIII exemplifies the approach of acknowledging one’s predecessors within one’s own tradition of enquiry and working to advance or improve that tradition in the pursuit of objective truth. 
  • Of the three versions of moral enquiry treated in 3RV, only tradition, exemplified in 3RV by the Aristotelian, Thomistic tradition, understands itself as a tradition that looks backward to predecessors in order to understand present questions and move forward
  • Encyclopaedia obscures the role of tradition by presenting the most current conclusions and convictions of a tradition as if they had no history, and as if they represented the final discovery of unalterable truth
  • Encyclopaedists focus on the present and ignore the past.
  • Genealogists, on the other hand, focus on the past in order to undermine the claims of the present.
  • In short, Genealogy denies the teleology of human enquiry by denying (1) that historical enquiry has been fruitful, (2) that the enquiring person has a real identity, and (3) that enquiry has a real goal. MacIntyre finds this mode of enquiry incoherent.
  • Genealogy is self-deceiving insofar as it ignores the traditional and teleological character of its enquiry.
  • Genealogical moral enquiry must make similar exceptions to its treatments of the unity of the enquiring subject and the teleology of moral enquiry; thus “it seems to be the case that the intelligibility of genealogy requires beliefs and allegiances of a kind precluded by the genealogical stance” (3RV, p. 54-55)
  • MacIntyre uses Thomism because it applies the traditional mode of enquiry in a self-conscious manner. Thomistic students learn the work of philosophical enquiry as apprentices in a craft (3RV, p. 61), and maintain the principles of the tradition in their work to extend the understanding of the tradition, even as they remain open to the criticism of those principles.
  • 3RV uses Thomism as its example of tradition, but this use should not suggest that MacIntyre identifies “tradition” with Thomism or Thomism-as-a-name-for-the-Western-tradition. As noted above, WJWR distinguished four traditions of enquiry within the Western European world alone
  • MacIntyre’s emphasis on the temporality of rationality in traditional enquiry makes tradition incompatible with the epistemological projects of modern philosophy
  • Tradition is not merely conservative; it remains open to improvement,
  • Tradition differs from both encyclopaedia and genealogy in the way it understands the place of its theories in the history of human enquiry. The adherent of a tradition must understand that “the rationality of a craft is justified by its history so far,” thus it “is inseparable from the tradition through which it was achieved”
  • MacIntyre uses Thomas Aquinas to illustrate the revolutionary potential of traditional enquiry. Thomas was educated in Augustinian theology and Aristotelian philosophy, and through this education he began to see not only the contradictions between the two traditions, but also the strengths and weaknesses that each tradition revealed in the other. His education also helped him to discover a host of questions and problems that had to be answered and solved. Many of Thomas Aquinas’ responses to these concerns took the form of disputed questions. “Yet to each question the answer produced by Aquinas as a conclusion is no more than and, given Aquinas’s method, cannot but be no more than, the best answer reached so far. And hence derives the essential incompleteness”
  • argue that the virtues are essential to the practice of independent practical reason. The book is relentlessly practical; its arguments appeal only to experience and to purposes, and to the logic of practical reasoning.
  • Like other intelligent animals, human beings enter life vulnerable, weak, untrained, and unknowing, and face the likelihood of infirmity in sickness and in old age. Like other social animals, humans flourish in groups. We learn to regulate our passions, and to act effectively alone and in concert with others through an education provided within a community. MacIntyre’s position allows him to look to the animal world to find analogies to the role of social relationships in the moral formation of human beings
  • The task for the human child is to make “the transition from the infantile exercise of animal intelligence to the exercise of independent practical reasoning” (DRA, p. 87). For a child to make this transition is “to redirect and transform her or his desires, and subsequently to direct them consistently towards the goods of different stages of her or his life” (DRA, p. 87). The development of independent practical reason in the human agent requires the moral virtues in at least three ways.
  • DRA presents moral knowledge as a “knowing how,” rather than as a “knowing that.” Knowledge of moral rules is not sufficient for a moral life; prudence is required to enable the agent to apply the rules well.
  • “Knowing how to act virtuously always involves more than rule-following” (DRA, p. 93). The prudent person can judge what must be done in the absence of a rule and can also judge when general norms cannot be applied to particular cases.
  • Flourishing as an independent practical reasoner requires the virtues in a second way, simply because sometimes we need our friends to tell us who we really are. Independent practical reasoning also requires self-knowledge, but self-knowledge is impossible without the input of others whose judgment provides a reliable touchstone to test our beliefs about ourselves. Self-knowledge therefore requires the virtues that enable an agent to sustain formative relationships and to accept the criticism of trusted friends
  • Human flourishing requires the virtues in a third way, by making it possible to participate in social and political action. They enable us to “protect ourselves and others against neglect, defective sympathies, stupidity, acquisitiveness, and malice” (DRA, p. 98) by enabling us to form and sustain social relationships through which we may care for one another in our infirmities, and pursue common goods with and for the other members of our societies.
  • MacIntyre argues that it is impossible to find an external standpoint, because rational enquiry is an essentially social work (DRA, p. 156-7). Because it is social, shared rational enquiry requires moral commitment to, and practice of, the virtues to prevent the more complacent members of communities from closing off critical reflection upon “shared politically effective beliefs and concepts”
  • MacIntyre finds himself compelled to answer what may be called the question of moral provincialism: If one is to seek the truth about morality and justice, it seems necessary to “find a standpoint that is sufficiently external to the evaluative attitudes and practices that are to be put to the question.” If it is impossible for the agent to take such an external standpoint, if the agent’s commitments preclude radical criticism of the virtues of the community, does that leave the agent “a prisoner of shared prejudices” (DRA, p. 154)?
  • The book moves from MacIntyre’s assessment of human needs for the virtues to the political implications of that assessment. Social and political institutions that form and enable independent practical reasoning must “satisfy three conditions.” (1) They must enable their members to participate in shared deliberations about the communities’ actions. (2) They must establish norms of justice “consistent with exercise of” the virtue of justice. (3) They must enable the strong “to stand proxy” as advocates for the needs of the weak and the disabled.
  • The social and political institutions that MacIntyre recommends cannot be identified with the modern nation state or the modern nuclear family
  • The political structures necessary for human flourishing are essentially local
  • Yet local communities support human flourishing only when they actively support “the virtues of just generosity and shared deliberation”
  • MacIntyre rejects individualism and insists that we view human beings as members of communities who bear specific debts and responsibilities because of our social identities. The responsibilities one may inherit as a member of a community include debts to one’s forbearers that one can only repay to people in the present and future
  • The constructive argument of the second half of the book begins with traditional accounts of the excellences or virtues of practical reasoning and practical rationality rather than virtues of moral reasoning or morality. These traditional accounts define virtue as arête, as excellence
  • Practices are supported by institutions like chess clubs, hospitals, universities, industrial corporations, sports leagues, and political organizations.
  • Practices exist in tension with these institutions, since the institutions tend to be oriented to goods external to practices. Universities, hospitals, and scholarly societies may value prestige, profitability, or relations with political interest groups above excellence in the practices they are said to support.
  • Personal desires and institutional pressures to pursue external goods may threaten to derail practitioners’ pursuits of the goods internal to practices. MacIntyre defines virtue initially as the quality of character that enables an agent to overcome these temptations:
  • “A virtue is an acquired human quality the possession and exercise of which tends to enable us to achieve those goods which are internal to practices
  • Excellence as a human agent cannot be reduced to excellence in a particular practice (See AV, pp. 204–
  • The virtues therefore are to be understood as those dispositions which will not only sustain practices and enable us to achieve the goods internal to practices, but which will also sustain us in the relevant kind of quest for the good, by enabling us to overcome the harms, dangers, temptations, and distractions which we encounter, and which will furnish us with increasing self-knowledge and increasing knowledge of the good (AV, p. 219).
  • The excellent human agent has the moral qualities to seek what is good and best both in practices and in life as a whole.
  • The virtues find their point and purpose not only in sustaining those relationships necessary if the variety of goods internal to practices are to be achieved and not only in sustaining the form of an individual life in which that individual may seek out his or her good as the good of his or her whole life, but also in sustaining those traditions which provide both practices and individual lives with their necessary historical context (AV, p. 223)
  • Since “goods, and with them the only grounds for the authority of laws and virtues, can only be discovered by entering into those relationships which constitute communities whose central bond is a shared vision of and understanding of goods” (AV, p. 258), any hope for the transformation and renewal of society depends on the development and maintenance of such communities.
  • MacIntyre’s Aristotelian approach to ethics as a study of human action distinguishes him from post-Kantian moral philosophers who approach ethics as a means of determining the demands of objective, impersonal, universal morality
  • This modern approach may be described as moral epistemology. Modern moral philosophy pretends to free the individual to determine for her- or himself what she or he must do in a given situation, irrespective of her or his own desires; it pretends to give knowledge of universal moral laws
  • Aristotelian metaphysicians, particularly Thomists who define virtue in terms of the perfection of nature, rejected MacIntyre’s contention that an adequate Aristotelian account of virtue as excellence in practical reasoning and human action need not appeal to Aristotelian metaphysic
  • one group of critics rejects MacIntyre’s Aristotelianism because they hold that any Aristotelian account of the virtues must first account for the truth about virtue in terms of Aristotle’s philosophy of nature, which MacIntyre had dismissed in AV as “metaphysical biology”
  • Many of those who rejected MacIntyre’s turn to Aristotle define “virtue” primarily along moral lines, as obedience to law or adherence to some kind of natural norm. For these critics, “virtuous” appears synonymous with “morally correct;” their resistance to MacIntyre’s appeal to virtue stems from their difficulties either with what they take to be the shortcomings of MacIntyre’s account of moral correctness or with the notion of moral correctness altogether
  • MacIntyre continues to argue from the experience of practical reasoning to the demands of moral education.
  • Descartes and his successors, by contrast, along with certain “notable Thomists of the last hundred years” (p. 175), have proposed that philosophy begins from knowledge of some “set of necessarily true first principles which any truly rational person is able to evaluate as true” (p. 175). Thus for the moderns, philosophy is a technical rather than moral endeavor
  • MacIntyre distinguishes two related challenges to his position, the “relativist challenge” and the “perspectivist challenge.” These two challenges both acknowledge that the goals of the Enlightenment cannot be met and that, “the only available standards of rationality are those made available by and within traditions” (p. 252); they conclude that nothing can be known to be true or false
  • MacIntyre follows the progress of the Western tradition through “three distinct traditions:” from Homer and Aristotle to Thomas Aquinas, from Augustine to Thomas Aquinas and from Augustine through Calvin to Hume
  • Chapter 17 examines the modern liberal denial of tradition, and the ironic transformation of liberalism into the fourth tradition to be treated in the book.
  • MacIntyre credits John Stuart Mill and Thomas Aquinas as “two philosophers of the kind who by their writing send us beyond philosophy into immediate encounter with the ends of life
  • First, both were engaged by questions about the ends of life as questioning human beings and not just as philosophers. . . .
  • Secondly, both Mill and Aquinas understood their speaking and writing as contributing to an ongoing philosophical conversation. . . .
  • Thirdly, it matters that both the end of the conversation and the good of those who participate in it is truth and that the nature of truth, of good, of rational justification, and of meaning therefore have to be central topics of that conversation (Tasks, pp. 130-1).
  • Without these three characteristics, philosophy is first reduced to “the exercise of a set of analytic and argumentative skills. . . . Secondly, philosophy may thereby become a diversion from asking questions about the ends of life with any seriousness”
  • Neither Rosenzweig nor Lukács made philosophical progress because both failed to relate “their questions about the ends of life to the ends of their philosophical writing”
  • First, any adequate philosophical history or biography must determine whether the authors studied remain engaged with the questions that philosophy studies, or set the questions aside in favor of the answers. Second, any adequate philosophical history or biography must determine whether the authors studied insulated themselves from contact with conflicting worldviews or remained open to learning from every available philosophical approach. Third, any adequate philosophical history or biography must place the authors studied into a broader context that shows what traditions they come from and “whose projects” they are “carrying forward
  • MacIntyre’s recognition of the connection between an author’s pursuit of the ends of life and the same author’s work as a philosophical writer prompts him to finish the essay by demanding three things of philosophical historians and biographers
  • Philosophy is not just a study; it is a practice. Excellence in this practice demands that an author bring her or his struggles with the questions of the ends of philosophy into dialogue with historic and contemporary texts and authors in the hope of making progress in answering those questions
  • MacIntyre defends Thomistic realism as rational enquiry directed to the discovery of truth.
  • The three Thomistic essays in this book challenge those caricatures by presenting Thomism in a way that people outside of contemporary Thomistic scholarship may find surprisingly flexible and open
  • To be a moral agent, (1) one must understand one’s individual identity as transcending all the roles that one fills; (2) one must see oneself as a practically rational individual who can judge and reject unjust social standards; and (3) one must understand oneself as “as accountable to others in respect of the human virtues and not just in respect of [one’s] role-performances
  • J is guilty because he complacently accepted social structures that he should have questioned, structures that undermined his moral agency. This essay shows that MacIntyre’s ethics of human agency is not just a descriptive narrative about the manner of moral education; it is a standard laden account of the demands of moral agency.
  • MacIntyre considers “the case of J” (J, for jemand, the German word for “someone”), a train controller who learned, as a standard for his social role, to take no interest in what his trains carried, even during war time when they carried “munitions and . . . Jews on their way to extermination camps”
  • J had learned to do his work for the railroad according to one set of standards and to live other parts of his life according to other standards, so that this compliant participant in “the final solution” could contend, “You cannot charge me with moral failure” (E&P, p. 187).
  • The epistemological theories of Modern moral philosophy were supposed to provide rational justification for rules, policies, and practical determinations according to abstract universal standards, but MacIntyre has dismissed those theorie
  • Modern metaethics is supposed to enable its practitioners to step away from the conflicting demands of contending moral traditions and to judge those conflicts from a neutral position, but MacIntyre has rejected this project as well
  • In his ethical writings, MacIntyre seeks only to understand how to liberate the human agent from blindness and stupidity, to prepare the human agent to recognize what is good and best to do in the concrete circumstances of that agent’s own life, and to strengthen the agent to follow through on that judgment.
  • In his political writings, MacIntyre investigates the role of communities in the formation of effective rational agents, and the impact of political institutions on the lives of communities. This kind of ethics and politics is appropriately named the ethics of human agency.
  • The purpose of the modern moral philosophy of authors like Kant and Mill was to determine, rationally and universally, what kinds of behavior ought to be performed—not in terms of the agent’s desires or goals, but in terms of universal, rational duties. Those theories purported to let agents know what they ought to do by providing knowledge of duties and obligations, thus they could be described as theories of moral epistemology.
  • Contemporary virtue ethics purports to let agents know what qualities human beings ought to have, and the reasons that we ought to have them, not in terms of our fitness for human agency, but in the same universal, disinterested, non-teleological terms that it inherits from Kant and Mill.
  • For MacIntyre, moral knowledge remains a “knowing how” rather than a “knowing that;” MacIntyre seeks to identify those moral and intellectual excellences that make human beings more effective in our pursuit of the human good.
  • MacIntyre’s purpose in his ethics of human agency is to consider what it means to seek one’s good, what it takes to pursue one’s good, and what kind of a person one must become if one wants to pursue that good effectively as a human agent.
  • As a philosophy of human agency, MacIntyre’s work belongs to the traditions of Aristotle and Thomas Aquinas.
  • in keeping with the insight of Marx’s third thesis on Feuerbach, it maintained the common condition of theorists and people as peers in the pursuit of the good life.
  • He holds that the human good plays a role in our practical reasoning whether we recognize it or not, so that some people may do well without understanding why (E&P, p. 25). He also reads Aristotle as teaching that knowledge of the good can make us better agents
  • AV defines virtue in terms of the practical requirements for excellence in human agency, in an agent’s participation in practices (AV, ch. 14), in an agent’s whole life, and in an agent’s involvement in the life of her or his community
  • MacIntyre’s Aristotelian concept of “human action” opposes the notion of “human behavior” that prevailed among mid-twentieth-century determinist social scientists. Human actions, as MacIntyre understands them, are acts freely chosen by human agents in order to accomplish goals that those agents pursue
  • Human behavior, according to mid-twentieth-century determinist social scientists, is the outward activity of a subject, which is said to be caused entirely by environmental influences beyond the control of the subject.
  • Rejecting crude determinism in social science, and approaches to government and public policy rooted in determinism, MacIntyre sees the renewal of human agency and the liberation of the human agent as central goals for ethics and politics.
  • MacIntyre’s Aristotelian account of “human action” examines the habits that an agent must develop in order to judge and act most effectively in the pursuit of truly choice-worthy ends
  • MacIntyre seeks to understand what it takes for the human person to become the kind of agent who has the practical wisdom to recognize what is good and best to do and the moral freedom to act on her or his best judgment.
  • MacIntyre rejected the determinism of modern social science early in his career (“Determinism,” 1957), yet he recognizes that the ability to judge well and act freely is not simply given; excellence in judgment and action must be developed, and it is the task of moral philosophy to discover how these excellences or virtues of the human agent are established, maintained, and strengthened
  • MacIntyre’s Aristotelian philosophy investigates the conditions that support free and deliberate human action in order to propose a path to the liberation of the human agent through participation in the life of a political community that seeks its common goods through the shared deliberation and action of its members
  • As a classics major at Queen Mary College in the University of London (1945-1949), MacIntyre read the Greek texts of Plato and Aristotle, but his studies were not limited to the grammars of ancient languages. He also examined the ethical theories of Immanuel Kant and John Stuart Mill. He attended the lectures of analytic philosopher A. J. Ayer and of philosopher of science Karl Popper. He read Ludwig Wittgenstein’s Tractatus Logico Philosophicus, Jean-Paul Sartre’s L'existentialisme est un humanisme, and Marx’s Eighteenth Brumaire of Napoleon Bonaparte (What happened, pp. 17-18). MacIntyre met the sociologist Franz Steiner, who helped direct him toward approaching moralities substantively
  • Alasdair MacIntyre’s philosophy builds on an unusual foundation. His early life was shaped by two conflicting systems of values. One was “a Gaelic oral culture of farmers and fishermen, poets and storytellers.” The other was modernity, “The modern world was a culture of theories rather than stories” (MacIntyre Reader, p. 255). MacIntyre embraced both value systems
  • From Marxism, MacIntyre learned to see liberalism as a destructive ideology that undermines communities in the name of individual liberty and consequently undermines the moral formation of human agents
  • For MacIntyre, Marx’s way of seeing through the empty justifications of arbitrary choices to consider the real goals and consequences of political actions in economic and social terms would remain the principal insight of Marxism
  • After his retirement from teaching, MacIntyre has continued his work of promoting a renewal of human agency through an examination of the virtues demanded by practices, integrated human lives, and responsible engagement with community life. He is currently affiliated with the Centre for Contemporary Aristotelian Studies in Ethics and Politics (CASEP) at London Metropolitan University.
  • The second half of AV proposes a conception of practice and practical reasoning and the notion of excellence as a human agent as an alternative to modern moral philosophy
  • AV rejects the view of “modern liberal individualism” in which autonomous individuals use abstract moral principles to determine what they ought to do. The critique of modern normative ethics in the first half of AV rejects modern moral reasoning for its failure to justify its premises, and criticizes the frequent use of the rhetoric of objective morality and scientific necessity to manipulate people to accept arbitrary decisions
  • MacIntyre uses “modern liberal individualism” to name a much broader category that includes both liberals and conservatives in contemporary American political parlance, as well as some Marxists and anarchists (See ASIA, pp. 280-284). Conservatism, liberalism, Marxism, and anarchism all present the autonomous individual as the unit of civil society
  • The sources of modern liberal individualism—Hobbes, Locke, and Rousseau—assert that human life is solitary by nature and social by habituation and convention. MacIntyre’s Aristotelian tradition holds, on the contrary, that human life is social by nature.
  • MacIntyre identifies moral excellence with effective human agency, and seeks a political environment that will help to liberate human agents to recognize and seek their own goods, as components of the common goods of their communities, more effectively. For MacIntyre therefore, ethics and politics are bound together.
  • For MacIntyre ethics is not an application of principles to facts, but a study of moral action. Moral action, free human action, involves decisions to do things in pursuit of goals, and it involves the understanding of the implications of one’s actions for the whole variety of goals that human agents seek
  • In this sense, “To act morally is to know how to act” (SMJ, p. 56). “Morality is not a ‘knowing that’ but a ‘knowing how’”
  • If human action is a ‘knowing how,’ then ethics must also consider how one learns ‘how.’ Like other forms of ‘knowing how,’ MacIntyre finds that one learns how to act morally within a community whose language and shared standards shape our judgment
  • MacIntyre had concluded that ethics is not an abstract exercise in the assessment of facts; it is a study of free human action and of the conditions that enable rational human agency.
  • MacIntyre gives Marx credit for concluding in the third of the Theses on Feuerbach, that the only way to change society is to change ourselves, and that “The coincidence of the changing of human activity or self-changing can only be comprehended and rationally understood as revolutionary practice”
  • MacIntyre distinguishes “religion which is an opiate for the people from religion which is not” (MI, p. 83). He condemns forms of religion that justify social inequities and encourage passivity. He argues that authentic Christian teaching criticizes social structures and encourages action
  • Where “moral philosophy textbooks” discuss the kinds of maxims that should guide “promise-keeping, truth-telling, and the like,” moral maxims do not guide real agents in real life at all. “They do not guide us because we do not need to be guided. We know what to do” (ASIA, p. 106). Sometimes we do this without any maxims at all, or even against all the maxims we know. MacIntyre Illustrates his point with Huckleberry Finn’s decision to help Jim, Miss Watson’s escaped slave, to make his way to freedom
  • MacIntyre develops the ideas that morality emerges from history, and that morality organizes the common life of a community
  • The book concludes that the concepts of morality are neither timeless nor ahistorical, and that understanding the historical development of ethical concepts can liberate us “from any false absolutist claims” (SHE, p. 269). Yet this conclusion need not imply that morality is essentially arbitrary or that one could achieve freedom by liberating oneself from the morality of one’s society.
  • From this “Aristotelian point of view,” “modern morality” begins to go awry when moral norms are separated from the pursuit of human goods and moral behavior is treated as an end in itself. This separation characterizes Christian divine command ethics since the fourteenth century and has remained essential to secularized modern morality since the eighteenth century
  • From MacIntyre’s “Aristotelian point of view,” the autonomy granted to the human agent by modern moral philosophy breaks down natural human communities and isolates the individual from the kinds of formative relationships that are necessary to shape the agent into an independent practical reasoner.
  • the 1977 essay “Epistemological Crises, Dramatic Narrative, and the Philosophy of Science” (Hereafter EC). This essay, MacIntyre reports, “marks a major turning-point in my thought in the 1970s” (The Tasks of Philosophy, p. vii) EC may be described fairly as MacIntyre’s discourse on method
  • First, Philosophy makes progress through the resolution of problems. These problems arise when the theories, histories, doctrines and other narratives that help us to organize our experience of the world fail us, leaving us in “epistemological crises.” Epistemological crises are the aftermath of events that undermine the ways that we interpret our world
  • it presents three general points on the method for philosophy.
  • To live in an epistemological crisis is to be aware that one does not know what one thought one knew about some particular subject and to be anxious to recover certainty about that subject.
  • To resolve an epistemological crisis it is not enough to impose some new way of interpreting our experience, we also need to understand why we were wrong before: “When an epistemological crisis is resolved, it is by the construction of a new narrative which enables the agent to understand both how he or she could intelligibly have held his or her original beliefs and how he or she could have been so drastically misled by them
  • MacIntyre notes, “Philosophers have customarily been Emmas and not Hamlets” (p. 6); that is, philosophers have treated their conclusions as accomplished truths, rather than as “more adequate narratives” (p. 7) that remain open to further improvement.
  • To illustrate his position on the open-endedness of enquiry, MacIntyre compares the title characters of Shakespeare’s Hamlet and Jane Austen’s Emma. When Emma finds that she is deeply misled in her beliefs about the other characters in her story, Mr. Knightly helps her to learn the truth and the story comes to a happy ending (p. 6). Hamlet, by contrast, finds no pat answers to his questions; rival interpretations remain throughout the play, so that directors who would stage the play have to impose their own interpretations on the script
  • Another approach to education is the method of Descartes, who begins by rejecting everything that is not clearly and distinctly true as unreliable and false in order to rebuild his understanding of the world on a foundation of undeniable truth.
  • Descartes presents himself as willfully rejecting everything he had believed, and ignores his obvious debts to the Scholastic tradition, even as he argues his case in French and Latin. For MacIntyre, seeking epistemological certainty through universal doubt as a precondition for enquiry is a mistake: “it is an invitation not to philosophy but to mental breakdown, or rather to philosophy as a means of mental breakdown.
  • MacIntyre contrasts Descartes’ descent into mythical isolation with Galileo, who was able to make progress in astronomy and physics by struggling with the apparently insoluble questions of late medieval astronomy and physics, and radically reinterpreting the issues that constituted those questions
  • To make progress in philosophy one must sort through the narratives that inform one’s understanding, struggle with the questions that those narratives raise, and on occasion, reject, replace, or reinterpret portions of those narratives and propose those changes to the rest of one’s community for assessment. Human enquiry is always situated within the history and life of a community.
  • The third point of EC is that we can learn about progress in philosophy from the philosophy of science
  • Kuhn’s “paradigm shifts,” however, are unlike MacIntyre’s resolutions of epistemological crises in two ways.
  • First they are not rational responses to specific problems. Kuhn compares paradigm shifts to religious conversions (pp. 150, 151, 158), stressing that they are not guided by rational norms and he claims that the “mopping up” phase of a paradigm shift is a matter of convention in the training of new scientists and attrition among the holdouts of the previous paradigm
  • Second, the new paradigm is treated as a closed system of belief that regulates a new period of “normal science”; Kuhn’s revolutionary scientists are Emmas, not Hamlets
  • MacIntyre proposes elements of Imre Lakatos’ philosophy of science as correctives to Kuhn’s. While Lakatos has his own shortcomings, his general account of the methodologies of scientific research programs recognizes the role of reason in the transitions between theories and between research programs (Lakatos’ analog to Kuhn’s paradigms or disciplinary matrices). Lakatos presents science as an open ended enquiry, in which every theory may eventually be replaced by more adequate theories. For Lakatos, unlike Kuhn, rational scientific progress occurs when a new theory can account both for the apparent promise and for the actual failure of the theory it replaces.
  • The third conclusion of MacIntyre’s essay is that decisions to support some theories over others may be justified rationally to the extent that those theories allow us to understand our experience and our history, including the history of the failures of inadequate theories
  • For Aristotle, moral philosophy is a study of practical reasoning, and the excellences or virtues that Aristotle recommends in the Nicomachean Ethics are the intellectual and moral excellences that make a moral agent effective as an independent practical reasoner.
  • MacIntyre also finds that the contending parties have little interest in the rational justification of the principles they use. The language of moral philosophy has become a kind of moral rhetoric to be used to manipulate others in defense of the arbitrary choices of its users
  • examining the current condition of secular moral and political discourse. MacIntyre finds contending parties defending their decisions by appealing to abstract moral principles, but he finds their appeals eclectic, inconsistent, and incoherent.
  • The secular moral philosophers of the eighteenth and nineteenth centuries shared strong and extensive agreements about the content of morality (AV, p. 51) and believed that their moral philosophy could justify the demands of their morality rationally, free from religious authority.
  • MacIntyre traces the lineage of the culture of emotivism to the secularized Protestant cultures of northern Europe
  • Modern moral philosophy had thus set for itself an incoherent goal. It was to vindicate both the moral autonomy of the individual and the objectivity, necessity, and categorical character of the rules of morality
  • MacIntyre turns to an apparent alternative, the pragmatic expertise of professional managers. Managers are expected to appeal to the facts to make their decisions on the objective basis of effectiveness, and their authority to do this is based on their knowledge of the social sciences
  • An examination of the social sciences reveals, however, that many of the facts to which managers appeal depend on sociological theories that lack scientific status. Thus, the predictions and demands of bureaucratic managers are no less liable to ideological manipulation than the determinations of modern moral philosophers.
  • Modern moral philosophy separates moral reasoning about duties and obligations from practical reasoning about ends and practical deliberation about the means to one’s ends, and in doing so it separates morality from practice.
  • Many Europeans also lost the practical justifications for their moral norms as they approached modernity; for these Europeans, claiming that certain practices are “immoral,” and invoking Kant’s categorical imperative or Mill’s principle of utility to explain why those practices are immoral, seems no more adequate than the Polynesian appeal to taboo.
  • MacIntyre sifts these definitions and then gives his own definition of virtue, as excellence in human agency, in terms of practices, whole human lives, and traditions in chapters 14 and 15 of AV.
  • In the most often quoted sentence of AV, MacIntyre defines a practice as (1) a complex social activity that (2) enables participants to gain goods internal to the practice. (3) Participants achieve excellence in practices by gaining the internal goods. When participants achieve excellence, (4) the social understandings of excellence in the practice, of the goods of the practice, and of the possibility of achieving excellence in the practice “are systematically extended”
  • Practices, like chess, medicine, architecture, mechanical engineering, football, or politics, offer their practitioners a variety of goods both internal and external to these practices. The goods internal to practices include forms of understanding or physical abilities that can be acquired only by pursuing excellence in the associated practice
  • Goods external to practices include wealth, fame, prestige, and power; there are many ways to gain these external goods. They can be earned or purchased, either honestly or through deception; thus the pursuit of these external goods may conflict with the pursuit of the goods internal to practices.
  • An intelligent child is given the opportunity to win candy by learning to play chess. As long as the child plays chess only to win candy, he has every reason to cheat if by doing so he can win more candy. If the child begins to desire and pursue the goods internal to chess, however, cheating becomes irrational, because it is impossible to gain the goods internal to chess or any other practice except through an honest pursuit of excellence. Goods external to practices may nevertheless remain tempting to the practitioner.
  • Since MacIntyre finds social identity necessary for the individual, MacIntyre’s definition of the excellence or virtue of the human agent needs a social dimension:
  • These responsibilities also include debts incurred by the unjust actions of ones’ predecessors.
  • The enslavement and oppression of black Americans, the subjugation of Ireland, and the genocide of the Jews in Europe remained quite relevant to the responsibilities of citizens of the United States, England, and Germany in 1981, as they still do today.
  • Thus an American who said “I never owned any slaves,” “the Englishman who says ‘I never did any wrong to Ireland,’” or “the young German who believes that being born after 1945 means that what Nazis did to Jews has no moral relevance to his relationship to his Jewish contemporaries” all exhibit a kind of intellectual and moral failure.
  • “I am born with a past, and to cut myself off from that past in the individualist mode, is to deform my present relationships” (p. 221).  For MacIntyre, there is no moral identity for the abstract individual; “The self has to find its moral identity in and through its membership in communities” (p. 221).
Javier E

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  • How should we choose among these dueling, high-profile nutritional findings? Ioannidis suggests a simple approach: ignore them all.
  • even if a study managed to highlight a genuine health connection to some nutrient, you’re unlikely to benefit much from taking more of it, because we consume thousands of nutrients that act together as a sort of network, and changing intake of just one of them is bound to cause ripples throughout the network that are far too complex for these studies to detect, and that may be as likely to harm you as help you
  • studies report average results that typically represent a vast range of individual outcomes.
  • ...17 more annotations...
  • studies usually detect only modest effects that merely tend to whittle your chances of succumbing to a particular disease from small to somewhat smaller
  • The odds that anything useful will survive from any of these studies are poor,” says Ioannidis—dismissing in a breath a good chunk of the research into which we sink about $100 billion a year in the United States alone.
  • nutritional studies aren’t the worst. Drug studies have the added corruptive force of financial conflict of interest.
  • Even when the evidence shows that a particular research idea is wrong, if you have thousands of scientists who have invested their careers in it, they’ll continue to publish papers on it,” he says. “It’s like an epidemic, in the sense that they’re infected with these wrong ideas, and they’re spreading it to other researchers through journals.
  • Nature, the grande dame of science journals, stated in a 2006 editorial, “Scientists understand that peer review per se provides only a minimal assurance of quality, and that the public conception of peer review as a stamp of authentication is far from the truth.
  • The ultimate protection against research error and bias is supposed to come from the way scientists constantly retest each other’s results—except they don’t. Only the most prominent findings are likely to be put to the test, because there’s likely to be publication payoff in firming up the proof, or contradicting it.
  • even for medicine’s most influential studies, the evidence sometimes remains surprisingly narrow. Of those 45 super-cited studies that Ioannidis focused on, 11 had never been retested
  • even when a research error is outed, it typically persists for years or even decades.
  • much, perhaps even most, of what doctors do has never been formally put to the test in credible studies, given that the need to do so became obvious to the field only in the 1990s
  • Other meta-research experts have confirmed that similar issues distort research in all fields of science, from physics to economics (where the highly regarded economists J. Bradford DeLong and Kevin Lang once showed how a remarkably consistent paucity of strong evidence in published economics studies made it unlikely that any of them were right
  • His PLoS Medicine paper is the most downloaded in the journal’s history, and it’s not even Ioannidis’s most-cited work
  • while his fellow researchers seem to be getting the message, he hasn’t necessarily forced anyone to do a better job. He fears he won’t in the end have done much to improve anyone’s health. “There may not be fierce objections to what I’m saying,” he explains. “But it’s difficult to change the way that everyday doctors, patients, and healthy people think and behave.”
  • “Usually what happens is that the doctor will ask for a suite of biochemical tests—liver fat, pancreas function, and so on,” she tells me. “The tests could turn up something, but they’re probably irrelevant. Just having a good talk with the patient and getting a close history is much more likely to tell me what’s wrong.” Of course, the doctors have all been trained to order these tests, she notes, and doing so is a lot quicker than a long bedside chat. They’re also trained to ply the patient with whatever drugs might help whack any errant test numbers back into line.
  • What they’re not trained to do is to go back and look at the research papers that helped make these drugs the standard of care. “When you look the papers up, you often find the drugs didn’t even work better than a placebo. And no one tested how they worked in combination with the other drugs,” she says. “Just taking the patient off everything can improve their health right away.” But not only is checking out the research another time-consuming task, patients often don’t even like it when they’re taken off their drugs, she explains; they find their prescriptions reassuring.
  • Already feeling that they’re fighting to keep patients from turning to alternative medical treatments such as homeopathy, or misdiagnosing themselves on the Internet, or simply neglecting medical treatment altogether, many researchers and physicians aren’t eager to provide even more reason to be skeptical of what doctors do—not to mention how public disenchantment with medicine could affect research funding.
  • We could solve much of the wrongness problem, Ioannidis says, if the world simply stopped expecting scientists to be right. That’s because being wrong in science is fine, and even necessary—as long as scientists recognize that they blew it, report their mistake openly instead of disguising it as a success, and then move on to the next thing, until they come up with the very occasional genuine breakthrough
  • Science is a noble endeavor, but it’s also a low-yield endeavor,” he says. “I’m not sure that more than a very small percentage of medical research is ever likely to lead to major improvements in clinical outcomes and quality of life. We should be very comfortable with that fact.”
Javier E

New Alternatives to Statins Add to a Quandary on Cholesterol - The New York Times - 0 views

www.nytimes.com/...a-quandary-on-cholesterol.html

statin research medical science health-care

shared by Javier E on 30 Aug 15 - No Cached
  • “We’ve reached a point where patients are increasingly facing five- and six-figure price tags for medications that they will take over the course of their lifetimes,” said Matthew Eyles, an executive vice president for America’s Health Insurance Plans, the national trade association for the insurance industry. “If this is the new normal to treat common and chronic conditions, how can any health system sustain that cost?”
  • Doctors with patients who maintain they are intolerant to statins say they are confronted with a clash between the art and the science of medicine.
  • Dr. Peter Libby, a doctor and researcher at Brigham and Women’s Hospital in Boston, said that in his role as a physician, “the patient is always right.” But, he added, “as a scientist, I find randomized, large-scale, double-blind studies more persuasive than anecdote.”
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  • The statin trials, which involved tens of thousands of people, found no more muscle aches, the most common complaint, in patients who took statins than in those who took placebos.
  • The widely held belief that statins affect memory also has not been borne out in clinical trials, said Dr. Jane Armitage of the University of Oxford. She and her colleagues studied memory problems in 20,000 patients randomly assigned to take a statin or a placebo. “There was absolutely no difference,” she said.
  • In a separate study, they looked at mood and sleep patterns and again found statins had no effect. Another study, in Scotland, detailed cognitive testing of older people taking statins or a placebo, and also found no effect.
sissij

How Inoculation Can Help Prevent Pseudoscience | Big Think - 2 views

bigthink.com/...can-help-prevent-pseudoscience

inoculation psychology science research

shared by sissij on 25 May 17 - No Cached
  • It is easier to fool a person than it is to convince a person that they’ve been fooled. This is one of the great curses of humanity.
  • Given the incredible amount of information we process each day, it is difficult for any of us to critically analyze all of it.
  • The state of Minnesota is battling a measles outbreak caused by anti-vaccination propaganda. And Discussion over the effects of misinformation on recent elections in Austria, Germany, and the United States is still ongoing.
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  • A recent set of experiments shows us that there is a way to help reduce the effects of misinformation on people: the authors amusingly call it the “inoculation.”
  • which even then were heavily influenced by their pre-existing worldviews.
  • teaching about misconceptions leads to greater learning overall then just telling somebody the truth.
  • sissij on 25 May 17
     
    Fake news and alternative facts are things that mess up our perception a lot. As we learned in TOK, there are a lot of fallacies in human reasoning. People tend to stick with their pre-existing worldview or ideas. I found it very interesting that people reduce the effect of misinformation by having an "inoculation". I think our TOK class is like the "inoculation" in a way that it asks us question and challenge us with the idea that everything might not seem as definite or absolute as it seems. TOK class can definitely help us to be immune of the fake news. --Sissi (5/25/2017)
oliviaodon

Identifying and Avoiding Bias in Research - 0 views

www.ncbi.nlm.nih.gov/...PMC2917255

shared by oliviaodon on 09 Feb 17 - No Cached
  • Bias can occur in the planning, data collection, analysis, and publication phases of research. Understanding research bias allows readers to critically and independently review the scientific literature and avoid treatments which are suboptimal or potentially harmful. A thorough understanding of bias and how it affects study results is essential for the practice of evidence-based medicine.
  • Bias is not a dichotomous variable. Interpretation of bias cannot be limited to a simple inquisition: is bias present or not? Instead, reviewers of the literature must consider the degree to which bias was prevented by proper study design and implementation. As some degree of bias is nearly always present in a published study, readers must also consider how bias might influence a study's conclusions
  • Chance and confounding can be quantified and/or eliminated through proper study design and data analysis. However, only the most rigorously conducted trials can completely exclude bias as an alternate explanation for an association.
catbclark

In Age of Science, Is Religion 'Harmful Superstition'? - 0 views

news.nationalgeographic.com/...ling-atheism-people-ngbooktalk

science religion superstition bias

shared by catbclark on 02 Jun 15 - No Cached
  • God is not only dead, author avers. He never lived. Not to mention the deaths of kids treated with faith instead of science-based medicine.
  • Another is free will: the idea that at any point in time all alternatives are open to us. This is the dualistic free will maintained by religions when they say you can choose to accept Jesus as your savior, or being homosexual is a choice. Science is starting to undercut this, by showing that there’s only one choice we can make, which is the output of our materialistic brains.
  • They’re incompatible first of all, because they both compete to find truths about the universe. There are some fundamental truths about the universe that believers have to accept in order to be religious.
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  • A purposeless, purely physical universe, in which human life is accidental and human consciousness is what you call “a neuronal illusion,” is a bleak vision, isn’t it?
Javier E

Uber's Business Model Could Change Your Work - NYTimes.com - 0 views

www.nytimes.com/...r-a-rising-business-model.html

work efficiency busing business model on-demand allocation employment career agency

shared by Javier E on 16 Feb 15 - No Cached
  • Just as Uber is doing for taxis, new technologies have the potential to chop up a broad array of traditional jobs into discrete tasks that can be assigned to people just when they’re needed, with wages set by a dynamic measurement of supply and demand, and every worker’s performance constantly tracked, reviewed and subject to the sometimes harsh light of customer satisfaction.
  • Uber and its ride-sharing competitors, including Lyft and Sidecar, are the boldest examples of this breed, which many in the tech industry see as a new kind of start-up — one whose primary mission is to efficiently allocate human beings and their possessions, rather than information.
  • “I do think we are defining a new category of work that isn’t full-time employment but is not running your own business either,”
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  • Various companies are now trying to emulate Uber’s business model in other fields, from daily chores like grocery shopping and laundry to more upmarket products like legal services and even medicine.
  • “We may end up with a future in which a fraction of the work force would do a portfolio of things to generate an income — you could be an Uber driver, an Instacart shopper, an Airbnb host and a Taskrabbit,”
  • But the rise of such work could also make your income less predictable and your long-term employment less secure. And it may relegate the idea of establishing a lifelong career to a distant memory.
  • “This on-demand economy means a work life that is unpredictable, doesn’t pay very well and is terribly insecure.” After interviewing many workers in the on-demand world, Dr. Reich said he has concluded that “most would much rather have good, well-paying, regular jobs.”
  • Proponents of on-demand work point out that many of the tech giants that sprang up over the last decade minted billions in profits without hiring very many people; Facebook, for instance, serves more than a billion users, but employs only a few thousand highly skilled workers, most of them in California.
  • at the end of 2014, Uber had 160,000 drivers regularly working for it in the United States. About 40,000 new drivers signed up in December alone, and the number of sign-ups was doubling every six months.
  • The report found that on average, Uber’s drivers worked fewer hours and earned more per hour than traditional taxi drivers, even when you account for their expenses. That conclusion, though, has raised fierce debate among economists, because it’s not clear how much Uber drivers really are paying in expenses. Drivers on the service use their own cars and pay for their gas; taxi drivers generally do not.
  • A survey of Uber drivers contained in the report found that most were already employed full or part time when they found Uber, and that earning an additional income on the side was a primary benefit of driving for Uber.
  • The larger worry about on-demand jobs is not about benefits, but about a lack of agency — a future in which computers, rather than humans, determine what you do, when and for how much. The rise of Uber-like jobs is the logical culmination of an economic and tech system that holds efficiency as its paramount virtue.
  • “These services are successful because they are tapping into people’s available time more efficiently,” Dr. Sundararajan said. “You could say that people are monetizing their own downtime.”Think about that for a second; isn’t “monetizing downtime” a hellish vision of the future of work?
  • “I’m glad if people like working for Uber, but those subjective feelings have got to be understood in the context of there being very few alternatives,” Dr. Reich said. “Can you imagine if this turns into a Mechanical Turk economy, where everyone is doing piecework at all odd hours, and no one knows when the next job will come, and how much it will pay? What kind of private lives can we possibly have, what kind of relationships, what kind of families?”
kushnerha

A Placebo Treatment for Pain - The New York Times - 0 views

www.nytimes.com/...lacebo-treatment-for-pain.html

new york times medicine research placebo effect

shared by kushnerha on 09 Jan 16 - No Cached
  • This phenomenon — in which someone feels better after receiving fake treatment — was once dismissed as an illusion. People who are ill often improve regardless of the treatment they receive. But neuroscientists are discovering that in some conditions, including pain, placebos create biological effects similar to those caused by drugs.
  • Taking a placebo painkiller dampens activity in pain-related areas of the brain and spinal cord, and triggers the release of endorphins, the natural pain-relieving chemicals that opioid drugs are designed to mimic. Even when we take a real painkiller, a big chunk of its effect is delivered not by any direct chemical action, but by our expectation that the drug will work. Studies show that widely used painkillers like morphine, buprenorphine and tramadol are markedly less effective if we don’t know we’re taking them.
  • Placebo effects in pain are so large, in fact, that drug manufacturers are finding it hard to beat them. Finding ways to minimize placebo effects in trials, for example by screening out those who are most susceptible, is now a big focus for research. But what if instead we seek to harness these effects? Placebos might ruin drug trials, but they also show us a new approach to treating pain.
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  • It is unethical to deceive patients by prescribing fake treatments, of course. But there is evidence that people with some conditions benefit even if they know they are taking placebos. In a 2014 study that followed 459 migraine attacks in 66 patients, honestly labeled placebos provided significantly more pain relief than no treatment, and were nearly half as effective as the painkiller Maxalt.
  • With placebo responses in pain so high — and the risks of drugs so severe — why not prescribe a course of “honest” placebos for those who wish to try it, before proceeding, if necessary, to an active drug?
  • Another option is to employ alternative therapies, which through placebo responses can benefit patients even when there is no physical mode of action.
  • a key ingredient is expectation: The greater our belief that a treatment will work, the better we’ll respond.
  • Individual attitudes and experiences are important, as are cultural factors. Placebo effects are getting stronger in the United States, for example, though not elsewhere.
  • Likely explanations include a growing cultural belief in the effectiveness of painkillers — a result of direct-to-consumer advertising (illegal in most other countries) and perhaps the fact that so many Americans have taken these drugs in the past.
  • Trials show, for example, that strengthening patients’ positive expectations and reducing their anxiety during a variety of procedures, including minimally invasive surgery, while still being honest, can reduce the dose of painkillers required and cut complications.
  • Placebo studies also reveal the value of social interaction as a treatment for pain. Harvard researchers studied patients in pain from irritable bowel syndrome and found that 44 percent of those given sham acupuncture had adequate relief from their symptoms. If the person who performed the acupuncture was extra supportive and empathetic, however, that figure jumped to 62 percent.
  • Placebos tell us that pain is a complex mix of biological, psychological and social factors. We need to develop better drugs to treat it, but let’s also take more seriously the idea of relieving pain without them.
sandrine_h

To advance science we need to think about the impossible | New Scientist - 0 views

www.newscientist.com/...-to-think-about-the-impossible

science research knowledge medicine

shared by sandrine_h on 06 Mar 17 - No Cached
  • Science sets out what we think is true – but when it gets stuck, it’s time to explore what we think isn’t
  • science has always advanced in small steps, paving the way for occasional leaps. But sometimes fact-collecting yields nothing more than a collection of facts; no revelation follows. At such times, we need to step back from the facts we know and imagine alternatives: in other words, to ask “what if?”
  • That was how Albert Einstein broke the bind in which physics found itself in the early 20th century. His conception of a scenario that received wisdom deemed impossible – that light’s speed is always the same, regardless of how you look at it – led to special relativity and demolished what we thought we knew about space and time.
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  • Despite its dependence on hard evidence, science is a creative discipline. That creativity needs nurturing, even in this age of performance targets and impact assessments. Scientist need to flex their imaginations, too.
  • “Let us dare to dream,” the chemist August Kekulé once suggested, “and then perhaps we may learn the truth.”
  • Physics isn’t the only field that might benefit from a judicious dose of what-iffery. Attempts to understand consciousness are also just inching forward
Javier E

Elon Musk May Kill Us Even If Donald Trump Doesn't - 0 views

jamestraub.substack.com/...usk-may-kill-us-even-if-donald

social media regulation effects

shared by Javier E on 15 Jan 24 - No Cached
  • In his extraordinary 2021 book, The Constitution of Knowledge: A Defense of Truth, Jonathan Rauch, a scholar at Brookings, writes that modern societies have developed an implicit “epistemic” compact–an agreement about how we determine truth–that rests on a broad public acceptance of science and reason, and a respect and forbearance towards institutions charged with advancing knowledge.
  • Today, Rauch writes, those institutions have given way to digital “platforms” that traffic in “information” rather than knowledge and disseminate that information not according to its accuracy but its popularity. And what is popular is sensation, shock, outrage. The old elite consensus has given way to an algorithm. Donald Trump, an entrepreneur of outrage, capitalized on the new technology to lead what Rauch calls “an epistemic secession.”
  • Rauch foresees the arrival of “Internet 3.0,” in which the big companies accept that content regulation is in their interest and erect suitable “guardrails.” In conversation with me, Rauch said that social media companies now recognize that their algorithm are “toxic,” and spoke hopefully of alternative models like Mastodon, which eschews algorithms and allows users to curate their own feeds
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  • In an Atlantic essay, “Why The Past Ten Years of American Life have Been Uniquely Stupid,” and in a follow-up piece, Haidt argued that the Age of Gutenberg–of books and the depth understanding that comes with them–ended somewhere around 2014 with the rise of “Share,” “Like” and “Retweet” buttons that opened the way for trolls, hucksters and Trumpists
  • The new age of “hyper-virality,” he writes, has given us both January 6 and cancel culture–ugly polarization in both directions. On the subject of stupidification, we should add the fact that high school students now get virtually their entire stock of knowledge about the world from digital platforms.
  • Haidt proposed several reforms, including modifying Facebook’s “Share” function and requiring “user verification” to get rid of trolls. But he doesn’t really believe in his own medicine
  • Haidt said that the era of “shared understanding” is over–forever. When I asked if he could envision changes that would help protect democracy, Haidt quoted Goldfinger: “Do you expect me to talk?” “No, Mr. Bond, I expect you to die!”
  • Social media is a public health hazard–the cognitive equivalent of tobacco and sugary drinks. Adopting a public health model, we could, for examople, ban the use of algorithms to reduce virality, or even require social media platforms to adopt a subscription rather than advertising revenue model and thus remove their incentive to amass ev er more eyeballs.
  • We could, but we won’t, because unlike other public health hazards, digital platforms are forms of speech. Fox New is probably responsible for more polarization than all social media put together, but the federal government could not compel it–and all other media firms–to change its revenue model.
  • If Mark Zuckerberg or Elon Musk won’t do so out of concern for the public good–a pretty safe bet–they could be compelled to do so only by public or competitive pressure. 
  • Taiwan has provide resilient because its society is resilient; people reject China’s lies. We, here, don’t lack for fact-checkers, but rather for people willing to believe them. The problem is not the technology, but ourselves.
  • you have to wonder if people really are repelled by our poisonous discourse, or by the hailstorm of disinformation, or if they just want to live comfortably inside their own bubble, and not somebody else’
  • If Jonathan Haidt is right, it’s not because we’ve created a self-replicating machine that is destined to annihilate reason; it’s because we are the self-replicating machine.
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