Tuesday 23 December 2014

Debates in Values-Based Practice: Arguments For and Against

This came out whilst I’ve been away and so now I can have a quick skim read. Obviously I won’t find my own chapter terribly interesting. But the rest looks to be. Well done to Michael Loughlin for getting it together. The official blurb from the CUP website runs thus:

Demands on healthcare systems are increasingly complex and diverse. Consumerism, multiculturalism and regulation challenge practitioners and policymakers. This has led to urgent debate about the value and purpose of healthcare as people seek to make serious, well-thought through decisions. This book helps readers to make rational decisions about healthcare provision in the context of complex and diverse values. It offers no easy solutions, instead presenting a range of perspectives and arguments on values-based practice, an increasingly influential approach to managing value-conflicts/differences in medicine, psychiatry, health and social care. Readers must make their own minds up about the controversies, but this book will give them a sense of the scene and the ability to defend their own position with clarity and confidence. This is a valuable resource for health practitioners and managers, academics in health services research and policy and students of management, bioethics, applied philosophy and political and social theory.

“What a privilege to listen in to a civilised discussion between the originator of value based medicine, Bill Fulford, and those who seek to understand, to take it further, practically and philosophically, and to dissent. This book gives us all of that and the gracious response of Fulford to both friend and foe alike. It shows how such discussion can improve the practice of medicine and, by extension, inform approaches to global health. There is much here for philosopher and practitioner alike.” Sir Michael Marmot, Director, University College London Institute of Health Equity.

List of contributors
Editorial introduction Michael Loughlin
Part I. VBP: Values, Practice and Philosophy:
1. Values-based practice: the facts K. W. M. (Bill) Fulford
2. Values-based clinical reasoning Ed Peile
3. Liberating practice from philosophy – a critical examination of Values-Based Practice and its underpinnings Elselijn Kingma and Natalie Banner
4. Values-based practice and authoritarianism Tim Thornton
5. VBP: but which values? And whose? Bob Brecher
6. Reframing health care: philosophy for medicine and human flourishing Phil Hutchinson and Rupert Read
7. Values-based practice: a new tool or a new package? Mona Gupta
8. Values or virtues? Richard Hamilton
9. Values-Based Practice, competence and expertise Gideon Calder
10. Wishing to remain ill: an unacceptable value? Harry Lesser
11. VBP and global health Sridhar Venkatapuram
12. Is VBP useful in psychiatry? – A practitioner's view Alistair Stewart
13. Living with uncertainty: a first person plural response to eleven commentaries K. W. M. (Bill) Fulford
Part II. VBM and the Basis for Medical Decisions: Survival, Security and Flourishing:
14. Values, foundations and being human Miles Little
15. Eliciting axioms to enrich debates about the pharmaceutical industry Wendy Lipworth and Kathleen Montgomery
16. Using the survival-security-flourishing model to explain the emergence and shape of the medical profession Kathleen Montgomery and Wendy Lipworth
17. Does medicine need a base? A critique of modest foundationalism Ross E. G. Upshur
18. VBM and the challenge of person-centred medicine Andrew Miles
19. Values-based medicine, foundationalism and casuistry Mark R. Tonelli
20. Values-based medicine and patient autonomy Robyn Bluhm
21. Responses to contributions, suggestions and critiques Miles Little
Part III. Conclusions:
22. Walking the VB-talk: concluding reflections on models, methods and practical pay-offs K. W. M. (Bill) Fulford and Miles Little

Monday 22 December 2014

Dialogues in Philosophy, Mental and Neuro Sciences

“Dear Colleague,
I'm pleased to inform you that the new issue of the international online journal Dialogues in Philosophy, Mental and Neuro Sciences has been published, it is freely readable at :
The issue contains:
Volume 7, Issue 2, December 2014

T. Ofengenden
Memory Formation and Belief

O. P. O'Sullivan
Losing control: the hidden role of motor areas in decision-making

G. Farina
Some reflections on the phenomenological method

B. G. Miraglia
A new classification of mental illness based on brain functions

A. Rastogi
Brain Network Commonality and the General Empirical Method

R. Henman
Neuroscience and generalized empirical method: a response to A. Rastogi

J. E. Porcher
The falsity criterion in the definition of delusion

Dialogues in Philosophy, Mental and Neuro Sciences proposes and includes Original Papers, Negative Experimental Results, New Ideas and Dialogues, as described in the guidelines for the authors.

Would you like to write a Dialogue? It is a short article (up to 600 words) freely published and without any deadline commenting another article already published on the previous issues of our Journal.
If you have any question about this Journal then please feel free to contact me at your convenience. I hope you find at least some of our publications of interest and value.
If you think someone of your friends or colleagues could be interested in our Journal please forward them this email. Anybody can register himself at our service of email-alert which will inform about new issues or other news about the Journal through an email. The service is completely free at www.crossingdialogues.com/alert.htm
Kind regards

Daniela Cardillo
Editorial Office info@crossingdialogues.com

Workshop: Particularism and Personalised Medicine, MMU 7-8 January 2015

Call For Registration
Workshop: Particularism and Personalised Medicine
Manchester Metropolitan University, 7-8 January 2015
Venue: New Business School, G.33 Lecture Theatre 4, MMU All Saints Campus
Organiser: Dr Anna Bergqvist, a.bergqvist@mmu.ac.uk

Dr Anna Bergqvist, Manchester Metropolitan University.

Professor Per Nortvedt, University of Oslo.

Dr Anne Raustøl, Diakonhjemmet University College Oslo.

Dr Benedict Smith, Durham University

Professor Tim Thornton, University of Central Lancashire.

Dr Anna Zielinska, CERSES Sorbonne.

Project Outline
This two-day workshop builds on our previous networking workshop on the topic Particularism in Bioethics, Professional Ethics and Medicine at MMU in Manchester (June 2014).  Our focus this time is Particularism and Personalised Medicine, focussing on conceptual issues and different research strategies for incorporating “personalised care” in public health care provision in Europe with a view to effect a comparative study of the prospects for applied particularism in the different national locations.

Traditionally conceived, the core of professional ethics and medical epistemology consists of impartial and universal ethical principles, e.g., non-maleficence and respect for autonomy. These principles are supposed to apply to all moral agents.  But patients, health care professionals and clinical settings differ in many and in crucial respects. One problem of the principled approach is to how to account for the ways in which impartial and universal principles are supposed to be sensitive contextual parameters such individual attitudes, cultural aspects and situational differences. Moral particularism is a philosophical tradition that is well equipped to make sense of how health care can be personalised in a context sensitive way. According to particularists, moral thought and judgement neither need nor should be principle-based but rather requires the exercise of discernment in a case-by-case basis. It is high time to move this theoretical debate into a wider, more practical context.

After long having been neglected, the possibility of applied moral particularism is once again being given serious consideration. For instance, there has been a strong emphasis on partiality and the development of personal relationships in the field of bioethics and professional ethics. Elsewhere in clinical medicine, there has been a renewed interest in the methodology of narrative medicine, personalised (or precision) models of medicine and value based practice. Nationally in the UK, in view of the Francis Report and the Secretary of State for Health’s initial response to the crisis in the Mid-Staffordshire Trust, the language of discernment, compassion, engagement and context which drives and motivates the distinctive particularist approach is becoming increasingly important as a focus for debates over the moral and vocational nature of health care and nursing ethics.

The workshop will bring together emerging and established scholars who have made notable contributions to the reception of moral particularism in applied philosophy and the health care profession.  
The workshop also serves as the inaugural workshop of the international research consortium Particularism in Bioethics, Professional Ethics and Medicine, directed by Anna Bergqvist, ccomprising Manchester Metropolitan University (UK), Durham University (UK), Uppsala University (Sweden), University of Oslo and Diakonhjemmet University College (Norway), Tilburg University (The Netherlands), CERSES Paris 1 Sorbonne (France). More information about the project can be found here:

Workshop Schedule
Wednesday 7th January 2015

9.30 – 10.00 Welcome and Registration

10.00 – 11.30 Anna Bergqvist (MMU): ‘Narrative Understanding, Value and Perspective: A Particularist Response to Fulford’

11.30 – 11.45 Tea and Coffee

11.45 – 13.15 Benedict Smith (Durham): ‘Particularism and Persons’

13.15 – 14.45 Lunch

14.45 – 16.15 Tim Thornton (UCLan): TBA

16.15 – 16.30 Tea and Coffee

16.30 – 18.00 Anne Raustøl (Oslo, Diakonhjemmet): ‘Compassion and Clinical Reasoning’

19.00 Dinner at Kro Bar (at self cost), 325 Oxford Road, Manchester M13 9PG

Thursday 8th January 2015

10.00 – 11.30 Anna Zielinska (Sorbonne) ‘Holism Without Principles: Decision Making in Ethics Committees in France, Germany and the UK’

11.30 – 11.45 Tea and Coffee

11.45 – 13.15 Per Nortvedt (Oslo, UiO): ‘Particularism – a Relevant Perspective in Bioethics?

13.15 – 14.30 Lunch and Roundtable Discussion

14.30 – 17.00 General meeting and networking activities of the consortium Particularism in Bioethics, Professional Ethics and Medicine.

17.00 Workshop Close

Financial Support
The organisers gratefully acknowledge the generous support of the Wellcome Trust and Manchester Metropolitan University Research and Knowledge Exchange.

Workshop Registration

Attendance is free and open to all. Registration by email to Dr Anna Bergqvist.

Tuesday 16 December 2014

Informal end of term report on my IAS fellowship / research leave

Coming to the end of my time as an Emergence Fellow at the Institute for Advanced Study, University of Durham, I have to write an end of fellowship report. But that prompts me to think more broadly about what it has been about. (A friend of mine once told his daughter that he had had a good day. The daughter apparently replied: ‘What was it about?’ I think I share her instinct.)

Naturally in academia, a first thought is output. In 12 weeks, I have written four draft articles totalling perhaps 25,000 words. One is owed to the IAS, Durham for their in-house electronic journal but will form the nucleus for a CUP chapter I owe on Wittgenstein and Davidson. The others are owed to an OUP edited book on gradualism in psychiatric taxonomy, an MIT edited book on harmful dysfunction as analysis of disorder and a Palgrave collection on transcultural psychiatry. My hunch is that all will probably be published after revisions. It also halves my list of outstanding commissions.

I have given an internal seminar to the IAS, one to the Philosophy Department, a closing paper to the Psychology Department’s graduate research day (a really good day attended by lots of staff) and an evening public lecture in the historic Senate Suite of University College (recording available here).

I have made significant inroads into the UK based backlog of work for the journal PPP, which resulted from my mother falling ill and dying earlier in the year, including helping it move to electronic submission at long last. (I should say that authors have been very understanding of the reasons for delay this year and that John Sadler (US Founding Editor) and Linda Muncy (who manages the journal) have been hugely supportive.)

More broadly, I have had many more academic conversations than I would have had at UCLan by attending more seminars, conferences, visiting international speakers, college dinners etc. But also, having a 30 minute coffee break with fellow IAS fellows and other visitors has been stimulating. Not always, I should add. Sometimes we have just talked about the eccentricities of UK trains. But that is also part of the accepted risk. An outgoing pro-VC at UCLan conducted a series of seminars asking what our university would look like if it looked like a world class university. I suggested it would look as though we were doing less because it would look as though we had time for coffee and other random social interaction across the institution. I don’t think that this was adopted as a central recommendation but it seems a pity as Durham clearly embraces just such a view of the importance of interaction. They do quite well at research, including interdisciplinary. (My own School within my University is, however, looking at just this issue as part of a Google inspired undirected time. Well done it!)

I hope that my PhD students haven’t suffered too much thanks to Skype, emails and one furtive visit to Preston. Thanks also to my colleague Gloria for looking after the Philosophy and Mental Health masters programme which I had not intended to step back from but was forced to.

I taught, or perhaps it would be better to say convened, what seemed to me this year to be a particularly successful six week post-doctoral module on the philosophy of the social aetiology of mental illness for the University of Toronto. So much depends on the students that I take no credit for it going well. This year they were happy to explore the idea that their interests raised as many conceptual as empirical issues.

I ran 235km. I drank in too many of the pubs of Durham. On the penultimate night, the IAS fellows took part in a pub quiz at Ye Old Elm Tree, Durham. It must have cost about £200,000 to assemble the team there. We came fourth.

All of that, however, seems quite lucky. I might have done nothing. My father’s death on the third day I was here has been harder to accept than I would have expected, not least after the death of my mother four months earlier. I might have just retired to bed. I certainly wanted to. So I think I have been lucky to be out of the direct firing line and coaxed by the very excellent IAS staff (both the academic leadership and administrative support) and fellows. So thanks to them. But also, and as much, to my Dean of School for letting me spend time ‘having coffee with a bunch of academics’ in his delightfully ironic phrase, a year ago.

Friday 12 December 2014

Emergence, meaning and rationality

A fourth draft paper written whilst a fellow of the Institute for Advanced Study, University of Durham

On ‘emergence’ in philosophy
In philosophy, ‘emergence’ is a semi-technical term whose meaning calls for stipulation as much as description since, unlike every day words with lives outside philosophy though subject to philosophical investigation, for example ‘knowledge’, it lacks a settled use. I take it, however, to be related, but to stand in contrast, to reduction.
Consider the length of a standard 4 x 2 stud Lego brick (that is 4 studs in length and 2 wide). These are 31.8 mm and they are constructed so that when slotted onto a studded base they leave a 0.2mm gap between bricks (to stop them sticking). Thus the effective length of a brick is 32mm. And thus a Lego building built using a line of 10 such bricks will have a length of 32mm x 10 – 2 x 0.1mm = 319.8mm or approximately 320mm. That overall length results from the combination of the basic length of the bricks, the ‘logic’ of the combination (in this case the small engineered gap between each) and some basic mathematics. The overall length can thus be reduced to a combination of the basic properties of the components. But the overall length would not, within philosophy, generally be said to emerge from those basic properties.
The mind, by contrast, is often said to be an emergent property. Tom Nagel proposes a distinction between reductive and emergent in the following way:
A reductive account will explain the mental character of complex organisms entirely in terms of the properties of their elementary constituents… An emergent account, by contrast, will explain the mental character of complex organisms by principles specifically linking mental states and processes to the complex physical functioning of those organisms—to their central nervous systems in particular, in the case of humans and creatures somewhat like them. The difference from a reductive account is that, while the principles do not reduce the mental to the physical, the connections they specify between the mental and the physical are all higher-order. [Nagel 2012: 54-5]
(Nagel uses the term ‘reductive’ for analyses or explanations of complex wholes using whatever properties of their most basic elements and ‘reductionist’ for a subset of those using exclusively physical properties.)
This use of ‘emerge’ attempts to reconcile two opposing intuitions. On the one hand, the mind is something to do with the brain or brain and body or brain, body and world. Perhaps it is a causal effect or perhaps a redescription highlighting different properties. Certainly possession of a brain seems to play a central role in also having a mind. And yet, on the other hand, it seems mysterious how the combination of the merely physical properties of physical material can result in the mind, or mental properties.
Two particular features of the mind seem to drive this latter intuition. First, the qualitative aspects, the phenomenology (small ‘p’) or qualia, of experiential states seem quite unrelated to physical properties. But second, the ‘aboutness’ or intentionality (another semi-technical term for the world-directedness of content-laden mental states or propositional attitudes) of mental states, the ability to have thoughts about things whether real or unreal, appears unlike any basic physical property. And hence some philosophers (and others outside philosophy) say that the mind is an ‘emergent’ property of the brain, or brain and body, or brain, body and world
Not all philosophers share this view of the intractability of the second intuition. In a book on intentionality, Jerry Fodor offers the following rationale for reductionism about the mind:
I suppose that sooner or later the physicists will complete the catalogue they’ve been compiling of the ultimate and irreducible properties of things. When they do, the likes of spin, charm and charge will perhaps appear upon their list. But aboutness surely won’t; intentionality simply doesn’t go that deep. It’s hard to see, in face of this consideration, how one can be a Realist about intentionality without also being, to some extent or other, a Reductionist. If the semantic and intentional are real properties of things, it must be in virtue of their identity with (or maybe of their supervenience on?) properties that are neither intentional nor semantic. If aboutness is real, it must be really something else. [Fodor 1987: 97]
The argument turns on the idea that a future completed physics serves as the benchmark of what is real. For any property there then seem to be only three possibilities.
·         They appear on the basic list.
·         They are reducible to something on the basic list.
·         Or they are not a real property after all.
Since the aboutness or intentionality of mental states is both real and ‘doesn’t go [as] deep’ as fundamental physics, it seems that it must be reducible to something on that list.
In fact the passage hedges its bets by introducing, in parenthesis, the possibility of something weaker. Perhaps intentional properties are real in virtue of merely their supervenience on fundamental physics. Supervenience is a brute dependency: fixing the physical fixes the mental but not vice versa. Thus this remark looks to acknowledge the possibility of the intractability of the second intuition above: that mental properties cannot be reduced. In fact, however, Fodor does aim to reduce intentional properties by combining an explanation of the systematicity and compositionality of thought via structured mental representations or symbols in a language of thought with a variant of a causal theory of how the symbols come to have worldly content or reference [Fodor 1987, 2008].
Nevertheless, Fodor’s argument highlights a key question, and hence distinction, in thinking about the motivation for emergence understood in this broad way. What is the nature of the mystery of the dependence of, in this case, mind on brain, body and external world? It could be that it marks a contingent de facto epistemic lack. Perhaps, for example, we cannot explain the connection at present. If so, some further work would be needed to articulate the standard of explanation in play. If, for example, it is the provision of some causal information a la David Lewis then some explanation of the connection of mind and body does seem to be available (minimally: the occurrence of the Big Bang) [Lewis 1986]. If, on the other hand, it requires a logically sufficient condition, then almost nothing in the universe can be explained [Hempel 1965].
A more promising approach is to look for a reason for the lack of explanation. We may lack an explanation of the general relation between mind and body because no such general explanation is possible because the kind of relation on which it would rely does not, and perhaps could not, exist. That would provide a principled distinction between reduction and emergence. In what follows in this brief note I will take this as a clue to emergence.

Davidson and radical interpretation
Fodor aims to shed on the nature of intentionality by reducing it. On his account mental content is supposed to reduce to, rather emerge from, neural states. But my focus here is with a contrasting approach to intentionality: the anti-reductionist approach of the recent American philosopher Donald Davidson. Davidson examines the nature of both linguistic meaning and mental content through the thought experiment of radical interpretation. His aim is to clarify the nature of both linguistic meaning and mental content more generally by examining how it is determined in radical interpretation. ‘What a fully informed interpreter could learn about what a speaker means is all there is to learn; the same goes for what the speaker believes’ [Davidson 1983: 315].
Radical interpretation is interpretation from scratch [Davidson 1993: 77]. It is a philosophical abstraction from the kind of interpretation undertaken by a field linguist having first contact with an alien tribe. Such interpretation cannot appeal to bilingual speakers or dictionaries because it precedes those resources. Furthermore, it cannot presuppose access to the content of the mental states of speakers. Whatever the connection between mental content and linguistic meaning, radical interpretation must earn access to, and cannot simply assume, facts about both. The intentional contents to which Grice appeals in the analysis of linguistic interchange, for example, cannot be identified prior to the interpretation of the agent’s language [Grice 1957]. Thus they cannot be appealed to in radical interpretation. Interpretation must, instead, rely only on the evidence of correlations between utterances and the circumstances which prompt them:
[The radical interpreter] interprets sentences held true (which is not to be distinguished from attributing beliefs) according to the events and objects in the outside world that cause the sentence to be held true. [Davidson 1983: 317]
Davidson thinks that the facts about mental content have to be determined in the same way. Meanings and contents are interdependent. This presents a principled difficulty for radical interpretation:
A speaker who holds a sentence to be true on an occasion does so in part because of what he means, or would mean, by an utterance of that sentence, and in part because of what he believes. If all we have to go on is the fact of honest utterance, we cannot infer the belief without knowing the meaning, and have no chance of inferring the meaning without the belief. [Davidson 1984: 142]
Thus the interpreter faces the task of unravelling two sets of unknowns - facts about meaning and facts about beliefs - with only one sort of evidence: linguistic actions which depend on both meaning and belief. Normally, we can find out what someone believes by asking them. But that presupposes we know what they mean. Equally, if we know what they believe then we can use this to establish what they mean in expressions of their beliefs. But if both factors are simultaneously unknown, how can one break into the circle?
Davidson’s solution has two ingredients. Firstly, he takes the evidential basis of radical interpretation to be the prompted assent of a speaker, which he characterises as ‘the causal relation between assenting to a sentence and the cause of such assent.’ [Davidson 1983: 315] It is possible to know that a speaker assents to a sentence without knowing what the sentence means and thus what belief is expressed by it (or vice versa). Characterising a speaker as holding a particular sentence true is an intentional interpretation of what is going on - the speaker is described by relation to a propositional content - but it does not presuppose a semantic analysis of the sentence. That will be derived later.
The second step is to restrain the degrees of freedom of possible beliefs in order to interpret linguistic meaning. The interpreter must impose his or her own standards of truth and coherence on ascriptions of beliefs and meanings. There must be a presumption that any utterance or belief held true is true and that beliefs are structured in accordance with basic logic, probability theory and decision theory. This underpins the interpretation of familiar logical connectives such as ‘and’, ‘or’, ‘not’ etc. [Davidson 1990: 326-328].
This complex of related assumptions governing the rationality imputed - generally briskly labelled the ‘Principle of Charity’ - enables interpretation to get off the ground. If utterances and underlying beliefs are assumed by the interpreter to be generally true, rationally structured and to concern the worldly states of affairs which prompt them, then they can be correlated with those observed states of affairs and their meaning determined.
But Davidson goes further. He argues that the facts available to radical interpretation are the only facts about meaning there are. After all, the only justification that can be offered for knowledge of a first language – the only potentially contrasting case – depends on facts available from the radical interpretation of the contextually located utterances of kith and kin. Since access to the only facts there are about meaning has to be mediated by the Principle of Charity, this is not merely an epistemological shortcut. It reflects an ontological feature of belief content and linguistic meaning itself. Both are governed by a constitutive principle: the ‘Constitutive Ideal of Rationality’ [Davidson 1980: 223]. Belief and meaning (both facets of human intentionality) are essentially governed by rationality.

Reduction to, or emergence from, the physical?
Davidson’s account of radical interpretation is a development from his teacher W.V.O. Quine’s account of a similar thought experiment: radical translation [Quine 1960: 26-79]. But one key difference is its characterisation of the evidence available to the interpreter or translator:
The crucial point on which I am with Quine might be put: all the evidence for or against a theory of truth (interpretation, translation) comes in the form of facts about what events or situations in the world cause, or would cause, speakers to assent to, or dissent from, each sentence in the speaker’s repertoire. We probably differ on some details. Quine describes the events or situations in terms of patterns of stimulation, while I prefer a description in terms more like those of the sentence being studied; Quine would give more weight to a grading of sentences in terms of observationality than I would; and where he likes assent and dissent because they suggest a behaviouristic test, I despair of behaviourism and accept frankly intensional attitudes toward sentences, such as holding true. [Davidson 1984: 230]
Davidson realises that his project cannot escape all meaning-related notions and especially in later accounts drops the requirements about its non-semantic nature:
My way of trying to give an account of language and meaning makes essential use of such concepts as those of beliefs and intention, and I do not believe it is possible to reduce these notions to anything more scientific or behaviouristic. What I have tried to do is give an account of meaning (interpretation) that makes no essential use of unexplained linguistic concepts. (Even this is a little stronger than what I think is possible.) It will ruin no plan of mine if in saying what an interpreter knows it is necessary to use a so-called intensional notion - one that consorts with belief and intention and the like. [Davidson 1984: 175-6]
This is significant because it marks a distinction between Quine’s scientistic project of reducing meaning-related notions to behaviouristic notions and hence, in principle at least, initiating a first reductionist step. Davidson has no such aims.
Further, a key aspect of Davidson’s broader philosophy of mind is to argue that the Constitutive Ideal of Rationality has ‘no echo in physical theory’ [Davidson 1980: 231]. Hence there cannot be lawlike relations between the rational domain of mental states and the nomological domain of underpinning neurological or physical states. Such lawlike connections would violate the constitutive principles of the mental. So mental content cannot be reduced to neural properties. The most there can be is something like emergence of the mental from the physical domain.

Reduction to, or emergence from, the rational?
Although Davidson denies the possibility of a reductionist project, using that word in Nagel’s sense to mean reducing mental properties to physical properties, the argument from radical interpretation nevertheless suggests a reductive project. Facts about meaning and mental content are reduced to a prior understanding of the demands of rationality in accord with the Principle of Charity. But the connection between meaning and mental content, on the one hand, and rationality, on the other, might place explanatory priority differently akin to the Euthyphro dilemma. Given a suitable theology, the following biconditional would be true:
·         For any act x: x is pious if and only if x is loved by the gods.
The dilemma stems from considering the ‘order of determination’, in Crispin Wright’s phrase, of this biconditional [Wright 1992]. Is the pious loved by the gods because it is pious, or is it pious because it is loved by the gods? In the epistemic approach to it outlined above, it looks as though Radical Interpretation explains meaning and mental content in terms of rationality. But it may be the case that the connection highlights an ontological dependence the other way. Or, it may be that there is equal priority.
One reason for denying that it is the first priority is the idea that grasping the meaning of words introduces new rational norms or ‘oughts’. Davidson himself argues that the output of Radical Interpretation can be codified using the logical machinery of Tarski’s semantic conception of truth [Tarski 1944]. Tarski uses this to shed light on the nature of truth (or, more accurately, the set of truths expressible in a language) presupposing facts about meaning. Davidson inverts that use to shed light on meaning by presupposing truth, in accord with the Principle of Charity. A central feature of both Tarskian and Davidsonian approaches is the derivation of instances of what is called the ‘T-schema’:
·         ‘Snow is white’ is true if and only if snow is white.
It has been argued that meaning relations as exemplified in instances of the T-schema are merely descriptive rather than normative [Hattiangadi 2006]. One argument for that is that it is hard to see how the norm in question could be, for example, a moral ought since there is no general moral obligation to use ‘snow’ to speak of snow. So what kind of ‘ought’ could it be?
But in accord with the general though experiment of radical interpretation – that is, if the ground rules for that thought experiment are accepted – such an equivalence is surely not normatively inert:
[W]hat makes it correct among speakers of English to make a claim with, say, the words ‘Snow is white’... is that snow is indeed white. I stress ‘correct’: truth in the sense of disquotability... is unproblematically normative for the practice of using the sentence mentioned on the left-hand side of T-sentences. [McDowell 2009: 214]
The equivalence expresses the kind of normative standard on which Radical Interpretation is built. In order to break into the circle of interdependence of belief and meaning, the Principle of Charity imposes rational constraints that speakers believe and say what they ought to in this sense. In this case, in order to say that snow is white in English, one ought to say ‘Snow is white’. Such a principle is part of the armoury of the radical interpreter in his or her broader holistic project of interpretation. The normativity, however, is not moral or prudential or any other species but specifically semantic.
On the Tarskian-Davidsonian conception the ‘oughts’ in question – the ‘oughts’ that are built into the idea of, say, denotation – are not separable from the idea of correctness in assertion... I think once we see that the intuition that meaning and aboutness are ‘ought’-laden does not require the relevant ‘oughts’ to be pre-semantical... we can see that there is no ground for the idea that linguistic behaviour must be governed by... proprieties that can be formulated in non-semantical terms... [McDowell 2009: 215-6]
The distinction between semantic and other kinds of normativity does not undermine the normativity of the former. It is sui generis. But its location within the broader framework of radical Interpretation suggests that it is nevertheless bound by the Constitutive Ideal of Rationality.
Davidson’s own presentation of Radical Interpretation seems to suggest that meaning is accessible to any rational subject since the standards of rationality mentioned are as general as logic, probability theory, and decision theory. Indeed, this thought underpins his argument against the very idea of many untranslatable and also of a single substantial conceptual schemes or scheme [Davidson 1984: 183-98].
Changing the priority suggests another possibility. If rationality and meaning go hand in hand, the rationality relevant for a particular tract of meaning may require a particular kind of mind. It may take a particular special design of mind to respond to and grasp certain kinds of meaning. Rationality may not be a universal ‘cognitive prosthetic’ in Charles Travis’ phrase. He says:
Our special design opens our eyes, as [John McDowell] puts it, to particular tracts of reality. That our eyes may be thus opened shows where, and how, there may be facts that it takes special capacities, not enjoyed by just any thinker, to see... Special knowledge-yielding capacities may be insusceptible to cognitive prosthetics. That is, what, with them, one is equipped to see need not be what would be derivable from some statable set of principles by a thinker lacking those capacities. [Travis 2002: 305, 325].
McDowell’s invocation of special design is usually associated with sensitivity to moral demands. The idea is this. On the assumption that, notwithstanding the influential contrary tradition in the moral philosophy, moral judgement cannot be codified in a set of principles, it must instead answer to the values inhering in worldly situations: moral particulars (or the evaluative equivalent of the facts to which empirical judgements answer). But in order to address a potential disanalogy with at least some empirical facts concerning primary qualities such as length and mass, McDowell suggests that moral values may be akin to secondary qualities such as colour, taste and smell. Grasp of secondary qualities and moral properties requires having a particular kind of perceptual system, or mind, or underpinning way of life: our special design. This in turn suggests that to understand those concepts, the meaning of the relevant words, and the norms that govern them also requires having a special design.
The possibility of an equal priority in the relation between the ideal of rationality and the facts about meaning and mental content it structures and the additional plausibility of the idea that some concepts are not accessible to just any rational subject suggests a more complex picture of the emergence of mind or, rather, minds. Whilst Davidson’s presentation of radical interpretation suggests a method to break into the holism of belief and meaning from a prior grasp of the ideal of rationality, the equal priority view suggests no such route and instead a more encompassing holism. Hence whilst Davidson denies the possibility of a reductionist account, he does suggest the possibility of a reductive one reducing meaning not to the physical but to rational relations. The alternative I have sketched is doubly emergent.

Davidson’s account of belief and meaning through the thought experiment of radical interpretation presents a principled account of intentionality in this sense. It offers an answer to the question: what justifies the description of a state as meaning-laden. The answer is that it plays a role within radical interpretation: the project of making sense of speech and action against the Constitutive Ideal of Rationality. Davidson uses this to argue against the reduction of the mental to the physical and hence against reductionism, in Nagel’s phrase. But the simplest way to think of the thought experiment, encouraged by Davidson’s own presentation, is, nevertheless, reductive: reducing the mental to the rational.
The equal priority view of meaning and rational norms sketched above suggests a more complex picture. Interpretation is still structured by respect of rational norms or ‘oughts’ but these are augmented by grasp of meanings. Further, some aspects of rationality are not universal. They require a special design of mind for their conception and detection. And hence an articulation of what it is like to have our kind of mind is an articulation from within \a particular grasp of the world. And hence it is couched in terms which are both higher order but also local.
This view, however, raises a question about the nature of philosophical inquiry. Reductive, and sometimes reductionist, approaches to complex concepts provide a model for philosophical clarification. Fodor’s argument for reductionism, quoted above, can serve as a manifesto for philosophical naturalism. Complex concepts can be fitted into a broader conception of nature and thus rendered unmysterious by reducing them to more basic constituents. But the equal priority view just sketched suggests no such method. Reduction to the physical world at best plays no role in the account of meaning or, at worst, is ruled out by a Davidsonian a priori argument. Even the connection to rationality provides no theory-neutral entry for thinking about meaning. Instead, the account is pitched within the phenomena it aims to clarify, highlighting internal constraints. In accord with Nagel’s suggestion for emergence, the connections are all higher order. But unlike Nagel’s account, no attempt is made to connect this to the world outside meaning except for its role in radical interpretation. This prompts the question of the kind of philosophical insight such an account can give. It can only address an audience of those with appropriate eyes to see and ears to hear. I suggest that this a puzzle for an emergentist account and suggests a paradox. The account can only be grasped by those who seem to have no need of it.

This paper was written whilst a fellow of the Institute for Advanced Study, University of Durham. My thanks both to the IAS, Durham and the University of Central Lancashire for granting me research leave.

Davidson, D. (1980) Essays on Actions and Events, Oxford: Oxford University Press
Davidson, D. (1983) ‘A coherence theory of truth and knowledge’ in Heinrich, D. (ed) (1983) Kant oder Hegel, Stuttgart: Klett-Cotta pp 423-438
Davidson, D. (1984) Inquiries into Truth and Interpretation, Oxford: Oxford University Press.
Davidson, D. (1990) ‘The Structure and Content of Truth’ Journal of Philosophy 87: 279-328
Davidson, D. (1993) ‘Reply to Jerry Fodor and Earnest Lepore’ in Stoecker, R. (ed) (1993) Reflecting Davidson, Berlin: de Gruyter pp77-84.
Fodor, J. A. (1987) Psychosemantics: the problem of meaning in the philosophy of mind, Cambridge, Mass.: MIT Press.
Fodor, J. A. (2008) LOT2: The language of thought revisited, Oxford: Oxford University Press
Grice, H. P. (1957) ‘Meaning’ Philosophical Review 66: 377–88
Hattiangadi, A. (2006) Oughts and Thoughts: Rule-Following and the Normativity of Content, Oxford: Oxford University Press
Hempel, C.G. (1965) Aspects of Scientific Explanation London: Free Press
Lewis, D. (1986) ‘Causal Explanation’ in Lewis, D. Philosophical Papers. Vol. 2, Oxford: Oxford University Press. pp. 214-40
McDowell, J. (2009) Having the World in View, Cambridge, Mass.: Harvard University Press
Quine, W.V.O. (1960) Word and Object, Cambridge, Mass.: MIT Press
Tarski, A. (1944) ‘The Semantic Conception of Truth’, Philosophy & Phenomenological Research 4:341-375
Travis, C. (2002) ‘Frege’s target’ Royal Institute of Philosophy Supplement 51: 305-343
Wittgenstein, L. (1953) Philosophical Investigations, Oxford: Blackwell.
Wright, C. (1992) Truth and objectivity, Cambridge, Mass.: Harvard University Press

Monday 8 December 2014

Some notes on David Papineau’s Durham Emergence talk: Emergent Causation and the Philosophy of Mind

I went off to hear my old Masters degree supervisor David Papineau talking on an aspect of the emergence theme. The abstract ran:

Intuitively, causal relations might seem to depend on impacts between microscopic physical objects. However I shall show that this is a superficial illusion, and that causation is an essentially macroscopic phenomenon. On this basis, I shall draw various conclusions about the causal autonomy of the mental realm.

My notes run as follows:

“How does the mind affect the physical world. Interactionist dualism is an intuitive default view. The mind is separate but has the power to come done and produce physical effects. But it is no longer popular in or outside philosophy. Why not?

Because  it seems plausible that all the laws governing brain and bodily processes involve only physical properties. This threatens to make any separate mental realm merely epiphenomenal. There is no space left for the mind to make any difference. A causal dangler. It is merely an illusion that the mental makes a difference, like a child with a toy steering wheel in a car. Worse than unattractive: it is incoherent. Conscious pain, eg., is never the reason for expressing it by a movement of the lips.

To avoid it, with the rise of materialism, one can instead argue that mental events just are complexes of neural events. The problem of causation is now akin to how political parties ever make a difference given that it is groups of people who produce social effects.

But since it seems to be the only contemporary option, why is it such a modern theory? 100 years ago it would have been a minority view. Answer: the assumption that all the laws governing brain and bodily processes only physical properties is itself a modern view. 150 years ago 'nervous energy' was not merely a metaphor. The conservation of energy would have included sui generis chemical, life, and mental energies. A kind of Newtonian interactionist dualism. But evidence has accumulated that there are no special forces operating within the body that do not also operate outside. Eg familiar electrical processes governing cellular processes.

Libet's work might suggest epiphenomenalism. But in other cases mental choices do have bodily effects. Libet's set up is not a paradigm of choice.

But are mental events just arrangements of neurons? One reason: the multiple realisation of mental states construed as functional, rather than type type physical states. But if so, the problem of epiphenomenalism returns since it is surely the neurons / hardware that moves the body around: epiphobia: the fear of functionalists who fear they are turning into epiphenomenalism. Much materialist literature aimed at resolving this problem. Striking that few people have attempted to explore gaps in the fabric of physical law. (Lowe is an exception.)

[It may be worth adding here that the fear of epiphenomenalism in the modern era is not that particular mental states or events are the epiphenomenal effects of neuronal causation. Since mental states are supposed just to be neuronal states, that cannot be the case. There can be no synchronic causation between what seem to be two states but which are really just the very same state. The worry is that the mental types or properties that particular token mental states possess play no causal role.]

A different route is to reexamine the nature of causation. Most philosophers think of causation as a series of pushes and pulls. But basic physics is symmetric in time whereas causation is not. This suggests that causation is a high level phenomenon akin to entropy. Increase in entropy cannot be explained in terms of basic physics because basic physics is symmetric in time. To explain the increase in entropy requires an addition to physics: two additions.

An analogy with the mixing up that a mix of hotter and colder gases will typically undergo. To explain the general pattern that such systems get mixed up requires throwing away information about each particular system.

On an analogous account, causes are macroscopic states that can be realised in different ways at the level of basic physics and their causal powers hinge on probabilistic facts about the  distribution of their realisers. At the level of basic physics, one loses the probabilistic structures on which causation (and entropy increase ) depend. Although this may not be how we intuitively think of causation that doesn't mean it isn't true.

Causation requires variable realisers.

So sometimes physical effects have mental causes and not specific neuronal causes. I waived for the taxi because I wanted to stop it , not because of specific neuronal arrangements.

Cf Stephen Yablo. The bull is angered by the cape's redness not its more specific crimson ness. Yablo turns out to be talking about real causation and not just explanatory salience. (The causal oomph need not be at the most basic level.)

Some effects result from specific neuronal arrangements such as the specific wys in which I waggle my arm. But in many cases mental states will be causes in their own right.

Once we realise that causation as emergent phenomenon relative to basic physics then we can understand how there can be autonomous mental causation.”

A couple of thoughts after the fact.

First, David Papineau was my first philosophy lecturer and so it is perhaps no surprise that much of the presentation and stage setting seems very familiar: the spatial metaphors for synchronic versus diachronic etc. I found that rather comforting.

Second, there is something admirable about the strategy of the talk. Causation at the microphysical level causes worry for functionalist physicalists about the merely epiphenomenal status of the mental (or mental properties). So the purpose of the talk was to destroy the very idea of causation at the microphysical level. Without it, there is no worrying comparison.

Still I have three immediate qualms.

First, it seems a high price to pay. So there is no causation at any level which does not admit multiple realization. I’m guessing at the physics here but that suggests that no Higgs Boson collision can cause anything. But we might think that it raises the probability of particular events, or is connected in some lawlike relations, or if the collision had not happened then neither would the subsequent event, or, by intervening on the Higgs Boson, one might be able to bring about some other desired event. Each of these is the core of a philosophical account or theory of causation. Papineau’s comment to defuse this seemed merely to be: although this may not be how we intuitively think of causation, that doesn't mean it isn't true. But it would be helpful to have some further argument for thinking it better to preserve causation only at the higher level.

Second, it seems to me that for a mental level causal link there might be a neuronal underpinning and that neurones are surely functional features thus themselves susceptible to multiple realisation. But if so causation continues at that level. And isn’t that how the worry about epiphenomenalism is usually put?

Third, I am not sure that the worry about epiphenomenalism need be couched in causal terms if causal terms are so understood. Suppose that the microphysical level cannot sustain causal relations. Still it might sustain sufficient conditions cashed out in nomological terms. (Some people might think this a matter of causation.) Suppose that that is the case. Would the nomological sufficiency of a microphysical redescription of a mental cause not itself be enough to raise the threat of epiphenomenalism?