Epistemic Domain Research Articles

Ethical decision making in pain management: a conceptual framework.

IntroductionThe practice and study of pain management pose myriad ethical challenges. There is a consensual opinion that adequate management of pain is a medical obligation rooted in classical Greek practice. However, there is evidence that patients often suffer from uncontrolled and unnecessary pain. This is inconsistent with the leges artis, and its practical implications merit a bioethical analysis. Several factors have been identified as causes of uncontrolled and unnecessary pain, which deprive patients from receiving appropriate treatments that theoretically they have the right to access. Important factors include (with considerable regional, financial, and cultural differences) the following: 1) failure to identify pain as a priority in patient care; 2) failure to establish an adequate physician–patient relationship; 3) insufficient knowledge regarding adequate prescription of analgesics; 4) conflicting notions associated with drug-induced risk of tolerance and fear of addiction; 5) concerns regarding “last-ditch” treatments of severe pain; and 6) failure to be accountable and equitable.ObjectiveThe aim of this article was to establish that bioethics can serve as a framework for addressing these challenging issues and, from theoretical to practical approaches, bioethical reflection can contextualize the problem of unrelieved pain.MethodsThis article is organized into three parts. First, we illustrate that pain management and its undertreatment are indeed ethical issues. The second part describes possible ethical frameworks that can be combined and integrated to better define the ethical issues in pain management. Finally, we discuss possible directions forward to improve ethical decision making in pain management.DiscussionWe argue that 1) the treatment of pain is an ethical obligation, 2) health science schools, especially medical training institutions, have the duty to teach pain management in a comprehensive fashion, and 3) regulatory measures, which prevent patients from access to opioid treatment as indicated in their cases, are unethical and should be reconsidered.ConclusionDeveloping an ethical framework for pain management will result in enhanced quality of care, linking the epistemic domains of pain management to their anthropological foundations, thereby making them ethically sound.

Teachers' Demonstrations of Epistemic Access in Teacher-Student Interactions in a Digital Setting

This paper is concerned with a Conversation Analytic (CA) study of teachers’ demonstrations of epistemic access to a student’s domain or territory of information in teacher-student interactions in a digital setting. It describes interactional practices analyzed in 12 excerpts with an explicit reference to information about students’ progress provided by the digital system. It will be shown that teachers initiate interactions about already fulfilled assignments that are shown to be problematic. In the opening of the interaction, teachers more or less explicitly refer to the digital programme as an information source and/or to the hitches in student’s progress. In the continuation of the interaction, teacher and student are concerned with a redoing of assignments. In this phase of the interaction, the teacher demonstrates epistemic access to possible causes for students’ mistakes. In all cases, students do not show resistance to teachers’ demonstrations of epistemic access to knowledge and experiences falling into their epistemic domain. The findings confirm teachers’ and students’ orientation to the educational context as being a specialized context where students’ problems are not treated as ‘theirs to know and describe’. The findings in this paper shed light on interactional practices in relation to epistemics, as well as on interactional practices in a digital setting.

Моделі рефлективізації контамінованої волітивності у діалогічному мовленні (на матеріалі висловлень-квестивів іспанською мовою)

The article deals with the problem of simulation of the model of reflectivisation of contaminated volition. The article offers a new approach towads the concept of "contaminated volition" under the criteria of differentiation of lacunae in the epistemic domain of the subject of contaminated volition and its affective states. There have been differentiated certain types of consciousness – the epistemic sphere, which acts as the authority of the modal estimation, which is the basis of the simulation of the reflection of contaminated volition. According to the analysis of the correlations between the nature of the contamination of the volition, the individual sphere of consciousness, causing the modal estimation, and the means of their speech expression, the study discusses the biases in the non-prototype modal estimation of the volition through a series of gradual transitions in the continuum of modal meanings: the possibility – objective probability – subjective probability (chance) – a negative possibility.

O que é agência epistêmica, afinal?

Neste artigo examino a possibilidade de agência no domínio epistêmico – a visão compartilhada por muitos filósofos de que possamos ser ativos, ao invés de passivos, em relação às nossas crenças e manifestações de conhecimento. Concluo que a noção de agência epistêmica é plausível apenas em sentido indireto, referindo-se as diferentes ações que realizamos com intuito de melhorar nossos compromissos epistêmicos. Trata-se de um tipo de agência prática, como qualquer agência, mas que não nos autoriza a pensar que possamos estar agindo de alguma maneira quando cremos ou conhecemos.

Metapragmatic appositions in German talk-in-interaction

AbstractIn German talk-in-interaction it can be observed that so-called loose appositions are frequently used as a grammatical resource for performing selfinitiated self-repairs in the domain of reference. In the current paper, it is argued that this kind of appositional pattern can be described as a grammatical construction which indicates that the incorporated grammatical elements give alternative ‘reference instructions’ for building up compatible conceptualizations of one and the same entity with respect to different epistemic domains. Thereby it offers the possibility to incrementally adjust the design of reference instructions to divergent knowledge states of the interlocutors. The use of appositional constructions is thus frequently linked to aspects of epistemic stance regarding a lack of common ground. Hence, it is argued that aspects of the local management of epistemic asymmetries can be considered part of the pragmatic specifications of the construction. These specifications are sometimes made explicit through the use of lexical markers like also ‘that is’ so that the extended pattern which contains such markers might be called a metapragmatic construction.

The use of why questions in child and adolescent mental health assessments

Questions form the basis of mental health assessments and yet there is limited empirical evidence about the linguistic structure of question formats in these clinical environments. While many types of questions are used, the focus of this research was on why-prefaced questions asked to children. Interaction analysis was employed to interrogate the data, paying specific attention to the interactional organisation of how ‘why-prefaced’ questions were asked and responded to. Analysis demonstrated that when three core components were present in the question, then it was usual for a reason/ explanation to be provided in response, and when one or more components were missing, it rarely elicited a reason or explanation in response. The three components were; the sequential position of the question, how the question was indexically tied to the child’s prior statement, and the epistemic domain of the question. Implications for therapeutic communication and training were discussed.

Epistemological closed questions: A reply to Greco

ABSTRACT According to G.E. Moore’s ‘Open Question’ argument (OQA), moral facts cannot be reduced or analyzed in non-normative natural terms. Does the OQA apply equally in the epistemic domain? Does Moore’s argument have the same force against reductionist accounts of epistemic facts and concepts? In a recent article, Daniel Greco has argued that it does. According to Greco (2015), an epistemological version of the OQA is just as promising as its moral cousin, because the relevant questions in epistemology are just as ‘open’ as those in ethics. In this paper, I offer a two-part reply to Greco. First, I argue that his argument in favor of the openness of epistemology is not persuasive. Second, I offer a case against the openness of epistemology. Unlike claims linking natural and moral properties, claims linking natural and epistemological properties do give rise to closed questions. An epistemological OQA is therefore not as promising as its moral cousin.

Expressing conditionality in Mandarin

AbstractAfter a broad overview of Mandarin Chinese conditionality marking, this paper presents a corpus-based analysis of two conditional connectives,rúguǒandzhǐyào(both translatable as ‘if’), from a syntactic and a cognitive perspective. We examine their use in narrative and informative texts along four parameters: clause order, position of the connective within the clause, domain, and counterfactuality. For all parameters, the two connectives displayed robust profiles across genres. Both connectives preferred an antecedent-consequent clause order. They displayed flexibility in their position, behaving like adverbs, withrúguǒshowing a stronger preference for the pre-subject position thanzhǐyào. In terms of domains,zhǐyàohas a stronger preference for content conditionals thanrúguǒ, which is also frequently used in the epistemic domain. In our data, onlyrúguǒwas used meta-metaphorically and in counterfactuals. We argue that both connectives can be translated with ‘if’, butzhǐyàoalso matches ‘so/as long as’.

Expressing conditionality in Mandarin

After a broad overview of Mandarin Chinese conditionality marking, this paper presents a corpus-based analysis of two conditional connectives,rúguǒandzhǐyào(both translatable as ‘if’), from a syntactic and a cognitive perspective. We examine their use in narrative and informative texts along four parameters: clause order, position of the connective within the clause, domain, and counterfactuality. For all parameters, the two connectives displayed robust profiles across genres. Both connectives preferred an antecedent-consequent clause order. They displayed flexibility in their position, behaving like adverbs, withrúguǒshowing a stronger preference for the pre-subject position thanzhǐyào. In terms of domains,zhǐyàohas a stronger preference for content conditionals thanrúguǒ, which is also frequently used in the epistemic domain. In our data, onlyrúguǒwas used meta-metaphorically and in counterfactuals. We argue that both connectives can be translated with ‘if’. Butzhǐyàoalso matches ‘so/as long as’.

Modeling and simulation support to the defense planning process

Defense planning is a crucial part of the defense process. It identifies the capabilities required for the future defense environment, analyzes the capability shortfalls, prioritizes them, and provides the fundamental inputs for their development. Modeling and simulation may significantly contribute to the success of defense planning. However, neither the theory nor the tools are mature enough to fulfill the defense planning requirements. Various types of simulation tools, such as static, dynamic, deterministic, stochastic, closed, discrete, continuous, and symbiotic, in multiple levels of resolution and fidelity are needed to support the different stages and phases. The verification and validation of the models and the analysis of the input and output data are critical. Yet another challenge is that the uncertainties related to the contemporary defense scenarios are mostly not in aleatory but in the epistemic domain. In this paper, we briefly present a new computer-assisted defense planning process. Then, we introduce the service-oriented cloud approach for the modeling and simulation support to the process.

Establishing Scientific Discourse in Classroom Interaction Teacher Students’ Orientation to Mundane Versus Technical Talk in the School Subject Norwegian

ABSTRACTThis article reports a case study on classroom interaction in teacher education in Norway. It addresses how teacher students in the school subject Norwegian constitute scientific talk in a student-led discussion. First, the analysis reveals tension in the classroom conversation between mundane talk—that is, where students make claims with reference to their personal epistemic domain—and scientific talk—that is, where students make claims with reference to a shared scientific epistemic domain. Then, the analysis identifies specific interactional resources (reproach, embedded correction, formulation, and recontextualization) that the students use to regulate and bridge the 2 levels of discourse. Finally, the article provides insights into how scientific discourse is collaboratively established through conversational turns and considers how teacher education might use these findings for communication-skill training.

The factualization of 'I suppose' in American English: a corpus based study of the subjectification of epistemic predicates toward factuality.

This work provides a case study centered on the cognitive phenomenon of factualization, viz. “the SP/W’s increasing certainty about the realization of an event or situation” (cf. Tantucci 2014, 2015a, b, 2016b). Factualization corresponds to a cognitive-control mechanism (i.e. Kan et al. 2013) specifically occurring in the epistemic domain. It instantiates both in online language production and throughout the diachronic reanalysis of a construction (i.e. grammaticalization, semasiological change or constructionalization, cf. Traugott and Dasher 2002; Traugott and Trousdale 2013). The case presented here focuses on the diachronic change of the epistemic construction I suppose in British English. It will be shown that I suppose developed through time an increasingly factual usage out of an original meaning conveying weak epistemicity. Qualitative and quantitative data from the Corpus of Historical American English will support the general claim that—to varying degrees—epistemic predicates diachronically tend to develop new polysemies encoding a Speaker/writer’s (henceforth SP/W) “subjectified form of certainty” towards a proposition P (cf. Tantucci 2015a: 371).

A social-technological epistemology of clinical decision-making as mediated by imaging.

In recent years there has been growing attention to the epistemology of clinical decision‐making, but most studies have taken the individual physicians as the central object of analysis. In this paper we argue that knowing in current medical practice has an inherently social character and that imaging plays a mediating role in these practices. We have analyzed clinical decision‐making within a medical expert team involved in diagnosis and treatment of patients with pulmonary hypertension (PH), a rare disease requiring multidisciplinary team involvement in diagnosis and management. Within our field study, we conducted observations, interviews, video tasks, and a panel discussion. Decision‐making in the PH clinic involves combining evidence from heterogeneous sources into a cohesive framing of a patient, in which interpretations of the different sources can be made consistent with each other. Because pieces of evidence are generated by people with different expertise and interpretation and adjustments take place in interaction between different experts, we argue that this process is socially distributed. Multidisciplinary team meetings are an important place where information is shared, discussed, interpreted, and adjusted, allowing for a collective way of seeing and a shared language to be developed. We demonstrate this with an example of image processing in the PH service, an instance in which knowledge is distributed over multiple people who play a crucial role in generating an evaluation of right heart function. Finally, we argue that images fulfill a mediating role in distributed knowing in 3 ways: first, as enablers or tools in acquiring information; second, as communication facilitators; and third, as pervasively framing the epistemic domain. With this study of clinical decision‐making in diagnosis and treatment of PH, we have shown that clinical decision‐making is highly social and mediated by technologies. The epistemology of clinical decision‐making needs to take social and technological mediation into account.

Tensions in the epistemic domain and claims of no-knowledge: A study of Swedish medical interaction

This article analyzes the halts in sequential progressivity that are caused by claims of no-knowledge in Swedish medical interaction. The focus is on responsive turns and turn-constructional units that are prefaced by the epistemic disclaimer jag vet inte ‘I don’t know’. We argue that this use of epistemic disclaimers does not primarily display the speaker's lack of knowledge, but that their presence signals interactional problems that are contingent on epistemic asymmetries between the participants. Patient replies that contain an epistemic disclaimer are nonconforming responses and they therefore resist something about the question: the presupposed access to knowledge or the rights to knowledge. The present analysis demonstrates that epistemic tensions, especially in lay–professional interaction, are handled by the lay party using epistemic disclaimers. These can initiate a shift in epistemic posture toward a more independent, more personally accurate formulation of knowledge that somehow contrasts with the professional party's assumptions.

<b>Interdisciplinaridade escolar no ensino médio: domínios epistêmicos como possibilidade para elaboração e avaliação de um trabalho coletivo

A Educação Científica obedece às contingências referentes à complexidade dos problemas atuais e, portanto, (re)configura condições didáticas para o Ensino de Ciências. A interdisciplinaridade emerge nesse contexto e carrega controvérsias semânticas, principalmente no que concerne à interdisciplinaridade escolar. Este trabalho procura relatar a importância da interdisciplinaridade escolar e do trabalho coletivo entre professores por meio dos dados obtidos por um projeto interdisciplinar realizado em uma escola pública. Para a realização do projeto, elaboramos uma tabela constituída pelos domínios epistêmicos do conhecimento (linguagens e seus valores e habilidades cognitivas) como uma forma de cada professor participante do projeto avaliar os alunos após as atividades propostas. A partir da análise da entrevista realizada com esses professores e do preenchimento das tabelas, concluímos que o instrumento permitiu o início de um trabalho coletivo, uma vez que professores de diferentes disciplinas tinham um objetivo de avaliação comum e dialogaram entre si, esboçando ideias e possibilidades sobre um trabalho interdisciplinar.

Conceptual Domains of KAU Revisited with Comments on Some Chinese KAU Researches

Firstly we briefly review the three conceptual domains of Sweetser (1990/2002), “content domain”, “epistemic domain”, and “speech-act domain” (Sweetserian trichotomy), and Shen (2003), the corresponding A(cting), K(nowing), U(ttering) (Shenian trichotomy)—our KAU, finding that they and their followers ignored largely the necessity to distinguish between these three domains in terms of the speaker, the listener and the other. Then, we clarify this issue and on this basis, analyze disadvantages of the study of three conceptual domains at the lexical level, thinking that previous studies failed to highlight the importance of syntactic and pragmatic factors to lexical level and thus did not rise to the pragma-syntactic level. On account of this, we put forward the “Lexico-Pragma-Syntactic Hypothesis” on the three conceptual domains, holding that the three of them should be studied by encompassing the three linguistic levels with pragmatics playing a prevailing role.

A first-order epistemic quantum computational semantics with relativistic-like epistemic effects

Quantum computation has suggested new forms of quantum logic, called quantum computational logics. In these logics well-formed formulas are supposed to denote pieces of quantum information: possible pure states of quantum systems that can store the information in question. At the same time, the logical connectives are interpreted as quantum logical gates: unitary operators that process quantum information in a reversible way, giving rise to quantum circuits. Quantum computational logics have been mainly studied as sentential logics (whose alphabet consists of atomic sentences and of logical connectives). In this article we propose a semantic characterization for a first-order epistemic quantum computational logic, whose language can express sentences like “Alice knows that everybody knows that she is pretty”. One can prove that (unlike the case of logical connectives) both quantifiers and epistemic operators cannot be generally represented as (reversible) quantum logical gates. The “act of knowing” and the use of universal (or existential) assertions seem to involve some irreversible “theoretic jumps”, which are similar to quantum measurements. Since all epistemic agents are characterized by specific epistemic domains (which contain all pieces of information accessible to them), the unrealistic phenomenon of logical omniscience is here avoided: knowing a given sentence does not imply knowing all its logical consequences.

Moral Reasons, Epistemic Reasons and Rationality

It is standard, both in the philosophical literature and in ordinary parlance, to assume that one can fall short of responding to all one's moral reasons without being irrational. Yet when we turn to epistemic reasons, the situation could not be more different. Most epistemologists take it as axiomatic that for a belief to be rational is for it to be well supported by epistemic reasons. We find ourselves with a striking asymmetry, then, between the moral and epistemic domains concerning what is taken for granted about whether failures to respond to reasons are failures of rationality. My aim in this paper is to interrogate this asymmetry, and ultimately to argue that the asymmetry is groundless. Instead, I will offer an error theory to explain the asymmetry in intuitions (away). This error theory suggests that we should amend the conventional wisdom about the relationship between epistemic reasons and rationality.

Counseling Online and Over the Phone: When Preclosing Questions Fail as a Closing Device

In this article, we present an analysis of closings in two counseling media: online, text-based exchanges (usually referred to as “chat” sessions) and telephone calls. Previous research has found that the participant who initiated a conversation preferably also initiates its termination with a possible preclosing. Advice acknowledgments, lying in the epistemic domain of the client, are devices that may work as preclosings. However, in text-based chat clients regularly refrain from advice acknowledgment. While counselors use various practices to elicit advice acknowledgment in the context of potential advice resistance, hoaxing, and/or seemingly long pauses, these questions do not always succeed as “closing devices.” This offers an explanation for counselors’ perception of online chatting as more difficult than calling. The data are in Dutch with English translation.

Epistemic Value Monism and the Swamping Problem

AbstractMany deontologists explain the epistemic value of justification in terms of its instrumental role in promoting truth – the original source of value in the epistemic domain. The swamping problem for truth monism appears to make this position indefensible, at least for those monists who maintain the superiority of knowledge to merely true belief. I propose a new solution to the swamping problem that allows monists to maintain the greater epistemic value of knowledge over merely true belief. My trick is to deny the swamping premise itself.