A Philosophy of Nursing Forum
Wednesday, October 25, 2006

A Weekend at “The Hill”

Every October for the last 40 years, The University of North Carolina at Chapel Hill has hosted a wonderful philosophy colloquium. It is certainly one of the most prestigious colloquia in the world of analytic philosophy - NO ONE turns down an opportunity to present there, or to be a commentator on an invited presentation. This year, presenters and commentators included Daniel C. Dennett, Hilary Putnam, Ruth Baron Marcus, Patricia Kitcher and Gideon Rosen. This is about as notable a collection of “heavy hitters” and philosophical “rock stars” as one could gather.

This year produced a unique opportunity for me- the chance to spend an hour on a Saturday evening standing around in Geoff Sayre-McCord’s kitchen, listening to Dan Dennett and Phillip Kitcher talk philosophy (and occasionally get a word in myself). The conversation was fascinating, and there were features of it, and one other conversation, that I think would be of considerable interest to the subscribers to this list.

Although I didn’t realize it at the time, since I hadn’t read the book, talk centered on issues surrounding Kitcher’s 2001 “Science, Truth and Democracy” (hereinafter STD). Needless to say, I came home and bought it immediately, and stayed up most of he night reading it.

Broadly speaking, the first part of STD is an elaboration and defense of Kitcher’s “moderate scientific realism,” and his heroic defense HERE

( http://www.columbia.edu/~psk16/correspondence_truth.htm)

of a correspondence theory of truth. For Kitcher, “realism” must be “moderate” because any scientific enterprise, with its particular aims, experiments, methodologies and classificatory systems, is undertaken for particular purposes, and to advance particular interests. When we do science, we inevitably construct models, or maps, of the world and pick out for inclusion in/on the model/map certain features of the world, and leave others off, and this process of inclusion/exclusion is governed by judgments about what is “significant.” Continuing with the map analogy, Kitcher thinks that “the ideal Atlas is a myth.”

Still, Kitcher argues, none of this is incompatible with realism. All that realism is committed to, on his account, are claims that the features selected for mapping can be represented more, or less, accurately; and, in addition, that these features exist independently of those individuals who are mapping them.

Kitcher’s realism may be moderate, but it is still realism. He continues to characterize claims by “creationists, romantics, feminists, postcolonialists and critical theorists” that science is only one of many possible, equally defensible, systems of belief fixation as “Luddites’ laments.” He is clearly committed to the view that, as against the “Luddites,” science at its best is the best way to find out about our world.

If Kitcher is right about all of this, though, at least some of the so-called Luddites have a point, even if it not precisely the point they hoped to make. Kitcher concedes that 1) “We divide things into kinds to suit our purposes,“ 2)there is no “ideal Atlas,” and 3) for any given scientific enterprise, there are particular interests (besides the production of knowledge) being advanced, purposes being fulfilled, and implicit judgments being made about what is, and is not, “significant.” So, even if it is perfectly sensible to say that some scientific enterprise has produced an accurate model, or map, of some features of external reality, it has chosen what features to map relative to particular interests, and those with other interests could have selected different features, significant for them, which would lead to an entirely different map or model of reality.

Well, at least in some cases. Science varies in terms of how “value laden” particular research projects are. Dividing things into “kinds” when the subject matter is, say, atomic particles, seems somehow less “value,“ or “purpose” driven than an enterprise like dividing humanity into “races.“ Stll, even if finding out about electrons is a result of knowledge obtained for the sake of knowledge, the project of learning about what we can DO with electrons, and what electrons can do to us, becomes VERY value laden VERY quickly. The fact that improvements in the electric chair outpaced improvements in the light bulb, at least for a while, speaks volumes on behalf of the “Luddites” complaints about the human condition, if not their diagnosis about what, exactly, has produced it.

Thus, even on Kitcher’s account, it is still a case of “them as has the gold, (mostly) makes the rules.” The evil patriarchy (or whoever) may not be “constructing reality,” exactly, but they are in various ways controlling what we can and do learn about it, and to what uses that knowledge is put, and this has approximately the same effect as “constructing reality“ would have. Indeed, the difference may only be of interest to metaphysicians and other pedants (like me). And, of course, Kitcher is perfectly well aware of this. What to DO about it, (how to address the perfectly justifiable complaints of those pesky “Luddites,” in other words, without sounding like Schopenhauer or Derrida) is the subject matter of the second half of his book.

Kitcher’s solutions in STD are, modestly, advanced only as a starting point for dialogue rather than as a final, magisterial answer. Still, as one would expect from a philosopher of his ability, they are sophisticated and plausible. Without getting deeply into the details (to vastly oversimplify his views, in other words), I would describe his approach as generally “Rawlsian,” with the idea being that what we need is a “well ordered” science, one in which research reflects the values established by a process of democratic deliberation somewhat like that which goes on in Rawls' “initial position” thought experiment in “A Theory of Justice,” but with a special role for those possessing expertise.

Whether or not Kitcher's suggestions are, in the end, workable is a subject that is worthy of years of debate, and probably will be kicked around in journals for quite some time. For what it is worth, I think the general idea has some considerable merit, but I also think it is subject to some of the same general objections that have been leveled at the overall “Rawlsian” position over the last 35 years – the most trenchant one being that the description of the “initial position” is a set up, engineered to produce conclusions about a just society that would be certain to appeal to an East Coast, Ivy League liberal intellectual like, say, John Rawls. Of course, I happen to LIKE the outcome Rawls produces, but that is no defense to the charge that he subtly begs the question. The suspicion would be that the Kitcher proposal could end up as a question begging enterprise in analogous ways. One way in which this could occur, which gives me special pause, is the role of “expert” in the deliberative process, and the question of whether “Nursing Expertise” would count.

It gives me special pause because of another conversation I had at the colloquium. I spent some time chatting with a VERY good woman philosopher who writes in the area of bioethics, and generally publishes in medical journals. She seemed amazed to learn that a) that there was a Journal entitled “Nursing Philosophy,” b) that nurses would read it, or that c) a philosopher would find anything interesting to publish in such a journal. As she thought all of this over she said “but they're (nurses) so submissive!"

I just let the comment go, figuring that she simply hadn't met any of the subscribers to this list. In fact, I think she must not have met very many nurses, period. I can't think of any I have worked for or with in the last 12 years that I would call “submissive.” Still, the comment was both surprising and disconcerting, since it came from a very bright, otherwise liberal and progressive woman thinker who should know better. And if SHE doesn't quite get the emerging role of nursing in health care policy and analysis, what are the chances that anyone else will? Where would nurses sit at Kitcher's deliberation table? Would they be entitled to an “expert” chair?

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