A Philosophy of Nursing Forum
Thursday, September 24, 2009
Our first official class discussion blog with Professor Bob Newsom! Let's get started...

We will be discussing scientific theory and epistemology this week.

Discussion Questions:

1. Scientific explanations should be testable, according to Rosenberg. Explain your understanding of the statement in chapter 4 (p 84):

…”almost from the onset science has explained by appeal to a realm of untestable entities, processes, things, events and properties. As far back as Newton, physicists and philosophers have been uncomfortable about the fact that such things seem both necessary and unknowable.”

2. Discuss critically: “Lots of scientists pursue science successfully without any regard to epistemology. The idea that science has an ‘official one’, and that empiricism is it, is wrong-headed.”


Bob and everyone. I am attempting to cut and paste from our discussion last week.

As I was reading your postings this week, did you notice how we moved to labels and titles, names, which inevitably lead to positions and one-up-'man'-ship? Knowledge leads us to happiness, success, autonomy, right? Certainly if attached to the right degrees. If only nurses truly valued degrees at the bacc level then so would the public, MDs and the rest of the known world. Knowledge would (if we buy the assumption that knowledge equals higher education) set us free to practice nursing as a scientific discipline, holistically and the way Nightingale envisioned it to be. You all have not mentioned that she also saw nursing as an art, not just an evidence based (ie scientific) profession. We so easily categorize (again with the divisions and labels) theories, practices, paradigms, patients with set boundaries and the system (created by humans) reinforces this with rewards (payment, job security, grants, good evaluations). I hope you will read Newman's "boundary" concerns as it relates to your theory course as well as how she asks if a unifying theory is desirable or in nursing's best interest. Bacon --certainly one of the poster boys for a utopian world ONLY if scientifically based--came to the conclusion that science by itself is NOT ENOUGH. That there must be a force and discipline OUTSIDE of science to 'coordinate them and point them to a goal'. He believed that science needs a philosophy, to help 'rightly place' our goals, to analyze continously the scientific method. Without this, he saw ANY scientific endeavor as superficial. "Only philosophy can give a life of turmoil and grief the stately peace that comes of understanding." A bit of wisdom is a joy forever, but ONLY when the the goal is 'rightly placed'. It seems that in nursing we may think about our patients and our place in the system but for the most part, do we 'know' or even go far enough to wonder about why we exist as a profession? I don't see it very often in practice. We 'do' without such insightful reflective thinking because this is where the reward is.
Now where does that lead us? Perhaps we have tiptoed out of Plato's cave but we are hardly running back in to enlighten the others. Many of us seek the solace and isolation of academe; is this but another cave of illusions?
Forgot to add that we will be talking about Plato's cave allegory on Tuesday. On a side note, Bacon in perhaps his greatest written work on philosophy of science (in my humble opinion) Novum Organum about the errors of logic. He started with the belief that 'philosophy had been barren so long because she needed a new method to make her fertile." Of course, his remedy was science and dominion over nature through science! I see a Mother Nature lack of respect here. Ok, won't go further with this but his second class of errors in this writing was what he called the Idols of the Cave. Errors peculiar to the individual person. "For every person has a cave or den or his own, which refracts and discolors the light of nature, this is his character as formed by nature AND NURTURE and by his mood or condition of body and mind." He went on to compare these nuances or worldviews of the artist, the poet and the philsopher and scientist and how we hold to these ideas or values, see the world through our own little view and thus, the 'error' of 'truth knowing no parties'. So my challenge for you is to know that you come from a particular 'cave' as we all do and that changes everything. My fear is that medicine has created for many decades our 'false consciousness' as Marx would say that nursing holds to be our self evident truths. Are we not looking out from the cave of medicine, rather than from the art and science of nursing and caring? Science or not science, evidence or not evidence, it changes everything. Or nothing.
While I am thinking of this and unsure of my source (maybe some of you who have read most recently can tell me?)...the first Copernican revolution was of the outer world (laws of physics) and the second is of the inner world (post modernism, phenomenology).
Sounds like Jean Watson?
Hi Sandra, as usual I am good at being vague...sorry for confusion. I used the term one up MAN ship because I could not spell hierarchical! It is a poor choice of terms. By virtue of our language--which let's assume for a moment somehow represents 'ideas' as per Plato--we categorize and name. Eventually those naming 'conventions' evolve, dichotomies emerge (Rogers notes Nightingale's "nursing: what it is and what it is not" as example) and values are attached to the words we use. I am jumping ahead a bit here but when we get to post modernism this will become the focus of a NON paradigm as constantly being created through language. Ever changing.
So how can we express our interpretations, opinions, ideas separately but yet move to 'connections', common ground, agree to disagree without moving to control, defense of our 'truths'? Words can become weapons, positions to defend. I am paraphrasing from Think above, but author says something fairly profound about ideas: that in the end, is is ideas for which people kill each other. Plato would most likely agree. Do you? The present health care reform is an excellent example of the post modernist position that the ideological boundaries which separate us can be either our greatest strength or lead to our demise. While Hegal would contend that the conflict itself through dialectical process can create new and improved synthesis. I suppose as Rogers said, we stand in the middle of our own truths. Your thoughts? And thanks for asking! I was free associating last night, could you tell??? (:
PS Sorry for not including my references ---will provide in class tomorrow.
Let's start with introductions. Hello Professor Bob, we are so pleased that you have agreed to share your caring matters blog with our class! Class, will you write a bit about yourself as an introduction and don't forget to upload a photo, if you wish.

Blog away,
Kay Lundy
Hello Professors Newsom, Lundy and Story:
OK, let me introduce myself as a student in the Nursing 701 fall class. I am Sandra Waguespack and I am faculty at LSUHSC School of Nursing BSN Program. I live in New Orleans near the zoo and Audubon Park. I received my MSN degree at USM and had such a pleasant experience (long ago) that I have returned for more.
This Philosophy of Nursing course is introducing me to blogging along with the intellect and insight of the great philosophers...very enlightening...
Hello Professors Newsome, Lundy and Story,
My name is Melissa Martin. I teach Practical Nursing at Pearl River Community College in Hattiesburg, MS. My MSN degree is from William Carey University. And this is my first experience blogging.
Melissa’s response:

Science- meaning knowledge or to know, by definition, will not be comfortable with things being ‘unknowable’. Scientist attempt to explain that which seems unexplainable. The very nature of science causes the pursuit of truth beyond a cursory explanation. Truth seems established, in many cases, only when sufficient evidence is gathered through empirics. However, as Rosenberg points out on page 84, even Newton struggled with the idea that some things are unknowable or in Newton’s case- unseen. Rosenburg first speaks of this dilemma on page 22; when he calls “questions about the nature, extent, and justification of knowledge, and in particular scientific knowledge” a question that has “vexed philosophers since the time of Socrates and Plato”. Rosenburg states “things seem both necessary and unknowable” (p. 84). By ‘necessary’ I believe Rosenberg means the consideration of all that is potentiated in an explanation and not just the portion of the explanation observed through experience (22). Often scientific breakthroughs answer one question and leave us searching for the many new questions that have arisen. We can agree there are forces in the world and universe that we do not yet fully understand and perhaps can not even see or sense in any capacity. There are many cases in which we only have minimal indirect observation of phenomena, but we use logic and reasoning to scientifically prove or disprove the occurrence. I believe Rosenberg is saying it is acceptable to ask epistemological questions and perhaps even (however uncomfortable) also acceptable when we can’t touch the answer.
Drs. Lundy, Newsome and Story,
My name is Louanne Friend. My undergraduate degree was earned at Clemson University which is in South Carolina. (Just south of the heaven of North Carolina.) My master’s degree is from LSU where I focused on nursing administration. I teach Adult Health One at LSUHSC in New Orleans. In the six weeks that I have been taking philosophy, I believe that I have truly encountered existential angst. (I do hope that as I have read, this is merely a stage and will lead to a new consciousness as stated by Gaarder.)

Science and epistemology are the two concepts to be critically discussed. I completely agree with Melissa’s response that she believed Rosenberg was stating that it is acceptable to ask epistemological questions even when we cannot completely answer the question. I too believe that science is the process by which many questions are asked, but epistemology considers the nature, extent and justification of knowledge (Rosenberg.) An example that I can offer is this. We now have the technology to treat infertility with in vitro fertilization. However, what happens if the wrong embryo is implanted in the unsuspecting patient? This is the question raised by a recent lawsuit in New Orleans filed against Ochsner Foundation. Science gave us the technology, but philosophy and logic will hopefully determine how we utilize the technology.
The idea that empiricism is the base of science without epistemology is our second question. The empiricists or positivist believed that the only knowledge worth acquiring could be obtained via the scientific method. They also believed that knowledge can be justified only by the senses. The problem of course with positivism is that the choice of what questions to be answered by science are not often always based on observable phenomenon. (Rosenberg offers the following as unobservable phenomenon: atoms, electrons, charge, acid and genes.) Nursing has expounded on many concepts which cannot be observed such as caring and excellence. However, we also read a great deal about evidenced based practice. Does this mean that we will follow the medical model and ignore the nature and justification of knowledge?
I would like to end my post with a response to Dr. Lundy’s comment regarding our use of labels, boundaries, and the fact that nursing has often looked out of the cave of medicine. We do utilize labels and classify everyone and everything .However, in defense of our focus on baccalaureate education, in 1923, M. Adelaide Nutting published an article regarding her impression of thirty years of progress in nursing. She eloquently begins by asking what progress is. Is it something that can be measured or is it a spiritual thing?(Science versus philosophy again.) The main example that Nutting discusses as epitomizing the advancement of nursing is the transition of nursing education from the hospital to the university setting. Nutting states that by placing education of nurses in the university setting, nursing will have adequate funds for education and an administrative body charged with the responsibility of conducting educational work. Yes, we do label nurses and place value on baccalaureate education, but is that not one of the indicators of nursing’s progress as a profession? In respect to the medical model, Elizabeth Kubler Ross said, “We have to ask ourselves whether medicine is to remain a humanitarian and respected profession or a new but depersonalized science in the service of prolonging life rather than diminishing human suffering.” Nursing is different from medicine and must continue to expound upon these differences. Nutting and her peers identified the problems of being tied to hospitals (and physicians) yet nurses have yet to break the chains and are still only looking ahead at the shadows. Hopefully we can continue to grow as a profession and lead healthcare to a place where human suffering is diminished and people no longer endure death by hospitalization.
I am responding to the thoughts posed by Dr. Lundy for this week's discussion:

#1.Scientific explanations should be testable, according to Rosenberg. Explain your understanding of the statement in chapter 4 (p 84):…”almost from the onset science has explained by appeal to a realm of untestable entities, processes, things, events and properties. As far back as Newton, physicists and philosophers have been uncomfortable about the fact that such things seem both necessary and unknowable.”

Newton coined the term ‘gravity’…Gravity is a mysterious force since it cannot be identified by senses alone. It is undetectable except for its effect. The cause remains cloaked, but the effect can be sensed and measured scientifically.
Recall the classic situation of Newton observing an apple falling out of a tree-the classic effect of gravity…people have a need to put a ‘label’ on phenomena such as this. So, everyone uses the label of gravity, or gravitational pull, to explain why things have weight (another label).

Empiricists thought there would be no problem with laws or theories of science if the terms (labels) used to name them could be defined by observing things and their properties (Rosenberg, 2005, p. 87).
But unobservable phenomena are rarely, if ever, defined in terms of observable properties.

Consider hypertension, the silent killer. It is a scary disorder for those that have it, mainly because it is unknown forces that cannot be sensed. The scientific laws apply to the forces within the human vascular system, cannot be sensed but can be measured with a blood pressure cuff.
The effects of hypertension are observable as it becomes severe enough to damage normal physiologic functioning and even then the patient may not understand how hypertension could make his/her kidneys fail or have a stroke
Throughout the centuries, people, in general, want to know and understand the ‘invisible’ forces that surround and impact us on a daily basis.

2. Discuss critically: “Lots of scientists pursue science successfully without any regard to epistemology. The idea that science has an ‘official one’, and that empiricism is it, is wrong-headed.”

There is no need for an 'official one' and all can agree to disagree on this...
Hypotheses and measurable proofs are part of the backbone of scientific theories and facts. Observation is the epistemological standard.
Empiricism is a form of epistemology, based on experiences.
Empiricism of experiences includes cognitive processes of ideas and unconscious associations that are not connected to observed phenomena.
Epistomology and empiricism are tangled together so tightly that scientists need to realize that both are a necessary part of scientific knowledge.
Hi everyone. Good comments and much to digest. See Professor Newsom's post on a new thread above, you will need to post under his thread. This is a bit confusing, you will see another post when you click on "comments". It will take you a while to read, but you know are well prepared to comment...under 'theory and reality'.
Dr. Lundy
The blog and data is excellent and informative as well. nursing shoes
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