Wednesday, May 17, 2023

Becoming Beloved Community

The following is a reflection I shared with my fellow parishioners at the "Faith at Eight" service at church, on Sunday, January 17, 2021.

The gospel readings from this week and last week describe the beginning of Jesus's ministry. The reading last week from Mark (1:4-11) describes the baptism of Jesus, and the reading this week from John (1:43-51) describes Jesus's calling his disciples to follow him.
      So what exactly was the purpose of Jesus's ministry? What was his mission? Why did he come to us? Why did he offer himself as a sacrifice for us?
      Each of us may have our own answers to these questions. Some possible answers include:
      (1) Jesus came to fulfill the law. In Matthew 5:17, Jesus says, "Think not that I have come to abolish the law and the prophets; I have come not to abolish them but to fulfill them."
      (2) Jesus came to do God's will. In John 6:38-40, Jesus says, "For I have come down from heaven, not to do my own will, but the will of him who sent me...For my Father's will is that everyone who looks at the Son and believes in him shall have eternal life, and I will raise them up at the last day."
      (3) Jesus came to bring light into the world. In John 12:46, Jesus says "I have come as light into the world, that whoever believes in me may not remain in darkness."
      (4) Jesus came to sacrifice himself for us, so that we might be saved from sin. John 3:17 says, "For God sent the Son into the world, not to condemn the world, but that the world might be saved through him."
      There are of course many other possible answers to the question of what was the nature or purpose of Jesus's ministry. But what is the nature or purpose of our own ministry as followers of Jesus? What is our mission? We each have our own mission or purpose, our reason for being in the world. We each have a purpose to fulfill, individually as well as collectively. What then is that purpose or mission? Perhaps our purpose is to make the world a better place? Perhaps our purpose is to love and care for one another? Perhaps our purpose is simply to be the best people we can be, and thus to glorify God?
      I'd like to explore these questions in the context of the life and ministry of the Rev. Dr. Martin Luther King Jr., since we're celebrating his birthday tomorrow. What did Dr. King see as his lifelong mission or purpose? What did he mean when he talked about the redemptive power of love and the creation of a beloved community?
      I learned a few things about Dr. King yesterday when I was reading about his life and career as a minister and civil rights leader. He was born January 15, 1929, in Atlanta, and he died April 4, 1968 in Memphis. He was born Michael King Jr., the second of three children, to the Rev. Michael King Sr. and Alberta King. In 1934, the Rev. King Sr. traveled to the Middle East and Berlin, Germany for a meeting of the World Baptist Alliance, and when he returned, he began referring to himself as Martin Luther King Sr., and to his son as Martin Luther King Jr. The Rev. King Sr. later explained that the reason he changed his name was because he had an uncle named Martin and an uncle named Luther, but it's said to be likely that his visit to Germany had an impact on him, and that he was moved by having visited the country that was the birthplace of Lutheranism and Protestantism.1 
      MLK Jr.'s birth certificate was later changed to read "Martin Luther King Jr." in 1957, when he was 28 years old.1 
      His maternal grandfather, Adam Daniel Williams, served as pastor of Ebenezer Baptist Church in Atlanta, but after his death, Rev. King Sr., became pastor of Ebenezer Baptist Church. 
      MLK Jr. studied at Morehouse College, at Crozer Theological Seminary in Upland, Pennsylvania, and then at Boston University, where he earned a PhD in theology in 1955. He became pastor of Dexter Avenue Baptist Church in Montgomery, Alabama in 1954, and he became co-pastor with his father of Ebenezer Baptist Church in 1959. 
      His father died in 1984. His mother, Alberta, was murdered by a 23-year-old man in 1974 at the Ebenezer Baptist Church during Sunday services. The man stood up, and yelled "You are serving a false god," and fatally shot Mrs. King and the Rev. Edward Boykin, who was a deacon at the church. The gunman, Marcus Wayne Chenault, later died in prison of a stroke in 1995.
      In 1967, Dr. Martin Luther King Jr. delivered a sermon entitled "The Birth of a New Nation" at Dexter Avenue Baptist Church. In it, he said that the aftermath of violence is emptiness and bitterness, but the aftermath of nonviolence is reconciliation, redemption, and the creation of a beloved community.2
      The phrase "beloved community" came from the American philosopher Josiah Royce (1855-1916), who taught at Harvard University from 1882-1916. Royce wrote on such subjects as metaphysics, ethics, and the philosophy of religion, and he was a friend and colleague of the philosopher William James (1842-1910), who also taught at Harvard.
      While Dr. King was studying at Boston University, he attended philosophy classes at Harvard and became familiar with Royce's philosophy.
      Royce described the beloved community as an ethical ideal, insofar as its realization can be taken as a standard of our moral conduct. Royce said, "Every proposed reform, every moral deed, is to be tested by whether and to what extent it contributes to the realization of the Beloved Community...When one cannot find the beloved community, one needs to take steps to create it, and if there is not evidence of the existence of such a community, then the rule is to act so as to hasten its coming."3
      Dr. King, although he didn't specifically define what a beloved community is, saw the creation of such a community as a goal of the civil rights movement.
      The Episcopal Church has promoted Dr. King's vision of the beloved community, and in a document entitled "Becoming Beloved Community" (published in 2017), which can be found at the episcopalchurch.org website, it describes what such a commitment might mean for us. The document displays an image of a circular labyrinth, with four interrelated commitments listed along the circumference of the labyrinth. At the top left is "Telling the Truth." At the top right is "Proclaiming the Dream." At the bottom right is "Practicing the Way," and at the bottom left is "Repairing the Breach." So a kind of cyclical process is described.
      The first commitment, to tell the truth, leads to such questions as "Who are we?" and "What things have we done and left undone regarding racial justice and healing?" The second commitment, to proclaim the dream, leads to such questions as "How can we publicly acknowledge things done and left undone?", "What does beloved community look like?", and "What actions and commitments will promote reconciliation, justice, and healing?" The third commitment, to practice the way of love, leads to such questions as "How will we grow as reconcilers, healers, and justice-bearers?" and "How will we actively grow in relationship across dividing walls and seek Christ in the other?" And the fourth commitment, to repair the breach, leads to such questions as "What institutions and systems are broken?" and "How will we participate in repair, restoration, and healing of people, institutions, and systems?"4
      The document explains that the image of the labyrinth is chosen because there's no single path for each person to follow. People may draw on their own experiences, and they may arrive at different answers for the same questions.5
      The document also explains that becoming beloved community represents "not so much a set of programs as a journey and a set of interrelated commitments around which Episcopalians may organize our many efforts to respond to racial injustice and grow as a community of reconcilers, justice-makers, and healers. As the Episcopal branch of the Jesus movement, we dream and work to foster beloved communities where all people may experience dignity and abundant life and see themselves and others as beloved children of God."6
      So what are our responsibilities regarding the fulfillment of Dr. King's vision of the beloved community? Is the beloved community merely a utopian ideal? Do we really need such ideal models of justice in order to remedy present injustice?
      What is the utility of "ideal" versus "non-ideal" theories of racial justice?
      Charles W. Mills, professor of philosophy at The Graduate Center, CUNY, has argued that  so-called "ideal theory" concerning justice in a perfectly just society must be replaced by "non-ideal theory" concerning justice in an imperfect and unjust society. Mills provides many persuasive criticisms of ideal theory, including the criticism that it may divert attention from real-world problems and that we don't necessarily need to be able to envision justice in an ideal world in order to be able to correct justice in the real world.7
      Tommie Shelby, professor of philosophy at Harvard University, on the other hand, has argued that ideal theory and non-ideal theory may be complementary, and that ideal theory, which studies the principles of justice in a perfectly just society, may provide standards of justice for non-ideal theory, which studies the principles that should guide our responses to injustice in our own society.8
      The website of The King Center explains that "For Dr. King, The Beloved Community was not a lofty utopian goal to be confused with the rapturous image of the Peaceable Kingdom, in which lions and lambs coexist in idyllic harmony. Rather, The Beloved Community was for him a realistic, achievable goal that could be attained by a critical mass of people committed to and trained in the philosophy and methods of nonviolence."9
      The website also explains that "Dr. King's Beloved Community is a global vision, in which all people can share in the wealth of the earth. In the Beloved Community, poverty, hunger, and homelessness will be not be tolerated because international standards of human decency will not allow it. Racism and all forms of discrimination, bigotry and prejudice will be replaced by an all-inclusive spirit of sisterhood and brotherhood. In the Beloved Community, international disputes will be resolved by peaceful conflict-resolution and reconciliation of adversaries, instead of by military power. Love and trust will triumph over fear and hatred. Peace with justice will prevail over war and military conflict."10
      So what steps can we as individuals, as a community, and as a society take today and in the coming year to promote the becoming of a beloved community?


FOOTNOTES

1DeNeen L. Brown, "The story of how Michael King Jr. became Martin Luther King Jr.," The Washington Post, January 15, 2019, online at https://www.washingtonpost.com/history/2019/01/15/story-how-michael-king-jr-became-martin-luther-king-jr/
2Martin Luther King Jr., "The Birth of a New Nation," April 7, 1957, in The Papers of Martin Luther King, Jr., Volume IV, edited by Clayborne Carson, et al., (Berkeley: University of California Press at Berkeley and Los Angeles, 2000), online at https://kinginstitute.stanford.edu/king-papers/documents/birth-new-nation-sermon-delivered-dexter-avenue-baptist-church
3Josiah Royce, online at Building the Beloved Community: An Interfaith Initiative for Fair Housing, https://www.bbcfairhousing.org/about-the-initiative/
4The Episcopal Church, "Becoming Beloved Community," 2017, online at https://www.episcopalchurch.org/wp-content/uploads/sites/2/2021/01/becoming_beloved_community_summary.pdf
5Ibid.
6Ibid.
7Charles W. Mills, "Realizing (Though Racializing) Pogge," in Thomas Pogge and His Critics, edited by Alison M. Jaggar (Cambridge, Polity Press, 2010), p. 102.
8Tommie Shelby, "Racial Realities and Corrective Justice: A Reply to Charles Mills," in Critical Philosophy of Race, Vol. 1, No. 2, 2013, pp. 155-156.
9The King Center, "The King Philosophy - Nonviolence 365," online at https://thekingcenter.org/about-tkc/the-king-philosophy/
10Ibid.


Thursday, April 27, 2023

Nicholas Rescher's Inquiry into the Limits of Knowledge

What are the theoretical and practical limits of human knowledge? What are the reasons for our inability to know certain facts about the world? What distinguishes knowable from unknowable facts?
      How can we ever know whether the universe is finite or infinite? How can we ever know whether it had a beginning, and whether it will have an ending? How can we ever know how space, time, matter, and energy originated?
      How can we ever discover historical facts the evidence of which has been permanently lost?
      How can we ever really know what others are thinking and feeling? The thoughts and feelings of others are to some extent unknowable to us, in the sense that we can't think those thoughts exactly as they think them or feel those feelings exactly as they feel them. We can only say, "I know what you're thinking" or "I know what you're feeling" by means of deduction, inference, reasoning, intuition, imagination, or other means. To use a commonly cited example, we can't ever really know whether others experience the color red in the same way that we experience the color red.
      Some facts (for example, the contents of a classified file or document) may be contingently (but not in principle) unknowable, because they're concealed or because public access to them is forbidden. Our personal data, such as our birthdates, computer passwords, social security numbers, etc., may be contingently unknowable to others, because we generally refuse to share such information with everyone. The details of our own bodies may be contingently unknowable to others, because they're hidden by our clothing.
      To say we know about something may not necessarily be to say that we know everything about it. We may have a relatively complete or incomplete knowledge about a certain thing. If we can't ever really know everything about it, then it may to some extent be unknowable to us, at least in its totality (given our limited cognitive resources).
      Many facts may be unknowable yet trivial, and thus we may not really be interested in knowing them. 
      If there are no facts about certain things, i.e. if there is "no fact of the matter" about them, then they may also be unknowable.
      Nicholas Rescher (2009) explains that reasons for our not being able to know certain things include our not being smart enough to figure them out, and the unavailability of further data we would need to know about them. But we may also not be able to know about certain things because they are in principle unknowable, and this in-principle unknowability is what Rescher is concerned with, rather than unknowability due to our contingent cognitive limitations.
      He describes three kinds of necessary or demonstrable unknowability: (1) logical unknowability (which is demonstrable on the basis of the considerations of epistemic logic), (2) conceptual unknowability (which is demonstrable on the basis of the concepts involved), and (3) in-principle unknowability (which is demonstrable on the basis of the basic principles that delineate some field of inquiry or area of concern).1
      He also explains that some facts are unknowable because they depend on future contingencies. Thus, we can't know, at the present moment, precisely who will be killed in an automobile accident next year or whose life will be saved by the enactment of a certain automobile speed limit.2
      Some facts may also be unknowable because they're unidentifiable. Examples include claims about the existence of such unidentifiable entities as (1) something whose identity will never be known, (2) some idea that has never occurred to anyone, (3) some person whom no one remembers at all, (4) some event that no one has ever mentioned, and (5) some integer that is never individually specified.3
      Clearly, we may know some facts without being consciously aware that we know them. So every known fact may not be immediately identifiable. We may also be able to individuate some unknowable facts without being able to identify them or say precisely what they are. But we can't know facts that can never be specifically instantiated.
      Rescher also notes that if some facts are unknowable, then we can't rightly be held to be culpably ignorant of them.4
      What distinguishes answerable from unanswerable questions? Rescher argues that all scientific questions are potentially answerable (if not at present, then in the future). Even such ultimate questions as "Why is there anything rather than nothing?" and "Why are there any natural laws?" are potentially answerable. The presence of scientific questions that haven't yet been answered doesn't necessarily mean those questions can never be answered or will always remain unanswered. 
      Thus, he rejects the existence of insolubilia (inherently unsolvable scientific problems or inherently unanswerable scientific questions), because of the unpredictability of future scientific developments.5 He argues that we can't predict with certainty what will be the future limits of scientific knowledge.
      He also describes four main reasons for the unknowability of, or impracticability of cognitive access to, certain facts about the world: (1) developmental unpredictability (the inability to predict with certainty what will happen in the future and what will be discovered by future science), (2) verificational surdity (the inability to explain facts on the basis of general principles or to derive them from the definitions and laws of their natural domain), (3) ontological detail (the inability to know all the facts about certain things, due to their factual limitlessness and inexhaustibility), and (4) predicative vagrancy (the inability to instantiate any predicates about things that are unspecificable).6
      He also discusses the formal logic of unknowability, including such topics as the problem of demonstrating the existence of unknowable truths. This problem has been investigated by many philosophers, including Frederic Fitch, W.D. Hart, J.J. MacIntosh, Richard Routley, Timothy Williamson, Rescher, and others.
     Timothy Williamson (2000) refers to an argument by Frederic Fitch (1963) called the Paradox of Unknowability, which says that if something is an unknown (but perhaps knowable) truth, then its being an unknown truth is itself an unknowable truth.7 An unknown truth cannot be known to be unknown.
      Williamson describes strong verificationism as the theory that every truth is actually known (at some point in the past, present, or future), and weak verificationism as the theory that every truth is in principle knowable. The former is called the "omniscience principle," while the latter is called the "knowability thesis." Fitch's paradox is an argument against both kinds of verificationism.
      Williamson explains that

"As Joseph Melia (1991) points out, [Fitch's argument] does not show that if there are unanswered questions, then there are unanswerable questions. More precisely, it does not show that if for some proposition p, it is unknown whether p is true, then...it is unknowable whether p is true. In particular, if p is an unknown truth, then it is unknowable that p is an unknown truth, but it does not follow that it is unknowable whether p is an unknown truth. For that it is an unknowable truth that p is an unknown truth does not imply the... impossibility of a situation in which p is false and even known to be false, and thereby known not to be an unknown truth. Equally, ...it...does not imply the...impossibility of a situation in which p is shown to be true, and even known to be known to be true, and thereby known not to be an unknown truth. In situations of both kinds, it is known whether p is an unknown truth."8

       Verificationism is anti-realist in the sense that it holds that every truth (or fact) is in principle knowable and thus accessible to human thought, while a realist position would hold that at least some truths (or facts) are actually unknowable and exist independently of human thought.
      Helge Rückert (2004) explains that Fitch's paradox may be derived as follows:

      (1)   α → ♢Kα   (which may be read as, "if there is a truth α, then it's possible for it to be known")
      (2)   (Kα → α)  (necessarily, if a truth α is known, then it's a truth α
      (3)   ロ(K(α ⋀ β) → (Kα ⋀ Kβ))  (necessarily, if a truth α and a truth β are known, then α is known and β is known)
      (4)   ♢K(α ⋀ ¬Kα)  (it's impossible for an α and an unknown α to be known)
      (5)   (α ⋀ ¬Kα) → ♢K(α ⋀ ¬Kα)  (if there is an α and an unknown α, then it's possible for an α and an unknown α to be known)
      (6)   ¬(α ⋀ ¬Kα)  (there can't be an α and an unknown α)
      (7)   α → Kα  (if there is a truth α, then it's known)

So weak verificationism entails or "collapses into" strong verificationism. The relatively plausible thesis that every truth is in principle knowable collapses into the wholly implausible thesis that every truth is actually known. This is a significant problem for verificationism.9


FOOTNOTES

1Nicholas Rescher, Unknowability: An Inquiry into the Limits of Knowledge (Lanham, MD: Rowman & Littlefield, 2009), p. 3.
2Ibid., p. 3.
3Ibid., p. 65.
4Ibid., p. 6.
5Ibid., p. 16.
6Ibid., p. ix.
7Timothy Williamson, Knowledge and its Limits (Oxford: Oxford University Press, 2000), p. 270.
8Ibid., p. 289.
9Helge Rückert, "A Solution to Fitch's Paradox of Knowability," in Logic, Epistemology, and the Unity of Science, edited by Shahid Rahman, John Symons. et al. (Dordrecht: Kluwer Academic Publishers, 2004), pp. 352-353.

OTHER REFERENCES

Frederic Fitch, "A Logical Analysis of Some Value Concepts," in Journal of Symbolic Logic, Vol. 28 (1963), pp. 135-142.

Joseph Melia, "Anti-Realism Untouched," in Mind, 100 (1991), pp. 341-342.

Wednesday, April 19, 2023

Edith Stein, on Finite and Infinite Being

Edith Stein (1891-1942) was a German Jewish philosopher who converted to Catholicism and became a Carmelite nun. She was born in Breslau, Germany (now Wroclaw, Poland), and died at Auschwitz. She studied at the University of Breslau, the University of Göttingen, and the University of Freiburg, where she completed her doctoral thesis on the phenomenology of empathy. She worked as an assistant to the philosopher Edmund Husserl at Freiburg from 1916-1918. After she read the autobiography of St. Teresa of Avila, she converted to Catholicism, and she was baptized into the Catholic Church in 1922. In 1933 she entered the Carmelite convent at Cologne, taking the religious name Teresa Benedicta of the Cross (Teresia Benedicta a Cruce). In 1938, she and her sister Rosa, who had also converted, were transferred for their own safety to the Carmelite monastery in Echt, Netherlands, but after the Dutch bishops condemned Nazism in 1942, all baptized Catholics of Jewish ancestry were arrested. Edith and Rosa were sent to a concentration camp at Amersfoort, then to Westerbork, and then to Auschwitz, where they died in a gas chamber on August 9, 1942.
      Stein's many writings included Zum Problem der Einfühlung (1917, On the Problem of Empathy, 1989), Potenz und Akt: Studien zu einer Philosophie des Seins (1931, Potency and Act: Studies on a Philosophy of Being, 2009), Endliches und ewiges Sein (1949, Finite and Eternal Being, 2002), Kreuzeswissenschaft (1942, The Science of the Cross, 2003), and Wege der Gotteserkenntnis (1940, Ways to Know God, 1993). She was beatified by the Catholic Church in 1987, and was canonized Saint Teresa Benedicta of the Cross in 1988.
      In Finite and Eternal Being: An Attempt at an Ascent to the Meaning of Being, Stein takes as her starting point the fact of our own being. She takes our own being as given, rather than as a conclusion (as suggested by Descartes' cogito). She asks, "What is that being of which I am conscious?" and "What is that self which is conscious of itself?"1
       She explains that Husserl calls the self that is immediately given in conscious experience the pure ego, and that the pure ego knows itself simultaneously as an actually present existent and as an actual existent that emerges from a past and lives into the future.2
        She also explains that our own being is inseparable from temporality, while pure being has no temporality. Our own being is an actually present being, a "now" between a "no longer" and a "not yet." But in pure being, there isn't a "no longer" or "not yet." Pure being is eternal, and not temporal.3
      Our own present actual being contains within itself the possibility of future actual being and is thus both actual and potential. In this sense, our own being is always a becoming. The becoming actual of our future being is a transition from potentiality to actuality, and the transition from potential to actual being is a transition from one mode of being to another.4 
      Stein thus accepts St. Thomas Aquinas's distinction between act and potency as modes of being. She argues that we must distinguish between active and passive potency, and that the potency belonging to God is active potency. In God, there is no unactivated potency. God's potency is completely actualized.5
      She also accepts Aquinas's view of the "first existent" as pure being and pure act. In our own being, which is finite being, we encounter a kind of received being that is the support and ground of our being.6 This ground and support of our being is a necessary being, of which there can only be one, just as there can only be one first existent. This necessary being is also perfect and eternally immutable being. Indeed, it is being itself. Thus, the distinction between finite and infinite being is also the distinction between the temporal and the eternal, between our own being and God's being. 
      Existents may be divided into various genera according to their quiddity (their natures or essences or whatnesses). Essential being is the being of natures or essences when they are considered apart from their actualization.7 Essential being is also a timeless (or non-temporal) being-unfolded or being-unfolding of meaning. Ideal being is a special kind of essential being, and also a special kind of (non-temporal) unfolding of ideal objects. On the other hand, real being is "an unfolding that proceeds from an essential form, from potency toward act, and within time and space."8
      Just as a distinction may be made between potential and actual being, a distinction may be made between potential and actual existents. But the first existent (God) is also the first being, and God's existence cannot be separated from God's being. God's being is pure being, in which there is no non-being. In the infinite and eternal, being cannot be separated from existence, but in all finite things, being and existence are different from each other.9
      In response to the question of whether any distinction can be made between God's essence and God's existence, Stein explains they are in fact an undivided unity, and thus they cannot be subjected to analytical articulation.10
      The first being (God) is also pure act, and in this being there is no passing from potentiality to actuality. Temporal being, on the other hand, is not pure act, and it may be a progressive actualization of unfulfilled potentialities.

FOOTNOTES

1Edith Stein, Finite and Eternal Being: An Attempt at an Ascent to the Meaning of Being, translated by Kurt F. Reinhardt (Washington, D.C.: ICS Publications, 2002), p. 37.      
2Ibid., p. 54
3Ibid., p. 37.
4Ibid., p. 34.
5Ibid., p. 2.
6Ibid., p. 59.
7Ibid., p. 91.
8Ibid., p. 331.
9Ibid., p. 335.
10Ibid., p. 342.

Sunday, April 9, 2023

Problems for the Supposed Maximality of Possible Worlds

Alvin Plantinga (1974) defines a possible world as a possible state of affairs that is maximal or complete. Every possible world is a possible state of affairs, he says, but not every possible state of affairs is a possible world. A state of affairs S is maximal or complete if (and only if) for every state of affairs S', S either includes or precludes S'. The actual world we live in is one of these possible worlds; it's the maximal possible state of affairs that is actual.1
      The reason for defining possible worlds in terms of maximality or completeness is that not every possible state of affairs is complete enough to be considered a possible world. Plantinga gives as an example the proposition that "Socrates is snubnosed." A possible state of affairs must include or preclude more than that in order to be considered a possible world.
      Similarly, Robert C. Koons and Timothy K. Pickavance (2017) define a possible world as a possibility that's maximal insofar as every proposition is either true or false according to it.2 They also describe concretism and abstractionism as two contrasting views about the nature of possible worlds. While concretism is the view that possible worlds are maximal possible concrete objects, abstractionism is the view that possible worlds are maximal possible abstract objects.3
      Dale Jacquette (2006) explains that if a logically possible world is taken to be a maximal consistent set of propositions, then it could (theoretically) be constructed by randomly choosing one logically possible proposition and then considering an exhaustive ordering of all other logically possible propositions, and adding each one to the given set if and only if it is logically consistent with the propositions already collected, until there are none left. The propositions in a maximally consistent set of propositions would therefore collectively represent every state of affairs associated with a corresponding logically possible world.4
     Another conclusion, however, might be that the actual world is the only maximally consistent set of propositions, and that all other logically possible but nonactual worlds are submaximally consistent.
     But what about propositions whose truth or falsehood is indeterminate or undecidable? In the actual world we live in, there are such undecidable propositions. Is the actual world then not a possible world? How then can maximality or completeness be considered a valid criterion for some possible state of affairs to be considered a possible world? Must a possible world be maximal in the sense that every proposition is decidably true or false according to it, and therefore also in the sense that for every proposition there is some rational procedure that can determine in a finite number of steps the truth or falsehood of that proposition according to it?
      These questions are motivated by Gödel's first incompleteness theorem, which says, roughly, that for any consistent system S of formal arithmetic in which (1) the set of axioms and the rules of inference are recursively definable, and (2) every recursive relation is definable, there are undecidable arithmetical propositions of the form xF(x), where F is a recursively defined property of natural numbers.5
      Thus, it seems that possible worlds can't be both complete and consistent, because the actual world isn't that way. For every possible proposition expressible within a nontrivial formal system of arithmetic to be provable or disprovable, that system has to be in some way inconsistent. All consistent nontrivial formal systems of arithmetic are deductively incomplete.
     Of what use then is the concept of maximality or completeness as a means of better understanding the metaphysics of modality?
      Patrick Grim (1991) presents an argument similar to the Liar Paradox as a refutation of the maximality of possible worlds. He explains that if possible worlds are taken to be or to correspond to maximal consistent sets or propositions, and if the actual world, on such an account, is taken to be or to correspond to the maximal set of all truths, then we can examine the proposition A: The proposition A is not a member of the maximal set M of all truths. Is A a member of set M or not? If it's a member, then it must not be, and if it's not a member, then it must be.6
      Tony Roy (2012) also presents an argument against the maximality of possible worlds, by employing Cantor's Theorem (that the set of all subsets of a given set has a greater cardinality than the set itself):

      "Suppose that for any proposition a, some sentence expresses a and some sentence expresses not-a...Then the supposition that worlds are maximal and so include one of a or not-a for every sentence is incoherent. Consider a world w, and the set P(w) which has as members all the subsets of w. By Cantor's Theorem, there are more sets of sentences in P(w) than sentences in w. Trouble.
      ...And this generates a problem about the maximality of w. Suppose w is maximal; then given our assumption that there are sentences to express any proposition and its negation, for any A in P(w), w includes one or the other of,
      a1 Some member of A is true; and
      aNo member of A is true.
So w includes at least one sentence for each member of P(w); so there are not more members in P(w) than w. This is impossible; reject the assumption; w is not maximal.
     So given a language with adequate expressive power, the very attempt to say everything about a world is self-defeating."7

FOOTNOTES

1Alvin Plantinga, The Nature of Necessity (Oxford: Clarendon Press, 1974), pp. 44-45.
2Robert C. Koons and Timothy K. Pickavance, The Atlas of Reality: A Comprehensive Guide to Metaphysics (Chichester: John Wiley & Sons, 2017), p. 318.
3Ibid., p. 321.
4Dale Jacquette, "Propositions, Sets, and Worlds," in Studia Logica, Vol. 82, No. 3, April 2006, pp. 338-340.
5Kurt Gödel, "On formally undecidable propositions of Principia Mathematica and related systems," [Über formal unentscheidbare Sätze der Principia Mathematica und verwandter Systeme," 1931] in Kurt Gödel Collected Works, Volume I, edited by Solomon Feferman, et al. (Oxford: Oxford University Press, 2004) p. 181.
6Patrick Grim, The Incomplete Universe: Totality, Knowledge, and Truth (Cambridge: MIT Press, 1991), pp. 6-8.
7Tony Roy, "Modality," in The Continuum Companion to Metaphysics, edited by Neil A. Manson and Robert W. Barnard (London: Continuum, 2012), pp. 51-52.

Thursday, March 23, 2023

Medical Hermeneutics

Medical hermeneutics may include the interpretation of a variety of clinical data, such as a patient's medical history, family history, social history, present complaints, clinical symptoms, clinical signs, laboratory results, and radiological results. It may also include review of a patient's previous treatment, present medications, allergies, response to treatment, and compliance with treatment.
      It may also include the interpretation of various sociocultural aspects of the clinical encounter, such as the patient's and provider's interpretation of their own roles in the patient-provider relationship. 
      The provider's interpretation of their role may include a conception of their professional duties and responsibilities, as well as the patient's rights and responsibilities, the standard of care for the given clinical problem, the best way to fulfill the standard of care, and the best way to address the patient's concerns and expectations. The patient's interpretation of their role may include an expectation to be informed of the nature of their medical condition, as well as an expectation to be informed of the planned diagnostic approach, the possible burdens and side-effects of treatment, and the best course of treatment.
      Since a successful outcome of the clinical encounter depends on clear and effective communication, core competencies for clinicians include communicative competence, cultural competence, interpersonal skills, professionalism, medical knowledge, practice-based learning (including evidence-based care, and consideration of recent improvements in patient care), and systems-based practice (including accessing of healthcare system resources in order to provide the best possible care).1
      Medical interpretation may also be a means of communicating with patients, e.g. through a medical interpreter or translator when a patient speaks a foreign language that isn't understood by the healthcare provider or has some other difficulty communicating (for example, due to speech, hearing, or cognitive disability).
      Correct interpretation of clinical findings may depend on consideration of epidemiological data such as risk factors for a given disease-process in a particular patient population.
      Correct interpretation of laboratory test results may also depend on awareness of their sensitivity, specificity, and predictive accuracy for the disease-process in question in the given patient group, community, or population. It may also depend on awareness of the possible causes of false-positive and false-negative test results.
      Radiological interpretation may include interpretation of radiological images and reports, combined with the ability to determine the diagnostic certainty of positive or negative findings, and the ability to determine an appropriate response to uncertain or indeterminate findings.
      Narrative interpretation in medicine may include interpretation of patient narratives (oral, written, and behavioral) and narrative reports, as well as illness-related and historical narratives presented by medical records, office notes, and procedure notes.
      Hermeneutics is traditionally defined as the art or science of interpretation. Friedrich Schleiermacher (1838) defined it as the art of correctly understanding the meaning of another person's utterance, and he contrasted it with criticism as the art of correctly determining the truth or falsity of another person's utterance.2
      Hans-Georg Gadamer (1975) explains that while traditional literary and theological hermeneutics attempted to be an art or science of interpretation, the hermeneutics he proposes is not a method of interpretation or understanding, but rather an attempt to describe the conditions under which interpretation and understanding are possible. A condition of understanding a text's meaning is that in order for understanding to occur, it must have a historical background. Our understanding of a text's meaning is always influenced by our own historical situation. A text to be interpreted always speaks to a situation that's conditioned by previous opinions and interpretations.3 The interpretation of a text therefore requires us to be aware of our preconceptions about the text and of how they may contribute to our understanding (or misunderstanding) of it. The hermeneutical experience also requires us to recognize that the nature of our understanding may change over a period of time, and that our interpretations of textual meaning are always situated within an ongoing hermeneutical tradition, to which we contribute.
      Paul Ricoeur (1981) defines hermeneutics as the theory of the operations of understanding in relation to the interpretation of texts,4 and he defines a text as any discourse fixed by writing.5
      However, as Gadamer showed, the meaning of texts is never fixed or unchanging, and it may depend on (social, cultural, and historical) context. The meaning of a text may be changed by the way in which we "read" or experience it. Our interpretation or understanding of a text may change each time we reread or reexperience it.
      Wolfgang Iser (1978) argues that every text may have "gaps" or "blanks" or "places of indeterminacy" in its meaning that the reader must try to fill in, by questioning the text and by determining its "projected" meanings, in order to fulfill the task of interpretation. What isn't said by the text is relevant to what is said. The implications of a text may be a key to understanding its meaning. Thus, the "gaps" in the text may function as a hinge or pivot of the whole text-reader relationship.6
      Umberto Eco (1979) explains that the interpretation of a text depends on the sharing of a code between author and reader that assigns content to the various expressions the author uses in the text. A code is a set of rules that determines how the expression of signs is to be correlated to their content. Because texts often have to be interpreted against a background of codes that may differ from those intended by the author, a distinction can be made between an "open" text that can be interpreted in a variety of ways and a "closed" text that aims for a precise response from the reader.
      Stephen L. Daniel (1986) proposes that the interpretation of medical signs, symptoms, and other clinical data may be analogous to the interpretation of a literary text and may therefore be described by a hermeneutical model of clinical decision-making. The patient is the primary text, while the secondary text is provided by the healthcare provider's documentation of the clinical encounter, including the case summary, diagnosis, treatment plan, and progress notes in the patient's record.7 From a multiplicity of possible meanings of a patient's clinical signs and symptoms, the provider must determine the true meaning so that appropriate diagnostic modalities can be employed and appropriate treatment can be provided. The hermeneutical process may therefore proceed on four levels: (1) interpretation of the patient's history and physical findings, (2) interpretation of the diagnostic data, (3) clinical decision-making regarding treatment, and (4) change in both the patient's and provider's life-worlds (including the experience of healing for the patient) as a result of the clinical encounter.8
      Drew Leder (1990) explains that medical hermeneutics may include the interpretation of a variety of "texts." He accepts Daniel's definition of a text as any group of signs or set of elements that constitute a whole and that take on meaning through interpretation.9 While the "person-as-ill" may be the primary text, there may also be secondary texts, such as (1) the "experiential text" provided by the patient's experience of their own illness, (2) the "narrative text" provided by the patient's account of their symptoms and medical history, (3) the "physical text" provided by the physical findings on patient examination, and (4) the "instrumental text" provided by diagnostic technologies. All of these texts may define or shape the encounter of the patient with the provider and healthcare system. One of the tasks of the provider may then be to "read" or understand these texts in such a way that they have a coherent meaning. The patient and provider may collaborate in this activity. Careful listening, mutual dialogue, and explanation are therefore fundamental aspects of the clinical encounter.10
      It may be noted that the intertextuality or transtextuality of the clinical encounter may be defined by the fact that the primary and secondary texts described by Leder may all be in dialogue and may communicate with one another.
      It may also be noted that a particular kind of understanding may be required for each of the kinds of secondary texts that Leder describes: experiential understanding, narrative understanding, physical understanding, and instrumental understanding.
      Richard J. Baron (1990), however, questions "textual" interpretation as a metaphor for the clinical encounter between patient and provider. He argues that the shifting nature of the clinical "text" leads to the question of whether there is actually any text at all. The text (which is actually the patient-provider relationship) is dynamic and changing, rather than fixed and static, and it's mutually created by the participants. Thus, patients and providers shouldn't distract themselves by looking for, or trying to define, a text to be interpreted; they are the text.11
      Baron seems to assume, however, that if something is a text, then it must be fixed, and its meaning can't be uncertain or indeterminate. He acknowledges that "patients are busy interpreting themselves all the time, and any presentation to the doctor is only one frame in a very long movie,"12 so he recognizes that interpretations may change, just as our presuppositions about, and experiences of (clinical, social, and cultural) texts may change.
      Fredrik Svenaeus (2000) also argues that it's false to assume that medical hermeneutics must be a method of textual interpretation. He says the metaphor of "reading a text" may be inadequate as a theoretical model, and that medical hermeneutics is a dialogic activity rather than one consisting of textual interpretation. He also explains that the methodology of textual interpretation may be replaced by "an ontological and phenomenological hermeneutics in which understanding is a necessary feature of the being-together of human beings in the world."13


FOOTNOTES

1Accreditation Council for Graduate Medical Education, "The Milestones Guidebook," Version 2020, online at https://www.acgme.org/globalassets/milestonesguidebook.pdf
2Friedrich Schleiermacher, Hermeneutics and Criticism, and Other Writings, translated and edited by Andrew Bowie (Cambridge: Cambridge University Press, 1998)
3Hans-Georg Gadamer, Truth and Method (New York, The Seabury Press, 1975), p. 429.
4Paul Ricoeur, Hermeneutics and the Human Sciences (Cambridge: Cambridge University Press, 1981), p. 43.
5Ibid., p. 145.
6Wolfgang Iser, The Art of Reading: A Theory of Aesthetic Response (Baltimore: Johns Hopkins University Press, 1978), pp. 167-169.
7Stephen L. Daniel, "The Patient as Text: A Model of Clinical Hermeneutics," in Theoretical Medicine, Volume 7 (1986), p. 202.
8Ibid., p. 195.
9Drew Leder, "Clinical Interpretation: The Hermeneutics of Medicine," in Theoretical Medicine and Bioethics, Volume 11, Issue 1, March 1990, p. 11.
10Ibid., p. 17.
11Richard J. Baron, "Medical Hermeneutics: Where is the "Text" We are Interpreting?", in Theoretical Medicine and Bioethics, Volume 11, Issue 1, March 1990, pp. 27-28.
12Ibid., p. 27.
13Fredrik Svenaeus, "Hermeneutics of Clinical Practice: The Question of Textuality," in Theoretical Medicine and Bioethics, Volume 21, 2000, p. 180.


OTHER SOURCES

Umberto Eco, The Role of the Reader: Explorations in the Semiotics of Texts (Bloomington: Indiana University Press, 1979).