DOCSLIB.ORG

Person Centered Healthcare and Clinical Research: the Necessity of an Evolutionary Hierarchy of Knowing and Doing

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Person Centered Healthcare and Clinical Research: the Necessity of an Evolutionary Hierarchy of Knowing and Doing European Journal for Person Centered Healthcare 2020 Vol 8 Issue 2 pp 235-250 ARTICLE Person Centered Healthcare and Clinical Research: The Necessity of an Evolutionary Hierarchy of Knowing and Doing Peter Wyer MDa & Michael Loughlin PhDb a Associate Professor of Medicine, Columbia University Medical Center, NYC, USA b Professor of Applied Philosophy & Co-Director, European Institute for Person Centred Health & Social Care, University of West London, London, UK Abstract Effective person-centred care requires recognition of the personhood not only of patients but of practitioners. This chapter explores the consequences of this recognition for major debates in medical epistemology, regarding clinical reasoning and the relationship between research and practice. For too long these debates have been dominated by false dichotomies - subjectivity versus objectivity, judgement versus evidence, reason versus emotion. Based on flawed understandings of such core concepts as “objectivity” and “engagement”, this distorted dissection of the subject-object relationship has served to depersonalise practice. The costs of this depersonalisation include over-regulation and micromanagement of healthcare processes by administrators and payers at the same time that information from clinical research remains under-utilized and the personhood of patients’ risks being ignored. Science is a human practice, founded in a broader conception of human reasoning, ontologically dependent on human beings living and engaging with the world in social, emotional and ethical contexts. After looking at different conceptions of epistemic hierarchies and their uses in the analysis and evaluation of reasoning in a range of practice contexts, we propose a “nested hierarchy” that effectively turns upside-down the flawed evidence hierarchies that have helped to depersonalise care. T.S. Eliot’s “wisdom, knowledge, information” scheme (to which we add “data” below “information”) provides a model for a person-centred epistemic hierarchy. This crucial, person-centred inversion represents levels of awareness that characterize more or less developed thinking and judgment on the part of the particular practitioner. Keywords Engagement, epistemic hierarchies, evidence, evidence-based medicine, judgement, knowledge, person-centered care, personhood, reasoning, science, wisdom Correspondence address Dr. Peter Wyer. E-mail: [email protected] Accepted for publication: 17 November 2019 Introduction and clinical decision-making. If we predicate the term “objective” primarily of a person (rather than an impersonal method) and if, by an “objective” person we “The clinical encounter is an interaction between mean someone who puts aside prejudice, thinks critically, persons.” Stephen Henry [1]. questions her own assumptions and searches for the truth, Who is “the person” in person-centered healthcare (PCH)? then it is of course palpably absurd to deny the importance While many authors explain PCH and its importance by of objectivity in all rational thought, including clinical focusing on what it means to treat “the patient” as a reasoning. But the term has a long history, and its current person, [2-4] others note the significance of recognizing usage – in particular its status as an antonym of the term the personhood of practitioners [1,5,6]. This chapter “subjective” - is shaped by assumptions that are so explores the consequences of this recognition for major fundamental in nature that they typically escape critical debates in medical epistemology, regarding clinical attention. And yet, these assumptions have framed the reasoning and the relationship between research and discussion of medical epistemology in this century [7-9]. practice. The conceptual framework shaping our thinking about For many years, medical epistemology has been objectivity has led us to focus on a hierarchy of knowledge dominated by an epistemic hierarchy thought to be designed to delimit the role of “subjective” or “personal” “objective” - but what does this term mean? There are judgment. Attempts to “de-emphasise” intuition, the numerous senses of the term “objective” that render practitioner’s personal experience, tacit and context- objectivity an indispensable aspect of responsible research specific knowledge [11-15], and to elevate such skills as 235 Wyer & Loughlin Person Centred Healthcare and Clinical Research “efficient literature searching and the application of formal of the medical professional as a (usually) male, dedicated, rules of evidence evaluating the clinical literature”, are ethically bound but ultimately paternalistic shepherd motivated by a concern to see reasoning and practice based overseeing the health needs of his patients. Era 2, increasingly on “methodologically sound research” and characterized by the flowering of clinical and health “scientific principles” [11] whose vindication is, precisely, services research, saw the emergence of the need for that they are untainted by the personal and subjective systems development, standardization of services, factors that we rely on in our everyday interactions with regulation of practice and outcome measurements, all in other people [9]. response to the increasing complexity of the healthcare Given that practitioners are, in fact, persons, and rely environment and the emergence of third party payers as on such “subjective” factors as tacit awareness, essential stakeholders in the system. Berwick [19] engagement and empathy [1,6] to understand the real perceives that the processes of standardization, regulation people with whom they must interact and who they aim to and measurement have reached and surpassed a point at assist, discussions have focused on how to “integrate” the which they cease to become assets and begin to become subjective, cultural and personal factors of human major burdens to the efficiency and effectiveness of the knowledge into models of clinical practice that nonetheless system. He proposes the necessity for an “Era 3”, in which place objective evidence at the top of a presumed epistemic regulation and measurement are relaxed in favor of a shift hierarchy [16-18]. in incentives and, among other changes, an emphasis on The problems with this integration project (or rather, patient empowerment and autonomy [20]. re-integration project, since it only becomes necessary to The call for a more user-friendly, consumer-oriented “integrate” these features once a theoretical separation has and humanistic healthcare environment takes place amidst been performed) have led some authors to reject the idea of a proliferation of buzz phrases that correspond to a hierarchy altogether, and to call for a “horizontal sometimes very different outlooks and perspectives. These epistemology” for clinical practice, one which “collapses include ‘patient-centered care’, ‘relationship centered epistemic hierarchies into horizontally ordered libraries of care’, ‘person-centered care’ and ‘whole person care’. In clinical knowledge sources, from which ‘library’ the wise most cases, the corresponding constructs are, at best, clinician will need to draw when considering the unique loosely defined and furthermore tend to ignore the role of personal circumstances of the individual clinical case and the practitioner as a vital partner in healthcare decision- making decisions with him/her” [10]. Here, we argue that making. When an appealing new conceptual framework is the notion of an epistemic hierarchy is indeed advanced and defined only in the most generic, rhetorically indispensable, but it needs to be one that reflects the appealing terms, the resulting buzz phrase is prone to concerns of these critics by considering how individual multiple interpretations and applications whose underlying practitioners can develop their understanding so as to content and motivations may differ widely [21-23]. This practice more wisely. T.S. Eliot’s “wisdom, knowledge, liability is particularly manifest when the concept in information” scheme, to which we would add “data” below question is widely taken up and disseminated. Tanenbaum “information”, represents a model for a person-centered demonstrated that the label ‘patient centered care’ has epistemic hierarchy. This is not a hierarchy of come to refer to at least four different dimensions of “impersonal” knowledge, but rather a representation of healthcare [24]. Indeed, when the uptake of a popular label levels of awareness that characterize more or less is sufficiently broad and the corresponding descriptors developed thinking and judgment on the part of the sufficiently vague, distinctions may break down altogether particular practitioner. and a semantic ‘unity of opposites’ may emerge. Hence Far from ‘de-emphasizing’ personal judgment, or EBM, a movement focused on the importance of research relegating it to a lower form of evidence than supposedly literacy in medical education [25], has been portrayed by ‘impersonal’ sources, we need “an approach to medical some of its advocates as the preferred label to be used in epistemology that places the concept of judgment at the connection with humanistic, patient empowered healthcare centre, and treats the (primarily moral) project of how to [26]. cultivate good judgement as its central concern” [8]. The jumble of terms, slogans and labels pertaining to care of the person that populates the recent healthcare literature reflects a confusion on a much deeper level, one that calls for attention to the underlying epistemological Research, paradigms and practice and
Load more

Recommended publications
  • The Problem of Evil in Augustine's Confessions
    University of South Florida Scholar Commons Graduate Theses and Dissertations Graduate School 2011 The rP oblem of Evil in Augustine's Confessions Edward Matusek University of South Florida, [email protected] Follow this and additional works at: http://scholarcommons.usf.edu/etd Part of the American Studies Commons, and the Philosophy Commons Scholar Commons Citation Matusek, Edward, "The rP oblem of Evil in Augustine's Confessions" (2011). Graduate Theses and Dissertations. http://scholarcommons.usf.edu/etd/3733 This Dissertation is brought to you for free and open access by the Graduate School at Scholar Commons. It has been accepted for inclusion in Graduate Theses and Dissertations by an authorized administrator of Scholar Commons. For more information, please contact [email protected]. The Problem of Evil in Augustine’s Confessions by Edward A. Matusek A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy Department of Philosophy College of Arts and Sciences University of South Florida Major Professor: Thomas Williams, Ph.D. Roger Ariew, Ph.D. Joanne Waugh, Ph.D. Charles B. Guignon, Ph.D. Date of Approval: November 14, 2011 Keywords: theodicy, privation, metaphysical evil, Manichaeism, Neo-Platonism Copyright © 2011, Edward A. Matusek i TABLE OF CONTENTS Abstract iii Chapter One: Introduction to Augustine’s Confessions and the Present Study 1 Purpose and Background of the Study 2 Literary and Historical Considerations of Confessions 4 Relevance of the Study for Various
    [Show full text]
  • Critical Inquiry As Virtuous Truth-Telling: Implications of Phronesis and Parrhesia ______
    ______________________________________________________________________________ Critical Inquiry as Virtuous Truth-Telling: Implications of Phronesis and Parrhesia ______________________________________________________________________________ Austin Pickup, Aurora University Abstract This article examines critical inquiry and truth-telling from the perspective of two comple- mentary theoretical frameworks. First, Aristotelian phronesis, or practical wisdom, offers a framework for truth that is oriented toward ethical deliberation while recognizing the contingency of practical application. Second, Foucauldian parrhesia calls for an engaged sense of truth-telling that requires risk from the inquirer while grounding truth in the com- plexity of human discourse. Taken together, phronesis and parrhesia orient inquirers to- ward intentional truth-telling practices that resist simplistic renderings of criticality and overly technical understandings of research. This article argues that truly critical inquiry must spring from the perspectives of phronesis and parrhesia, providing research projects that aim at virtuous truth-telling over technical veracity with the hope of contributing to ethical discourse and social praxis. Keywords: phronesis, praxis, parrhesia, critical inquiry, truth-telling Introduction The theme of this special issue considers the nature of critical inquiry, specifically methodological work that remains committed to explicit goals of social justice and the good. One of the central concerns of this issue is that critical studies have lost much of their meaning due to a proliferation of the term critical in educational scholarship. As noted in the introduction to this issue, much contemporary work in education research that claims to be critical may be so in name only, offering but methodological techniques to engage in critical work; techniques that are incapable of inter- vening in both the epistemological and ontological formations of normative practices in education.
    [Show full text]
  • Bibliography
    Comp. by: C. Vijayakumar Stage : Revises1 ChapterID: 0002195881 Date:30/10/ 14 Time:14:12:02 Filepath://ppdys1122/BgPr/OUP_CAP/IN/Process/ 0002195881.3d243 OUP UNCORRECTED PROOF – REVISES, 30/10/2014, SPi Bibliography Accattino, P. (1985). Alessandro di Afrodisia e Aristotele di Mitelene. Elenchos 6, 67–74. Ackrill, J. L. (1962). Critical Notice: Die Aristotelische Syllogistik. By Gün- ther Patzig. Mind, 71, 107–17. Ackrill, J. L. (1963). Aristotle: Categories and De Interpretatione. Oxford: Oxford University Press. Ackrill, J. L. (1997). Essays on Plato and Aristotle. Oxford: Oxford University Press. Adamson, P. (2005). On Knowledge of Particulars. Proceedings of the Aris- totelian Society, 105, 257–78. Adamson, P. (2007a). Knowledge of Universals and Particulars in the Bagh- dad School. Documenti e studi sulla tradizione filosofica medievale, 18, 141–64. Adamson, P. (2007b). Al-Kindī. New York: Oxford University Press. Adamson, P., Baltussen, H., and Stone, M. W. F. (eds). (2004). Philosophy, Science and Exegesis in Greek, Arabic, and Latin Commentaries. London: Institute of Classical Studies, University of London. Adamson, P., and Taylor, R. C. (eds). (2005). The Cambridge Companion to Arabic Philosophy. Cambridge: Cambridge University Press. Algra, K. A., van der Horst, P. W., and Runia, D. T. (eds). (1996). Polyhistor: Studies in the History and Historiography of Ancient Philosophy Presented to Jaap Mansfeld on his Sixtieth Birthday. Leiden: Brill. Allen, J. (2005). The Stoics on the Origin of Language and the Foundations of Etymology. In D. Frede and B. Inwood (eds), Language and Learning: Philosophy of Language in the Hellenistic Age, pp. 14–35. Cambridge: Cambridge University Press. Allen, R.
    [Show full text]
  • Phronesis, Artifacts and Leadership Practice
    Phronesis, Artifacts and Leadership Practice Richard Halverson University of Wisconsin - Madison Abstract This paper develops Aristotle’s idea of phronesis, or practical wisdom, as a framework to access, represent and communicate the complexity of successful instructional leadership practice in schools. The design and use of artifacts, the tools leaders develop and implement in their practice, provide a window into the patterns of problem-setting and problem-solving that guide the expression of phronesis in school leadership. Introduction It has long been recognized that where you find good schools, you also often find the legacy of strong leadership. Prior research has defined many of the characteristics of schools with strong instructional programs, such as professional community grounded in instruction among teachers and leaders, a shared sense of instructional vision, group ownership of the instructional process and links between supervisory, assessment and instructional practices. 1 School leaders are responsible for the design and maintenance of these essential conditions in existing school systems.2 However, while we know quite a bit about the characteristics of such school communities, we know quite a bit less about how these characteristics develop together to become distinctive features of the school community. A strong professional community among teachers, for example, can either presuppose or help create group ownership of instructional process, which in turn may Submitted for publication: Please to not cite without the author’s permission 1 2 depend upon or generate the need for stronger internal linkages between assessment and instruction. The implementation and coordination of these conditions is an important aspect of improving student learning in schools.3 Accessing how school leaders understand and manage schools calls for a new approach to understanding the leadership practice.
    [Show full text]
  • Management Education from Episteme to Phronesis: the Contribution of French Didactic Theory Corinne Hahn, Christophe Vignon
    Management education from episteme to phronesis: The contribution of French didactic theory Corinne Hahn, Christophe Vignon To cite this version: Corinne Hahn, Christophe Vignon. Management education from episteme to phronesis: The contribu- tion of French didactic theory. Management Learning, SAGE Publications, 2019, 50 (3), pp.337-354. 10.1177/1350507619831118. halshs-02068936 HAL Id: halshs-02068936 https://halshs.archives-ouvertes.fr/halshs-02068936 Submitted on 25 Apr 2019 HAL is a multi-disciplinary open access L’archive ouverte pluridisciplinaire HAL, est archive for the deposit and dissemination of sci- destinée au dépôt et à la diffusion de documents entific research documents, whether they are pub- scientifiques de niveau recherche, publiés ou non, lished or not. The documents may come from émanant des établissements d’enseignement et de teaching and research institutions in France or recherche français ou étrangers, des laboratoires abroad, or from public or private research centers. publics ou privés. Management education from episteme to phronesis: The contribution of French didactic theory Corinne Hahn ESCP Europe Christophe Vignon University of Rennes 1, France Abstract In this article, we review some of the criticisms levelled at current management education provided by business schools and the recommendations made by critical management studies scholars. These authors generally recommend placing greater emphasis on phronesis, that is, the manager’s practical wisdom. We investigated this path and formulated a practical solution, rooted in the operational framework provided by French didactic theory. It takes the form of a specific pedagogical device, the aim of which is to foster closer connections between experience acquired in professional settings and theoretical knowledge derived from management sciences.
    [Show full text]
  • The Stoics and the Practical: a Roman Reply to Aristotle
    DePaul University Via Sapientiae College of Liberal Arts & Social Sciences Theses and Dissertations College of Liberal Arts and Social Sciences 8-2013 The Stoics and the practical: a Roman reply to Aristotle Robin Weiss DePaul University, [email protected] Follow this and additional works at: https://via.library.depaul.edu/etd Recommended Citation Weiss, Robin, "The Stoics and the practical: a Roman reply to Aristotle" (2013). College of Liberal Arts & Social Sciences Theses and Dissertations. 143. https://via.library.depaul.edu/etd/143 This Thesis is brought to you for free and open access by the College of Liberal Arts and Social Sciences at Via Sapientiae. It has been accepted for inclusion in College of Liberal Arts & Social Sciences Theses and Dissertations by an authorized administrator of Via Sapientiae. For more information, please contact [email protected]. THE STOICS AND THE PRACTICAL: A ROMAN REPLY TO ARISTOTLE A Thesis Presented in Partial Fulfillment of the Degree of Doctor of Philosophy August, 2013 BY Robin Weiss Department of Philosophy College of Liberal Arts and Social Sciences DePaul University Chicago, IL - TABLE OF CONTENTS - Introduction……………………..............................................................................................................p.i Chapter One: Practical Knowledge and its Others Technê and Natural Philosophy…………………………….....……..……………………………….....p. 1 Virtue and technical expertise conflated – subsequently distinguished in Plato – ethical knowledge contrasted with that of nature in
    [Show full text]
  • Making Political Science Matter? Phronetic Social Science in Theory and Practice
    | | ⅜ Review Essay Making Political Science Matter? Phronetic Social Science in Theory and Practice Edward W. Gimbel Real Social Science: Applied Phronesis. Edited by Bent Flyvbjerg, Todd Landman, and Sanford Schram. New York: Cambridge University Press, 2012. 320p. $95.00 cloth, $32.99 paper. eal Social Science: Applied Phronesis, edited by Bent (Virginia Eubanks’ “Feminist Phronesis and Technologies Flyvbjerg, Todd Landman, and Sanford Schram, is of Citizenship”), transitional justice in post-Amnesty Law R an interesting read in the context of the current Brazil (Tricia D. Olsen, Leigh A. Payne, and Andrew G. assault on both the scientific status and the practical util- Reiter’s “Amnesty in the Age of Accountability: Brazil in ity of social science in general and political science specif- Comparative Context”), and how cartographic represen- ically. In it, the editors collect examples of social scientific tations of “at-risk” communities in Toronto have served to work that embrace what Flyvbjerg and others have deflect critical attention from the broader structural con- described as phronetic social science. This approach makes ditions of neoliberal policy (Ranu Basu’s “Spatial Phrone- creative use of the Aristotelian intellectual virtue of phro- sis: A Case Study in Geosurveillance”). “Methodologically” ⅜ nesis, or practical wisdom, which the editors identify with we see approaches that emphasize researcher participation the knowledge of how to address and act on social prob- in social projects, digital ethnography, post-structualist dis- lems in a particular context. Rather than emphasizing the course theory, Foucauldian genealogy, feminist epistemol- universal truth (episteme) that has traditionally been the ogy and sociology of knowledge, and others.
    [Show full text]
  • Nous As the Ground of Aristotle's Metaphysics?
    Binghamton University The Open Repository @ Binghamton (The ORB) The Society for Ancient Greek Philosophy Newsletter 12-1993 Nous as the Ground of Aristotle's Metaphysics? John J. Cleary Boston College Follow this and additional works at: https://orb.binghamton.edu/sagp Part of the Ancient History, Greek and Roman through Late Antiquity Commons, Ancient Philosophy Commons, and the History of Philosophy Commons Recommended Citation Cleary, John J., "Nous as the Ground of Aristotle's Metaphysics?" (1993). The Society for Ancient Greek Philosophy Newsletter. 164. https://orb.binghamton.edu/sagp/164 This Article is brought to you for free and open access by The Open Repository @ Binghamton (The ORB). It has been accepted for inclusion in The Society for Ancient Greek Philosophy Newsletter by an authorized administrator of The Open Repository @ Binghamton (The ORB). For more information, please contact [email protected]. Nous as the Ground of Aristotle's Metaphysics? — John J. Cleaiy Introduction: This paper explores the implications of Aristotle's puzzling suggestions that the possibility of first philosophy somehow depends on whether part of the soul is separable from material body. My Conjecture1 is that for Aristotle the science of metaphysics depends on a special activity of nous that grasps die self-identical essences which are objects of first philosophy, as distinct from physics and mathematics. From Aristotle's perspective, of course, it is the existence of such essences that makes metaphysics possible, but it is arguable that without a corresponding mode of cognition this would not be a human science. It is a moot question whether it could be a divine science either, though one can argue that for Aristotle the divine mode of cognition, involving the complete identity of knower and known, represents the ideal to which human noetic activity aspires.
    [Show full text]
  • Aristotle's Phronesis: Putting Some Meat on The
    ARISTOTLE’S PHRONESIS: PUTTING SOME MEAT ON THE PHILOSOPHY OF INNOVATION Gabriel J. Costello 1. Introduction Dante in the Divine Comedy describes his encounter with Aristotle as follows: “I saw the master sage of those who know” Inferno Canto IV, 131 (Dante, 1984 translation) . Dante considered Aristotle as epitomizing the pinnacle of human reason and his references to Aristotle came second only to that of the Bible. Without doubt, Aristotle is one of the most influential thinkers in the history of western civilisation. His works have covered an eclectic range of subjects such as logic ethics, metaphysics, politics, natural science and physics (ODE, 2006). Aristotle’s science was not superseded until the scientific revolution of the 16th and 17th centuries (ODS, 1999). Crithcley (2001) points out that among other things, ancient philosophy endeavoured to amalgamate knowledge and wisdom: “namely, that knowledge of how things were the way they were would lead to wisdom in the conduct of one’s life. The assumption that ties knowledge and wisdom together is the idea that the cosmos as such expresses a human purpose. This is called the “teleological view of the universe” (p. 7). This paper will focus on Aristotle’s ethical writings, especially examining his synthesis of the ideas of knowledge and wisdom and their application in practice. This he achieved through the concept of phronesis (phronēsis) variously described as practical wisdom. Taylor (2005) explains phronesis as having, in ancient Greece, connotations of intelligence and soundness of judgement. In his deliberations on ethics, Aristotle used the term to represent the complete excellence of the practical intellect.
    [Show full text]
  • Aristotelian Phronesis As a Key Factor for Leadership in the Knowledge-Creating Company According to Ikujiro Nonaka* Germán Scalzo** Guillermo Fariñas***
    ARISTOTELIAN PHRONESIS AS A KEY FACTOR FOR LEADERSHIP IN THE KNOWLEDGE-CREATING COMPANY ACCORDING TO IKUJIRO NONAKA* Germán Scalzo** Guillermo Fariñas*** * doi: 10.11144/Javeriana.cao31-57.apkfl. Reflection paper. Received: 28/04/2018 and accepted: 14/11/2018. Cite as: Scalzo, G., & Fariñas, G. (2018). Aristotelian phronesis as a key factor for leadership in the knowledge-creating company according to Ikujiro Nonaka. Cuadernos de Administración, 31(57), 19-44. http://dx.doi.org/10.11144/Javeriana.cao31-57.apkfl. ** Universidad Panamericana, Mexico. E-mail: [email protected] *** Universidad Monteávila, Venezuela. E-mail: [email protected] Cuad. admon.ser.organ. Bogotá (Colombia), 31 (57): 19-44, julio-diciembre de 2018 | issn 0120-3592 / e-issn 1900-7205 19 Germán Scalzo, Guillermo Fariñas Aristotelian phronesis ABSTRACT. In the last decades, there has been an increasing interest on knowledge as a key factor for in the business realm. Japanese scholar Ikujiro Nonaka was among the main theoretical and practical contributors to knowledge creation in organizations, leadership in the as well as a promoter of including practical reason in the research of business knowledge-creating topics such as decision-making, knowledge management, ethics and leadership. company according to In his theory, a Western classical tradition, namely the virtue of phronesis, is Ikujiro Nonaka combined with the Japanese notion of Ba (context-based learning), to explain the way people engage in communities of practice as opportunities for learning. This paper describes his theory of knowledge creation, pointing to phronetic leadership skills as essential drivers of knowledge creation in organizations, in light of the Western classical tradition.
    [Show full text]
  • A Synchronic Justification for Aristotle's Commitment to Prime Matter Author(S): Margaret Scharle Source: Phronesis, Vol
    A Synchronic Justification for Aristotle's Commitment to Prime Matter Author(s): Margaret Scharle Source: Phronesis, Vol. 54, No. 4/5 (2009), pp. 326-345 Published by: BRILL Stable URL: http://www.jstor.org/stable/40387994 . Accessed: 06/02/2015 02:19 Your use of the JSTOR archive indicates your acceptance of the Terms & Conditions of Use, available at . http://www.jstor.org/page/info/about/policies/terms.jsp . JSTOR is a not-for-profit service that helps scholars, researchers, and students discover, use, and build upon a wide range of content in a trusted digital archive. We use information technology and tools to increase productivity and facilitate new forms of scholarship. For more information about JSTOR, please contact [email protected]. BRILL is collaborating with JSTOR to digitize, preserve and extend access to Phronesis. http://www.jstor.org This content downloaded from 134.10.2.4 on Fri, 6 Feb 2015 02:19:12 AM All use subject to JSTOR Terms and Conditions '"'-'& ¿ PHRONESIS brii i Phronesis54 (2009) 326-345 hriii.ni/phr«, A SynchronieJustification for Aristotle's Commitmentto PrimeMatter MargaretScharle Reed College,3203 SE WoodstockAve, Portland, OR 97202, USA scharlem@reed. edu Abstract The currentdebate overAristotle's commitment to primematter is centeredon diachronic considerationsfound in his theoryof substantialchange. I argue that an appeal to this theoryis not requiredin orderto establishhis commitmentto the existenceof primemat- - ter.By drawingon PhysicsII. Is conceptionof what it is foran elementto have a nature thatis, to have an innersource of movementand rest- I introducea synchroniejustification forthe existence of primematter. By tradingon the relationshipbetween the thingthat has a sourceof change and the sourceit has, I show thatsomething that has a source in itself cannot be identicalwith itssource, and thata typeof matterthat has no natureof itsown (a kindof primematter) is requiredto block thisidentification at the levelof theelements.
    [Show full text]
  • Aristotle and His School Felix Grayeff
    ARISTOTLE AND HIS SCHOOL FELIX GRAYEFF Duckworth ARISTOTLE AND HIS SCHOOL An Inquiry into the History of the Peripatos With a Commentary on Metaphysics z, H, A and 0 Felix Grayeff Duckworth CONTENTS Preface 7 List of Abbreviations 8 Introduction 9 Part One 1. Life of Aristotle 13 2. The Peripatos after Aristotle's Death 49 3· The Emergence of New Philosophical Schools during the Fourth and Third Centuries B.C. 57 4· The Library of the Pcripatos and its History 69 Part Two S· The Structure of Metaphysics Z (a) The Parts of z 89 (h) The Composition of Z 1 II 6. Peripatetic Ontology according to Metaphysics H 127 7· Peripatetic Ontology according to Metaphysics A 143 R-xcursus: The Theory of the Proper Place 183 8. A Volume on Potentiality and Actuality: Metaphysics 0 r87 Select Bibliography 213 Index of Passages Cl!Ioted in Text 219 General Index 225 Lift ofAristotle him Regent. So conditions at the Macedonian court were un­ favourable, even threatening, for a youth of Greek birth and a favourite of the toppled royal house at that. It is therefore possible that Aristotle's premature journey to Athens (for he was still a minor) was partially due to the unrest in Macedonia. It can be assumed that Aristotle joined the Academy as soon as he arrived in Athens, doubtless in accordance with the wishes of his guardian. The choice of the Academy was not a matter of course. At that time there was another famous school, that of !socrates, which engaged in keen rivalry with the Academy.
    [Show full text]