Foundations of Nursing Science

PART I © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTIONFoundationsNOT of FOR SALE OR DISTRIBUTION Nursing Science

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CHAPTER 1 © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR PhilosophyDISTRIBUTION of Science:NOT FOR SALE OR DISTRIBUTION An Introduction

E. Carol Polifroni © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

INTRODUCTION Philosophy of science is a perspective, a lens, a way one views the world, and, in the© Jones case of &advanced Bartlett practice Learning, nurses, LLC the viewpoint the nurse utilizes© Jones in & Bartlett Learning, LLC everyNOT encounter FOR SALE with a patient,OR DISTRIBUTION family, or group. A person’s philosophyNOT of sciFOR- SALE OR DISTRIBUTION ence creates the frame on a picture—a message, which becomes a paradigm and a point of reference. Each individual’s own philosophy of science will permit some things to be seen and others blocked. It allows people to be open © Jones & toBartlett some thoughts Learning, and potentiallyLLC closed to others.© A Jones philosophy & Bartlett will deem Learning, LLC some ideas as correct, others as inconsistent, and some as simply wrong. While NOT FOR SALEphilosophy OR ofDISTRIBUTION science is not meant to be viewed asNOT a black FOR or white SALE proposi OR -DISTRIBUTION tion, it does provide perspectives that include some ideas and thoughts and, therefore, must necessarily exclude others. The important key is to ensure that the ideas and thoughts remain consistent with one another, rather than being © Jones & Bartlett Learning,in opposition. LLC © Jones & Bartlett Learning, LLC Discussions of science, philosophy, and philosophy of science could all fill NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION books unto themselves. Although the aim of this chapter is to introduce readers to these topics, it is constructed on the form of a survey, which is designed to launch inquiry in myriad ways. The purpose is to encourage nurses to think in ways that they may not yet have discovered and to examine their assumptions and© actions Jones in &their Bartlett role as advancedLearning, practice LLC nurses. If nurses leave this© Jones chap- & Bartlett Learning, LLC ter NOTwithout FOR questioning SALE theirOR assumptions,DISTRIBUTION the author has not done herNOT job! One FOR SALE OR DISTRIBUTION must appreciate the personal assumptions used in everyday professional life. Nurses, for example, must question their assumptions and reaffirm (appreciate and understand) what it is that they believe. © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 3

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4 Chapter 1 • Philosophy of Science: An Introduction © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC SCIENCE BeforeNOT philosophy FOR SALE of science OR DISTRIBUTION is examined in greater depth and particularNOT FOR SALE OR DISTRIBUTION philosophies of science are specifically explored, it is important to begin by developing an appreciation of the meaning of science and philosophy. Science, which comes from the Latin word scientia, meaning “knowledge,” traditionally © Jones & refersBartlett to both Learning, a process LLCand the outcomes of processes,© Jones such as & general Bartlett laws Learning, LLC NOT FOR SALEand observations. OR DISTRIBUTION General laws are considered to beNOT the lawsFOR of SALE nature OR that DISTRIBUTION guide physical life, such as the laws of gravity, energy, and motion. Generators of science utilize these laws in a systematic way to create a body of knowledge about a specific topic. The culmination of using the scientific method (systematic process) provides a set of data (evidence) supported by propositions about © Jones & Bartlett Learning,an area LLCof study (Boyd, Gasper, & Trout,© Jones 1991). & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Natural Hard Sciences As an outcome, science is a body of knowledge. Physics, mathematics, and chemistry are three examples of scientific disciplines composed of unique bodies of knowledge. These sciences are often classified as natural sciences because© Jones they employ& Bartlett the general Learning, laws of LLC nature and begin with the© physical Jones & Bartlett Learning, LLC notionNOT of FOR the world. SALE These OR naturalDISTRIBUTION sciences (which are sometimesNOT referred FOR SALE OR DISTRIBUTION to as the physical sciences) are also known as pure sciences. “Pure,” in this context, means a unique body of knowledge. A pure science is independent of others; it is able to stand alone, and it may be developed and furthered for the abstract cause of the knowledge itself. Pure science is not pursued for its util- © Jones & ityBartlett or value. Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALENatural OR and DISTRIBUTION pure sciences are based on the assumptionNOT FORthat reality SALE is objec OR -DISTRIBUTION tive, rather than subjective. As a result of this objectivity, natural science is consistent—in other words, it is reproducible and reliable. Natural science further encompasses the assumption that human beings have the capacity to be accurate in their objectivity. © Jones & Bartlett Learning,Lastly, LLC natural scientists believe© Jonesthat explanations & Bartlett (using Learning, the method LLC NOT FOR SALE OR DISTRIBUTIONdescribed later in this chapter) areNOT present FOR within SALE the naturalOR DISTRIBUTION or real world. As a consequence, explanations are reasonable, constant and consistent, accurate, objective, discoverable, and understandable. Owing to its basis in objectivity, natural science is predicated on the belief that there is an external world structure© Jones independent & Bartlett of self Learning, that is grounded LLC in reliability. © Jones & Bartlett Learning, LLC NOTNatural FOR physical SALE sciences OR DISTRIBUTIONare referred to as “hard science.” In recentNOT years, FOR SALE OR DISTRIBUTION quantum physicists have begun to integrate the role of the observer into their discipline, which is still categorized as a hard science. This conundrum will be addressed as part of the discussion of complexity science found at the end of this chapter. © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

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Science 5 © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC Examples of the physical sciences present in health care include the biophysicalNOT FOR and SALE biochemical OR DISTRIBUTION processes related to diabetes, cardiovascuNOT FOR- SALE OR DISTRIBUTION lar disease, and cancer. Using the physical sciences in health care involves assuming a disease focus, rather than a person focus. The science is about diagnosis, treatment, and outcomes of treatment. It is about side effects and © Jones & itBartlett is about pathology.Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALESoft Applied OR DISTRIBUTION Sciences NOT FOR SALE OR DISTRIBUTION Sociology, psychology, and anthropology are three examples of applied sciences. Applied sciences have their own unique body of knowledge, albeit a different one than is found in the natural sciences category. They are known © Jones & Bartlett Learning,as applied LLC sciences because the focus© Jones is on &the Bartlett application Learning, of the related LLC NOT FOR SALE OR DISTRIBUTIONknowledge, usually to meet someNOT type ofFOR human SALE need OR (and DISTRIBUTION not to gener- ate knowledge for the sake of knowledge). Additionally, the term “applied” is used to convey the understanding that, in the development of their own knowledge, applied scientists use the knowledge from the pure sciences. Sociologists, who study people and behavior, rely on and use the natural sciences© Jones and their & inherentBartlett assumptions Learning, to LLC further their work. Thus sociology© Jones & Bartlett Learning, LLC is anNOT applied FOR science. SALE Mathematicians OR DISTRIBUTION and physicists do not use psychologyNOT FOR SALE OR DISTRIBUTION or sociology to add knowledge to their scientific disciplines, because mathematics and physics are pure sciences, whereas psychology and sociology are applied sciences. Although applied scientists use what they deem accurate and appropriate © Jones & fromBartlett the natural Learning, sciences, LLC they do not subscribe to the© rigidJones belief & of Bartlett objectivity Learning, LLC NOT FOR SALEand reliability. OR DISTRIBUTION In applied science, the focus is on humanNOT beings FOR and SALE the utility OR DISTRIBUTION of the science to them and for them. Consequently, objectivity, observation, and reproducibility are diminished or perhaps not present at all. Therefore, the applied sciences are sometimes referred to as “soft science.” Inherent in the distinction between hard and soft science are certain © Jones & Bartlett Learning,assumptions LLC and beliefs. Hard scientists© Jones assume & objectivity,Bartlett Learning, whereas soft LLC sci- NOT FOR SALE OR DISTRIBUTIONentists do not. Hard scientists operateNOT on FORa belief SALE in an externalOR DISTRIBUTION world structure independent of self, whereas soft scientists do not. The hard sciences are grounded in a worldview of reliability and consistency as contrasted with the soft sciences, which allow for individuality and originality. These distinctions are© not Jones minor semantics,& Bartlett but Learning, rather indicators LLC of major differences in© philoso Jones- & Bartlett Learning, LLC phyNOT and perspective. FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Examples of using soft applied sciences in health care can be found in social work, the work of a psychotherapist, and the examination of healthcare disparities between people of color, those of wealth, and fragile elders. Some state practice acts define nursing as specialized knowledge integrating both © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

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6 Chapter 1 • Philosophy of Science: An Introduction © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC physical and social sciences. In these instances, the acts combine the concepts of hard,NOT soft, FOR pure, SALE and appliedOR DISTRIBUTION sciences. NOT FOR SALE OR DISTRIBUTION

Human Science In addition to the categories of science discussed previously, human sci- © Jones & enceBartlett is an importantLearning, type LLC of science. Few scholars ©would Jones choose & Bartlett to classify Learning, LLC human science as either hard or soft, but rather might prefer to classify it as NOT FOR SALEsomething OR totally DISTRIBUTION different. Human science is not NOTa new FORterm. SALEIt was intro OR -DISTRIBUTION duced by Dilthey in the late 1800s (Ermarth, 1978). As a German philosopher, Dilthey was concerned about the focus on objectivity and value-free science, which left the person out of the process. He expressed concern about a sci- © Jones & Bartlett Learning,ence and LLC a subsequent knowledge© base Jones that &did Bartlett not include Learning, the everyday LLC NOT FOR SALE OR DISTRIBUTIONlived reality of individuals. Along theNOT way, FOR Dilthey SALE created OR theDISTRIBUTION discipline of human science, which captures human beings and their experiences as the source for knowledge. With this understanding of human science, the scientist becomes as much a part of the experience as does the participant. This view is in direct opposition© Jones to the neutral & Bartlett or value-free Learning, experience LLC of the physical scientist,© Joneswhose & Bartlett Learning, LLC lifeNOT is irrelevant FOR SALE to his orOR her DISTRIBUTION work. Thus the nature and focus of theNOT science FOR SALE OR DISTRIBUTION and the process and role of the scientist are different when the subject area is viewed as a human science. In the physical sciences, the scientist and the subject are not one. In the applied sciences, the science and the scientist are not necessarily one. In contrast, in human science, they are one; they cannot © Jones & beBartlett separated Learning, from each LLCother. © Jones & Bartlett Learning, LLC NOT FOR SALEIs nursing OR DISTRIBUTION a human science? Is the work of theNOT advanced FOR practice SALE nurseOR DISTRIBUTION inextricably interwoven with the population served? When nurses speak of patients and families in one breath, is this a function of a human science view or of something else? For nursing to be a human science, nurses must recog- nize themselves as scientists. The work they do in the provision of care to indi- © Jones & Bartlett Learning,viduals, LLC families, and communities ©may Jones be viewed & Bartlett from a lens Learning, of science LLC that NOT FOR SALE OR DISTRIBUTIONis simultaneously physical (hard), appliedNOT FOR (soft), SALE and human. OR DISTRIBUTION

SCIENTIFIC METHOD FOR THE PHYSICAL SCIENCES (TRADITIONAL) As ©an Jones approach & orBartlett a method, Learning, traditional LLC physical science uses a process© Jones of & Bartlett Learning, LLC linearNOT steps FOR to solve SALE a problem. OR DISTRIBUTION Most nurses are familiar with the termNOT scien FOR- SALE OR DISTRIBUTION tific method, but few appreciate the assumptions inherent within the method itself. An assumption is a position about what one believes to be true and right. The scientific method is based on the assumptions that observation is © Jones & universal,Bartlett Learning,that laws of natureLLC guide every action, and© Jonesthat the &outcome Bartlett of anLearning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

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Scientific Method for the Physical Sciences (Traditional) 7 © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC experiment will be useful in predicting and, therefore, controlling the object of theNOT experiment. FOR SALEBeing universal, OR DISTRIBUTION as the term is used in relation to theNOT scientific FOR SALE OR DISTRIBUTION method and science, means that all essences are the same and that individuality does not apply. The laws of nature are those that are connected to the physical world structure independent of human consciousness, such as the laws of © Jones & thermodynamicsBartlett Learning, and gravity. LLC Control through prediction© Jones is the & ultimate Bartlett aim Learning, LLC NOT FOR SALEof the scientific OR DISTRIBUTION method. Control occurs through theNOT accurate FOR SALEand reprodu- OR DISTRIBUTION cible predication of events. The scientific method is more than a linear process to conduct an experiment. Although hard scientists would say that it is value neutral, the scientific method is an interwoven and value-laden approach to the solution to a prob- © Jones & Bartlett Learning,lem. Objectivity LLC is a key factor that© is Jones used to &validate Bartlett the scientificLearning, method, LLC NOT FOR SALE OR DISTRIBUTIONyet what the scientist considers to beNOT part FORof the SALEprocess ORis a value-ladenDISTRIBUTION deci- sion, regardless of whether objectivity is used later. Arguments about science being value neutral versus value laden color the aims of the two categories of science: pure and applied. © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC AimNOT of Science FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION The pure hard sciences have a single aim of knowledge development for the sake of knowledge development and the search for truth. To the hard scientist, a single truth exists that can be discovered once human beings have the physical capacity to make the necessary discovery. This “single truth” approach is © Jones & basedBartlett on a Learning, belief that an LLC objective world exists independent© Jones of& humanBartlett con Learning,- LLC NOT FOR SALEsciousness. OR DISTRIBUTIONTraditional science aims to describe andNOT to FORexplain SALE this exter OR -DISTRIBUTION nal world structure. Another aim of the physical, pure sciences is to control phenomena through an empirical approach to scientific inquiry. Control is achieved as a result of the accurate prediction of universal descriptions of outcomes. When it is known, the world can be controlled. © Jones & Bartlett Learning,The LLCaim of the applied sciences, ©by Jonescomparison, & Bartlett is the application Learning, of know- LLC NOT FOR SALE OR DISTRIBUTIONledge for a specific purpose, therebyNOT yielding FOR SALEutility. ORApplied DISTRIBUTION science is not focused on generating knowledge for the sake of having knowledge, but for the development of applications that can better a situation, improve a process, or change the way that situations are viewed. In human science, the aims are all about individuals, families, and communities.© Jones Aims & ofBartlett human scienceLearning, may LLCbe to improve quality of life,© assureJones & Bartlett Learning, LLC dignifiedNOT FOR beginnings SALE and OR ends DISTRIBUTION to life, uncover meaning in everydayNOT life, FORand SALE OR DISTRIBUTION highlight the roles of individuals within this examination. The aims of human science may be simply stated as to know and understand what works for people to maximize their ability to be fully functioning individuals, fami- © Jones & lies,Bartlett and communities Learning, LLCat whatever level they are able© Jones to function. & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

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8 Chapter 1 • Philosophy of Science: An Introduction © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC Scientific Methods in Human Science HumanNOT science FOR SALErequires OR different DISTRIBUTION methods. While the scientific methodNOT FORmay SALE OR DISTRIBUTION be applied in the abstract, the end for the human scientist is greater than the sum of the parts. Thus varied methods are needed. In human science, the scientists and the subject (content area) being studied are treated as parts © Jones & ofBartlett the same Learning, whole. Therefore, LLC the methods used can© Jones be neither & Bartlett linear nor Learning, LLC NOT FOR SALEconstant. OR Instead, DISTRIBUTION the methods need to be dynamic,NOT while FOR still SALEmeeting OR the DISTRIBUTION same expectation of rigor found in the hard sciences. Rigor—a notion usually associated with randomized control studies, reliability, and validity in the hard sciences—is not the goal in human science. Rather, contextual consistency, purposive sampling within the population experiencing the essence © Jones & Bartlett Learning,to be described, LLC validity of questions,© Jonesa detailed & auditBartlett trail Learning,of data collection LLC NOT FOR SALE OR DISTRIBUTIONand data analysis, and a return to theNOT participants FOR SALE for validation OR DISTRIBUTION of the message sent and received are emphasized.

Criteria for Science An important distinction to address is the difference between science and non- science.© Jones This discussion& Bartlett has Learning, been going LLCon for centuries. Some scholars© Jones may & Bartlett Learning, LLC lookNOT at human FOR scienceSALE asOR non-science. DISTRIBUTION Pseudoscience—comprising NOTscientific FOR SALE OR DISTRIBUTION theories that are not falsifiable—is the bane of existence for the hard physical scientist, even though it clearly has popular appeal. Therefore, it is important for the hard physical sciences to demarcate themselves from pseudoscience © Jones & and,Bartlett perhaps, Learning, applied and LLC human sciences. Five criteria© Jones are used & Bartlettfor this pur Learning,- LLC pose: intersubjective testability, reliability, definiteness and precision, coher- NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION ence, and comprehensiveness and scope (Feigl, 1988). Intersubjective testability is based on a belief in the value of corrobora- tion and on the idea that two people who view the same entity in the same manner should obtain the same results; if this criterion is met, the method © Jones & Bartlett Learning,is objective. LLC Using the word “objective”© Jones as a synonym& Bartlett for Learning,intersubjectivity LLC NOT FOR SALE OR DISTRIBUTIONmeans that “the belief is not based NOTon hallucination FOR SALE or deception OR DISTRIBUTION and it is not a state of mind but truly exists . . . the belief is neither private nor unique. It can be and must be verified . . . and be empirically tested” (Polifroni & Welch, 1999, pp. 3–4). Reliability, the second criterion, means that researchers achieve the same result© Jones time and & again Bartlett when theLearning, circumstances LLC of their study have not ©changed. Jones & Bartlett Learning, LLC If findingsNOT FOR demonstrate SALE OR reliability, DISTRIBUTION then the same outcomes are achievedNOT FORwith SALE OR DISTRIBUTION repeated tests, thereby confirming the beliefs and premises set forth by the scientist. Reliability is the basis for prediction and subsequent control. Definiteness and precision, which collectively constitute the third criterion, are words used to convey exactness and rigid adherence to objectivity. © Jones & PrecisionBartlett isLearning, not about approximates, LLC but rather exactness;© Jones it is& about Bartlett specif Learning,- LLC NOT FOR SALEics, not ORgeneralities. DISTRIBUTION If experimentation meets the criterionNOT FOR of definiteness SALE OR and DISTRIBUTION

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Philosophy 9 © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC precision, creating the same circumstances for repeated experimentation leads to aNOT reasonable FOR SALEexpectation OR DISTRIBUTIONthat the same results will be achieved.NOT Definite FOR- SALE OR DISTRIBUTION ness and precision are not about inclusion of the researcher or fluidity of ideas; indeed, they focus on the opposite goal. Coherence or systematic character, the fourth criterion, addresses connect- © Jones & ednessBartlett and Learning, wholeness. How LLC do the parts relate to one© another Jones to & form Bartlett a unique Learning, LLC NOT FOR SALEbody of ORknowledge? DISTRIBUTION The connectedness (the sense ofNOT a whole FOR with SALE integrated OR DISTRIBUTION parts, not disparate ideas) is the coherence required in science that is not necessarily present in pseudoscience. It is important to distinguish the wholeness of coherence from holism in human science. In coherence, the focus is on the parts and their relation to one another. In contrast, holism in human science © Jones & Bartlett Learning,focuses LLC on the whole from the outset,© Jonesand not the& Bartlett parts. Learning, LLC NOT FOR SALE OR DISTRIBUTIONThe fifth criterion, comprehensivenessNOT FOR and scope,SALE encompasses OR DISTRIBUTION the ability of the science to be used for something other than its intended purpose. Comp- rehensiveness and scope define the application based on that which was not the planned study and achieving the expected outcome through appropriate utilization. “The thrust of this criterion is the maximum explanatory power of the© science Jones and & its Bartlett related theories.Learning, . . . aLLC science is not a science if it© does Jones not & Bartlett Learning, LLC explainNOT and FOR address SALE events OR and DISTRIBUTION related concerns beyond the issue underNOT study FOR SALE OR DISTRIBUTION at the present time” (Polifroni & Welch, 1999, p. 4).

QUESTIONS FOR THE PRACTITIONER © Jones & TheBartlett five criteria—intersubjective Learning, LLC testability, reliability,© Jones definiteness & Bartlett and preLearning,- LLC NOT FOR SALEcision, coherence,OR DISTRIBUTION and comprehensiveness and scope—serveNOT FOR to SALEseparate OR sci -DISTRIBUTION ence and pseudoscience, as well as common sense. It is important for advanced practice nurses to ask, “Is nursing a science?” Is nursing work that of pure science or applied science? Is the care provided to patients, families, and communities done for the purpose of prediction and control? Are there universals © Jones & Bartlett Learning,within patientLLC care provision? Is there© anJones external & Bartlettworld independent Learning, of human LLC NOT FOR SALE OR DISTRIBUTIONconsciousness that colors the care delivered?NOT FOR Does SALE nursing OR as DISTRIBUTIONa science satisfy the five demarcation criteria? Is nursing practice objective?

PHILOSOPHY Box 1–1 Questions for Advanced Whereas© Jones science & Bartlettis about knowledge, Learning, LLCPractice Nurses © Jones & Bartlett Learning, LLC philosophyNOT FOR (originally SALE from OR the DISTRIBUTION Greek 1. Is nursing a science? NOT FOR SALE OR DISTRIBUTION word philosophia) means “love of 2. Does your practice “fit” with wisdom.” Enjoyment of the thought the five criteria of a science? process, the notion of thinking for the 3. How do you use universals sake of thinking (how often have you in your care and make it © Jones & said,Bartlett “If I onlyLearning, had time LLC to think. . .”), individualized?© Jones & Bartlett Learning, LLC NOT FOR SALEthe examination OR DISTRIBUTION of ideas, and the NOT FOR SALE OR DISTRIBUTION

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10 Chapter 1 • Philosophy of Science: An Introduction © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC search for truth are all part of philosophy.NOT Philosophy FOR SALEalso involves OR DISTRIBUTION a search Box 1–2 Essential TerminologyNOT FOR SALE OR DISTRIBUTION for meaning; it represents a perspec- in Philosophy tive, and it is a set of beliefs. Philoso- Analytic philosophy phy, like science, is both a process and Antirealism © Jones & anBartlett outcome. Learning, The process LLC of philoso- A priori © Jones & Bartlett Learning, LLC NOT FOR SALEphy is the OR critical DISTRIBUTION inquiry and exami- Chaos NOT FOR SALE OR DISTRIBUTION nation of meaning and the method one Complexity science undertakes when beliefs are exam- Continental philosophy ined, ideas are proposed, and assump- Empiricism tions are challenged. Epistemology © Jones & Bartlett Learning,Philosophy LLC encompasses more© JonesEssence & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTIONthan rhetoric; it is the guide by whichNOT FORExperience SALE OR DISTRIBUTION situations are approached, the view- Hermeneutics point used to see what is before one, Idealism and the method by which one searches Logical positivism for truth, as well as an understanding Ontology of ©what Jones truth &is. Bartlett Philosophy Learning, is con- LLCPhenomenology © Jones & Bartlett Learning, LLC textuallyNOT FOR grounded; SALE it ORrelies DISTRIBUTION on the Positivism NOT FOR SALE OR DISTRIBUTION Post-structuralism present but is embedded in the his- Pragmatism torical past. Philosophy is dynamic, it Priori evolves, and it is subtle while simulta- Realism neously being overt. © Jones & Bartlett Learning, LLC Truth © Jones & Bartlett Learning, LLC Philosophy captures the essence of NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION a human being, such as the essence of what it means to be a provider in a caring profession. The deliberate use of the word “caring” here indicates a philosophical belief based on the author’s experience, gender, and role as a scientist. Philosophy is more than just a belief—it © Jones & Bartlett Learning,is the application LLC of that belief to situations© Jones known & Bartlett and unknown. Learning, Philosophy LLC NOT FOR SALE OR DISTRIBUTIONis epistemology and ontology, the knowledgeNOT FOR of and SALE the belief OR aboutDISTRIBUTION something. Epistemology is the study of knowing, of determining what knowledge is and how that knowledge is relevant and related to extant knowledge. Ontology is the study of being and of meaning. All schools of philosophical thought cannot possibly be explored in a single chapter.© Jones One way& Bartlett to undertake Learning, a large surveyLLC of philosophical thought© Jones is to & Bartlett Learning, LLC examineNOT theFOR various SALE perspectives OR DISTRIBUTION in terms of two major schools of philosophiNOT FOR- SALE OR DISTRIBUTION cal thought: analytic and continental. Analytic philosophers originally were those primarily located outside of Europe, whereas advocates of continental philosophy originally emanated from Europe. While the two schools are often discussed in opposition to each other, their discordant viewpoints are actually © Jones & aBartlett matter of Learning, the philosophers LLC using a different lens, ©differing Jones approaches, & Bartlett and Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

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Philosophy of Science 11 © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC differing subjects. Analytic philosophy is wedded to objectivity and reproducibility,NOT whereas FOR SALEcontinental OR philosophyDISTRIBUTION is about essence and experience.NOT FOR SALE OR DISTRIBUTION Continental philosophy is grounded in the viewpoint that the phenomena of interest are deeply embedded in the human experience. Analytic philosophy, by comparison, focuses more on the use of the process of logic and rational © Jones & discourseBartlett thanLearning, on the subject LLC itself. Analytic philosophies© Jones include & Bartlett positivism, Learning, LLC NOT FOR SALEempiricism, OR instrumentalism,DISTRIBUTION pragmatism, and rationalism,NOT FOR whereas SALE continen OR -DISTRIBUTION tal philosophies include phenomenology, hermeneutics, critical social theory, feminism, structuralism, post-structuralism, and postmodernism. Some of these views will be discussed later in this chapter.

© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTIONPHILOSOPHY OF SCIENCE NOT FOR SALE OR DISTRIBUTION Philosophy of science exists at the intersection of philosophy and science— where the two meet to form a new perspective that aims to examine the body of knowledge and the approaches to the study of the body of knowledge. Phi- losophy of science in nursing is an “examination of nursing concepts, theories, laws© andJones aims &as Bartlettthey relate Learning, to nursing practice. LLC Through such an understand© Jones- & Bartlett Learning, LLC ingNOT and deliberate FOR SALE thought, OR DISTRIBUTIONpraxis evolves” (Polifroni & Welch, 1999,NOT p. FOR5). SALE OR DISTRIBUTION Praxis is the planned, deliberate, and thoughtful creation of a plan of action to achieve a set goal. Philosophy of science in nursing explores the meaning of truth, the meaning of evidence, and the meaning of life through praxis. © Jones & BartlettIt is nurses’ Learning, responsibility LLC to view science from© a Jones multitude & Bartlettof perspec Learning,- LLC tives: as nurse scientist; as care provider; and from the perspective of the NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION patient, family, and society. Each perspective potentially offers a different lens for examining the same concept. Each lens brings certain assumptions to the forefront, which colors both the lens and the object of review. Analytic philosophers, who are often physical scientists, examine the © Jones & Bartlett Learning,nature LLCof truth using a lens of objectivity,© Jones linear & Bartlett thinking, Learning, and rationality. LLC NOT FOR SALE OR DISTRIBUTIONContinental philosophers explore theNOT meaning FOR SALEand nature OR ofDISTRIBUTION truth from an individual lens focusing on the experience of truth from the perspective of the person (including the perspective of the scientist), which leads to some subjectivity in the results. These two lenses or perspectives require practitioners to examine their own perspective of truth and ask, “Is there only one© truth? Jones Does & Bartletttruth reside Learning, in the external LLC world structure independent© Jones & Bartlett Learning, LLC of humanNOT FOR consciousness, SALE OR or DISTRIBUTION is truth found within the individual andNOT highly FOR SALE OR DISTRIBUTION contextual? Is there more than one truth? Is truth even a relevant subject for discourse, or should the focus of practice be on the outcomes of treatment modalities?” The answers to these questions enable providers to become comfortable with the assumptions and underpinnings of the various philo- © Jones & sophicalBartlett perspectives. Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

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12 Chapter 1 • Philosophy of Science: An Introduction © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC How Do We Know? AnsweringNOT FOR the questionSALE OR “How DISTRIBUTION do we know?” is key to helping anyoneNOT under FOR- SALE OR DISTRIBUTION stand philosophy of science. This question can be pondered by considering where knowledge and knowing originate. A first thought is that people know because of tradition: Experiences that happened yesterday color and shape © Jones & whatBartlett is known Learning, about today. LLC Tradition often shapes ©experiences Jones & into Bartlett a repeti Learning,- LLC NOT FOR SALEtive pattern OR DISTRIBUTIONof behavior. Authorities also inform whatNOT is FORknown. SALE An author OR -DISTRIBUTION ity may be a person, a role, or an institution. A police officer is an authority; a college professor is an authority; an institution of higher learning is an authority, as is a church. In addition, doctrine can shape what is known. Without evidence or in the face of contradictory evidence, those who believe © Jones & Bartlett Learning,in and practiceLLC a religion profess it ©as Jonestheir knowing. & Bartlett Reason, Learning, without regard LLC NOT FOR SALE OR DISTRIBUTIONfor religion or tradition, is yet anotherNOT realm FOR of SALE knowing. OR Reason DISTRIBUTION may lead to a path that contradicts religion or tradition; thus individuals must decide what to believe. Common sense is a form of knowing also: People know that they become wet when it rains and, therefore, they should seek shelter. If people do not eat, they© knowJones that & they Bartlett will become Learning, hungry LLC and should find food. These© Jonesare two & Bartlett Learning, LLC examplesNOT FOR of common SALE sense. OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Finally, there is science as a way of knowing (to know = science). Sci- ence is knowledge derived from methods that may be linear or complex (cha- otic) depending on the view and approach. Science could be physical science, © Jones & socialBartlett science, Learning, human science, LLC or nursing science. Science© Jones is how & people Bartlett know, Learning, LLC regardless of the type of science. NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Analytic Philosophy of Science The analytic and continental categories are merely one way to examine philosophical schools of thought. Other options are to use received and perceived © Jones & Bartlett Learning,views (Suppe, LLC 1977), a historical timeline,© Jones a context & Bartlett of major Learning, events in history, LLC NOT FOR SALE OR DISTRIBUTIONor many others. Choosing the analyticNOT and FOR continental SALE categoriesOR DISTRIBUTION as criteria implies nothing more than a framework choice for examination. It is important to note that continental philosophers analyze and analytic philosophers examine applications. The analytic perspective is closely associated with positivism and, more specifically,© Jones &with Bartlett logical positivism. Learning, Given LLC that a significant amount© Jones of what & Bartlett Learning, LLC canNOT be read FOR about SALE philosophy OR DISTRIBUTION today is contrary to logical positivism,NOT it FOR is SALE OR DISTRIBUTION important to understand that base. Logical positivism is a school of thought that originated in the early twentieth century under the aegis of the Vienna School in Austria. That geographic location, while on the European continent, does not mean that the analytic perspective is necessarily associated with © Jones & continentalBartlett Learning, philosophy, LLChowever. © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

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Philosophy of Science 13 © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC Logical positivism actually began earlier than the twentieth century, withNOT Comte’s FOR (1788–1857) SALE OR view DISTRIBUTION of positivism. Comte, the father of positivism,NOT FOR SALE OR DISTRIBUTION asserted that human history progresses from the theological to the metaphysi- cal to the positivistic. By the last term, he asserted the positive role that the universal laws of nature provided. Following in Comte’s footsteps, Kolakowski © Jones & (asBartlett cited in Learning,MacKenzie, 1977)LLC suggested four characteristic© Jones rules & of Bartlett positivism: Learning, LLC NOT FOR SALEphenomenalism, OR DISTRIBUTION nominalism, the denial of cognitiveNOT value FORin value SALE judgments OR DISTRIBUTION and normative statements, and the essential unity of the scientific method. The major tenants of logical positivism, consistent with the use of an analytic approach to problem solving, require a rigid adherence to the scientific method (deductive nomological approach), a belief in cause and effect, a solid © Jones & Bartlett Learning,underpinning LLC of replicability, and an© unwaveringJones & Bartlett belief in anLearning, external world LLC NOT FOR SALE OR DISTRIBUTIONstructure that remains independentNOT of self. FOR It is SALE the final OR point DISTRIBUTION that provides the platform for the cause-and-effect relationship and the needed objectivity divorced from humans and subjectivity. The noted philosophers Carnap, Feigl (demarcation criteria), Hempel and Oppenheim (1948), and Popper (2002) developed logical positivism with an aim© to Jones affirm &the Bartlett external Learning,world structure, LLC solidify a reliance on the© inherent Jones & Bartlett Learning, LLC lawsNOT of nature, FOR SALEand promote OR DISTRIBUTION the deductive method of analysis to achieveNOT FOR a SALE OR DISTRIBUTION problem’s solution. These logical positivists believed in the verifiability prin- ciple—the belief that a statement is meaningful only if it is proven true or false through the means of experience (experiment). They suggested that there is a © Jones & logicalBartlett structure Learning, of scientific LLC theories, probability is© meaningfulJones & in Bartlett science (asLearning, LLC opposed to possibility), science is a deductive experience, and the sources of NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION knowledge are twofold (logical reasoning and empirical experience). A large amount of literature in the nursing field has criticized logical positivism as being too rigid, too deductive, and without an appreciation or rec- ognition of the human experience. To overcome these objections, logical © Jones & Bartlett Learning,positivism LLC eventually segued into empiricism.© Jones Empiricism,& Bartlett which Learning, relies on LLC the NOT FOR SALE OR DISTRIBUTIONscientific method for the productionNOT of truth,FOR heldSALE to tenets OR DISTRIBUTION similar to those underlying logical positivism, except that the empiricist required actual experience. The logical positivist accepted the external world structure, whereas the empiricist, while neither accepting nor dismissing the existence of the external world’s structure, required that science be generated through the senses of experience.© Jones Empiricism & Bartlett is whatLearning, is commonly LLC called science in today’s© world.Jones & Bartlett Learning, LLC NOTOver time,FOR both SALE empiricism OR DISTRIBUTION and logical positivism were incorporatedNOT into FOR SALE OR DISTRIBUTION the received view described by Suppe (1977). The received view of science states that a theory is either right or wrong, mature or developed theories must be formalized, a theory must be axiomized (taken apart into propositions and independently tested), all sciences should be patterned after physics, and © Jones & thereBartlett is a clear Learning, separation LLC between theoretical and empirical© Jones understandings. & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

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14 Chapter 1 • Philosophy of Science: An Introduction © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC The received view is strongly supportive of the prominence and dominance of physicalNOT sciences.FOR SALE It is based OR DISTRIBUTION on the search for truth, wherein a singleNOT truth FOR is SALE OR DISTRIBUTION desired and possible to identify. Put simply, empirical (scientific) methods lead the knower to the answer. This view of empiricism, which is embedded in analytic philosophy, is com- © Jones & monlyBartlett known Learning, as traditional LLC science. It is how most people© Jones are taught & Bartlett in elemen Learning,- LLC NOT FOR SALEtary and OR high DISTRIBUTION schools throughout the United States. NOTLearning FOR physical SALE science OR DISTRIBUTION by having opportunities to experience through observation is the gold stan- dard of science, knowledge, and truth. Prediction, using descriptive laws and understanding initial conditions, is the purpose of science for scientists who advocate a received view. Such value-free science relies on a single universal © Jones & Bartlett Learning,scientific LLC method. The received view© isJones sometimes & Bartlett known asLearning, realism. LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Continental Philosophy of Science Whereas the analytic philosophy of science focuses on the search for a single truth through a scientific process of controlled experimentation, the continental philosophy of science is concerned with the connection of an idea to the© world Jones around & Bartlett the idea and Learning, its historical LLC context. Continental philosophy© Jones is & Bartlett Learning, LLC notNOT about FOR theories SALE or truths, OR DISTRIBUTIONbut rather about the relationships amongNOT people, FOR SALE OR DISTRIBUTION ideas, meaning, and their historical connectedness. Georg Hegel, Wilhelm Dilthey, Pierre Duhem, Paul Thagard, Philip Kitcher (2001), Edmund Husserl, and Martin Heidegger (1962) all have written from the continental philosophy of science perspective. Their works focus on the © Jones & appliedBartlett sciences Learning, of sociology LLC and psychology, the historical© Jones approach & Bartlett and con Learning,- LLC NOT FOR SALEtext, the OR understanding DISTRIBUTION of power (Foucault, 1976), andNOT the FOR lived experienceSALE OR of DISTRIBUTION the subject and scientist (philosopher). Human science is the domain of the continental philosophy of science. As described earlier, human science deals with persons and their connectedness to the world in which they live and the lived experiences of their life. Conti- © Jones & Bartlett Learning,nental philosophersLLC examine this lived© Jones experience & Bartlett in the past Learning, as well as LLC the NOT FOR SALE OR DISTRIBUTIONpresent. Using continental philosophyNOT requires FOR SALEan examination OR DISTRIBUTION of historical context as much as it does what is happening in the present time. Continental philosophers of science believe not in cause and effect, but rather in connectedness and the often used proverb “Past is prologue.” ©Phenomenology Jones & Bartlett is an example Learning, of a philosophy LLC that emanates from© the Jones con- & Bartlett Learning, LLC tinentalNOT philosophy FOR SALE of science OR DISTRIBUTION perspective. In phenomenology, as inNOT philoso FOR- SALE OR DISTRIBUTION phy, value is placed on universal experiences. Husserl (1990), a continental philosopher, believed that while human experience is personal, the essence of it is universal. For example, the essence of grief is strikingly similar whether one is grieving the loss of a limb, a loved one, a home, or a pet. For Husserl, © Jones & phenomenologyBartlett Learning, entails LLCa focus on examining phenomena© Jones that & appear Bartlett in the Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

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Philosophy of Science 15 © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC consciousness of the subjects. It is about personal experience; from an exami- nationNOT of FORsuch experience, SALE OR the DISTRIBUTION essences of the phenomena are drawn.NOT FOR SALE OR DISTRIBUTION Hermeneutics is another continental philosophy. As a philosophy, hermeneutics deals with the interpretation and understanding of a message that is being delivered. The name of this school of thought derives from Hermes, the © Jones & messengerBartlett Learning,of the Greek LLC gods. Hermeneutics is characterized© Jones by & theBartlett assump Learning,- LLC NOT FOR SALEtions that OR people DISTRIBUTION are social and dialogical beings;NOT that FORculture, SALE language, OR DISTRIBUTION skills, and experiences create shared understandings; that there is a contin- ual circle of connectedness and understanding; that understanding precedes interpretation; and that the interpreter and the interpreted are seen as one. In hermeneutics, meaning and understanding are identified as the aims of © Jones & Bartlett Learning,the philosophical LLC inquiry. © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTIONPost-structuralism, another philosophyNOT FOR that SALE falls under OR theDISTRIBUTION broad rubric of continental philosophy, speaks to the premise that the study of structures (above and below the surface of relationships and contexts) must be viewed as a cultural phenomenon. As a result, the analysis is open to a variety of interpre- tations and likely misinterpretations. Post-structuralism conveys the message that© both Jones the object& Bartlett and its Learning,context for creation, LLC development, and evaluation© Jones & Bartlett Learning, LLC mustNOT be studied.FOR SALE This view OR is DISTRIBUTION similar to that taken by all the continentalNOT phi FOR- SALE OR DISTRIBUTION losophies, which are based on a contextual grounding for the analysis. The assumptions of post-structuralism are typically that the meaning of a message is based on the perception of the receiver and that the person who conveys © Jones & theBartlett message Learning, is not necessarily LLC significant in terms© of Jones the message & Bartlett itself. ForLearning, LLC example, this view would suggest that an advanced practice nurse is not the NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION important component in the delivery of a message; rather, what is important is what the patient hears and interprets the message to be. This approach serves to equalize the imbalance of power between healthcare providers and patients noted in the healthcare field today. © Jones & Bartlett Learning,Although LLC the three varieties of ©continental Jones & philosophy Bartlett Learning,described in LLC this NOT FOR SALE OR DISTRIBUTIONsection certainly demonstrate someNOT differences, FOR SALE all revolve OR DISTRIBUTIONaround context, meaning, and the knowing subject of the discourse or action. Collectively, continental philosophies may also be called the perceived view, antirealism, or idealism. These terms are meant to intrigue the reader and encourage further exploration, as the space limitations here do not permit an adequate discussion© of Jones them. & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Perceived View Suppe (1977) examined the perceived view with a different lens. As with the view evinced by the continental philosophers, who engaged the notion of human science and the human experience in the search for truth and knowing, © Jones & theBartlett perceived Learning, view is more LLC fluid and dynamic than© the Jones received & Bartlettview. Within Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

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16 Chapter 1 • Philosophy of Science: An Introduction © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC the perceived view, theories are neither right nor wrong. This position stands in starkNOT contrast FOR SALE to the verificationOR DISTRIBUTION approach of the received view. NOT FOR SALE OR DISTRIBUTION In the perceived view, observation leads to the generation of theory, which in turn is value laden. Both the received and perceived views rely on observation, but the meaning of this term and the process by which observation is © Jones & achievedBartlett differ Learning, for the two LLC views. Observation for the© received, Jones analytic & Bartlett philos Learning,- LLC NOT FOR SALEopher is OR precise, DISTRIBUTION detailed, physical, objective, and inherentlyNOT FOR value SALE neutral OR or DISTRIBUTION value free. For people subscribing to the perceived view, observation involves the utilization of the senses and the mind. Observation is accurate but is not reliant on precision; it is both physical and mental; observation is detailed but not necessarily measurable; and it is subjective. Therefore, observation from © Jones & Bartlett Learning,the perceived LLC view perspective is inherently© Jones subjective. & Bartlett What Learning, one chooses LLC to NOT FOR SALE OR DISTRIBUTIONobserve is as much a part of the processNOT as FOR is the SALE observation OR DISTRIBUTION itself. The received view supports the beliefs that progression in science leads to a deeper understanding and that this understanding leads to theories for examination. Perceived view proponents believe in using different kinds of theories and many methods to obtain truth, although some do not seek truth at all, only understanding.© Jones & Whereas Bartlett following Learning, the tenets LLC of the received view requires© Jones use & Bartlett Learning, LLC of theNOT scientific FOR SALE method, OR exploration, DISTRIBUTION and experimentation, proponentsNOT of FORthe SALE OR DISTRIBUTION perceived view use varied approaches to science and seeking truth, such as phenomenology, grounded theory, case method, and hermeneutics. Received view scientists use the quantitative © Jones & methodBartlett in Learning, their pursuit LLC of science, © Jones & Bartlett Learning, LLC whereas perceived view scientists use Box 1–3 What Image Emerges? NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION methods appropriate to the question “Work-up” asked, which may be either quantita- “Diagnose” tive, qualitative, or mixed methods. “Fine-tune” “Prescribe” “Industry” © Jones & Bartlett Learning,CHAOS LLC AND COMPLEXITY © Jones & Bartlett Learning, LLC “Engineer” NOT FOR SALE OR DISTRIBUTIONSCIENCE NOT FOR SALE OR DISTRIBUTION “Design” Contemporary philosophers of sci- “Operate” ence synthesize the work of both the “Control” analytic and continental philosophers “Check” into a new and emerging philosophy © Jones & Bartlett Learning, LLC“Evolve” © Jones & Bartlett Learning, LLC of science. The emerging philosophy NOT FOR SALE OR DISTRIBUTION“Adapt” NOT FOR SALE OR DISTRIBUTION incorporates chaos and complexity “Emergent” science, which is closely aligned with “Self-organize” quantum physics. Truth, the domain “Diversity” of the analytic scientists and philoso- “Ecology” © Jones & phers,Bartlett and Learning, understanding, LLC the realm © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

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Question the Assumptions 17 © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC of the continental philosophers and scientists, come together in a different and dynamicNOT FORway in SALE chaos andOR complexityDISTRIBUTION science. Complex adaptive,NOT dynamic FOR SALE OR DISTRIBUTION systems (organic or inorganic) are connected to environments and are influ- enced by what has come before and what will come after; these systems are irreducibly whole. © Jones & BartlettComplexity Learning, science andLLC a view of complex adaptive© Jones systems & with Bartlett the lan Learning,- LLC NOT FOR SALEguage of OR fluidity DISTRIBUTION and dynamicism push the scientist toNOT look FORat things SALE differently. OR DISTRIBUTION Is there a real difference—not just a semantic difference—between the images conjured up by the terms “fine-tune” and “emergent” or “work-up” and “evolve”? Bohm (1980) stated that the “universe is no longer seen as a machine, made up of objects, but rather pictured as one indivisible whole whose parts are © Jones & Bartlett Learning,essentially LLC interrelated and can only© Jonesbe understood & Bartlett as patterns Learning, of a cosmic LLC NOT FOR SALE OR DISTRIBUTIONprocess” (p. 29). The assumptions aboutNOT complex FOR SALE adaptive OR systems DISTRIBUTION are many, and include the characteristics of embeddedness (meaning patterns that can be traced backward and forward); distributed control (an equalization of power bases); nonlinearity; multidirectionality; emergence in the dynamic, diversity of subjects and objects; a simultaneous coexistence of order and dis- order;© Jones and outcomes & Bartlett that are Learning, inherently unpredictable. LLC This perspective© Jonesstands & Bartlett Learning, LLC in directNOT contrastFOR SALE to the ORnotion DISTRIBUTION of traditional science that aims to explainNOT andFOR SALE OR DISTRIBUTION predict so as to control.

QUESTION THE ASSUMPTIONS © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Box 1–4

Provider Questions 1. What is my view of truth? © Jones & Bartlett Learning, 2. Are LLC there multiple truths? © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION 3. What if my patient and I do not agreeNOT on FOR the truth SALE or the OR view DISTRIBUTION of truth? 4. Is the lived experience important? 5. Is the lived experience more important than lab values and blood gases? 6. How do I justify/juggle evidence-based practice guidelines and individuality? © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC DiscussionNOT FOR Questions SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 1. What are my assumptions that color/shape my approach to care? 2. Describe the revolution needed within health care to address the major issues facing us today. © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

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18 Chapter 1 • Philosophy of Science: An Introduction © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC There is more to philosophy of science than what is presented here. Whole schoolsNOT of FOR thought SALE have OR not beenDISTRIBUTION addressed. Throughout the chapter,NOT several FOR SALE OR DISTRIBUTION underlying questions have colored all else: What are the assumptions of each nurse’s philosophy of science? Do nurses aim to diagnose and treat, or to diagnose and treat human responses? Do nurses aim to control through prescrip- © Jones & tion,Bartlett or do theyLearning, aim to understand LLC and co-create meaning© Jones and action? & Bartlett Is there Learning, LLC NOT FOR SALEa single OR way DISTRIBUTIONto resolve a problem, or are different viewsNOT and FOR approaches SALE OR per -DISTRIBUTION missible? Is one’s praxis dynamic and wedded to a guideline, a critical path, or a set of standing orders? What do nurses need to be the best practitioners that they can be? What do patients, families, and communities need? Finally, each nurse is encouraged to ask, “Am I the nurse that I want to be?” © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION REFERENCES Bohm, D. (1980). Wholeness and the implicate order. London, UK: Routledge. Boyd, R., Gasper, P., & Trout, J. D. (Eds.). (1991). The philosophy of science. Cambridge, MA: Blackwell. Ermarth,© Jones M. (1978). & WilhelmBartlett Dilthey: Learning, The critique LLC of historical reason. Chicago, IL:© University Jones & Bartlett Learning, LLC ofNOT Chicago FOR Press. SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Feigl, H. (1988). The scientific outlook: Naturalism and humanism. In E. D. Klemke, R. Hollinger, & A. D. Kline (Eds.), Philosophy of science (pp. 427-437). Buffalo, NY: Prometheus Books. Foucault, M. (1976). The will to know. Paris, France: Gallimard. Heidegger, M. (1962). Being and time (J. Macquarrie & E. Robinson, trans.). New York, NY: © Jones & BartlettHarper & Row.Learning, LLC © Jones & Bartlett Learning, LLC Hempel, C., & Oppenheim, P. (1948). Studies in the logic of explanation. Philosophy of Science, NOT FOR SALE15, 135–175. OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Husserl, E. (1990). The idea of phenomenology (W. Altson & G. Nakhnikian, trans.). Boston, MA: Kluwer Academic. Kitcher, P. (2001). Science, truth, and democracy. Oxford, UK: Oxford University Press. MacKenzie, B. D. (1977). Behaviourism and the limits of scientific method.London, UK: Rout- © Jones & Bartlett Learning,ledge &LLC ˆ Paul. © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTIONPolifroni, E. C., & Welch, M. (1999). PerspectiveNOT on FORphilosophy SALE of science OR inDISTRIBUTION nursing: An historical and contemporary anthology. Philadelphia, PA: Lippincott. Popper, K. (2002) [1959]. The logic of scientific discovery (2nd English ed.). New York, NY: Routledge. Suppe, F. (1977). The structure of scientific theories. Chicago, IL: University of Illinois Press. © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION