Critically assess Descartes’ three arguments for his claim that mind and body are distinct. The concept of Mind-Body dualism is one that has its roots in early classical philosophy, with both Plato and Aristotle setting out strong arguments for this philosophy of the mind. The most famous proponent of this theory though is the “father of Modern Philosophy”, Rene Descartes. This belief fundamentally stems from the appearance of humans having both mental and physical properties, properties which seem to be radically different.
As a response to this Descartes proposed that these properties are contained within two radically different substances, res cogitans, or thinking substance, and res extensa, extended substance. This thinking substance is what makes up a mind and the extended substance a body. Within his Discourse on Method and the Meditations, Descartes outlines three arguments for this distinction between the mind and the body.
These arguments, varying in their strength, have been analysed fervently since Descartes published them, and much philosophy of the mind centred on Descartes theses until the beginning of the last century and debate still remains today. The first argument that Descartes sets out in his Meditations for mind body distinctness is what has become known as the doubting argument. This argument first appeared in the Discourse (Descartes, 1971, pp. 32) and he expanded upon it in the Meditations (Descartes, 1641, 2:6).
Though the argument changed structure slightly between the two texts it can be broadly seen as: P1- I can doubt that my body exists P2- I cannot doubt that my mind exists P3- Identical substances must have identical properties C- My mind and body are different substances. It should be noted before examining this argument further that the third premise is a general principle of Descartes’s employed in much philosophical discussion. This principle states that if something is true of X and not true of Y then they are distinct, or in other words if X has some property that Y does not they are entirely different things.
This principle is commonly referred to as Leibniz’s Law, or the Principle of the Indiscernibility of Identitcals. Descartes has previously shown in his meditations that all corporeal, physical things can be doubted and should not be assumed to exist. This is shown using his dream, deceiving god, and the evil demon arguments. Premise one then directly follows form the conclusions of this section in the meditations. He also previously concluded that the existence of the mind is indubitable, with his famous conclusion cogito ergo sum, or I think therefore I am (Descartes, 1641, 7:140).
Descartes’ second premise in this argument follows wholly from this assertion and cannot be questioned. The third premise, sometimes missing in analyses of the argument, is simply the principle of the indiscernibility of Identitcals. Though this premise is needed for the argument to flow logically its inclusion causes Descartes much difficulty. The strongest criticism of this argument is that this doubt is not a property of the substance; rather it is a property of the observer.
In other words, doubt about the existence of the thing does not come from what the substance is, but rather from ignorance on the part of Descartes. Many examples have been used to highlight the inherent weakness in this argument. Perhaps the earliest of these objections came from Antoine Arnauld in 1641 within his Fourth Objections. (http://www. earlymoderntexts. com/pdf/descobje. pdf, pp. 56-57) Here Arnauld uses the example of a right angled tri angle to show the flaw in Descartes reasoning.
He says that while a person may not doubt that an triangle is right angled, he can at the same time doubt that Pythagoras’s theorem holds. The person observing the triangle obviously does not have a clear and distinct perception of the triangle but how, Arnauld asks, is “But how is my perception of the nature of my mind any clearer than his perception of the nature of the triangle? He is just as certain that the triangle has one right angle as I am certain that I exist because I am thinking. ” This objection has come in other forms such as Blackburn’s Masked Man Fallacy (Think, pp. 9-30). Since this flaw in the argument was so obvious to even Descartes contemporaries, the question arises as to why he even chose to include it in his Meditations? Well it is clear from his own writings that Descartes was aware of this and explicitly states that he refuses to conclude that his mind is distinct because of his ignorance of his nature (Descartes, 1641, 7:27) Descartes second argument again tries to show that the mind and the body have different properties, and by utilising his general principle, must therefore be different substances.
This time though instead of using the inherently difficult property of whether a substance’s existence can be doubted, he examines each substance’s respective divisibility. His argument goes as follows: P1- My body is divisible P2- My mind is not divisible C- My mind and body are distinct This argument’s main merit, as opposed to the previous one, lies in the fact that the property it is concerned with, divisibility is one which is inherent in the object. As such the Principle of the Indiscernibility of Identicals can be applied here.
The inference then from the two premises is not one that can be attacked or need be justified. Likewise the first premise which states that a physical body can be divided is a biological fact and again one that cannot be questioned. Where the issues arise in relation to this argument is its second premise which states that a mind is a substance that cannot be divided, an assertion which is at best controversial. As one would expect Descartes justifies this belief through reason alone rather than by any scientific analysis.
He states that “”When I think about my mind—or, in other words, about myself insofar as I am just a thinking thing—I can’t distinguish any parts; I understand myself to be a single, unified thing. Although my whole mind seems united to my whole body, I know that cutting off a foot, arm, or other limb would not take anything away from my mind. ” (Descartes, 1971, pp. 138). This premise has two main issues related to it. Firstly Descartes here is committing the logical fallacy of begging the question.
This premise explicitly assumes that there is a difference between the mind and the body, which is meant to be what Descartes is proving (Hatfield, 2003, Chp. 8). Secondly this premise has also been entirely discredited thanks to modern work in neurophysiology we know that if a part of my material brain is removed something will also have been taken away from my mind. Similarly, when the group of nerve fibres connecting the two hemispheres of the human brain, or the corpus callosum is completely torn in an operation called a corpus callostomy, the mind appears to separate into two different conscious awarenesses.
The lay term for this phenomenon is split-brain. (Gazzaniga, 2005) For Descartes these modern developments would surely have undermined much of what he was trying to attempt in this divisibility argument. Descartes third argument is perhaps his most celebrated defence of dualism and it is his attempt to prove beyond doubt that the mind and the body are distinct. The argument runs as follows, with the references to God omitted for the purposes of clarity. P1-I can conceive that I, a thinking thing, exist without my extended body existing. P2-Anything that I can conceive is logically possible.
P3-If it is logically possible that X exist without Y, then X is not identical with Y. C- I, a thinking thing, am not identical with my extended body. Though this argument is widely discredited academics differ in their reasons for why exactly this argument is false. It appears that there are problems with almost all of the parts in this argument. The first premise has its roots in the first and second Meditations where Descartes, through his method of doubt and in particular the deceiving God argument, comes to conclude that a world consisting only of immaterial minds is conceivable.
Many ardent empiricists though would dispute the claim that a non-corporeal world such as this, which by definition is something entirely distinct from experience, is truly conceivable at all. The main problem with this premise though is that it assumes that Descartes comprehends his mind in a complete fashion. He claims that the thought process is a transparent one which he has a clear understanding of. This assertion is one that is by no means apparently the case. It is quite possible, and indeed common that our emotions and feelings, for instance, are no directly apparent.
Quite often we can have the feeling of fear without it being directly registered to ourselves. This is also true of the mental state of pain, which may not be directly at our disposal. This particular criticism was put forward largely by Gilbert Ryle, and largely led to the development of his philosophy of the mind, behaviourism (Ryle, 1949, p. 11). The second premise though is where most philosophers have found fault with Descartes’ argument. This assertion about logical possibility has been the subject of much debate up to the present time.
Arguments against have pointed out that statements of numerical identity (x=x, x=y) are necessarily true though they may be conceived as false. Arnauld’s example of the right angle triangle can be used here. True mathematical propositions are also necessarily true though they be conceived of as false as well. Goldbach’s Conjecture, which states that any even number greater than two must be the sum of two prime numbers, is an example of a mathematical truth that can be thought of as wrong. It is possible that I can conceive that someday a number that does not hold to this conjecture will be discovered.
Just because I can conceive of these two events does not mean they are logically possible. (Chalmers, 2002) Descartes in this argument fails to explain why his conception of the mind is different than these two other examples. It is quite obvious after analysing Descartes’ arguments that none of descartes’ arguments do not stand up to much intense scrutiny. Each of the three main arguments for dualism have their own distinct problems. It must be pointed out though that many of the stronger objections to dualism have arisen due to developments in the field of neurophysiology in this century and the last.
This information was not available to Descartes’ at the time, and while they may be valid criticisms of the arguments he put forward, we should not dismiss his work entirely. In contemporary philosophy there can be a tendency to ignore the long legacy of dualism and to simply dismiss it without thought, this is a trend that I see as Bibliography: Blackburn, S. , Think, Oxford University Press, Oxford, 1999 Chalmers, D. , “Does Conceivability entail Possibility? ”, Published in (T. Gendler & J. Hawthorne, eds) Conceivability and Possibility (Oxford University Press, 2002), pp. 145-200. ] Descartes, R. , Meditations on First Philosophy, 1641 Descartes, R. , Philosophical Writings, translated and edited by E. Anscombe and P. T. Geach, (Indeanapolis: Bobbs-Merrill, 1971) Descartes, R. , Arnauld, A. , http://www. earlymoderntexts. com/pdf/descobje. pdf, pp. 56-57, retrieved: 27/03/2013 Gazzaniga, M. S. , “Forty-five years of split-brain research and still going strong”, [Review], Nature Reviews Neuroscience, 6(8), 653-U651, 2005 Hatfield, G. , Descartes and his Meditations, Routledge, 2003 Ryle, G. , The Concept of Mind (1949); The University of Chicago Press edition, Chicago, 2002
Communication Studies Analysis
I have chosen to analyze my reflective piece, “Diary of an Insecure Girl” in terms of the attitudes to language and communicative behaviors which are found therein. Attitudes to Language refer to the manner in which people use and view the varieties of English spoken in the Caribbean. A consideration adopted in looking at attitudes is the question as to whether Creole English is fitting and appropriate for certain uses. Code switching or adopting the variety of English spoken also indicate specific attitudes to language.
In the short story, the persona code switches when she was talking to the cashier in the cafeteria. She began by speaking the Trinidadian Creole when she said “Mornin leh meh get ah cake an ah Cokes please. ” The cashier was in disbelief and found that way of speaking was inappropriate for the school environment. The persona apologized and code switched by speaking Standard English, “Good morning Miss. May I please have a slice of cake and a bottle of Coca-Cola? However, the persona did not feel a sense of belonging in the school because speaking Creole, which is part of her identity, is looked down upon so she felt that she is not permitted to truly be herself. She expresses that the students are fake because of the American and European lifestyles they try to imitate through the way they speak which the persona refers to as “Yankee accent. ” Communicative behaviours refer to communicating impressions to others unconsciously and inevitably. They are used by speakers to emphasize their words and they can also be use to interpret how the speakers truly feel.
These are used throughout the short story for example when the persona said, “I roll my eyes in exasperation” she used movement to show the discontent she felt towards the way she looks. Another example of this was when the cashier said, “Excuse me?! ” she used vocalics to express her annoyance at the Creole spoken by the persona. Also when the persona says that she walks with her head hanging low, this movement shows her lack of confidence. Attitudes to language and communicative behaviours are but two of the elements that make for an effective analysis and have therefore greatly contributed to my portfolio.
Harvard Business School Case Study – Intermountain
Healthcare Case Study Gina L. Turley Northwestern University In the Harvard Business School case study of Intermountain Health Care (IHC), we learned about the efforts made by IHC to adopt a new strategy for managing health care delivery that is focused on improving care quality while simultaneously saving money. Beginning in 1986 as a series of experiments tying cost outcomes to traditional clinical trials, IHC’s approach to delivering care became known as “Clinical Integration” which “referred to both an organizational structure and a set of tools” (Bohmer, 2002).
The organizational structure required a departure from the traditional administrative management model to one that “involved administrative and medical staff working together to implement a system of gathering, storing, and making accessible detailed medical data on each patient”. Once gathered, IHC analyzed that “data across all patients to create decision support tools (protocols) that helped medical providers determine the best medical interventions for each patient and also increase efficiencies” (Bohmer, 2002).
Between 1986 and 1996, IHC made two attempts to establish a self-governance model for its physicians, both of which proved unsuccessful. However, through an iterative, continuous process-improvement program highly focused on medical personnel education, IHC was eventually able to establish “quality (defined as process management with measured outcomes) as IHC’s core business approach and to extend full management accountability to IHC’s clinical functions” (Bohmer, 2002). In 1986, IHC, led by Dr.
Brent James, successfully tested Dr. W. Edwards Deming’s theory that “high quality would lead to lower cost” by developing an activity-based cost accounting system that created cost profiles of different strategies for managing particular clinical conditions (Bohmer, 2002). Equipped with these cost profiles, IHC senior management “felt they could realize Deming’s maxim by allowing their physician population to self-manage” and formed The Great Basin Physician Corporation for community physicians within IHC (Bohmer, 2002).
While the idea of “self-governance and protocols for care ‘helped pull the physicians together’”, it never really materialized and “sort of died quietly on its own” (Bohmer, 2002). It did, however, set the stage for a quality movement within the organization and in 1991, IHC conducted a series of workshops where James more deeply introduced the concept of protocols to control care delivery and encouraged discussion how IHC might implement them.
Though no formal conclusions were reached, those meeting proved crucial as the “shared vision that [they] came away with from that series of meetings has informed [their] decision making ever since” (Bohmer, 2002). In 1993 IHC again attempted to establish physician self-management, this time “by hiring physician leaders and providing them with management tools. ” (Bohmer, 2002). Despite ample financing and training, the program once again proved unsuccessful. In both cases (1986 and 1993), this was primarily due to two issues.
The first was that they provided the physician leaders the wrong data, namely, “financial data organized for facilities management, but without the associated clinical detail” (Bohmer, 2002). Per James, “the key to engaging physicians in clinical management is aligning data collection to work processes” (Bohmer, 2002). In the old model, managers thought “in terms of cost-per-facility” but “physicians think in terms of tests and treatments required for a specific condition” (Bohmer, 2002). You manage what you measure…Doctors manage patients, not money” (Bohmer, 2002). Therefore, if you want to change clinical behavior, you have to provide physicians with the relevant clinical data. The second reason for the failures was that they lacked “an overarching guidance structure” (Bohmer, 2002). Essentially, without direct medical personnel management and accountability, a strategy for protocol development, a method for implementation and a clinical feedback loop, the diffusion of responsibility makes success nearly impossible.
Building upon the knowledge gained in its previous attempts, over the next several years, IHC went about creating the infrastructure necessary to support such a model. IHC reorganized its management teams to include “a clinical administrative structure to be the clinical counterpart of the administrative structure at each level of the organization” (Bohmer, 2002). Guidance Councils (consisting of a physician leader and nurse manager) were formed for each clinical program and were responsible for coordinating program goals, management strategies and data collection across the system.
Within the Guidance Councils were interdisciplinary Development Teams who identified “the key work processes and medical conditions for which protocols should be developed”, then created, implemented and refined said protocols (Bohmer, 2002). This was made possible by engaging practicing physicians (who were wisely reimbursed for their time) in the process, which gave them both the direct experience of the systems they created (be it paper or computer) and a provided feedback loop within the clinical community.
Furthermore, IHC created a culture around process improvement, organizing “everything around value-added (front line) work processes” while offering “extensive training in clinical process improvement” as well as operational process improvement (Clark, 2010). At the beginning of this case study, it was presented that there was some initial resistance to the Clinical Integration concept due to the commonly held view in the clinical community that “each patient [is] unique and could not be treated in an assembly line manner” (Bohmer, 2002).
While many have argued that evidence-based medicine is “cookbook medicine” or medicine that strictly adheres to practice guidelines rather than clinical judgment, I disagree. IHC simply developed a model that provides a structure for clinicians to standardize their care, while still allowing for their experience and knowledge of the patient to drive their decisions. This can be seen in IHC’s development of its EMR, which integrates clinical decision support protocols designed by the Development Teams into the data entry process.
While the system provides evidence-based guidance, it still affords a measure of physician autonomy by allowing the doctor to provide an override reason (which is often used to refine the protocol). This direct entry of data allows for increased efficiency and more complete documentation (which has the added benefit of increased billing). Once proven successful, this strategy would eventually lead to a “tipping point” of physicians espousing the benefits of the model, a necessity for system wide adoption.
Furthermore, as they smoothed out the data collection methods and could produce measurable outcomes, it became possible to align both medical and administrative personnel’s financial incentives to match the organizational goals. Considering this case study is 11 years old, it is natural to question if this model proved to be successful in the end. The unfortunate truth is that while the protocols did show a marked improvement in both clinical outcome and reduction of costs, they also had the unintended consequence of reducing reimbursements to its physicians and hospitals (Clark, 2010).
For example, IHC instituted a CPAP protocol for neonates with respiratory distress syndrome. “The use of nasal CPAP with oxygen and surfactant (preventing alveolar collapse) at the birth hospital allowed the region to reduce transport to NICU [tertiary hospital] from 78 to 18 percent in the first year following implementation” (Clark, 2010). “Revenue to the birth hospital (American Fork) is increased, but it is decreased at the tertiary hospital (Utah Valley). Further, transport costs are reduced, but staffing is not changed. This results in a net loss to the healthcare delivery system” of over $300,000 for one year (Clark, 2010).
An example such as the above “emphasizes the perversity in the reimbursement system that does not necessarily align financial incentives with improvements in quality and efficiency” (Clark, 2010). Despite this, I would absolutely consider IHC’s model to be not only successful but to position them well for the upcoming changes in the healthcare landscape. “Generally, the fulcrum for market competitiveness is tilting from revenue generation and increasing utilization to favor the most efficient and lowest-cost providers with the best clinical outcomes.
Industry experts and policy wonks acknowledge that in the coming years, healthcare reform will introduce the biggest utilization change of all—internal utilization management via bundled payment and capitation. If commercial insurers adopt accountable care organization strategies, we are likely to see an emergence (or, in some cases, a reemergence) of provider-led value enhancement” (Clark, 2010). At that time, I expect IHC will be most richly rewarded for its innovative and patient-centered thinking. Reference Bohmer, R. , Edmondson, A. Feldman, L. (2002). Intermountain Health Care. Harvard Business Review. Retrieved from http://hbr. org/product/intermountain-health-care/an/603066-PDF-ENG Clark, D. , Savitz, L. , Pingree, S. (2010). Cost Cutting in Health Systems Without Compromising Quality Care. Frontiers of Health Service Management. Retrieved from http://web. ebscohost. com. turing. library. northwestern. edu/ehost/detail? sid=70bf874f-1c96-4c40-a2d5-330dd2a9339asessionmgr115&vid=1&hid=117&bdata=JnNpdGU9ZWhvc3QtbGl2ZQ#db=bth&AN=60616963