Daniele Chiffi

The beliefs involved in the placebo effect are often assumed to be self-fulfilling, that is, the truth of these beliefs would merely require the patient to hold them. Such a view is commonly shared in epistemology. Many epistemologists focused, in fact, on the self-fulfilling nature of these beliefs, which have been investigated because they raise some important counterexamples to Nozick’s “tracking theory of knowledge.” We challenge the self-fulfilling nature of placebo-based beliefs in multi-agent contexts, analyzing their deep epistemological nature and the role of higher-order beliefs involved in the placebo effect.

The present paper is intended to analyse from a theoretical point of view the relationships between natural language and idiolects in the context of communication by means of the Davidson–Dummett controversy on the nature of language. I will explore from a pragmatic point of view the reliability of an alternative position inspired by the recent literalism/contextualism debate in philosophy of language in order to overcome some limitations of Dummett’s and Davidson’s perspectives on language, idiolects and communication.

I saggi che compongono questo libro intendono presentare in maniera organica e interdisciplinare, anche se da una prospettiva fondazionale logico-filosofica, il ruolo che il concetto di prova svolge in differenti ambiti del sapere. L’elemento innovativo e caratterizzante del volume è quello di stabilire e formulare quali sono le condizioni di adeguatezza materiale e formale per una corretta esplicazione del concetto di prova nelle sue differenti applicazioni. Si cercherà, inoltre, di cogliere cosa ha qualificato storicamente e qualifica tuttora il concetto di prova tentando di individuarne, da un lato, le caratteristiche persistenti o invarianti e, dall’altro, le differenze specifiche che esso assume in molteplici settori della ricerca. Vengono così presentati sette saggi che spaziano sui seguenti temi: dalle procedure logiche di prova medievali (Alfredo Di Giorgio), si va alla nozione di prova da Frege a Wittgenstein (Carlo Penco), al problema delle verità delle proposizioni gödeliane (Sergio Galvan), alla fondazione delle leggi logiche (Ciro De Florio), ai fondamenti del linguaggio pragmatico (Antonio Negro e Davide Sergio), alla relazione tra conoscibilità e prova (Massimiliano Carrara e Daniele Chiffi), fino all’analisi del paradosso del buon samaritano (Andrea Favaro e Silvia Gaio).

Diagnostic frameworks are essential to many scientific and technological activities and clinical practice. This study examines the main fundamental aspects of such frameworks. The three components required for all diagnoses are identified and examined, i.e. their normative dimension, temporal nature and structure, and teleological perspective.The normative dimension of a diagnosis is based on (1) epistemic values when associated with Hempel's inductive risk concerning the balance between false‐positive and false‐negative outcomes, leading to probabilistic judgements; and (2) non‐epistemic values when related to ideas such as well‐being, normality, illness, etc, as idealized norms or ideal points of reference.It should be noted that medical diagnoses match the three necessary components, while some essential diagnostic frameworks – the taxonomies ofGordon andNANDA– in nursing lack some components. The main lack is normative as the most popular frameworks in nursing diagnosis seem to be descriptions of observed reality rather than normative and value‐based judgements in which both epistemic and non‐epistemic values may coexist.

Nursing knowledge stems from a dynamic interplay between population‐based scientific knowledge (the general) and specific clinical cases (the particular). We compared the ‘cascade model of knowledge translation’, also known as ‘classical biomedical model’ in clinical practice (in which knowledge gained at population level may be applied directly to a specific clinical context), with an emergentist model of knowledge translation. The structure and dynamics of nursing knowledge are outlined, adopting the distinction between epistemic and non‐epistemic values. Then, a (moderately) emergentist approach to nursing knowledge is proposed, based on the assumption of a two‐way flow from the general to the particular and vice versa. The case of the ‘placebo effect’ is analysed as an example of emergentist knowledge. The placebo effect is usually considered difficult to be explained within the classical biomedical model, and we underscore its importance in shaping nursing knowledge. In fact, nurses are primarily responsible for administering placebo in the clinical setting and have an essential role in promoting the placebo effect and reducing the nocebo effect. The beliefs responsible for the placebo effect are as follows: (1) interactive, because they depend on the relationship between patients and health care professionals; (2) situated, because they occur in a given clinical context related to certain rituals; and (3) grounded on higher order beliefs concerning what an individual thinks about the beliefs of others. It is essential to know the clinical context and to understand other people's beliefs to make sense of the placebo effect. The placebo effect only works when the (higher order) beliefs of doctors, nurses and patients interact in a given setting. Finally, we argue for a close relationship between placebo effect and nursing knowledge.