In my ‘Mind’s Eye’: introspectionism, detectivism, and the basis of authoritative self-knowledge

It is widely accepted that knowledge of certain of one’s own mental states is authoritative in being epistemically more secure than knowledge of the mental states of others, and theories of self-knowledge have largely appealed to one or the other of two sources to explain this special epistemic status. The first, ‘detectivist’, position, appeals to an inner perception-like basis, whereas the second, ‘constitutivist’, one, appeals to the view that the special security awarded to certain self-knowledge is a conceptual matter. I argue that there is a fundamental class of cases of authoritative self-knowledge, ones in which subjects are consciously thinking about their current, conscious intentional states, that is best accounted for in terms of a theory that is,
broadly speaking, introspectionist and detectivist. The position developed has an intuitive plausibility that has inspired many who work in the Cartesian tradition, and the potential to yield a single treatment of the basis of authoritative self-knowledge for both intentional states and sensation states.

In My 'Mind's Eye': Introspectionism, Detectivism, and the Basis of Authoritative Self-Knowledge

It is widely accepted that knowledge of certain of one’s own mental states is authoritative in being epistemically more secure than knowledge of the mental states of others, and theories of self-knowledge have largely appealed to one or the other of two sources to explain this special epistemic status. The first, ‘detectivist’, position, appeals to an inner perception-like basis, whereas the second, ‘constitutivist’, one, appeals to the view that the special security awarded to certain self-knowledge is a conceptual matter. I argue that there is a fundamental class of cases of authoritative self-knowledge, ones in which subjects are consciously thinking about their current, conscious intentional states, that is best accounted for in terms of a theory that is, broadly speaking, introspectionist and detectivist. The position developed has an intuitive plausibility that has inspired many who work in the Cartesian tradition, and the potential to yield a single treatment of the basis of authoritative self-knowledge for both intentional states and sensation states.

UK consensus project on quality in palliative day services: developing a quality indicator set using the RAND/UCLA appropriateness method

Introduction
Evaluating quality of palliative day services is essential for assessing care across diverse settings, and for monitoring quality improvement approaches.

Aim
To develop a set of quality indicators for assessment of all aspects (structure, process and outcome) of care in palliative day services.

Methods
Using a modified version of the RAND/UCLA appropriateness method (Fitch et al., 2001), a multidisciplinary panel of 16 experts independently completed a survey rating the appropriateness of 182 potential quality indicators previously identified during a systematic evidence review. Panel members then attended a one day, face-to-face meeting where indicators were discussed and subsequently re-rated. Panel members were also asked to rate the feasibility and necessity of measuring each indicator.

Results
71 indicators classified as inappropriate during the survey were removed based on median appropriateness ratings and level of agreement. Following the panel discussions, a further 60 were removed based on appropriateness and feasibility ratings, level of agreement and assessment of necessity. Themes identified during the panel discussion and findings of the evidence review were used to translate the remaining 51 indicators into a final set of 27.

Conclusion
The final indicator set included information on rationale and supporting evidence, methods of assessment, risk adjustment, and recommended performance levels. Further implementation work will test the suitability of this ‘toolkit’ for measurement and benchmarking. The final indicator set provides the basis for standardised assessment of quality across services, including care delivered in community and primary care settings.

Reference

• Fitch K, Bernstein SJ, Aguilar MD, et al. The RAND/UCLA Appropriateness Method User’s Manual. Santa Monica, CA: RAND Corporation; 2001. http://www.rand.org/pubs/monograph_reports/MR1269