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Critical Responses to Descartes Skeptical Arguments
Critical Responses to Descartes Skeptical Arguments
In this essay, I will examine Rene Descartes’ skeptical argument and responses by
O.K. Bouwsma and Norman Malcolm. I intend to prove that while both Bouwsma and Malcolm make points that refute specific parts of Descartes’ argument in their criticisms, neither is sufficient in itself to refute the whole.
In order to understand Descartes’ argument and its sometimes radical ideas, one must have at least a general idea of his motives in undertaking the argument. The seventeenth century was a time of great scientific progress, and the blossoming scientific community was concerned with setting up a consistent standard to define what constituted science. Their science was based on conjunction and empirical affirmation, ideally without any preconceived notions to taint the results. Descartes, however, believed that the senses were unreliable and that science based solely on information gained from the senses was uncertain. He was concerned with finding a point of certainty on which to base scientific thought. Eventually he settled on mathematics as a basis for science, because he believed mathematics and geometry to be based on some inherent truths. He believed that it was through mathematics that we were able to make sense of our world, and that the ability to think mathematically was an innate ability of all human beings. This theory becomes important in Descartes’ Meditations because he is forced to explain where the mathematical ideas that he believed we were born with came from. Having discussed Descartes’ background, I will now explain the specifics of his argument.
The basis of Descartes’ entire argument is that the senses cannot be trusted, and his objective is to reach a point of certainty, one undeniable truth that fixes our existence.
He said it best in his own words, “I will . . . apply myself earnestly and openly to the general destruction of my former opinions.”1 By opinions he meant all the facts and notions about the world which he had previously held as truths. Any point which had even the slightest hint of doubt was discarded and considered completely false. Descartes decided that he would consider all things until he found that either nothing is certain, which is itself a point of certainty, or he reached the one undeniable truth he was searching for. In order to accomplish this certainty, in the first Meditation he asks the reader to assume that they are asleep and that all their sensory information is the product of dreams. More significantly, Descartes implies that all consciousness could actually be a dream state, thus proving that the senses can be doubted. The dream argument has its intrinsic problems, however. One, is that images in dreams can be described as “painted images”.2 In other words, a dream image is only a portrait of a real-life object, place or person. If we are dreaming then it is implied that at some point we were conscious and able to perceive these things. If we are able to perceive these things then we must admit that we have senses and that our senses are, at least in part, true. This was exactly what Descartes was trying to disprove, and it was one reason he abandoned the dream argument.
The second problem with this argument is that it points to mathematics as a point of certainty. I believe Descartes best explained this in his own words: “[W]hether I be awake or asleep, two plus three equals five and a square does not have more than four sides: nor does it seem possible that such obvious truths can fall under the suspicions of falsity.”3 Even when we are dreaming, the laws of mathematics and geometry hold true, but they cannot be Descartes’ point of certainty for a simple reason; these abilities that Descartes believed were innate still had to come from somewhere. If they are in our heads when we are born, someone had to put them there. Descartes’ question is who, and he comes up with two possibilities.
One possibility is that our inherent mathematical abilities are the gift of a benign creator, a gift of God. As a supremely good being, he would not allow us to be deceived, and mathematical processes would be a point of certain and undeniable truth.
If this were the case, the idea of mathematics would meet Descartes’ objectives as a point of certainty. The existence of God, however, cannot be proven and so there is a second possibility that Descartes proposed. He asks the reader to imagine that instead of a benign God, there is an “evil genius . . . who has directed his entire effort to misleading [us] “4 In this case, all things in the physical world would have to be thought of as deceptions, because all our sensory information, including ideas of sizes, shapes and colors would be fed to us by the evil genius. This is enough to prove that mathematics cannot be a point of certainty. It is here that he concludes the first Meditation.
Having decided that we have no senses that are not deceptive, Descartes, in the second Meditation, looks for something outside the world of sensation to find some certainty. What he discovers is that he knows he exists. He knows he exists because he is thinking he exists. If there is an evil genius out there deceiving him at least he is secure in his thoughts. By thinking he exists, by knowing he is “something”, not even the evil genius can convince him he is “nothing”.5 His point of certainty comes down to the statement “I am, I exist”6 or more aptly translated “I think, therefore I am”.
Descartes ideas sometimes seem radical or extreme and his argument has been challenged many times. Two particular criticisms that we discussed were “Descartes’
Evil Genius” by O.K. Bouwsma and “Knowledge Regained” by Normon Malcolm. I would like to examine the significant points each has made in their criticisms and then discuss why I believe each argument is damaging but not sufficient to refute Descartes’ argument.
Bouwsma’s criticism focuses on Descartes’ idea of an evil genius creating an “illusory” world. His intent was to prove that Descartes’ ideas of illusion and deception were misleading. First, Bouwsma set out to define “illusions” and to show how they are detected. In order to accomplish this goal, he gave the example of the evil genius turning the world and everything in it into paper. “An illusion,” Bouwsma says, “is something that looks like or sounds like, so much like, something else that you either mistake it for something else, or you can easily understand how someone might come to do this.”7 In this first example, the reader watches “Tom” as he is exposed to and realizes the difference between the real world and the genius’ paper one. Although the evil genius attempted to create a realistic world out of paper, Tom saw through the illusion when he realized the difference between the paper flowers and real flowers. Tom was not really deceived by the paper illusion since he saw through it rather quickly, but he did “experience” the illusion.8 He experienced it and he detected it. Bouwsma, with this example, is trying to point out the importance of how people detect illusions. For instance, Tom detects the illusion because he knows the difference between flowers and paper. If he did not know the difference, he would not be able to detect the illusion and he would go on being deceived. Bouwsma also states that it is critical that the genius also understand the difference between his illusion and reality even if Tom does not.
Bouwsma then admits that Descartes had something slightly different in mind. He asks the reader what would happen if Descartes’ ideas were true, if the genius’ illusion were so perfect that it would be impossible to tell the difference between the illusion and reality.
Here Bouwsma sets up a second example, one in which the world has been destroyed but Tom goes on believing that the world exists, just as Descartes had imagined. Tom cannot detect this illusion, for it is completely unlike the paper illusion. In this example, there is no difference between the illusory world and the real one. Tom continues living in what he thinks is the real world; he goes on being deceived. What Bouwsma wants the reader to think about is this idea of deception. Is Tom really being deceived if he cannot tell the difference between the real world that the genius destroyed, and the illusory one the genius created for him? Bouwsma does not believe that Tom is being deceived. The evil genius has a sense of the world that Tom cannot comprehend, because the genius is the only one who knows the difference between the real world and the illusion that he has created. The word “illusion” then, would mean something different to the evil genius than it does to Tom. In order for something to be an illusion, there must be a way to detect the reality, like in the paper example. Because there is no way for Tom to detect the difference, there is no illusion. For Tom, the “illusion” becomes the reality and the existence of the evil genius does not alter his life.
Malcolm comes up with a very different criticism of Descartes. His argument focuses on the simple premise that there is nothing more real to a person than their sensory experience. He begins by stating two points commonly associated with Descartes and skepticism in order to challenge their validity. First, that any sensory experience one has now, can be refuted sometime in the future and second that any statement made based on sensory experience is purely hypothetical. Malcolm attempts to show that the opposite is true; that sensory experience cannot be refuted and that it is in fact the only certain knowledge a person can have.
In order to prove his idea, Malcolm makes three propositions. The first is what one would call a factual statement. The second is a type of belief, and the third is an observation based on direct sensory experience. Malcolm attempts to show the reader that what one considers fact can be proven wrong by new evidence that is discovered in the future, but that sensory experience cannot be refuted. For example, he used the statement: “The sun is about ninety million miles from the earth.”9 New evidence could turn up in the future that could drastically alter that figure. This statement that is considered fact could be disputed. But what about a statement of near certain belief, such as Malcolm’s example: “There is a heart in my body.”10 This statement seems impossible to deny, but what if one were presented with incontrovertible evidence to the contrary.
Eventually, the person would come to believe the evidence presented to them and accept that they had no heart. From this example, one can gather that even statements of almost absolute certainty can be proven wrong. Malcolm then examines his final proposition:
“Here is an ink-bottle.”11 This statement is an observation. Malcolm sees the ink-bottle on the desk before him. This, Malcolm believes, is a certain, indisputable statement. If at that moment he sees the ink-bottle, no evidence can convince him he did not, at least at that moment, see the ink-bottle. Direct sensory experience, according to Malcolm, brings certainty. As in the example, a person has no direct sensory experience of the distance of the sun from the earth. This is the problem with statements of fact and belief and explains why they can so easily be proven wrong.
Malcolm believed that people are psychologically impelled to believe in their immediate sensory experiences.
Bouwsma and Malcolm offer sound and reasonable arguments, but neither is able to completely defeat skepticism. They are damaging to Descartes, but not destructive to the whole of skepticism. For example, Bouwsma makes an excellent case against the evil genius argument by suggesting that what the genius would consider illusion, people would consider reality. But it must be noted that while Bouwsma has made a valid suggestion, it does not prove that the evil genius does not exist. It is as impossible to prove that the evil genius does not exist as it is to prove that God does exist. Also Bouwsma’s criticism focused primarily on the evil genius example and did not take into account the rest of Descartes’ argument. There is a lot more to Descartes’ argument than that particular point. Descartes only brought up that extreme example in order to prove that we cannot trust our senses. It is important to keep in mind that Descartes’ purpose in undertaking the skeptical argument was to find a point of certainty in our existence and not to prove that the world is meaningless.
Malcolm has made an admirable case for the validity of the senses, but upon careful examination he says very much the same thing as Bouwsma. Namely, that the senses are real to us. Bouwsma came to this point by examining the idea of the evil genius and the idea of “illusions”. Malcolm came to it through examining the differences between fact, belief and sensory information. Despite the differences in how they discovered it, they both came to the same conclusion. The point is valid and their reasoning is sound, but it does not prove that Descartes is wrong.
The strength of the skeptical argument lies in the fact that it cannot be completely disproved. No one can prove or disprove the existence of an evil genius, they can only go so far as to say that it does not matter. This is essentially what Bouwsma and Malcolm have done. They tried to prove that the existence of the evil genius would not make a difference in our lives. For this reason, I believe that although Bouwsma and Malcolm have made a valid point, they have only touched the surface of Descartes’ argument. They have succeeded in proving that life is not meaningless, but that was not the purpose of Descartes’ argument to begin with.
Diabetic foot ulcer short answer questions
Diabetic foot ulcer short answer questions
Name of student
Name of tutor
Course
Name of institution
Date
PART I:
A foot ulcer comes as a complication in diabetes. The main feature if an underlying diabetic foot is damage to nerves, leading to dilated blood vessels, blood supply is increased, and atherosclerosis leads to reduced blood flow causing pulses to disappear. The medial wall caisifies and arteriovenus shunting occur. Neuropathy is an underlying feature in the development of a foot ulcer. It comes about as a result of increased glucose levels. The hyperglycemia leads to increased action of the enzymes sorbitol dehydrogenase and aldose reductase. The increased action of the resulting enzymes leads to the accelerated conversion of the intracellular glucose, forming the enzymes. This leads to nerve damage, which is the underlying cause of the ulcer (Jack et al., 2013).
Proliferation of skin layer cells prevents damage by ensuring that dermis is intact always. Whenever the cells of the skin grow old, they are worn out and replaced with new ones. This assists in the maintenance of the integrity of the skin. When the integrity is maintained, micro-organisms that cause disease are not able to penetrate the skin. The process of desquamation ensures that dead cells are worn out. Retention of water by the skin, and also deposition of more skin content on some parts like palms
The ulcer in Cathy’s foot started with the integrity of the skin being compromised. This led to nerve damage through primary injury. Tissue damage and nerve damage led to reduced blood supply. The reduction in blood supply caused the cells to lose isotonic power. Physiological processes that maintain the integrity of the cells were compromised leading to loss of function. This caused the ulcer.
Inflammation is the pathological response behind reddening in a wound (Lara, Giovanni & Stefano, 2013). It is a primary immune response towards fighting micro-organisms. It involves an increase in flow of blood through arterioles. The hormones released cause the permeability of capillaries to increases. Blood proteins move from the capillaries to the interstitial spaces. Neutrophils also migrate out of capillaries to the interstitial spaces. They then release paracrines and cause excytocic activity. The exocytotic activities help in resisting infection of the wound by microorganisms.
The four factors that affect skin integrity in relation to this wound are:
Failure of inflammation leading to infection of the wound, damaged nerves that would lead to worsening of the wound; compromised blood supply leading to necrosis; inadequate nutrients that would lead to cell death.
PART II:
Cathy is more predisposed to infection because his immune system is compromised by the ailment’s process. This does not happen to a person without diabetes. The hyperglycemic environment characteristic of diabetic promotes immune dysfunction, and thus promotes infection. Immune dysfunction comes in that the cells of the immune system are not able to perform their function, as a result of weakening by high amounts of glucose. For example, it leads to damage to macrophages which prevent micro-organisms (Khardori, 2013).
The inflammatory phase of wound healing requires many cells of the immune system that facilitate exocytosis of microorganisms. Diabetes creates an environment of hyperglycemia. Immune cells that are involved in the inflammatory process do not survive in this environment. This leads to the depression of the antioxidant system. Neutrophils are damaged. The damage to neutrophils leads to failure of immune function.
Cathy waited for long before seeing her practitioner because the healing of the foot was being delayed by the reversal of healing processes. In diabetics, wound healing is delayed because of the interference of the process secondary to the disease process. The interruption of the inflammatory phase, for example, led to the prolongation of the healing of the ulcer (Jack et al., 2013).
The microbiological, bacteriological investigation of the wound at this stage should target both anaerobic bacteria, aerobic bacteria, with consideration of both gram-positive and gram-negative. This because, at this stage, a diabetic foot is attacked by mixed bacterial flora. Although the gram-positive bacteria are commonly isolated in diabetic wounds, the hyperglycemic environment of the wound attracts a variety of bacteria (Metreveli et al., 2010).
The wound is in secondary wound healing stage. A close look at the wound shows that the edges are not approximated. It has a reddish, punkish appearance. The wound also has some tannish necrotic tissue. The epithelial tissue is dry. The wound has not tunneled. It is irregular and macerated. It also has little serous exudate.
PART III:
A large section was removed from Cathy’s foot to promote healing. For wound healing process to be realized faster and effectively, necrotic material needs to be removed frequently. The section of tissue that was removed helped do away with foreign tissue, and that contaminated by bacteria. If the contaminated tissue is not removed from a wound, it would lead to infection, which delays wound healing. It also helped decrease scarring, and the maintenance of the wound bed. Scarring can delay wound healing by delaying approximation of the edges. In addition, maintenance of wound bed is vital for wound healing. Also, it reduces pressure and helps in inspection of the wound (Wounds International, 2013).
The enrolled nurse would monitor the wound by checking for dryness. A dry wound heals faster than a wet wound. To keep the wound dry, it has to be cleaned well to prevent infection. For this reason, the nurse also maintains the hygiene of the wound by frequently checking for signs of infection. For example, an oozing wound is an infected wound. The nurse also checks for tunnels and desiccation in the wound. This is to ensure that the wound does not lead to damaging of the underlying tissues. Infection to the underlying tissues can lead to migration of infection to other organs like the sensitive heart. Further, the nurse checks for the colour of the wound. The color of the wound helps the nurse determine the effectiveness of wound healing, through determining inflammation. The nurse also monitors the wound’s response to treatment, and the persistence of debridement tissue.
To decrease the chances of infection, the nurse has to observe thorough cleaning of the wound. This practice keeps the microorganisms away. Further, the patient has to be taught on the principles and procedures of caring for her wound. Empowering the patient to cooperate in their care improves clinical results in a great deal; hence, Cathy has to be taught on how to care for the wound. Debridement of the wound also helps to reduce infection. It helps in removing contaminated tissue. This leaves the wound free of a contaminant that can cause infection. The nurse also has to keep on re-examining the foot with the wound frequently. This will enable her identify any sign of infection at the earliest opportunity. The other intervention to reducing infection is dressing of the wound. It helps keep infection away, by protecting the area of the wound. Also, the nurse should keep on assessing vascular status and toe pressure. This may be an indication of infection (Aalaa, Malazy & Tehrani, 2012).
She should be taught to cooperate with the health care personnel in her care. This will in turn improve her health outcomes, towards the healing of the wound. Cathy also needs to be taught on how to keep the foot and the wound clean and also dry at all times. This will help keep infecting agents away. The patient should also be advised on eating a balanced diet. This will give enough nutrients to the body. She should report any sign of infection to the nurse. This will enable a quick response from the care team. She should also be ready to keep the area of the wound out of external pressure.
Community public health worker through the government programmes that support people with diabetes. Community health nurse responsible to community cases like the one for Cathy. Community diabetes clinic where people with diabetes are treated. Community health center through the diabetes clinic.
References
Aalaa, M., Malazy. T.O., & Tehrani, M. (2012). Nurse’s role in diabetic foot prevention and care: a review. Journal of Diabetes and Metabolic Disorders, Nov, 24: 2012
Jack, Y.C., Robert, D., Mohamad, M., Jacqueline, S., & Babak, B. (2013). An integrative approach towards chronic wounds in patients with diabetes: PPPM in action. Advances in Predictive, Preventive and Personalized Medicine. 3(2013): 283-321
Khardori, R. (2013). Infection in patients with diabetes mellitus. Retrieved online from Medspace at http://emedicine.medscape.com/article/2122072-overview
Lara, B., Giovanni, Z., & Stefano, V. (2013). Physical disability in the elderly diabetics: epidemiology and mechanisms. Current Diabetes Reports, 13(6): 824-830
Metreveli, D., Chikiviladze, D., Gachechiladze, K.H., & Avazashivili, D. (2010). Microbiological investigation of a diabetic foot infection. Georgian Medical News, 183: (22-26)
Wounds International. (2013). Best practice guidelines: wound and management in diabetic foot ulcers. London: Wounds International.
McIntosh (2004) suggests that they give a probability of increasing the chances of a person getting employed. The chances of them getting employment are much higher than the people who leave school without any training. For instance
men who have no training in any formal course have an employment rate of 68. Vocational training has the capability of increasing the employability to more than 75%. There is a major improvement to those who further advance their training to the next level. The improvement is noted to about 89%. If an individual takes their training to level 3
