'Freedom of belief' - really?

"We have seen that our beliefs are tightly coupled to the structure of language and to the apparent structure of the world. Our "freedom of belief," if it exists at all, is minimal. Is a person really to free to believe a proposition for which he has no evidence? No. Evidence (whether sensory or logical) is the only thing that suggests that a given belief is really about the world in the first place. We have names for people who have many beliefs for which there is no rational justification. When their beliefs are extremely common we call them "religious"; otherwise, they are likely to be called "mad," "psychotic," or "delusional." pp.71-72.

INDIVIDUAL
  |

     INTERPERSONAL    :     SCIENCES               

HUMANISTIC --------------------------------------  MECHANISTIC      

SOCIOLOGY  :   POLITICAL 

|

GROUP

my freedom of belief senses - logic my belief - beliefs belief hygiene my mental health state continuum model -  of mental health-illness	freedom of movement senses logic physical reality personal hygiene
culture organised religions our beliefs	theocracy secular states Mental health law

Harris, S. (2004) The End of Faith, London: Norton & Co.

Book: "Beyond Belief - How Evidence Shows What Really Works"

Beyond Belief

INDIVIDUAL

|

     INTERPERSONAL    :     SCIENCES               

HUMANISTIC --------------------------------------  MECHANISTIC      

SOCIOLOGY  :   POLITICAL 

|

GROUP

BEYOND BELIEF	How Evidence Shows What Really Works

Beyond Belief: How Evidence Shows What Really Works is a book by science journalist Helen Pearson, published by Princeton University Press.

 

My source: 
Pearson, H. Trials that quietly changed our lives, Life&Arts, FTWeekend, 18-19 April, 2026. p.2 

Previously: 'belief' : 'evidence' : 'information disorder' 

RCN member's survey on spirituality & H2CM

Originally published - 10 March 2010Source: http://www.rcn.org.uk/newsevents/news/article/uk/rcn_seeks_members_views_on_spirituality
The Royal College of Nursing has launched a survey to improve its understanding of nurses’ views on spirituality.
RCN members are invited to submit their thoughts on what they understand by the concepts of spirituality and spiritual care and whether they consider these to be legitimate areas of nursing practice. Specific questions will ask what level of training and support should be given to nurses to deal with spiritual issues.
RCN Executive Director of Nursing and Service Delivery Janet Davies says:

“The RCN is committed to the promotion of holistic care*, but we recognise that spirituality is a complex area. Although understood as an area of human life that applies to all, spirituality can also be subject to taboo and misunderstanding. We are committed to understanding nurses’ views on spirituality and to explore this issue further.”

The results of the survey will shape the RCN’s work in this area and will be presented at a fringe event at RCN Congress in April.

RCN members: Complete the spirituality survey by 31 March 2010.

* My emphasis.

Thoughts from Hodges' model (PJ):

Nurses most definitely need to be aware of and have due regard to care management theory and practice associated with spirituality. That is - how individuals, families, communities (and the State) express belief or non-belief concerning self, others, humanity, their environment, and their relationship with all that is, has been and will be. They need to discern when spiritual matters enter into religious affairs and the customs and rituals that exist ancient and modern. Nurses need to recognise when and where to seek guidance in how to proceed. Legislation, human rights, professional codes of conduct, local and national policies are also critical to a nurse's understanding and attainment of spiritual literacy.

This is an area were confusion can arise over terminology. What is the difference between spirituality, religion and beliefs (mine, yours)? In their training and ongoing careers students need to demonstrate an openness to spirituality in the sense of being neutral with regards to their own beliefs. In specific situations and medical procedures again professional advice may be needed.

Hodges' model is an ideal tool to support nurses in their appreciation of spiritual (and pastoral) aspects of care. The model is ethnoculturally neutral. This neutrality serves as a reservoir of deep respect, rapport and empathy and provides a foundation, a space upon which all spiritual elements of care can be written.

The spiritual is represented in h2cm as a whole.

The model's four care domains collectively represent a 5th domain - the spiritual. Strangely, as per the use of the term in technology circles, the model can be described as 'agnostic'. Not in the religious sense, but due to the fact that h2cm does not demand knowledge of, nor ascribe to any particular spiritual, religious or belief stance.

Modelling Belief, Leadership & Group Cognitive Therapy Older People

For the past two years come this Nov I have been occupied purely with health informatics. The clinical knowledge and experience of my colleagues and I have proved very beneficial in supporting the enormous changes taking place in our organisation and throughout the NHS. As 'Clinical Specialists' though, we are acutely aware of how quickly you can lose touch, how quickly your credibility with peers can start to wane. Of course, there's a whole debate around this which includes academic staff...

That debate aside - added factors for me are belief, leadership closely allied with Hodges' model. So some great news to report, a new job description means 25% of my time will be a return to clinical work (can you hear running feet?). The plan is to devote this time to establishing and running group therapy.

It's a really exciting prospect: finding a co-worker, planning, preparation, therapy manual / protocols, tools, materials, measures, records, supervision, engaging referrers AND clients!

Connecting with people - that's what IT's about. Having the time to focus on a therapy would be great. I've wanted to do this for so long. How many of us undertake specific therapy training, but are not able to practice? Now without a caseload of 25-30 and Team Leader responsibilities...

I don't know my co-worker as yet. Have they heard of Hodges' model? They will have their own cognitive and practical tools and views on others... They need not worry (I don't like pate), but if there's an opportunity to incorporate Hodges' model then my belief, leadership need be at the fore. It's early days - but fingers are x'd...

A Spin on Logic, Belief, Facts & Truth

individual

|

INTERPERSONAL : SCIENCES

humanistic -------------------------------------------  mechanistic

SOCIOLOGY : POLITICAL

|

group-population

Doxastic Logic Individual Belief	Post-truth (time) Short : Long term Statistics Facts Proton Spin Mystery
The public The crowd The people The public - the politicians deserve	Post-truth (politics) Alternative-Facts Fake news False promises True Spin The politicians - the public deserve

My original source:
Simon Kuper, (2017). The age of broken promises, FT, Magazine, 28/29 January, p.5.

Humanity: Still trying to join the Dots - Individual :: Collective

individual

|

INTERPERSONAL : SCIENCES

humanistic ----------------------------------------------- mechanistic

SOCIOLOGY : POLITICAL

|

group - population

sub-conscious pattern recognition   "Differences in belief have substantial impacts ranging from personal identity formation ...	"Our ancestors once saw the faces of gods in the stars - joining the dots in the heavens to create a celestial pantheon." Whipple
... to social/group affiliation and exclusion ...	... to national and international political dynamics."

 

Sources: 

Whipple, T. (2020) Join the dots for a glimpse of the Almighty, The Times, September 10. p.17.

Adam B. Weinberger, Natalie M. Gallagher, Zachary J. Warren, Gwendolyn A. English, Fathali M. Moghaddam, Adam E. Green. Implicit pattern learning predicts individual differences in belief in God in the United States and Afghanistan. Nature Communications, 2020; 11: 4503 DOI: 10.1038/s41467-020-18362-3

 

INTERPERSONAL links: Holistic Bliss or Tristram Shandy ... III

The INTERPERSONAL domain links are to my mind (no pun intended) fairly obvious, at least that first row complements the SCIENCES top row opposite.

Basically, who needs a talking therapy and who needs a drug therapy?

The two uppermost care domains are intended to represent the INDIVIDUAL axis, so just as the SCIENCES [ANATOMY & PHYS] domain covers physical care; so the INTERPERSONAL domain encompasses emotional and mental health care.

Hodges' model is comprised of four care domains, but it is these two [INTERPERSONAL : SCIENCES] applied to the individual that even today we struggle to balance in theory and practice.

A key factor in Brian Hodges' early nursing career (and mine) has been the role of institutions, organisations and the formal policies and structures they represent. This can be depicted as:

EMOTIONAL HEALTH : PHYSICAL HEALTH (both 'individual')
OTHERS family, society : INSTITUTIONS (both 'group')

As to the INTERPERSONAL links themselves - I arrived at mental health through reading a psychology text on Wundt and introspection, then James..... PSYCHOLOGY being of central importance in this domain has two listings, with MENTAL HEALTH and closely related THERAPIES also sharing the top row. I may swap these around: PSYCH-OLOGY as a cognitive science should be placed rightmost, while MENTAL HEALTH and THERAPIES should be further to the left being more 'humanistic'. What do you think?

Do the sciences have to be corralled in the SCIENCES domain? I think I remember Bryan Magee and John Searle in conversation noting that many disciplines with science in their title are probably not sciences - in that upper right hand quadrant sense. Maybe it is just that -

cognitive science : "SCIENCE" (physics, biology, chemistry)
social science : political science

- are still running wild out there, untamed and as yet unbroken? Cognitive science has however, clearly come of age and the 21st century will undoubtedly be the century of the brain when anatomy, physiology and genetics are linked to thought and individual (and even social) behaviour.

Already the content here highlights cognition (thought). The inclusion of other link categories in this upper-left set can be explained with recourse to cogitation. After PSYCHOLOGY, PHILOSOPHY (with ETHICS) is the rather obvious 'ology'.

For better or for worse our culture is driven more by IDEAS and ideology than philosophy. Call it the informal philosophical engine that drives CREATIVITY.

COMMUNICATION lies at the heart of all things human-e. Given the millennia that the patient-physician relationship has been around, you might expect it to be perfected by now. Well health and social care workers and the public they serve are still trying to reach empathic nirvana (although that may be to take communication a bit too far).

Hodges' model has a role to play supporting reflection for all.

IDEAS, COMMUNICATION lead us to belief and a central component in psychological therapies. Belief is also a thread can be used by one individual to lead others positively or to subvert other individual's capacity to think critically. It is in this INTERPERSONAL domain that good and evil are so proximal they create heat, fanned by a culturally driven winds of history and media from the South. Be-life indeed. Here then - THEOLOGY is purposefully placed with TRANSDISCIPLINARITY. If it is to serve humanity Religion must be bound and integrated into the corpus of knowledge and that includes reconciliation with the SCIENCES. We cannot deny myth and yet myth cannot deny evidence - a debate that will go on......

The economic emphasis placed currently on creativity is quite remarkable, not just at a national level (cue ramble...). Cities recognise that their future development, sustainability and very survival depends on the generation and flow of ideas. Some things do not change. In myth a special place has been reserved for the isolated thinker, the one individual who takes themselves away for weeks-months, to be touched by the spiritual realm, to return to the community delivering insight, creative sustenance. Now creative individuals are needed more than ever. The isolation is virtual, the community potentially global. The energies of individuals are directed at solving problems concerning more mundane matters of cost, risk, flexibility and growth. Those creative outputs are distilled through team work and although they are then diluted they remain invaluable - such is the scale of the problems to be solved. Just as the great rivers that feed our cities have their sources - often remote and isolated in the high mountains, so ideas and creativity begin with one individual. That flow of personal knowledge now finally enters the ocean of KNOWLEDGE MANAGEMENT - EXPERT SYSTEMS (decision support systems).

I have a little mantra that I share with students. It's not perfect as there is much overlap; but I figure that what aptitude is to engineering so attitude is to caring.

HEALTH PROTECTION and PROMOTION, SELF CARE are all about attitude. Of course, money in the form of departmental budgets (those institutions do matter) and family income can make a huge difference, but if the right attitudes are not present then you may as well - "go fish!".

In light of the above STUDY SKILLS and EDUCATION and TRAINING speak for themselves - on this occasion at least. One of the original purposes of Hodges' model was to facilitate reflective practice (more to follow). We are familiar with the mechanical tools in use everyday to the extent they are taken for granted. Now the focus of training is more likely on the software tools that translate IDEAS into art, artefacts and conceptual frameworks.... ;-) These graphical and design tools must be learnt and the HUMAN-COMPUTER INTERFACE and its ACCESSIBILITY 'quotient' can prove to be either a brick wall or a leg-up for the individual user (even if networked or a collaborative tool - see SOCIOLOGY links).

If the SOCIAL domain reflects the worlds of the others, then the last INTERPERSONAL row REST & RECREATION reflects something of me and my family.

"Next!" - the SOCIOLOGY domain links....

Book review iii: 'Categories we live by'

In thinking about (with?) Hodges' model, I often feel there is a flip-flop nature to where exactly concepts sit; or more accurately the perspective (care/knowledge domain) from which they are viewed.

Murphy introduces dual-character concepts, 'which are things that have both a prototype (or rule) and an ideal.' p.30. and quotes from:

Knobe J, Prasada S, Newman GE. Dual character concepts and the normative dimension of conceptual representation. Cognition. 2013 May;127(2):242-57. doi: 10.1016/j.cognition.2013.01.005. Epub 2013 Mar 1. PMID: 23454798.

Do dual character concepts operate at varied levels, and in their association (semantic) proximity - relationship to other concepts? All this changing according to context.

Murphy explores the dual category nature of people who claim to be scientists, but are really following a hobbyhorse. That is not lost on me. Others, a baker is following scientific principles while not technically being a scientist p.31. The discussion on art - artists is also informative; turn the page, and that on RINOs - Republican In Name Only - is very timely! There are the problems that science itself can contribute. If you don't know your oxeye daisy from osedaxes you can find out here: fascinating. 

'Health' is dual category in a great many respects (and with a chapter to follow). Many have been and will continue to be discussed here:

• person :: service-centredness
• parity of esteem (mental - physical)
• confusion - dementia :: delirium (infection, dehydration)
• mental capacity :: best interests
• community care :: 'in care'
• clinical risk - positive risk taking
• healthcare :: social care

There's a need for careful deliberation too as does this apply to any situation in which there is a smell of  dichotomy: good, or bad?

Chapter 3 'Categories in the World and in the Head' helps straight away - declaring a false dichotomy. For me, it's worth revisiting natural categories, natural kinds and essential categories and psychological essentialism. Get these right and surely that's a useful toolkit, or more accurately - first aid kit?

I'm grateful for the placeholder essence (p.46) from:

Medin, D. L., & Ortony, A. (1989). Psychological essentialism. In S. Vosniadou & A. Ortony (Eds.), Similarity and analogical reasoning (pp. 179–195). Cambridge University Press. https://doi.org/10.1017/CBO9780511529863.009

'Psychological essentialism should not be equated with the classical view that concepts are representations of classes of objects that have singly necessary and jointly sufficient conditions for membership. ... More generally, we propose that the knowledge representations people have for concepts may contain what might be called an essence placeholder. There are several possibilities for what is in such placeholder. In some cases, but by no means in all, it might be filled with beliefs about what properties are necessary and sufficient for the thing to be what it is. In other cases it might be filled with a more complex, and possibly more inchoate, "theory" of what makes the thing the thing that it is (see Murphy & Medin,1985). It might, additionally, contain the belief (or a representation of the belief) that there are people, experts, who really know what makes the thing the thing that it is, or scholars who are trying to figure out exactly what it is. Just as with theories, what the placeholder contains may change, but the placeholder remains.' pp.184-185.

Hodges' model provides four placeholders. In reading and watching videos on category theory, it appears there is a role for 'placeholders'. I realise the applications - contexts differ, but analogies are powerful too.

Regards, classification as an exercise in convenience, despite the emphasis upon evidence, how often even in clinical matters does it come down to convenience? More to follow on this.

I've never wanted Hodges' model to be a grab-bag for keywords, concepts - categories! So it helps ease that concern, in chapter 4 to see words and categories contrasted. I always wondered about the media's preoccupation with the Inuit and 'snow'. 'Salient' is here as expected in 'Language, Culture and Categories' and with the Sapir-Whorf hypothesis p.53. And, of course, nursing and everything else relies on language p.57. Prof. Murphy's mention of children figuring out when it comes to language, and adults just how crazy it - the rules - can seem. While impossible, by definition, I had this thought of toddlers instigating a class action to get things put right. I like the way Murphy reaches across cultures for answers, highlighting the field of ethnobiology p.61. The appeal of this is exaggerated as it stretches across Hodges' model diametrically [sociology - sciences]. I'm still on the look out for models possessed of an 'otherness', that retain legitimacy, validity where and for whom they are employed. (There is much to debate there still.) The objective and subjective dimensions also loom large. I remember a meeting concerned with nursing terminology 1990s, with reflection on the terms used for injection across the UK. That in itself demonstrated wide regional variations that also give pause for thought.

More to follow, with Part 2 'case studies'.

Murphy, Gregory L. Categories we live by: how we classify everyone and everything. Cambridge, MA: The MIT Press, 2024.

Many thanks to MIT Press for the review copy.

See also:

Categories are destiny' Freud p.6. of 'Categories we live by'

Book review: 'Categories we live by' ii

Book review iv: 'Categories we live by'

v Book review: 'Categories we live by'

Critical thinking: several definitions

Critical Thinking 
2nd Ed. Cover

An original purpose of Hodges' model was to facilitate reflection, and so help to develop practitioners who were also competent reflective practitioners, and critical thinkers.

Continuing to clear books, I've arrived at:

Fisher, A. (2001) Critical Thinking: An Introduction. Cambridge University Press, Cambridge, England. PB. 

Now in a 2nd edition (2011), my copy has several definitions of 'critical thinking' quoted below, with my emphasis.

There is a pdf of this 1st edition online which may be useful. The reward of the book, however, is in the discussion about each definition and how more recent work has built upon Dewey's legacy.  There is also a baseball analogy, which I will return to soon, or append here. I have omitted a definition by Richard Paul, which is nonetheless important to me, as it draws on meta-cognitive qualities:

"1.1.1 John Dewey and 'reflective thinking' ...

In fact, people have been thinking about critical thinking and have been researching how to teach it for about a hundred years In a way, Socrates began this approach to learning over 2,000 years ago, but John Dewey, the American philosopher, psychologist and educator, is widely regarded as the 'father' of the modern critical thinking tradition. He called it 'reflective thinking' and defined it as: 

"Active, persistent, and careful consideration of a belief or supposed form of knowledge in the light of the grounds which support it and the further conclusions to which it tends. (Dewey, 1909, p. 9)."' p.2.

 'Glaser defined critical thinking as:

(1) an attitude of being disposed to consider in a thoughtful way problems and subjects that come within range of one's experience; (2) knowledge of the methods of logical enquiry and reasoning; and (3) some skill in applying those methods. Critical thinking calls for a persistent effort to examine any belief or supposed form of knowledge in the light of the evidence that supports it and the further conclusions to which it tends. (Glaser, 1941, p.5).' p.3.

1.1.3 Robert Ennis - a widely used definition ...

'Critical thinking is reasonable, reflective thinking that is focused on deciding what to believe or do. (Cf. Norris and Ennis, 1989).' p.4.

Notice the emphasis on being 'reasonable' and 'reflective', which picks up on earlier definitions, but notice also that Ennis speaks of 'deciding what to do', which was not explicitly mentioned earlier; so decision making is part of critical thinking in Ennis's conception. Unlike Dewey's definition, this definition needs no further explanation

A final definition of critical thinking 

One last definition is worth reviewing. Michael Scriven has recently argued that critical thinking is 'an academic competency akin to defines it thus: reading and writing' and is of similarly fundamental importance. He defines it thus:

'Critical thinking is skilled and active interpretation and evaluation of observations and communications, information and argumentation. (Fisher and Scriven, 1997, p. 21).' p.10."

Seeking postdoctoral researchers for ERC project IDENTITY ERROR

Dear Colleagues
Please help connect people in your network with this ERC-funded postdoc opportunity in our department.

"The project will combine computational modelling and group-based experiments to scale individual models of epistemic vulnerability (i.e., belief in misinformation/conspiracy theories) to a social level."

Many thanks,

Mike
________________________________

The ERC-funded IDENTITY ERROR project is hiring 2 Postdoctoral Researchers (hosted in the Psychology Department in UL). The project will combine computational modelling and group-based experiments to scale individual models of epistemic vulnerability (i.e., belief in misinformation/conspiracy theories) to a social level. There is a computational post that will require some knowledge of network analysis and/or agent-based modelling, and a social psychology post that will require experience conducting behavioral experiments. We are a supportive group of interdisciplinary researchers, and we do not expect either postdoc to have full knowledge of these methods. We only expect a willingness to learn and a curious attitude. Further details on each post can be found at the links below. The closing dates for applications are October 28th (computational postdoc) and November 3rd (psychology postdoc). 

Each post is estimated to last for 3 years. Contact paul.maher AT ul.ie for enquires.

Computational post: https://my.corehr.com/pls/esbsheulrecruit/erq_jobspec_version_4.jobspec?p_id=079248

Social Psychology post: https://my.corehr.com/pls/esbsheulrecruit/erq_jobspec_version_4.jobspec?p_id=079308
------------------------------

My source: Mike Quayle, Mike.Quayle AT UL.IE
https://www.jiscmail.ac.uk/cgi-bin/webadmin?A0=simsoc
SIMSOC Digest - 15 Oct 2025 to 16 Oct 2025 (#2025-169)

Book review: Handbook on the Ethics of AI #2

Handbook on the Ethics of AI

Well, I am sold. So, encouraging again to read 'reflect -ion' on the first page and throughout chapter 1:

'... why the very idea of AI gives rise to (or should give rise to) ethical reflection.' (p.21), and I'm sure the book as a whole.

Most readers may pass this by, but to me this matters. Ethics scholars however will see how important and conjoint reflection is to deliberation and argumentation of ethics. Especially, as noted in post #1 the five part division of the text Foundations and Context; Responsibilities; Rights; Politics and Power; and Thinking Otherwise. 

Tables break up and inform the text. I like the way for many tables the source is: Author's own elaboration.

Given the subject matter, yes, the authors have the literature but they are also formulating their chosen theme against the present, near future, socio-political scenarios and much more. So, reflection - this should be expected. With Hodges' model I'm often asked why are those concepts placed in that particular domain? Perhaps that is a question for general artificial intelligence? Subjectivity is a key challenge, and its effective communication.

If I say, chapter 1 is a great primer on What Is This Thing Called the Ethics of AI and What Calls for It? I'd sell the book short, the whole text fulfills this purpose. The definitions and responses to What is A.I. are very helpful, taking into account ancient to more recent history. I've a book in a box by David Chalmers (sorry Prof.) - one day - which helps here discussing intelligence and consciousness.

I'm primed to pick up on 'gaps' (Theory-Practice) and in human experience they are inevitably legion. The responsibility gap (and meaningfulness!) c/o Sven Nyholm is a place to return to, to debate why A.I. raises such a broad range of ethical issues. Patiency is never far away. Here, the patient is stark: in  moral agents and moral patients (p.20 and 89). This blog is littered with posts on Drupal, which to date I have never mastered. I remember sitting in DrupalCon presentations, in the midst very skilled professional coders. A member of the community stood at the podium recounting their lived experience of impostor syndrome. In November with a presentation of my own, I had my own encounter. Well into reading this book, it really did help. The conclusion of chapter 1 contrasts the frequent need for a big-picture overview and reflection on more specific issues. That's quite fitting for me.

I am biased in the encouraging kernels I find: as seek them I do. Yes, as chapter 2 AI Ethics before Frankenstein begins: 'there remains work to be done in charting the long-range conceptual development of  AI in the history of political thought.' (p.27, my emphasis). And much more I hope. Chapter 2 combines literature, myth and I enjoyed the discussion on techne, Prometheus, Hobbes, the interdisciplinary bridge of techno-politics and articulating the mechanistic in our lives. Focussed recently on thresholds and threshold concepts in revising two papers: Hunt writes, 'Frankenstein is a "threshold" text for "modern political science fiction" (p.31). 

This  resonated - especially 'for its prediction that the nascent Enlightenment-era sciences of chemistry, anatomy, and electricity could be used to artificially make a human being' (p.31). The exploration of bad education and bad governance through Shelley and social history is other-worldly in itself. Hunt's conclusion which includes 'Wollstonecraft was the pivotal figure in the process of refracting ideas of AI from Hobbes to Shelley, ...' left me wondering about the refactoring of code. 

Chapter 3, Smith's Faith, Tech, and Ethics of AI brings more reflect -ion with the bonus for me of Descartes. On faith, the human situation is also repeatedly stressed. Delving into creation too, this is detailed on forms of theology - Augustine, Bede, for example, and philosophy Bacon, Hume, Kant and their role in diminishing the influence of religious thought and epistemology (p.39). How long a push was that? Surely it is ongoing - in some quarters? Medieval thought is discussed, and I recall this broad period also being regarded as misunderstood [Medieval Philosophy - Bryan Magee & Anthony Kenny (1987)] . 

On a personal level, I've always placed belief in the intra- interpersonal domain of Hodges' model. In psychosis, depression, anxiety, phobias in short mental health, beliefs can be disrupted, and influenced of course when all is well. Religion I have framed at the individual and socio-political level. Clinically, it is the individual patient's beliefs, if they follow a particular religion that we also need to be cognizant of as health personnel. Machine, or human; object or being as Smith asks:

SELF / INDIVIDUAL  -  OBJECT / THING

|

      INTERPERSONAL    :     SCIENCES               

HUMANISTIC  --------------------------------------  MECHANISTIC      

 SOCIOLOGY  :    POLITICAL 

|

GROUP

the human - the machine -	- can become machine - can become human
socio-	-political

There is depth of discussion too: in AI and Power; a Christian response to AI ethics. This handbook is not just for quick reference. There is indeed redemption (p.43) to be found:

'It is easier to cover a blemish than examine why it resulted in the first place: genetics, diet, stress, or lack of self-care.'

I argue for Hodges' model as a tool to identify, (re)present, and relate the determinants of health: all of them. The points and paragraphs on theology, mind, body and self are well worth revisiting.

Johnson's chapter 4, What are Responsible AI researchers really arguing about? provides support for my ongoing belief in the value of sociotechnical theories and approaches, and another book on enactivism. Given the ethics of the global south (and technological/electronic colonialism) more could perhaps be made of LMIC, but the point is made in Table 4.1 (Examples of functionalist evaluations of AI models, p.52). Constructivism 2.2 is a rich seam for me. Table 4.2 touches on medical diagnosis and socio-technical. Johnson notes that in seeking answers to AI ethics problems, scientists see constructivist approaches and '.. constructivism as a metaethic, holding a rich space for more research into pluralistic AI-Alignment', (p.53). And, the potential for much more. This is suggested (for me) in reference to the need for a holistic view of AI model's genesis, and 'two sides of one coin' - dichotomy, polarity, oppositions, binary reductions ... ? 

Johnson's conclusion is an indirect thumbs up (cue Arnie style - of course) to Hodges' model as a project. Conceptual frameworks can indeed:

'... offer unique perspectives on the methods commonly employed and to understand and mitigate the risks and dangers of AI.' (p.62).

If ethics gets 'technical' then the book's full title is well-earned. Two case studies demonstrate functionalist and constructivist debates in responsible AI. I don't remember Capt. Kirk et al. stating to a malign alien 'intelligence' "The trophy doesn't fit in the suitcase because it's too large (small)," (p.58). The writer's put other solutions to the characters lips. Spock, however, would find the discussion here on 'Artificial General Intelligence, 4E Cognition and Enactivism' - "Fascinating!"

Much more to follow ...

Handbook on the Ethics of Artificial Intelligence. David J. Gunkel (ed.). Cheltenham, UK: Edward Elgar Publishing Ltd. ISBN: 978 1 80392 671 1245
https://www.e-elgar.com/shop/gbp/handbook-on-the-ethics-of-artificial-intelligence-9781803926711.html

Book review: Handbook on the Ethics of AI #1

Related previous posts: 'general + AI'

Oh dear! I forgot to ask the nurse (doctor)....

Hodges' model introduction II:

The view from the other side of the fence

Have you ever been to see the doctor or nurse and shortly after leaving the surgery, or clinic you've remembered something? These days - very sadly - many people go to the doctor to seek help for their memory, but for others this is a fact of that frustrating mix of vital questions and issues to raise amid recognition that the time of nurses and doctors is very precious.

This post introduces a framework that can help people to prepare for a consultation and maintain a record of just where their care situation is up to. The framework in question is called Hodges' model. It is named after a retired Senior Lecturer - Mr Brian E. Hodges who lives in Sheffield, England. Brian Hodges created the model to help nurses and community staff ensure the care they deliver is holistic. Holistic in this sense means covering all the essential aspects that contribute to health and well-being, so that includes physical, emotional and mental and even spiritual health.

If you need to go into hospital you do not want to be treated like a faulty machine. Of course, in an emergency those machine-like things we do like heart beat, respiration, temperature regulation are of central importance. Should you ever need emotional care for a severe mental health problem then you would also expect that your physical needs are taken fully into account. Amidst these aspects of care the health care team must also pay attention to culture, equality, diversity and access to services.

Although the model was developed in the 1980s its relevance and potential increases in all the time. This is because of the following:

* health care and medicine is increasingly complex;
* people may have long term and multiple chronic problems;
* education is essential to 21st century care management - as people are expected to 'self-care';
- people may also be managing their own care budget and so need information and 360 vision;
* policy makers stress the need for 'patient choice';
* high quality health and social care is very expensive;
* as people live longer and may have several relationships spanning cultures and belief systems the notion of a health career is the career.

Hodges' model builds on two basic facts of life (and death):

From your point of view and that of any health or social care professional your health is about you - an INDIVIDUAL.

Your health affects other people - most significantly your family. Rather than you being ill, you may of course be a carer having to look after a relative. Also affected are work colleagues, the wider community through to whole GROUPS of people.

We now talk about medicine, well-being, and health in terms of global health since the population of Earth is so tightly linked and interdependent.

In order to maintain health there is a need to diagnose and intervene - or assess, plan, intervene and evaluate. Here the model can also take into account ethnic and transcultural aspects of health. Diagnosis and intervention in Western medicine is frequently MECHANISTIC and this is balanced (remember that HOLISTIC part of the model) by the need for HUMANISTIC interventions. This is what we mean by 'bedside manner' and people being 'caring'. The ability to empathise with others and develop a therapeutic rapport after physical and emotional trauma is a great gift - that while often innate can also be learned and honed.

Once Brian Hodges had identified the following dimensions of care:

INDIVIDUAL - GROUP and HUMANISTIC - MECHANISTIC

he considered the types of knowledge that health and social care workers need to not only do their job safely, effeciently and effectively, but also help people to help themselves. This led to the FOUR CARE or KNOWLEDGE DOMAINS, each covers a key aspect of care:

SCIENCES: e.g. anatomy, physiology,healing process, drugs, risk, diagnosis...

INTRAPERSONAL: e.g. mood, thinking, beliefs, communication, education, learning, coping...

SOCIOLOGY: e.g. relationships, roles, meaning, groups, resources

POLITICAL: e.g. choice, consent, autonomy, policy, legislation, finances

Students - young and mature - who decide to study health and social care can use the model to help them reflect on critical events in their training and learning. The model can help them gain some insights in completing essays and case studies integrating knowledge and experience. When you think about it: if it essential that care professionals are able to have an effective dialogue with patients and the public then they should also be capable of having an effective 'dialogue' with themselves.

Members of the public can also be taught the model to help them appreciate the factors involved in their care programs, solutions and ongoing management if required. Hopefully this brief explanation sheds some light on the model's mantra:

Hodges' Health Career (Care Domains) Model: h2cm
h2cm: help 2C more - help 2 listen - help 2 care

Hodges' model is no universal panacea it is just a tool; but while services stress the need for person-centered, integrated, value-for-money, high quality services ... built on respect, dignity, trust and choice - YOUR health career matters.

h2cm can help pull the many threads together....

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On the website's homepage there are four introductions based upon the care domains. Each one addresses a particular audience: learners (SCIENCES); patient (INTRAPERSONAL); carer (SOCIOLOGY) and policy maker / manager (POLITICAL). They all need updating (re-writing?!).

If you would like to contribute to this exercise please contact me through twitter or at h2cmng at yahoo.co.uk

Boxing 'II'

As young children we may encounter 'boxing' quite early on. This first experience, which we may or may not wholly remember is undoubtedly critical to our personality and subsequent psyche. Such early experiences influence our ability to 'look after ourselves', how we deal with bullies, anxiety, the potential for conflict and develop assertiveness skills. When a 'scrap' happens it can be quite sudden, that total impact of everything out of control, sheer danger and literal impacts. The environment might be nursery, playground, cloak room and the presence of peers as onlookers can be another key factor.

In the late 1960s early 70s I found some old boxing gloves under the stairs at my nan's. I had a handful of uncles on mum's side (just two now - Uncles Tom and Ken!) and the gloves had clearly been swung and jabbed down the line. I don't count myself as a fighter, unless someone tries to push their beliefs - without invitation - down my throat. Then it will be more a case of a reflex action. The 'arc' being comprised of vomit. In the school playground I learned to talk my way out of trouble, resorting to humour at times; as you learn to deploy whatever intellect you might have judiciously. Legs are essential to a boxer:

“First your legs go. Then you lose your reflexes. Then you lose your friends”

Willie Pep

My legs helped me a time or two.

Not too many years ago, so a new generation is in the frame and a nephew had boxing gloves of his very own. He trained with a local club and had some fights. I didn't go watching, but didn't make too big a big fuss either. He doesn't box now as it happens; he's married with family and busy earning a living. Over four decades I've cared for several gentleman, former boxers who developed dementia. Hence, my lack of enthusiasm. (Although the selective literature listed below does not reflect it, women's boxing is of course also well established.) The extent to which boxing caused their dementia is not the point here. It's trying to acknowledge the ongoing debate: the risks, the history (Ancient Greece 688BC), the discipline, sense of belonging and self-respect it can instill. Of course a great many sports can do this. Of course, I listened very attentively as one gent could still relate how perhaps he had been 'used' in terms of the fights and purses back in the 50s-60s. Vulnerable adults of today and yesteryear. Today American Football is concerned about head injuries, in football heading the ball repeatedly is in the news. Technology should be able to reduce the risks even more and protect individuals from injury that is obvious and more insidious in nature.

Some of these points I've considered in Hodges' model as follows:

individual

|

INTERPERSONAL : SCIENCES

humanistic ---------------------------------------  mechanistic

SOCIOLOGY : POLITICAL

|

group

SELF self-awareness Identity self-belief way-finding dementia - cognitive damage personality change aggression tactics  strategy motivation training attitude self-discipline ethics mental health - mental capacity emotions mood Personal safety	boxing technique reflexes speed movement balance punching fitness weight, reach, statistics THE RING stamina nutrition hydration concussion sub-concussive exposure models unconscious knockout Head - Brain injuries physics: force time (duration) momentum technology - sensor equipped gloves Sports Medicine Research Headgear Safety - Evidence Medical risks
OTHER Ethnographics Coaches <-> Boxers Mentors Support network THE STREET personal history-family History sports history trainer friends club Sporting behaviour family friends Socio-	Rules (changes) Conflict Power promotion media finance codification rules Amateur Professional Refereeing Regulating bodies Governance Law Contracts Economics

Selective reading:

Sacha, J. (2017). Fighting Feelings. Sociological Perspectives, 60(1), 77-94.

Erlanger, D. (2015). Exposure to sub-concussive head injury in boxing and other sports. Brain Injury, 29(2), 171-4.

Falvey, &., & Mccrory, P. (2015). Because not all blows to the head are the same. British Journal of Sports Medicine, 49(17), 1091.

Mcintosh, A., & Patton, D. (2015). Boxing headguard performance in punch machine tests. British Journal of Sports Medicine, British Journal of Sports Medicine, 14 July 2015.

http://www.welshboxers.com/quotes/

See related post 2016: 'Boxing' I

Conceptual spaces and innovative environments

Continuing to read Scott Berkun's the myths of innovation there is a really useful reference and illustrative source for Hodges' model.

The reference I must chase is - according to Berkun on page 90 - Alex F. Osborn's excellent book Applied Imagination. It is Osborn who apparently coined brainstorming and the management and creative industry of which Hodges' model is a (small) part. There's much more here as the original brief on how to - has been corrupted, consequently failed in application and lost its potential.

Later in the text Scott highlights the importance of environment and management's contribution to creating and protecting innovative assets (teams), that may not be valued in the rest of the organization. Berkun quotes Tom Kelly (IDEO) who notes that:

Innovation flourishes in greenhouses. What do I mean by a greenhouse? A place where the elements are just right to foster the growth of good ideas. Where's the heat, light, moisture, and plenty of nurturing. The greenhouse we're talking about, of course, is the workplace, the way spaces take shape in offices and teams work together. p.103.

Guess what - does this h2cm translation make sense to you....?

Light	Heat
Moisture	Nurturing

'Light'? Well I know there's E=mc² but here it's about purpose, leadership, spirit and belief.
'Heat'? This is the current physical element, technical white heat, global heat and need.
'Nurturing'? Great managers nurture and create the political space for innovation.
'Moisture'? Well this is to be found in the sociological domain: think about it....! ;-)

I never thought of Hodges' model as a greenhouse, but then it is far more than a brainstorming plug-in. Maybe it can act as a catalyst for change for you?

h2cmng AT yahoo.co.uk

Ref. Osborn, Alex (1953). Applied Imagination: Principles and Procedures of Creative Problem Solving. New York, New York: Charles Scribner's Sons. ISBN 978-0023895203.

World Mental Health 'Day' - what about the night shift?

For convenience sake our lives usually follow the sun's traverse. The majority of events associated with World Mental Health Day will take place during office hours and early evening.


I am looking forward to a local event in Leyland, Lancashire on Monday, which includes speed dating. This will provide that 10-15 minute opportunity to share and obtain information about other services and people involved in local mental health care. The agenda looks excellent and includes the active participation of carers and service users.

So, what of World Mental Health 'Day'?

Mental health - like all health and social care is a 24 hour affair. How often do we forget this? Of all the care (knowledge) domains I write about here, mental health remains the 'silent one'. If you have had worries, anxiety and much more besides you know full well there are actually 24 hours in a day and the silence is not because 'mental health' sleeps. So 'Day' is quite apposite in shedding light on what remains a poorly understood and  stigmatised aspect of health care and our lives. 

Comprising all four declared domains and uncertainty - the spiritual domain is not referred to in Hodges' model explicitly and yet in our day-to-day existence spiritual matters figure in lives just begun, journeys ongoing and lives at an end and people remembered. Whether we practice a religion, follow a belief there is no escape from news that relates to religion. Strange then: not listed in Hodges' model and yet more evident and prevalent than mental health it seems. In my career I have noticed how religion and mental health can be very uncomfortable companions for some individuals. One exacerbating or being the cause of problems in the other. By the same, or maybe a different token, religion is also a great source of comfort, solace, affirmation, peace and reconciliation for many and a crucial resource through the many people who work under the auspices of the World's religions.

I have tried to catch this 'relationship' in my categorization of links in the INTER - INTRAPERSONAL domain which includes:

Psychology, Mental Health, Therapies, with Philosophy, Ethics, Ideas, Context, Creativity, Theology and Inter-Transdisciplinary resources.

So wherever you are, I hope you find peace especially through this day and night, whether or however you illuminate your mind, heart and soul.

Image source: http://www.daily-tangents.com/ImageCat/ErthMoon/
and NHS various.

Visual Methodologies Workshop in Newcastle

After Oxford Drupal Education Camp this Friday-Saturday proceedings move on to a NE workshop.

If your focus is on person-centered health care then the volume of data involved that pertaining to the individual can be readily apprehended. At least the example of a single episode of care. Of course, there are exceptions, people who might be the subject of special case studies so complex is their condition and pathology. Data volumes do vary markedly from person to person. A great deal of generated data in an individual instance might be taken for granted. In the reported findings, for example, of an MRI scan that is included in a referral. When provided existing diagnoses do much to enrich the information and knowledge contained in a referral, whilst reducing possible avenues for further data gathering.

Once we move from individuals to groups and populations then the volumes involved quickly become massive. Purposes and context reflect this change in scale; codified, anonymised, aggregated the individual is lost.

Both my day-to-day work and study of Hodges' model (in nursing, informatics, literacy...) are centered on individuals. 'Caseness' in a clinical word: a referral, home visits for the day, face-to-face interaction, care concepts in assessments, plans. ... Then there is envisioning a nurse-patient (carer) interaction, or individual's episode of care through Hodges' model. As per the model's structure, however, groups and populations must also be represented. This duality of personal and data scales makes this workshop on visual methodologies of instant relevance. The two days next week cover (with my emphasis):

Introduction to working with visual methodologies: understanding epistemologies and disciplinary boundaries

• Mapping
• Story-boarding
• Artefacts

Quality in visual methods: ethics, validity and reliability
Doing visual methods: lived examples of managing data capture, synthesis, analysis and dissemination
Modes of analysis: focusing on methodological and epistemological influence on the research process

Workshop part 1: working with self-created data
Workshop part 2: creating shared analytic frameworks for self-created data
Overarching ideas and ways forward for thinking about visual methodology

Hodges' model can be readily interpreted and presented as a map and a series of story boards. The model can also support analysis, synthesis: well, this is my belief that is shared by some people.

I have completed modules on research methods, but it seems increasingly that research methods, methodologies, data structures and algorithms overlap. It may be that advances in media, technology, data gathering and improved access to data sets is having this effect. Perhaps more integrative and open attitudes (interdisciplinarity) towards quantitative and qualitative research also accounts for this blurring; or it could just be me? Whatever is the case, I'm really looking forward to the programme, meeting the facilitators and students. I am hoping this will inform my project as per the aims of the workshop:

• Consider the role of visual methods in data collection, research ethics, synthesis, analysis and dissemination;
• Explore the theoretical prospectives, epistemological traditions and latest practices that have shaped the development of visual methodologies; and
• Enable participants to translate how visual methodologies can be used to support their own research.

I'll try and post from Oxford this Friday - Saturday and from Newcastle next week. From Newcastle I'll be heading to Edinburgh for the Scottish Ruby Conference. Lots to follow as I put 10 days unpaid leave to use.

So, I can proceed, fall flat on my face - [ concepts-maths iii/iii ]

- and utilise the inevitable!

'Decades after struggling to understand math as a boy, Alec Wilkinson decides to embark on a journey to learn it as a middle-aged man. What begins as a personal challenge—and it's challenging—soon transforms into something greater than a belabored effort to learn math. Despite his incompetence, Wilkinson encounters a universe of unexpected mysteries in his pursuit of mathematical knowledge and quickly becomes fascinated; soon, his exercise in personal growth (and torture) morphs into an intellectually expansive exploration.' 

https://us.macmillan.com/books/9781250168580/adivinelanguage/

 

A Divine Language

As observed many times in the literature and here on W2tQ writing about Hodges' model, healthcare - medicine and nursing are both a science and art. Hodges' model is an invitation to the arts in liberal form, with an emphasis on practice: social sciences, humanities, physical sciences and even mathematics. 

There is now quite a bank of posts on W2tQ tagged art/arts and more specifically prints. I still plan to attend a workshop on printing. As ever, in my head, my mind's eye - I've an amazing, brilliant .. (!?) arts project, just waiting to be released. A true collage of the care concepts.

If Hodges' model is 'simple' in its basic form, then it is clearly possible for other people to create their own artistic impressions, interpretation of Hodges' model. My effort would of course be unique, as would theirs. There could be a competition and I end-up missing out. Not even short-listed for a prize; a victm of familiarity perhaps? 

Quite 'naturally' in a way, or at least by way of childhood experiences, a need for therapy and validation; I have also arrived at a belief that there is a mathematical project here (Oh, for goodness sake! Is there no end to this?). 

As posted before, like Alec Wilkinson I am no mathematician. Embarrased, shamed to a husk at school on many occasions, I encountered math teachers who must have empathised. Well, that's one way to explain the appreciation of maths I have always felt. Or more accurately, a love of knowledge; of which maths and logic are a part? Since I can hardly understand, I am more in love with the idea of maths, than mathematics itself. I have always been in awe of maths and people who 'get it', even if that is only  mastery of the high school mathematics curriculum.

Convinced that there is more to Hodges' model than meets the eye, I have thought of following Wilkinson - who tries to be systematic - to underpin a book - back into the nightmare lands of my youth. Should I retake GCSE maths? 'There be dragons', without a doubt. The heat can be recalled, like it was yesterday. This isn't just a dragon, it is a chimera. At times it wants to be a friend, providing familiar terms, domain, set, and group. Wilkinson's quest is structured and seeks a reasoned and disciplined approach. Why am I bothering? I have a choice surely? Nursing, health, global health can all collectively furnish many items of epistemological fruit. No need for calculative flagellation. Through Hodges' model you can productively span the disciplinary bridges once again: call in - sociology, economics, policy and more. How many Königsberg bridges do you need?

While the artist in me, might waste time. In pointing to Hodges' model as a potential mathematical object, this little seed might fall on fertile and (much) more capable ground(?), as Wilkinson describes:

'Mathematics might be the only creative pursuit in which inevitability figures. Other artists might be defeated by a task beyond their capabilities, but they do not live with knowing that sooner or later, if their work is consequential, someone will do what they haven't been able to do. Mathematicians work within a discipline in which, so long as their suppositions are correct, there is always a precise and irrefutable answer, even if they can't find it.' p.135.

I can hope for this at least.

Alec Wilkinson. (2022) A Divine Language. Learning Algebra, Geometry, and Calculus at the Edge of Old Age. New York: Farrar, Straus and Giroux. https://us.macmillan.com/books/9781250168580/adivinelanguage/

Previously: How 'divine' is the language of care?

Rediscovering nursing ...? [ concepts-maths i/iii ]

Care concept engineering - anyone? [ concepts-maths ii/iii ]

n.b. At some point I will go though all the posts and unpublish/delete items that add little to the core.

Submit your pitch for Black History Month 2025

London Arts and Health
and The Culture Health and Wellbeing Alliance

To celebrate Black History Month this year, London Arts and Health and The Culture Health and Wellbeing Alliance will commission six artists to explore and showcase their creative practices. This initiative is rooted in the belief that the arts can be a powerful force for health, climate justice, and cultural empowerment.

More details ...

Evidence-based care: The original Gordian Knot

or - Choose your audience carefully.

Within health and social care (and other - safety-critical - academic and professional fields) evidence-based care is pivotal as proof of safety, reproducibility, effectiveness, efficacy, professionalism, and benefits for the subjects of care and public. How best then to prove the scope, scale, relevance and safety of Hodges' model? How to demonstrate in theory and practice the utility and increasing relevance of Hodges' model? There are times I have to temper my belief, passion and enthusiasm for h2cm; am I too ardent, and at risk of coming across as preaching? There is a further tension. The one that is constant: language.

As a nurse, attention to language and terminology is vital to effective communication, establishing and sustaining rapport and empathy. This concern applies across situations, contexts and encounters; with patients, patient and carer (family), and colleagues. We are encouraged to avoid jargon, abbreviations  and technical terms. I use Hodges' model implicitly (aide-mémoire, assess, plan, evaluation, prioritise) and explicitly - sharing the model on some occasions but not all.

In the role of researcher / author, the audience, especially - editors, reviewers, and readers have expectations in how concepts, ideas, theories are expressed and explained. To a degree, the very title of a publication, preempts the language to follow. As I present, or write, sources must be declared and  referenced. Again, resort to jargon is discouraged. Clarity and brevity are strengths. And yet how likely is it that at least 1/3 reviewers will demand more technical rigour and explanation? If terms are used from other disciplines, the expectation follows that their cross-disciplinary application is explained and argued for, and meanings differentiated.

With potential theoretical underpinnings for Hodges' model to be found in Gärdenfors's Conceptual Spaces, and Meyer & Lands's Threshold Concepts and others (nursing and healthcare no-less); John D. Cook provides additional pause for thought - as I look even further afield:

"When I was in college, I sat in on a communication workshop for Latin American preachers. ...

Another lesson from that workshop, the one I want to focus on here, is that you don’t always need to convey how you arrived at an idea. Specifically, the leader of the workshop said that if you discover something interesting from reading the New Testament in Greek, you can usually present your point persuasively using the text in your audience’s language without appealing to Greek. This isn’t always possible—you may need to explore the meaning of a Greek word or two—but you can use Greek for your personal study without necessarily sharing it publicly. The point isn’t to hide anything, only to consider your audience. In a room full of Greek scholars, bring out the Greek.

This story came up in a recent conversation with Brent Yorgey about category theory. You might discover something via category theory but then share it without discussing category theory. If your audience is well velrsed in category theory, then go ahead and bring out your categories. But otherwise your audience might be bored or intimidated, as many people would be listening to an argument based on the finer points of Koine Greek grammar. ...

Some things may sound profound when expressed in esoteric language, such as category theory or Koine Greek, that don’t seem so profound in more down-to-earth language. Expressing yourself in a different language helps filter out pedantry from useful ideas. (On the other hand, some things that looked like pure pedantry have turned out to be very useful. Some hairs are worth splitting.) 

Sometimes you have to introduce a new terms because there isn’t a colloquial counterpart." ...

 Category theory and Koine Greek: John D. Cook. 

Category theory and Koine Greek: John D. Cook. 
https://www.johndcook.com/blog/2016/06/27/category-theory-and-homiletics/

See also: Applied category theory: John D. Cook

https://www.johndcook.com/blog/applied-category-theory/

BBC Radio 'File on Four' - DASH to Instrumentalise

Of course, I'd like to see Hodges' model applied to many purposes.

As probably posted at some point, the thought of Hodges' model being instrumentalised goes back a long way. To the time of microcomputers in fact and 'CAPA' which stood for 'Computer-Aided Patient Assessment':

Jones, P. (1986) Computing in Nursing NEWS. Computerised Patient Assessment. Nursing Times. 85: 5. Sep 3-9;82(36):63-5. PMID: 3532039

[Describes 'CAPA', a BBC BASIC microcomputer program for student nurses.]

Even before discovering Hodges' model in the late 1980s, I was sensitive about being seen to mechanise nursing and care delivery. Nursing was still preoccupied with the nursing process and individualised care. The last thing I would want is to be seen as supporting the processing of patients. The person, their social context and identity becoming lost. It was a long-term and ongoing co-author who drew my attention to Hodges' model as an instrument. Which I've considered for each and across the care domains. CAPA was simplistic, even beyond the programming language employed. A dependency score from 1-5 was allocated (it's a long time ago!) to each of the activities of daily living for a patient:

Roper, N., Logan, W., & Tierney, A. J. (2000). The Roper-Logan-Tierney model of nursing: Based on activities of living. Churchill Livingstone.

In healthcare we are trained and become accustomed to the use of many assessment tools, checklists; this includes mental health nursing and specific therapies. Emphasis, is rightly placed upon the safety, validity and hence testing of tools. Some are 'broad brushes'. Others are specific - outcomes, anger, a carer's knowledge, conviction of belief, mood, impulsivity and many more. Drift away from the original goal and purpose and problems can (predictably) ensue. Training will and must be updated, but do all assessment tools have a 'Use By' date? Hopefully there is ongoing development, version control and sustained trials and testing of the instruments themselves.

'File on Four' BBC Radio 4 this evening concerns DASH, which stands for "Domestic Abuse, Stalking and ‘Honour’- based abuse".