In 1877, William Kingdon Clifford propositioned in his book â€œEthics and Beliefâ€ that belief in something without sufficient evidence is irrational. Whilst he accepted that in many beliefs there is often an epistemic gap between the evidence and the conclusion (inductive reasoning) he did also claim that â€œIt is wrong always, everywhere, and for anyone, to believe anything upon insufficient evidence.â€ Furthermore he claimed that that tolerating credulity (a tendency to believe readily) and superstition will damage ultimately society. He concurred with David Hume (1711-76) when he said â€œAll wise men proportion their belief to the evidence.â€ This stance â€“ that belief without sufficient evidence is irrational â€“ is called evidentialism, and is adopted by many atheists (including Clifford and Hume) in their view of theology. However, natural theology instead attempts to meet evidentialism on its own terms by trying to show that belief in God is actually rational. It draws collectively upon all of the a posteriori arguments for Godâ€™s existence including the teleological, cosmological, moral and experiential arguments. However, it is rare that an atheist will be convinced by the evidence of these arguments anywhere beyond the point of agnosticism. It is generally accepted that belief in God requires some element of seemingly irrational faith. Indeed, the stance of fideism states that reason plays no part in belief. â€œWhoever attempts to demonstrate the existence of Godâ€¦is an excellent subject for a comedy of higher lunacy.â€ â€“ Soren Kierkegaard. Moderate fideists suggest that reason can actually be destructive to oneâ€™s faith. They claim that reason leads to arrogance by encouraging the idea that human reason alone will suffice and that God unnecessary for moral or spiritual direction. Whilst moderate theists view reason as a barrier to true faith however, (thus disregarding natural theology as irrelevant) extreme theists go so far as to agree with Tertullian when he said (AD 155-222) â€œCredo quia absurdum est.â€ or â€œI believe because it is absurd.â€ Aquinas (1225-74) claimed that there were two ways in which to know God. The first is through natural theology, including his five a posteriori proofs constructed by human reason. The second is through â€œrevealed theologyâ€ which cannot be found by human reason alone, but must involve divine intervention or revelation. The acceptance of these revealed truths requires faith, and this is fundamental to the Christian religion. For example, only faith can reveal the truth behind the statement â€œGod is the father, the son and the Holy Ghostâ€ or that â€œthe bread of communion is the body of Christâ€. Thus revelation provides us with a body of truths, which must be taken on faith alone. Aquinas claims that faith is a combination of reason and opinion. It involves reason since it is propositional i.e. claims certain beliefs to be true and therefore similar to scientific knowledge. On the other hand these truths cannot be proved, and so involve an epistemic gap. It is this epistemic gap that makes faith a matter of opinion and so allows humanity free will over their belief. The stance that it is our choice whether or not to take a leap of faith was also held by Soren Kierkegaard (1812-1855). Alvin Plantinga (1932-) proposed that the classical foundationalism upon which evidentialism is based is flawed. Foundationalist beliefs are described by Plantinga as â€œthe starting points for thoughtâ€ and he summarises their definition as: â€œI am entitled to believe X without any evidence if and only if it is self-evident, incorrigible or certain to me in some wayâ€. He argues that this is flawed, since this statement is itself neither self-evident, incorrigible nor is it certain in some way. It appears therefore that foundationalism defines itself as irrational. He also states that there are many beliefs that can be held rationally, but that do not fall under the foundationalist criteria or that can be justified contingently. For example, the trust we have in our memory, or the belief that other people have minds of their own. Plantinga argues that we must ultimately reject classical foundationalism on the grounds that it is incoherent, and also because it rejects many beliefs that common sense tells us to be properly basic. He propositions that his reformed epistemology should take the place of classical foundationalism, and because of this: â€œIt is entirely right, rational, reasonable and proper to believe in God without any evidence at all.â€ A theist might claim that it just appears obvious to them that God exists, and for Plantinga this is good enough. However, surely this would mean that anything we like can be a properly basic belief? Could a childâ€™s belief in Santa Clause not be defined as properly basic? Plantinga would respond by saying that it is the beliefs directly connected to Godâ€™s existence that are properly basic, rather than the belief in Godâ€™s existence itself. For example, the guilt felt after committing a bad deed or the sense that something must have created and designed the universe. BlaisÃ¯Â¿Â½ Pascal (1623-1662) deemed that it was reasonable to have faith in God by a sheer act of will, so certain was he that he put forward a wager: â€œLet us weigh the gain and loss in wagering that God is (exists)â€¦If you gain, you gain all, if you lose, you lose nothing.â€ By this, he meant that the theist stands the chance of gaining entrance to heaven at the risk of nothing, whilst the atheist however risks damnation to hell. However, surely this basis of self-gain is at odds with the teachings of the Christian church? W.K.Clifford suggested that God would deny heaven to those who followed Pascalâ€™s wager on the basis that faith should be founded upon trust and morality, not self gain. Pascal might have responded that true belief would arise from the habit of religion i.e. baptism, mass, prayer etc. However, this is contradicted somewhat by his opinion that oneâ€™s relationship with God should be somewhat deeper. â€œIt is the heart which perceives God and not reason.â€ Furthermore, Pascalâ€™s definition of faith appears to ignore the recognition of Godâ€™s immanence and His affect on our everyday lives. William James (1842-1910) found Pascalâ€™s proposition that we can change our beliefs by an act of will entirely ridiculous. He claimed solidly that our beliefs are contingent i.e. each new belief is connected to the previous one. He does agree however that it is rational to sustain a belief even without sufficient evidence given certain circumstances. The first circumstance is where the evidence is indeterminate between two beliefs i.e. favours neither option. The second circumstance is if we are faced with a genuine option i.e. one that is living, forced and momentous. By living James means one that is a reality, as opposed to a dead option, that whilst theoretically possible, isnâ€™t actually going to happen e.g. a devout Catholic supporting the gay pride movement. A forced option is one that cannot be avoided, e.g. choosing whether to go to school or to have a lie in when your alarm goes off at 7:30. A momentous option is one that is unique and irreversible e.g. joining the army â€“ as opposed to a trivial option which is reversible and one that happens regularly throughout life. James states that it is therefore sometimes rational to believe in God without sufficient evidence if the choice is a genuine option. He disputes Pascalâ€™s wager as necessarily being a genuine option as it is not necessarily forced (one could deny the possibility of going to hell) nor is it necessarily living (one might be a devout follower of a different religion). However, he does accept that for a person who perceives the evidence as indeterminate and is already open to belief in God, Pascalâ€™s wager might succeed in tipping the scales and getting them to make that leap of faith. James does believe however that faith can in some instances be a genuine option, and a decision that involves seizing the opportunity and taking a risk. He states that when faced with a genuine option and without sufficient evidence, making a decision will then reveal the evidence to us. For example, one cannot be sure of a strangerâ€™s kindness until they have decided to trust the stranger and give them a chance. Similarly, by making a leap of faith in God, the definitive truth will be later revealed by eschatological verification. However, natural theologians such as Aquinas would certainly dispute Jamesâ€™ claim that the evidence is indeterminate, for the cosmological, teleological, moral and experiential arguments â€“ whilst inconclusive â€“ can be extremely persuasive. Furthermore, like Pascal, he seems to ignore faith as an acceptation of Godâ€™s immanence and active presence in our lives. The version of faith held by Aquinas, Plantinga, Pascal and James is propositional in that they all claim that faith about believes in Godâ€™s objective existence. However, faith can also be seen existentially as an attitude incorporating God subjectively into the believerâ€™s life. For instance, when I say â€œI believe that murder is wrongâ€ or â€œI believe in free speechâ€ I am not stating anything about existence, but rather about my commitment towards certain values. H.H.Price (1899-1985) claimed that the statement â€œI believe in Godâ€ is similar to this in that it is a way of perceiving the world using certain values. â€œto see oneself as a created, dependent creature, receiving life and well being from a higher sourceâ€¦the only appropriate attitude is one of grateful worship and obedience.â€ â€“ John Hick. To conclude; each of the arguments examined above vary in their relationship with reason, but what they all have in common is that faith is central to the believer and must work independently of reason to some degree. Some of the arguments incorporate reason, some reject it entirely, but the transcendent nature of God can never be proved, can never be indubitable, for faith is an integral part of religion. Perhaps then natural theology is not trying to prove Godâ€™s existence to the point where faith is cast out and certainty resides in its place, but rather it is merely trying to explore Godâ€™s nature. â€œI do not seek to understand so that I may believe, but I believe in order to understandâ€ â€“ St. Anselm (1033-1109) Proslogian 1. Natural theology could therefore be seen as an expression of faith, rather than a foundation for it. The majority of theists argue that faith is necessary, for if God proved himself to us, we would no longer have free will over our belief and so would be robots without dignity. On the other hand, surely God in His omnipotence could find some way of maintaining our freedom whilst simultaneously providing us certainty of his love? Why not give certainty to the millions of His helpless and suffering children who have lost faith; for where is their dignity?
The Institute of Medicine Report Essay The impact of the Institute of Medicine report on nursing education suggests the nursing profession should have a more advanced education system providing limitless opportunities for growth. The future of nursing providing care to the entire realm of health care, especially primary care and community settings, will be determined by the evolution of a new educational system. The IOM report states that sixty percent of hospital employed nurses will be impacted by the Affordable Care Act because of the transition of patients to primary and community health care. (National Research Council, 2011) Tension in the current educational system has been steadily increasing due to the newly required nursing skills in many specialty areas. That being said, the new educational structure will have to be expanded immensely. The IOM report suggests increasing the number of baccalaureate nurses from fifty to eighty percent by the year 2020. (National Research Council, 2011, p. 12) The report also suggests doubling the current number of nurses with a doctorate degree. Reaching these goals along with overcoming many other educational obstacles will require many changes and modifications to the current system. Increasing the use of technology to educate nurses through on-line programs is one necessary effective strategy. This will create continuous opportunities for nurses from all ethnic groups with associate degrees to obtain their baccalaureate and masterâ€™s degrees. Leaders of organizations, hospitals, accreditors, philanthropist, employers, etc. should work cohesively to secure funding for these educational programs. Generating more diversity in nursing will help meet the demands of the projected increase of ethnic groups receiving health care due to the ACA. Intra-professional diversity has been suggested by the IOM report too. (National Research Council, 2011) It is recommended that nurses, physicians and other health care disciplines should be educated together as students and their professions. The IOM report suggests utilizing a nurse empowering trend by hospitals around the country. This trend consists of health care organizations encouraging their nurses with associate degrees to enter into baccalaureate nursing programs within a few years of graduation or hire. (National Research Council, 2011) Impact of the IOM Report on Primary Care Nursing Practice The impact of the IOM report on primary care nursing practice suggests a direct link to the conversion of the education system. With specialty care expecting to diminish, primary care is foreseen to generate large numbers of health care consumers in the near future. People across the country will have increased access to primary care. Therefore, it is speculated that primary care nursing practice will require more opportunities and faster transitions for the advancement of nurses to obtain BSN, masterâ€™s and doctorate degrees. Advanced practice registered nurses should have a huge role in the success of primary care. Since there are few APRNs practicing in primary care settings then there will be plenty of opportunity for this group to grow. If these ideas do not evolve as projected then nursing shortages for primary care providers could impede nursing care. The IOM report states that continuous updates to nursing practice and education should be created by collecting and analyzing data from each role and scope of practice. (National Research Council, 2011) The collected data will also be used for future predictions of health care professional requirements in each setting. My Practice Changes in Regard to the IOMâ€™s Report My practice changes in regard to the IOM report in many ways. It is not rare that my unit admits children who are over or under dosed on their medication or are prescribed medicines that are ineffective or not recommended for their diagnosis. I could change my practice to meet the goals of the IOM report by providing families and patients information about their mental health diagnosis, signs and symptoms of an exacerbation of their disorder, contact information to our facility and collect their contact information for a discharge phone call. More so, I can provide them with contact information for trained and skilled mental health professionals in their area and have appointments scheduled within a week or two of discharge. I would ask if the information discussed in the discharge meeting is realistic for them and meets their expectations. Another way I can change my practice to meet the goals of the IOM report is by continuing to chair and co-chair evidence based practice projects pertaining to technology. Technology is mentioned in several case studies in the IOM report and I agree that we should continue to find methods to use it being fiscally responsible. Recommendations for the Nurse Leader Recommendations for the nurse leader according to the IOM report are for nurses and physicians to start working as complete equals while providing healthcare. Nursing must contribute more to leadership roles and continue their education in these roles to help provide increased quality care to patients. Nurses must become more fluent in policy reform by becoming more involved as members of committees, councils and legislation. There should be a greater emphasis and expanded education on nursing leadership in educational programs and employer based competencies. Employers should begin or continue incentives for professional development as the IOM report suggests more nurse leaders are required for reform. (National Research Council, 2011) References National Research Council. The Future of Nursing: Leading Change, Advancing Health. Washington, DC: The National Academies Press, 2011. Retrieved from http://www.iom.edu/Reports/2010/The-Future-of-Nursing-Leading-Change-Advancing-Health.aspx