The New Science of Practical Wisdom: A Critical Appraisal

Abstract

I. INTRODUCTION

Since the 1950s, there has been a rebirth of interest in virtue ethics, in part as a result of the publication of G. E. M. Anscombe’s seminal article “Modern Moral Philosophy” (Anscombe, 1958). Subsequently, other scholars, including Alasdair MacIntyre, Philippa Foot, and Stanley Hauerwas, to name a few, followed in the footsteps of Anscombe. From this renewal of interest in virtue ethics emerged a body of work focusing on the study of practical wisdom. Most investigations occurred in the context of moral philosophy and theological ethics, as well as in the philosophy of medicine. However, other disciplines outside the humanities (psychology, neuroscience) have since contributed to research and scholarship in virtue ethics and practical wisdom, which has led to what some have called the “new science of practical wisdom.”

Rowley notes the utility of wisdom lies in “its impact on success at individual, organizational, and community levels” (Rowley, 2006, 1247; cited in Massingham, 2019). Given its general definition as everyday good decision-making, practical wisdom has become a focus for a variety of professions, including medicine, using the insights of psychology and neuroscience. Thus, analyzing practical wisdom critically from a scientific perspective provides future researchers and educators a framework for developing this human ability deemed important in the training of clinicians and in clinical practice. Of course, examining a philosophical concept such as practical wisdom through the lens of science is likely to raise concerns, and for good reason. There is the danger of falling into reductive materialism and biologism, where mental states, sense of self, and behavior are understood and explained mainly by the structural, chemical, and neural activity of the brain. This reductionist interpretation of neuroscientific findings can lead to an overestimation of what natural science (i.e., biology) can say about human behavior. It can result in an overemphasis on neuroscience as the main source of explanation for such notions as self, moral agency, and consciousness, and in a potential marginalization of traditional sources (i.e., the humanities) for insights regarding human behavior (Tallis, 2016). The third-person observational perceptions of the modern sciences cannot exhaust the self-reflexive interpretive insights of the humanities (Taylor, 1989). That being said, it would be a mistake not to include the insights gained through neuroscientific and psychology research, since it has been clearly established through observation how insults to various brain structures due to disease, trauma, or neurological interventions can affect behavior.

A recent article by Jeste et al. (2019) summarizes the historical definitions of practical wisdom within a more contemporary framework. Specifically, the authors describe practical wisdom as a scientific construct constituting a complex set of interacting components. These components reflect the psychological processes of social decision-making, emotion regulation, prosocial behavior, self-reflection, acceptance of uncertainty, decisiveness, and spirituality (Jeste et al., 2019). Importantly, these traits serve both the individual and society in promoting overall well-being (i.e., health, happiness, and life satisfaction). While the authors point to a consensus around the broader psychological processes of decision-making, which allows for the justification of practical wisdom as a personality trait, there is still much to be agreed on to formulate a combined or integrative philosophical, psychological, and neurological consensus of practical wisdom.

This special issue further addresses the philosophical, psychological, and neurological attempts to define practical wisdom in order to foster a broader deliberation of the operational definition of practical wisdom for scientific inquiry. Notably, Jeste et al. (2019) address the biological perspective of practical wisdom, given that biological processes are innate to any psychological process. The authors describe a putative model with limited evidence and acknowledge that such a model is an oversimplification and is likely incomplete. The relevant state of the art exists in how practical wisdom is being measured. As Jeste et al. (2019) note, the scientific measurement of practical wisdom relies heavily on self-report measures. Importantly, they identify a strong relationship between limited objective measures and self-report measures. However, this level of development is insufficient at this point, given the lack of consensus not only for an operational definition, but also for which scientific questions need to be addressed (Ellemers et al., 2019) and how they need to be addressed (Swartwood, 2020).

Philosophically, practical wisdom has been discussed within the context of virtue ethics as a deliberative process or one dependent on a constellation of other virtues. The context of virtue ethics provides additional relevant concepts to consider when defining and measuring practical wisdom. Broadening the psychological perspective to consider the practice of deliberation within decision-making or to examine the contributions of other virtues will advance the understanding of the nuances related to doing the right thing, at the right time, for the right reason toward a moral end. At the same time, with a more developed biological perspective, there can be advancements in the complexity and completeness of the biological model underlying the psychological processes of practical wisdom. Importantly, with a well-developed science of practical wisdom, one can foster behavioral changes in a professional agent conducive to making professionally wise choices. The aim of this collection of essays by experts in the field of practical wisdom is to bring together these multidisciplinary perspectives on the conceptualization of practical wisdom to guide a meaningful integration of concepts of competence and character with care into the education and support of medical professionals.

In the first contribution, “Virtue Monism and Medical Practice: Practical Wisdom as Cross-situational Ethical Expertise,” Mario De Caro et al. argue for the relevance of practical wisdom in the context of medical education and clinical practice. They propose a definition of practical wisdom with paradigm-shifting implications not only for philosophical discourses on virtue ethics, but also for how the virtues are understood and taught in medical education. Specifically, De Caro et al. define the practically wise person as an expert in the domain of morality—someone who, relative to others, “possesses outstanding moral perception, deliberation, emotion regulation, and motivation in all-things-considered decisions” across the moral domain (De Caro et al., 2025, 88). The authors thereby propose an “Aretai model,” an integrated, monistic account of the virtues in which practical wisdom is a necessary and sufficient condition. The virtuous life relies only on the possession and exercise of practical wisdom, such that other traditional virtues like fortitude, temperance, or justice are labels for the manifestations of practical wisdom in different situations. The upshot of the model for medical education is a shift in focus toward cultivating an expertise—a capacity for moral perception, deliberation, emotion regulation, and motivation—as opposed to a list of character traits and their associated behaviors. The relevance of practical wisdom for medical practice, on this account, is therefore greatly elevated. To be sure, whether the model is valid and how it should work in actual pedagogical practice remain open questions, and the authors allude to the need to pursue further corroborating empirical investigations. That being said, their model and its practical application hold much potential.

While De Caro et al. adopt practical wisdom as a relevant concept in medical education and for clinical practice, Christian B. Miller’s contribution, “Challenges Facing the Appeal to Practical Wisdom in Medicine and Beyond,” outlines key challenges in developing a comprehensive account of practical wisdom. His contribution first highlights the renewed scholarly interest in practical wisdom, both within virtue ethics and in professional fields like health care. Subsequently, Miller acknowledges that there is consensus regarding what practical wisdom is but also remarks that there is a lack of agreement about what practical wisdom is supposed to do. Thus, he raises five challenges concerning the nature and function of practical wisdom and asks whether it aligns with objective moral truths. The first challenge, the Arbitrariness Challenge, questions whether the various accounts of practical wisdom put forward offer a list of functions to practical wisdom that are justifiable and do not exclude other perspectives. The Independence Challenge highlights the difficulty of determining whether practical wisdom truly operates independently from other virtues or whether, as Miller puts it, “[practical wisdom] swallows up all the moral virtues,” which leads to the third challenge, the Unity Challenge (Miller, 2025, 97). Here the issue is to determine how practical wisdom, and its multiple functions, can be carried out by a single character trait. The next challenge, the Objectivity Challenge, aims at probing whether the current accounts of practical wisdom and its functions can be objective and therefore, in its implementation, can remain impartial, especially when influenced by personal values, emotions, or cultural perspectives. Hence, the last challenge: the Particularity Challenge. How does practical wisdom deal with specific, unique situations rather than general normative rules, principles, or virtues? In the context of medicine, for instance, can practical wisdom adapt to the nuances of each patient’s circumstances? Miller’s goal in his contribution is not to discourage a marriage between practical wisdom and medicine. His hope is that “this marriage goes through” because practical wisdom might be truly effective in guiding medical decisions (Miller, 2025, 101). However, these challenges must be addressed, suggesting that more work is needed to further clarify the nature, functions, and relevance of practical wisdom to medicine (and medical education).

Howard Nusbaum in “Understanding the Psychology of Practical Wisdom” draws on the psychological sciences to outline the reasons why an appeal to practical wisdom in the training of (future) physicians is warranted. Historically, the medical profession has prioritized the “physician-as-scientist” model, valuing intelligence and technical knowledge over capacities like empathy, compassion, and self-reflection. However, this narrow focus fails to account for the complex social, emotional, and ethical challenges faced by physicians. Nusbaum argues that while intelligence, expertise, and problem-solving abilities are important for physicians, the psychology literature shows that practical wisdom is equally critical for effective medical practice and also crucial in professional identity formation. Practical wisdom involves moral grounding, epistemic humility, and the integration of cognitive, affective, and social expertise. It involves skills like perspective-taking, emotional regulation, and the ability to acknowledge the limits of one’s own knowledge. It thereby enables clinicians to navigate ambiguity, balance competing values, and consider the broader implications of their decisions for patient well-being. By cultivating practical wisdom, Nusbaum argues, physicians can improve their decision-making, enhance their relationships with patients and families, and potentially mitigate the risk of professional burnout. He concludes that integrating practical wisdom into medical education and training could be a valuable avenue for reform, complementing the traditional focus on scientific expertise and technical skills. This broader approach to physician development may produce clinicians who are better equipped to provide compassionate, ethically grounded, and contextually appropriate care.

The fourth article, “A Critical Interpretive Literature Review of Phronesis in Medicine,” presents an interpretive analysis of a literature on phronesis (practical wisdom) that has grown rapidly in recent decades (Jameel, 2025). The effort is ambitious, given the nature of this literature, which is extensive and spans multiple disciplines, centuries, and conceptions. By distilling her more comprehensive dissertation into this article, Sabena Jameel maps the growing scholarship on practical wisdom in medicine under 12 distinct themes, organized in terms of a chronology of past, present, and future. She identifies the past arguments for phronesis vis-à-vis technē, scientism, and rules-based ethics, explores the boundaries of phronesis as universalist versus relativist, generalist versus particularist, and natural versus painful, and appraises the concept’s scope in the ethical versus clinical domains. Present literature on the empirical basis of phronesis, the phronesis of organizations, and its epistemological status are also described, as are future-oriented concerns about translating and applying phronetic theorizing into practice, experiences of moral distress, and medical education. In this way, Jameel brings to bear a detailed empirical analysis on a rich and traditionally philosophic but increasingly interdisciplinary literature. She clarifies some key definitions and distinctions in an otherwise complex literature and contributes a useful resource for philosophers and other interdisciplinary scholars seeking to understand and further advance the growing literature on phronesis in medicine.

In the fifth article of this special issue, “Changing the Paradigm: Practical Wisdom as True North in Medical Education,” Margaret Plews-Ogan builds on emerging scientific literature on the virtues to propose practical wisdom as the basic orientation of medical education. Plews-Ogan recognizes that ambiguity and uncertainty are inescapable features of medical practice, such that physicians are frequently involved in decisions and actions with high stakes and high emotions in urgent and challenging circumstances. She therefore argues that acquiring technical knowledge and procedural skills is inadequate for trainees. Arguing instead for practical wisdom as the proper “true north” of medical education, Plews-Ogan seeks an integration of the essential virtues like compassion and trustworthiness into the professional formation of trainees. She argues this point, moreover, by noting the growing social- and neuroscientific findings that are showing how the virtues impact our physiologic, measurable behaviors. She calls this body of findings an “exciting opportunity” (Plews-Ogan, 2025, 134). The point is not to ignore the epistemological limits of the sciences, but to learn from them and to use them to add to the centuries of contributions from humanistic studies on wisdom, how it is developed, and how it can be taught and mentored. She forcefully argues that this can indeed be done and outlines a comprehensive, concrete roadmap for this opportunity to realize practical wisdom as the true north of medical training.

In the last contribution, “Practical Wisdom, Clinical Judgments, and the Agential View,” Fabrice Jotterand et al. (2025) argue that practical wisdom is a helpful concept for comprehending the relationship among the scientific, technical, and moral dimensions of clinical practice. In addition, the introduction of practical wisdom in the training of future healthcare professionals offers a meaningful approach to help them understand how technical skills can align with their moral agency as medical professionals. However, because of competing obligations between patient rights and requests, institutional demands, and their own moral integrity, there is a need to develop a personal moral philosophy of clinical practice that integrates professional standards with their own moral commitments and identity. To this end, the authors put forward a philosophical position they call the agential view, which preserves an essentialist perspective on medicine (the objective intrinsic good of medicine) while stressing the necessity of promoting the good of the physician. Ultimately, the cultivation of practical wisdom within this framework offers clinicians the ability to make wise decisions, hence, promoting clinician well-being. This approach opens a path to revitalize the moral foundations of the medical profession, support the well-being of physicians, and ensure the continued delivery of high-quality, ethically grounded patient care.

Undoubtedly, this special issue only scratches the surface on how the humanities, social sciences, and sciences should dialogue and integrate the insights of other disciplines in their own conceptualization of practical wisdom, as well as how each discipline participates in the development of a definition that reflects human behavior. As the authors of the above articles demonstrate, the new science of practical wisdom extends traditional understandings of practical wisdom beyond the humanities by using scientific methods. Such explorations, however, should never succumb to the temptation of scientism.

ACKNOWLEDGMENTS

We want to thank Jeffrey Amundson for his help in the early conceptualization of this special issue.

REFERENCES