The rapid, recent emergence of new medical knowledge models has engendered a dizzying number of new medical initiatives, programs and approaches. Fields such as evidence-based medicine and translational medicine all promise a renewed relationship between knowledge and medicine. The question for philosophy and other fields has been whether these new models actually achieve their promises to bring about better kinds of medical knowledge—a question that compels scholars to analyze each model’s epistemic claims. Yet, these analyses may miss critical components that (...) explain how these models actually work and function. Using the case of translational medicine, this paper suggests that analyses which treat these models as a primarily epistemic interventions miss the way that new approaches are increasingly shaped by specific financial and commercial agendas. Ultimately, social epistemological analyses that are attentive to market forces are required to make sense of emerging bioscientific research models, which are increasingly tethered to or a manifestation of increasingly financialized models of science research and innovation. (shrink)

The article presents a doctor–patient relationship model based on the assumptions of a holistic approach to the patient. The author draws attention to selected patients’ needs, ones taken into account in this model. These are the right to autonomy and an individualised approach to the patient. These issues, considered in relation to philosophy, show a conflict between patients’ values and aspirations and doctors’ values and their experience. Nowadays, patients’ needs are protected by consumer rights as well as being strengthened by (...) postmodern philosophy, which shapes society’s awareness of various definitions of health and underlines the right of the individual to self‐determination. This situation creates an incredible challenge for doctors because attempts to assist is, according to medical knowledge, associated with an inevitable collision with the subjective perception of a patient’s health. Because of this issue, the author considers it necessary to enquire about the needs and aspirations of not so much patients as doctors themselves. It is assumed that the definition of what is currently important for this group determines the scope of any possible admission or intentional ignorance of patients’ needs. (shrink)

In this paper, I supplement T. A. Cavanaugh’s arguments against physician-assisted suicide in his book, Hippocrates’ Oath and Asclepius’ Snake, by focusing more specifically on the dangers of the misuse of physician power and on the virtues essential to restrain such power. Since Cavanaugh’s starting point is similar to Edmund Pellegrino’s views on the fundamental ends of medicine, I start with the question of the proper ends of medicine. Cavanaugh’s interpretation of the Hippocratic Oath as the limitation of physician power (...) to heal and to kill raises the issue of the proper use of physician power over the patient. In order to support and strengthen Cavanaugh’s case, I use Richard Zaner’s discussion of physician power over the patient and the attendant duty to use such power in a responsible way. Finally, I supplement Cavanaugh’s discussion with a fuller account of physician virtues as they relate to physician-assisted suicide. I first discuss the ends of medicine, medical power, and physician-assisted suicide. Second, I discuss the relationship between virtue and physician-assisted suicide. Third, I draw some final conclusions. (shrink)

What does the term academic ethics mean? How does this term relate to others in the academic integrity literature, such as research misconduct? Does conceptual confusion in the study of academic ethics complicate development of valid analyses of ethical behavior in an academic setting? The intended goal of many empirical projects on academic ethics is to draw causal conclusions about the factors that lead to faculty or students possessing or disregarding academic integrity. Yet, it is not clear that scholars using (...) the concept academic ethics are measuring the same phenomenon when they use associated concepts, such as responsible conduct of research. The purpose of this paper is to develop a taxonomy of concepts for the empirical study of academic ethics. Based in research on comparative analysis of democracy, another normatively preferable but multifaceted concept, I argue for a taxonomy of concepts for the study of academic integrity that reduces problems of “conceptual stretching” and challenges to the validity of empirical research in this field. (shrink)

Use of humanities content in American medical education has been debated for well over 60 years. While many respected scholars and medical educators have purported the value of humanities content in medical training, its inclusion remains unstandardized, and the undergraduate medical curriculum continues to be focused on scientific and technical content. Cited barriers to the integration of humanities include time and space in an already overburdened curriculum, and a lack of consensus on the exact content, pedagogy and instruction. Edmund Pellegrino, (...) physician and scholar of the latter twentieth century, spent much of his professional life promoting the value and importance of the humanities in medical education, seeking the best way to incorporate and teach this content in clinically relevant ways. His efforts included the founding of multiple enterprises starting in the 1960s and 1970s to promote human values in medical education, including the Society for Health and Human Values and its Institute on Human Values in Medicine. Regardless of his efforts and those of many others into the current century, the medical humanities remains a curricular orphan, unable to find a lasting home in medical education and training. (shrink)

Commercialisation and consumerism have had lasting and profound effects upon the nature of oral health and how dental services are provided. The stigma of a spoiled dental appearance, along with the attraction of the smile as a symbol of status and prestige, places the mouth and teeth as an object and product to be bought and sold. How the dental profession interacts with this acquired status of the mouth has direct implications for the professional status of dentistry and the relationship (...) between the profession and society. This essay examines the mouth’s developing position as a symbol of status and prestige and how the dental profession’s interaction and response to this may have important effects on the nature of dentistry’s social contract with society. As rates of dental disease reduce in higher socioeconomic groups, dentistry is experiencing a reorientation from being positioned within a therapeutic context, to be increasingly viewed as body work. This is not in of itself problematic; as a discipline dentistry places a very high value upon the provision of enhanced or improved aesthetics. This position changes when the symbolic exchange value of an aesthetic smile becomes the main motivation for treatment, encouraging a shift towards a commercialised model of practice that attenuates professional altruism. The dental profession should not welcome the association of the mouth as a status and prestige symbol lightly; this article examines how this paradigm shift might impact upon the social contract and dentistry’s professional status. (shrink)

Can doctors maintain good character? This paper shifts the focus from patient care to ethical considerations that bear on the physician and impact her as a person. By decentering patient care, the paper highlights certain factors that habituate a particular way of reasoning that is not conducive to inculcating good character. Such factors include, standards of professionalism, being influenced by external monitors, and emphasis on adherence to guidelines. While such factors may benefit patients, they often adversely affect the character of (...) physicians. (shrink)

Features and functions of laughter in contemporary hospital, new comic practices in medicine, the phenomenon of Clown Care and figures of “unfunny” and medical clown are researched in the article. Contemporary clinic is not “agelastical space” now. Clown Care is interpreted by the author with a focus on the ideas of V. Propp’ and O. Freudenberg’ about identification of laughter and life in the mythological consciousness and about archaic “fountainhead” laughter as a phenomenon that not only accompanies the transition from (...) death to life but also creates life. Medical clowns, as well as animal totem, king, slave and jester in ancient times, remain the dominant idea of overcoming death by immortal life as fundamental, structural and substantive basis of category of ultimate relations, directly present the principle universal-cultural formula – “generation and affirmation of life – denial of death – the resurrection and immortality”. An explication of the universally-cultural approach proposed A.S. Kiriliuk on the figure of the hospital clown and researching of notions of ultimate bases of new scientific region – medical gelotology, the science of laughter or laughterterapy. Ontological, communicative and protective function of laughter are investigated. The author noted the development of such urgency problems in theoretical terms, and for the practice of the restructuring of social and health sphere in Ukraine. In fact such integrative scientific discipline as a medical gelotologiya formed. It is necessary to give this branch of medicine status such as in physiotherapy, hydrotherapy, thalassotherapy, art therapy. In our opinion, this is problematic integrative perspective for philosophical studies of laughter, experts in the field of social philosophy, medical ethics and philosophical anthropology. (shrink)