Here is a thoroughly updated edition of a classic in palliative medicine. Two new chapters have been added to the 1991 edition, along with a new preface summarizing where progress has been made and where it has not in the area of pain management. This book addresses the timely issue of doctor-patient relationships arguing that the patient, not the disease, should be the central focus of medicine. Included are a number of compelling patient narratives. Praise for the first edition "Well (...) written. . .should be read by everyone in medical practice or considering a career in medicine."---JAMA. "Memorable passages, important ideas, and critical analysis. This is a book that clinicians and educators should read."---New England Journal of Medicine. (shrink)

" Dr. Cassell discusses the world of the sick, the healing connection and healer's battle, the role of omnipotence in the healer's art, illness and disease, and ...

Medicine and ethics alike must learn properly to attend to suffering. We can never truly experience another's distress. We can, however, learn to recognize the particular purposes, values, and aesthetic responses that shape the sense of self whose integrity is threatened by pain, disease, and the mischances of life.

The goals of medicine -- A story about a patient with aortic stenosis -- What are facts in medicine? -- Clarify the chain of events that led to the present state : the case as a narrative -- The case of Myra Manner -- Examine your presuppositions and preconceptions -- Separate and examine the values at issue -- A question of judgment -- The patient, the doctor, and the relationship -- Observation, prognosis, and prognosticating -- Thinking in medicine -- Accepting (...) the challenge. (shrink)

Like the broom in “The Sorcerer's Apprentice,” technologies take on a life of their own. To bring them under control, doctors must learn to tolerate ambiguity, resist the lure of the immediate, cease fearing uncertainty, and rechannel their response to wonder.

Phagocytosis is the process of recognition and engulfment of microorganisms or tissue debris that accumulate during infection, inflammation or wound repair. This ingestion, which is performed most efficiently by migrating, bone marrow‐derived cells called ‘professional phagocytes’, is essential for successful host defense. Ingestion results when an invading microorganism is recognized by specific receptors on the phagocyte surface and requires multiple, successive interactions between the phagocyte and the target. Each of these interactions results in a signal transduction event, which is confined (...) to the membrane and cytoskeleton around the ligated receptor and which is required for successful phagocytosis. Many molecules found at sites of inflammation or infection stimulate phagocytosis, so that efficient ingestion is confined to the site of infection or inflammation, which in turn limits the proinflammatory and tissue‐destructive processes that accompany phagocytosis. This review summarizes current understanding of this critical component of host defense and of its regulation. (shrink)

Healers: Extraordinary Clinicians at Work, by David Schenck and Larry R. Churchill, and What Patients Teach: The Everyday Ethics of Health Care, by Churchill, Joseph B. Fanning, and Schenck are both important and thought‐inspiring books. For the first, Schenck and Churchill recruited fifty practitioners, mostly physicians but some clinicians who practice alternative therapies, “identified by their peers as excellent healers,” and interviewed them to find out what they did to establish a good relationship with their patients. The results of their (...) interviews and how they wrote their book makes this the best and most concrete understanding of a necessary step to healing that I have read. What Patients Teach examines the patients’ perspective about forming relationships with their clinicians. The patients’ clinicians were asked to nominate patients to be interviewed to help answer the question. This volume, while important, is less extraordinary than the first because we hear less what the patients want to say and more what the authors want to tell us. That aside, taken together, these two books are a major advance in the literature of healing. (shrink)

Book reviewed in this article: Thinking Clearly About Death. By Jay F. Rosenberg.

Although written primarily for medical research, the Belmont principles have permeated clinical medicine as well. In fact, they are part of a broad cultural shift that has dramatically reworked the relationship between doctor and patient. In the early 1950s, medicine was about making the patient better and maintaining optimism when the patient could not get better. By the 1990s, medicine was about the treatment of specific physiological systems, as directed by the patient, but as limited by the society's concern for (...) justice. (shrink)

Extracorporeal membrane oxygenation (ECMO) is currently reserved predominantly for bridging patients to a different destination therapy, but the use of ECMO as a destination therapy itself (ECMO-DT...

The theory and practice of history and its relevance to the modern world, by Britains greatest radical historian.

To the student of the recent history of theological ideas in the West, it sometimes seems as though, of all the ‘new’ subjects that have been intro duced into theological discussion during the last hundred or so years, only two have proved to be of permanent significance. One is, of course, biblical criticism, and the other, the subject which in my University is still called ‘comparative religion’—the dispassionate study of the religions of the world as phenomena in their own right.

The legal and ethical asymmetry between honoring positive claims of conscience versus negative claims of conscience was recently analyzed by several articles in this journal. The first author of this article (ALB) identified unique but defeasible reasons against honoring positive claims of conscience, such as the greater threat they post to institutional values and institutional resources than negative claims of conscience. However, ALB wrote, when these reasons can be overcome, positive claims of conscience should enjoy the same ethical and legal (...) respect as negative claims of conscience. This article argues that the prescription of birth control by non-Roman Catholic physicians in Roman Catholic institutions is an example of a positive claim of conscience that can overcome concerns of institutional values and resources, and therefore ought to receive the same ethical respect and legal protection as negative claims of conscience. In making this argument, this article also responds to several of the thoughtful comments raised by Alberto Giubilini and Dominic Wilkinson. (shrink)

Bioethics, Volume 36, Issue 1, Page 63-70, January 2022.

The fundamental problems of a philosophy of science emerge as a set of antinomies: relativism-Absolutism, Subjectivity-Objectivity, And theory-Practice. Each one of these antinomies is overcome in dialectical philosophy. Science is a dialectical process and requires a dialectical philosophy. But unlike the hegelian dialectic which is initiated by only internal limitations, The dialectic of science is also generated by the external intervention of nature. Science is then necessarily a historical process. Therefore, A scientist is true to science and acts ethically "as (...) a scientist" only if he acts to secure the historical possibility of science in the future. Science is ethically complete when it creates only itself. (shrink)

Sound is key to our lives, and is the most accessible portal to the vibratory universe. This book takes you there.

Alexander George has put forward a novel interpretation of the Quine-Carnap debate over analyticity. George argues that Carnap's claim that there exists an analytic-synthetic distinction was held by Carnap to be empty of empirical consequences. As a result, Carnap understood his position to be empirically indistinguishable from Quine's. Although George defends his interpretation only briefly, I show that it withstands further examination and ought to be accepted. The consequences of accepting it undermine a common understanding of Quine's criticism of Carnap, (...) and I argue that it is difficult to find a perspective from which Quine can criticize Carnap in a non-question-begging way. (shrink)

The Prudence of Love focuses upon the intersection of philosophical, theological, and psychological issues related to love. Eric Silverman defends an account of love derived from the views of Thomas Aquinas and argues that love provides numerous psychological and relational benefits that increase the lover's happiness. Furthermore, he argues that love is beneficial according to all major contemporary accounts of happiness.

It has become increasingly evident that gene content of the sex chromosomes is markedly different from that of the autosomes. Both sex chromosomes appear enriched for genes related to sexual differentiation and reproduction; but curiously, the human X chromosome also seems to bear a preponderance of genes linked to brain and muscle functions. In this review, we will synthesize several evolutionary theories that may account for this nonrandom assortment of genes on the sex chromosomes, including 1) asexual degeneration, 2) sexual (...) antagonism, 3) constant selection, and 4) hemizygous exposure. Additionally, we will speculate on how the evolution of sex‐chromosome gene content might have impacted on the phenotypic evolution of mammals and particularly humans. Our discussion will focus on the mammalian sex chromosomes, but will cross reference other species where appropriate. BioEssays 26:159–169, 2004. © 2004 Wiley Periodicals, Inc. (shrink)

Patients with a life-threatening illness can be confronted with various types of loneliness, one of which is existential loneliness (EL). Since the experience of EL is extremely disruptive, the issue of EL is relevant for the practice of end-of-life care. Still, the literature on EL has generated little discussion and empirical substantiation and has never been systematically reviewed. In order to systematically review the literature, we (1) identified the existential loneliness literature; (2) established an organising framework for the review; (3) (...) conducted a conceptual analysis of existential loneliness; and (4) discussed its relevance for end-of-life care. We found that the EL concept is profoundly unclear. Distinguishing between three dimensions of EL—as a condition, as an experience, and as a process of inner growth—leads to some conceptual clarification. Analysis of these dimensions on the basis of their respective key notions—everpresent, feeling, defence; death, awareness, difficult communication; and inner growth, giving meaning, authenticity—further clarifies the concept. Although none of the key notions are unambiguous, they may function as a starting point for the development of care strategies on EL at the end of life. (shrink)

Patients with a life-threatening illness can be confronted with various types of loneliness, one of which is existential loneliness (EL). Since the experience of EL is extremely disruptive, the issue of EL is relevant for the practice of end-of-life care. Still, the literature on EL has generated little discussion and empirical substantiation and has never been systematically reviewed. In order to systematically review the literature, we (1) identified the existential loneliness literature; (2) established an organising framework for the review; (3) (...) conducted a conceptual analysis of existential loneliness; and (4) discussed its relevance for end-of-life care. We found that the EL concept is profoundly unclear. Distinguishing between three dimensions of EL—as a condition, as an experience, and as a process of inner growth—leads to some conceptual clarification. Analysis of these dimensions on the basis of their respective key notions—everpresent, feeling, defence; death, awareness, difficult communication; and inner growth, giving meaning, authenticity—further clarifies the concept. Although none of the key notions are unambiguous, they may function as a starting point for the development of care strategies on EL at the end of life. (shrink)

Debates concerning the relationship between Tridentine Catholicism and Catholicism after Vatican II dominate theological conversation today, particularly with regard to understandings of the Church and its engagement with the world. Current historical narratives paint ecclesiology after the Council of Trent as dominated by juridical concerns, uniformity, and institutionalism. Purportedly neglected are the spiritual, diverse, and missional aspects of the Church. This book challenges such narratives by investigating the Spanish Jesuit Francisco Suárez's theology of ecclesial unity and catholicity. Analyzing standard as (...) well as overlooked sources of Suárez's ecclesiology, the author shows how Suárez wrestles with the new demands of his time and anticipates later ecumenical developments in twentieth-century Catholic ecclesiology. Early modern expansion prompted theologians after Trent to reckon with the ecclesial status of baptized Protestants, the Greek Orthodox, and non-believers in the New World. It further prompted reflection on the universality, or catholicity, of the Church, and how the Church's mission to the nations serves her greater unity in Christ. Throughout this exposition, the author reveals Suárez's vision of the Church to be deeply spiritual, diverse, and missional-not at the expense of the institutional, but as it's necessary and life-giving source. The Church, for Suárez, is primarily a way of life. This book explores not only Suárez's speculative ecclesiology, but how the unity and catholicity of the body of Christ is lived out in practice, that is, in the worship and works of the faithful, and, most notably, in the charism of his own religious order, the Society of Jesus. Suárez thus shows his readers what the spiritual dynamic between Christic unity and missional catholicity should look like in the Church. (shrink)