In recent years, society has come to recognize that the work performed by scientists, like that of journalists and politicians, may be influenced by the interests they serve. As a result, scientists' research is increasingly contested as a source of reliable knowledge. Such has been the case in issues concerning the climate debate, for example, where research results are at times perceived to comfortably fit in with the viewpoints of interested parties outside science. In medicine, governmental as well as (...) commercial organizations influence the public health research agenda (McGarity and Wagner 2008). Also, studies sponsored by pharmaceutical companies, for example, often yield biased, favorable results for .. (shrink)

人のいのちと向き合う医学は、冷徹な科学的思考と人間哲学の激突する現場である。哲学としての医学概論を創始した澤瀉久敬の思想を繙き、分子生物学や臨床疫学、フランクルの人間論、さらには近藤誠のがんもどき理論 やスピリチュアリティなど現代の諸問題をも論じつつ、科学と哲学の葛藤を調停し、医学のあるべき思想的立脚点を探る。.

의학 현상학은 질병의 원인을 단순하게 환자의 신체 밖에 존재하는 병원체에서만 찾는 것이 아니라 신체 내부의 환경에서도 찾으려고 시도한다. 의학 현상학은 현상학적 세계 고찰을 통해서 환자의 내면적 체험을 중시하게 되었다. 최근 의학과 간호학에서 현상학적 연구 방법에 기초해서 이러한 환자의 체험에 대한 분석을 담은 연구들을 진행하고 있다. 그러나 전통 현상학 자체에 대한 이해 부족으로 연구 명칭은 현상학적 방법론이지만 그 내용은 형식적인 틀에 머물고 있는 연구물들이 많이 등장하고 있다. 이에 현상학자들의 텍스트 분석을 통해서 현상학의 기본 개념들이 어떻게 의학 현상학에서 응용될 수 있는지에 대한 (...) 기초 작업이 요구된다. 실재로 국내에는 현상학자들의 텍스트에 기초해서 의학 현상학을 소개하는 전문적인 논문들이 매우 적은 편이다. 이런 기초 작업을 위해서 연구자는 이 논문에서 하이데거의 『시간과 존재』에 기술된 ‘내집에 없음’(Unheimlichkeit)이란 개념과 질환 체험과 건강 체험의 유사성에 대해서 고찰하고 있다. 하이데거의 현상학적 존재론의 몇 가지 중요한 개념들을 분석하면서 이것들이 어떻게 의학 현상학에서 응용될 수 있는지를 밝히는 것이 이 논문의 최종 목표이다. (shrink)

Se realizó una estrategia para el perfeccionamiento del trabajo educativo en la Universidad de Ciencias Médicas de Camagüey y elevar la preparación científico-pedagógica de los profesores guías de la carrera de Medicina. En el trabajo se presenta como una de sus acciones la realización de talleres metodológicos interactivos, sus funciones y la metodología elaborada para su implementación. Se constató que la preparación y la experiencia de estos profesores es insuficiente para asumir la labor educativa, asimismo, se confirmó la necesidad de (...) asumir los talleres, como una de las formas del trabajo docente metodológico. A strategy in order to improve the educational work at the Medical University of Camagüey and to raise the scientific-pedagogical training of Medicine guide teachers was carried out. The research shows interactive methodological workshops as one of its main actions, its functions and the methodology designed for its implementation. It was found out that teachers training and experience was not enough to assume the educational work; likewise, the need to consider workshops, as one of the ways of the teaching methodological work was confirmed. (shrink)

Partiendo de las deficiencias detectadas en la realización de la discusión diagnóstica por los estudiantes de Medicina, determinadas en un estudio previo realizado en la Facultad de Ciencias Médicas de Camagüey, se diseñó una metodología para perfeccionar la realización de la discusión diagnóstica en la carrera de Medicina, en la cual se incluyeron un sistema de tareas y las acciones que permiten alcanzar el desarrollo de las habilidades relacionadas con la misma. También se reflejaron las formas organizativas de enseñanza y (...) las actividades de educación en el trabajo en las que se deben abordar los elementos de la metodología, así como la propuesta de criterios evaluativos para estas habilidades, y otros aspectos como la ejecución y evaluación de la metodología. Se consideró que esta propuesta metodológica puede constituir una herramienta útil para los profesores en la conducción del proceso de adquisición de las habilidades de razonamiento clínico en los estudiantes. On the basis of the deficiencies identified in the realization of the diagnostic discussion by medical students, which were determined in a previous study carried out in the Faculty of medical sciences of Camagüey, a methodology was designed to improve the realization of the diagnostic discussion in Medicine degree, which included a set of tasks and actions that allow the development of skills related to it. Also, the teaching organization forms and education activities at work that must deal with methodology elements were stated, as well as the proposal of assessment criteria for these skills and other aspects like assessment and implementation of methodology. It was considered that this methodology can be used as a useful tool for teachers as guides in the process of students´ acquirement of clinical reasoning skills. (shrink)

Drawing on and extending the Foucaultian philosophical framework that Jeffrey Bishop develops in his masterful book, The Anticipatory Corpse: Medicine, Power, and the Care of the Dying, we undertake a sociological analysis of the neurological procedure—deep brain stimulation —which implants electrodes in the brain, powered by a pacemaker-like device, for the treatment of movement disorders. Following Bishop’s work, we carry out this analysis through a two-fold strategy. First, we examine how a multidisciplinary team evaluates candidates for this implant at (...) a major medical center. We present excerpts from an ethnographic study of the “case conference” where disease entities are presented, contested, ratified, and made objects for intervention with this technology. The case conference becomes the key site in the transition from “person-with-illness” to “person-with-brain-implant” as a team of health professionals determines a plan of action by interpreting both statistical and “quality of life” data regarding their patients. Second, this article explores these decision-making processes through Bishop’s conceptualization of evidence-based medicine, which relies on statistical approaches as the ultimate authority in knowledge production and medical decisions. We then reflect on Bishop’s critique of the social sciences and the methodological, analytical, and substantive ramifications that The Anticipatory Corpse can offer future sociological work. (shrink)

The failure of medical codes to provide adequate guidance for physicians' moral dilemmas points to the fact that some rules of analysis, informed by moral theory, are needed to assist in resolving perplexing ethical problems occurring with increasing frequency as medical technology advances. Initially, deontological and teleological theories appear more helpful, but critcisms can be lodged against both, and neither proves to be sufficient in itself. This paper suggests that to elude the limitations of previous approaches, a method of moral (...) decision making must be developed incorporating both coherence methodology and some independently supported theoretical foundations. Wide Reflective Equilibrium is offered, and its process described along with a theory of the person which is used to animate the process. Steps are outlined to be used in the process, leading to the application of the method to an actual case. (shrink)

This volume approaches the philosophy of medicine from the broad naturalist perspective that holds that philosophy must be continuous with, constrained by, and ...

Perez-Rodriguez and de la Fuente (2017) assume that although human races do not exist in a biological sense (“geneticists and evolutionary biologists generally agree that the division of humans into races/subspecies has no defensible scientific basis,” they exist only as “sociocultural constructions” and because of that maintain an illusory reality, for example, through “racialized” practices in medicine. Agreeing with the main postulates formulated in the article, we believe that the authors treat this problem in a superficial manner and have (...) failed to capture the current state of the field of knowledge in science and the humanities. In our commentary, we want to highlight two main omissions, and to notice three important implications for “a postracial medicine.”. (shrink)

This book makes Classical Chinese Medicine intelligible to those who are not familiar with the tradition and who may choose to dismiss it off-hand or to assess it negatively. Keekok Lee uses two related strategies: arguing that all science and therefore medicine cannot be understood without excavating its philosophical presuppositions and showing what those presuppositions are in the case of CCM compared with those of biomedicine.

Woodger first gives a rough account of the "Boole-Frege" movement in modern logic and persuasively argues as to the importance of formalized language-systems for the methodology of science. Some of these arguments are as follows: A natural language such as English, he notes, "is not only used for purposes of communication in the scientific sense. It is also used for the writing of poetry, for religious devotion, for political controversy, and for persuading people to buy some of the products (...) of industrial activity which they would not otherwise want. But these pursuits make demands upon language which are very different from those made by science. The requirements of science prove on investigation to be quite surprisingly meagre and the excessive riches of a natural language like English are a source of embarrassment. They tempt us to employ linguistic devices borrowed from extra-scientific usages which can have unfortunate consequences. Metaphors, for example, with which some branches of biology abound, are often suggestive and may be harmless enough if they are recognized for what they are. But at best they are makeshifts and substitutes for genuine biological statements, and the fact that recourse is had to them is surely a sign of immaturity. Science demands great linguistic austerity and discipline, and the canons of good style in scientific writing are different from those of good writing in other kinds of literature." Another argument is that "sooner or later the linguistic habits of everyday life will cease to do justice to... the... increasing complexity and novelty of observation and hypothesis." A third argument is that scientific language is used not only for the purpose of communication, for recording observations, or for formulating general laws or hypotheses. It is also used for calculation and the unearthing of the consequences of our assumptions. The logic underlying a formalized language is explicitly designed to enable us to calculate easily and efficiently. The important, and now thoroughly established, methodological distinction between object-language and meta-language is blurred for natural language and is best maintained in terms of formalized language-systems. And, finally, in natural language the important distinction between syntax and semantics also tends to be blurred. "From both the syntactical and the semantical points of view natural languages are incredibly complicated and unruly. The rules of ordinary gram mar are quite insufficient from the standpoint of the requirements of science, and the problems connected with meaning and truth in relation to natural languages are enormously complicated and perhaps insoluble.". (shrink)

Extensive scientific, philosophical and artistic activities were carried out in the Islamic World’s various science and civilization centers during the early Middle Ages. In these centers, noteworthy works of mathematics, astronomy, geography, medicine, pharmacology, optics, botany, chemistry and other fields of science, which would later determine improvement paths for these fields, were created. Abu al-Izz Ismail ibn al-Razzaz al-Jazari (12th-13th centuries), was a magnificent Muslim scientist known for his work named The Book of Knowledge of Ingenious Mechanical Devices (Kitab (...) fi ma‘rifati’l-hiyal al-handasiyya) and he was born in geography where many scientists were trained. He contributed to the development of science and civilization, the joint legacy of humanity and demonstrated his true capability and success in the field of ilm al-hiyal (the scientific field which addresses the information and practices regarding mechanical technology and engineering in Islamic science history). From this perspective, it is evident that al-Jazari had a wide field of interest, made his mark in the age he lived in with his brave and innovative ideas, and was a wise engineer. al-Jazari’s detailed descriptions and explanations of water clocks, oil lamp clocks and water pumping machines, as well as their construction, were astounding. In addition, al-Jazari’s studies on metal casting techniques, cone valves, wheel balance and the real-world use of aspiration tubes are important in contemporary engineering studies. When all these are considered, it becomes clear that his designation as the “Leonardo da Vinci of the Islamic World” is not a coincidence. Many studies on al-Jazari’s scientific legacy have been conducted in various parts of the world. There are various manuscripts of his aforementioned book. Based on these manuscripts, the work has been -fully or partially- translated into many languages, including Turkish. The German and English translations served as a basis for studies on al-Jazari in other languages. In recent years, studies conducted on al-Jazari in Türkiye (books, articles, domestic and international symposiums, congresses etc.) have demonstrated his brilliance and competence as a scientist. Furthermore, studies on al-Jazari are still ongoing in Türkiye. As for Russia, the scientific legacy of the scientists raised in the Islamic World such as Avicenna, al-Farabi, Abu Bakr al-Razi, Abu Rayhan al-Biruni, Abu al-Qasim al-Zahrawi, Muhammad ibn Musa al-Khwarizmi, al-Battani, al-Kashi, Abd al-Rahman al-Khazini, Nasir al-Din al-Tusi was researched within the scope of a special plan and program. Depending on the relevant studies, al-Jazari and his work drew attention as well. A small portion of the aforementioned Russian studies is known in Türkiye. It is safe to assume that al-Jazari studies in Russia are virtually unknown in Türkiye. The present study primarily aims to contribute to the literature on the scientific legacy of al-Jazari, a Middle Age Islamic scientist best known for his famous work in the mechanical field. More specifically, the present study aims to: 1) to identify the studies on al-Jazari in Russia, and in the former USSR countries, where academic studies are still in Russian after the Soviet Union period, to create a chronological biography and to set forth their compilation; in other words, to create a bibliography which includes Russian studies on al-Jazari; 2) to provide information on the structure and content of the studies in question, to detect the methodological issues encountered in these works, and make solution recommendations to solve these issues; 3) to contribute to continuing and future studies in Türkiye on al-Jazari in terms of source and material index. In conclusion, it should be stated that comparative reading was conducted centered on The Book of Knowledge of Ingenious Mechanical Devices (Kitab fi ma‘rifati’l-hiyal al-handasiyya). It should also be noted that Russian popular internet publications (which are not based on academic research and are created/reproduced for commercial and personal purposes) were excluded from the assessment. (shrink)

In this paper, I argue (i) that there are certain methodological practices that are epistemically significant, and (ii) that we can test for the success of these practices empirically by examining case-studies in the history of science. Analysing a particular episode from the history of medicine, I explain how this can help us resolve specific cases of underdetermination. I conclude that, while the anti-realist is (more or less legitimately) able to construct underdetermination scenarios on a case-by-case basis, he will (...) have to abandon the strategy of using algorithms to do so, thus losing the much needed guarantee that there will always be rival cases of the required kind. (shrink)

In their 2013 study of traumatic flashback formation, Bourne, Mackay and Holmes raise the question of whether the propensity of a traumatic experience to produce flashbacks is determined by the emotions that are felt at the time of that experience. They suggest that it is not, but the grounds on which they make this suggestion are flawed. Further research is required. That research will need to overcome a significant methodological difficulty — one which is hard to avoid when fMRI data (...) and introspective reports are combined in a single causal inference. (shrink)

Research on the human microbiome has gen- erated a staggering amount of sequence data, revealing variation in microbial diversity at the community, species (or phylotype), and genomic levels. In order to make this complexity more manageable and easier to interpret, new units—the metagenome, core microbiome, and entero- type—have been introduced in the scientific literature. Here, I argue that analytical tools and exploratory statisti- cal methods, coupled with a translational imperative, are the primary drivers of this new ontology. By reducing the (...) dimensionality of variation in the human microbiome, these new units render it more tractable and easier to interpret, and hence serve an important heuristic role. Nonetheless, there are several reasons to be cautious about these new categories prematurely ‘‘hardening’’ into natural units: a lack of constraints on what can be sequenced metagenomically, freedom of choice in taxonomic level in defining a ‘‘core microbiome,’’ typological framing of some of the concepts, and possible reification of statistical constructs. Finally, lessons from the Human Genome Project have led to a translational imperative: a drive to derive results from the exploration of microbiome variation that can help to articulate the emerging paradigm of per- sonalized genomic medicine (PGM). There is a tension between the typologizing inherent in much of this research and the personal in PGM. (shrink)

This textbook introduces the reader to basic problems in the philosophy of science and ethics, mainly by means of examples from medicine. It is based on the conviction that philosophy, medical science, medical informatics, and medical ethics are overlapping disciplines. It claims that the philosophical lessons to learn from the twentieth century are not that nature is a 'social construction' and that 'anything goes' with respect to methodological and moral rules. Instead, it claims that there is scientific knowledge, but (...) that it is never completely secure; that there are norms, but that they are situation-bound; and that, therefore, it makes good sense to search for scientific truths and try to act in a morally decent way. Using philosophical catchwords, the authors advocate 'fallibilism' and 'particularism'; a combination that might be called 'pragmatic realism'. (shrink)

Research on the human microbiome has generated a staggering amount of sequence data, revealing variation in microbial diversity at the community, species (or phylotype), and genomic levels. In order to make this complexity more manageable and easier to interpret, new units—the metagenome, core microbiome, and enterotype—have been introduced in the scientific literature. Here, I argue that analytical tools and exploratory statistical methods, coupled with a translational imperative, are the primary drivers of this new ontology. By reducing the dimensionality of variation (...) in the human microbiome, these new units render it more tractable and easier to interpret, and hence serve an important heuristic role. Nonetheless, there are several reasons to be cautious about these new categories prematurely ‘‘hardening’’ into natural units: a lack of constraints on what can be sequenced metagenomically, freedom of choice in taxonomic level in defining a ‘‘core microbiome,’’ typological framing of some of the concepts, and possible reification of statistical constructs. Finally, lessons from the Human Genome Project have led to a translational imperative: a drive to derive results from the exploration of microbiome variation that can help to articulate the emerging paradigm of personalized genomic medicine (PGM). There is a tension between the typologizing inherent in much of this research and the personal in PGM. (shrink)

This paper discusses two methodological notions, the concepts Gegenprobe (countercheck) and Gegenversuch (counter-trial), which were widely applied, discussed, relied upon, and defended in German-language writings about empirical inquiry. In the decades around 1800, they were common in physiology; medicine; agriculture; chemistry; various technologies, such as printing, metallurgy, and mining; accounting; and legal and political argumentation. The ubiquity of those concepts signals a broad concern with securing empirical findings and empirical knowledge. Gegenproben and Gegenversuche – the terms as well as (...) the practices – are evidence for the close connection among explicitly knowledge-seeking endeavors and crafts and technologies. Physiological experiments, chemical analyses, agricultural or vaccination trials were indebted to applied and practical procedures of making and assaying. What united these different fields was the fact that the problems that had to be solved were very complex yet at the same time of immediate relevance to everyday lives (like diseases or crops) or highly controversial (like vital forces or spontaneous generation). We know that late eighteenth-century and early nineteenth-century practices of inquiry were firmly embedded in applied, technical contexts; this essay shows that methodological notions were anchored in applied, technical contexts as well. (shrink)

A consumer health information system must be able to comprehend both expert and non-expert medical vocabulary and to map between the two. We describe an ongoing project to create a new lexical database called Medical WordNet (MWN), consisting of medically relevant terms used by and intelligible to non-expert subjects and supplemented by a corpus of natural-language sentences that is designed to provide medically validated contexts for MWN terms. The corpus derives primarily from online health information sources targeted to consumers, and (...) involves two sub-corpora, called Medical FactNet (MFN) and Medical BeliefNet (MBN), respectively. The former consists of statements accredited as true on the basis of a rigorous process of validation, the latter of statements which non-experts believe to be true. We summarize the MWN / MFN / MBN project, and describe some of its applications. (shrink)

Semmelweis’ discovery of the etiology of childbed fever has long attracted the attention of historians of medicine and biographers. In recent years it has also become of increasing interest to philosophers. In this paper I discuss the interpretation of Semmelweis’ methodology from the viewpoint of the inference to the best explanation and argue that Popperian methodology is better at capturing the dynamics of the growth of knowledge. Furthermore, I criticize the attempts to explain the failure of Semmelweis (...) to have his discovery accepted on the basis of the Kuhnian concept of paradigms, and warn that this view may endorse dogmatism as the norm The Kuhnian position also raises the problem of the authoritarian nature of scientific institutions which defend a paradigm against unorthodox, rebellious views, such as in the case of Semmelweis. Popperian philosophy is seen as a challenge to promote a link between an open society and open science with its main aim being to cherish a free critical spirit. (shrink)

As it has historically been the case with many pandemics, the Covid-19 experience will induce many philosophers to reconsider the value of medical practice. This should be a good opportunity to critically scrutinize the way medical research and medical interventions are carried out. For much of its history, medicine has been very inefficient. But, even in its contemporary forms, a review of common protocols in medical research and medical interventions reveal many shortcomings, especially related to methodological flaws, and more (...) importantly, conflicts of interests due to profit incentives. In the face of these problems, we propose a program of “gentle medicine”. This term, originally formulated by philosopher Jacob Stegenga, describes a form of medicine in which physicians intervene less than they currently do. As part of this general program, we advance a series of reform recommendations that could be enacted both by medical staff in their everyday practice, but also by public health officials and policymakers. (shrink)

Objectives—To assess the relationship between the approval of trials by a research ethics committee and the fact that informed consent from participants was obtained, with the quality of study design and methods.Design—Systematic review using a standardised checklist.Main measures—Methodological and ethical issues of all trials published between 1993 and 1995 in the New England Journal of Medicine, the Lancet, the Journal of the American Medical Association and the British Medical Journal were studied. In addition, clinical trials conducted in Spain and (...) published by at least one Spanish author during the same period in any other journal were also included.Results—We studied the published articles of 767 trials and found the following indicators of lower methodological quality to be independent predictors for failure to disclose REC approval or ICP: absence of concealment of allocation, lack of justification for unblinded trials, not using a treatment for the patients in the control group, absent information on statistical methods, not including sample size estimation, not establishing the rules to stop the trial, and omitting the presentation of a baseline comparison of groupsConclusion—Trials of higher methodological and scientific quality were more likely to provide information about their ethical aspects. (shrink)

This book provides a systematic analysis of the ethical implications of traditional and complementary medicine, focusing on pragmatic solutions. The author uses a bioethical methodology called the “Ethical Matrix,” to consider the impact of T&CM use for animals and the environment as well as for humans. A systematic search of the literature reveals that most published ethical concerns are related to the safety of T&CM use for humans. However, application of the Ethical Matrix demonstrates that the ethical implications (...) for T&CM use are much broader. In this book, the author analyses the most serious implications, including adverse events related to homeopathy, the use of animals in T&CM products, and the impact of herbal medicine on the environment. Comparisons with the ethical implications of conventional biomedicine help readers to contextualise debate, and highlight aspects that may be unique to T&CM. Globally, many high-level health policy makers promote T&CM as an accessible and affordable healthcare option. However, their use is considered by some to be a waste of resources, unscientific, and unethical. Offering a frank analysis of this largely ignored field of healthcare ethics, this book is both timely and essential. It helps patients, policy makers, practitioners, researchers, and students gain the knowledge they need to make more informed decisions. (shrink)

Proponents of evidence-based medicine have argued convincingly for applying this scientific method to medicine. However, the current methodological framework of the EBM movement has recently been called into question, especially in epidemiology and the philosophy of science. The debate has focused on whether the methodology of randomized controlled trials provides the best evidence available. This paper attempts to shift the focus of the debate by arguing that clinical reasoning involves a patchwork of evidential approaches and that the (...) emphasis on evidence hierarchies of methodology fails to lend credence to the common practice of corroboration in medicine. I argue that the strength of evidence lies in the evidence itself, and not the methodology used to obtain that evidence. Ultimately, when it comes to evaluating the effectiveness of medical interventions, it is the evidence obtained from the methodology rather than the methodology that should establish the strength of the evidence. (shrink)

Concepts. Health ; Disease ; Death -- Models and kinds. Causation and kinds ; Holism and reductionism ; Controversial diseases -- Evidence and inference. Evidence in medicine ; Objectivity and the social structure of science ; Inference ; Effectiveness, skepticism, and alternatives ; Diagnosis and screening -- Values and policy. Psychiatry: care or control? ; Policy ; Public health.

The idea of personalised medicine (PM) has gathered momentum recently, attracting funding and generating hopes as well as scepticism. As PM gives rise to differing interpretations, there have been several attempts to clarify the concept. In an influential paper published in this journal, Schleidgen and colleagues have proposed a precise and narrow definition of PM on the basis of a systematic literature review. Given that their conclusion is at odds with those of other recent attempts to understand PM, we (...) consider whether their systematic review gives them an edge over competing interpretations. We have found some methodological weaknesses and questionable assumptions in Schleidgen and colleagues’ attempt to provide a more specific definition of PM. Our perplexities concern the lack of criteria for assessing the epistemic strength of the definitions that they consider, as well as the logical principles used to extract a more precise definition, the narrowness of the pool from which they have drawn their empirical data, and finally their overlooking the fact that definitions depend on the context of use. We are also worried that their ethical assumption that only patients’ interests are legitimate is too simplistic and drives all other stakeholders’ interests—including those that are justifiable—underground, thus compromising any hope of a transparent and fair negotiation among a plurality of actors and interests. As an alternative to the shortcomings of attempting a semantic disciplining of the concept we propose a pragmatic approach. Rather than considering PM to be a scientific concept in need of precise demarcation, we look at it as an open and negotiable concept used in a variety of contexts including at the level of orienting research goals and policy objectives. We believe that since PM is still more an ideal than an achieved reality, a plurality of visions is to be expected and we need to pay attention to the people, reasons and interests behind these alternative conceptions. In other words, the logic and politics of PM cannot be disentangled and disagreements need to be tackled addressing the normative and strategic conflicts behind them. (shrink)

Sports Medicine as an apparent sub-class of medicine has developed apace over the past 30 years. Its recent trajectory has been evidenced by the emergence of specialist international research journals, standard texts, annual conferences, academic appointments and postgraduate courses. Although this field of enquiry and practice lays claim to the title ‘sports medicine’ this paper queries the legitimacy of that claim. Depending upon how ‘sports medicine’ and ‘medicine’ are defined, a plausible-sounding case can be made (...) to show that sports medicine is not in fact a branch of medicine. Rather, it is sometimes closer to practices such as non-therapeutic cosmetic surgery. The argument of the paper is as follows. It begins with a brief statement concerning methodology. We then identify and subscribe to a plausible defining goal of medicine taken from a recognised authority in the field. Then two representative, authoritative, definitions of sports medicine are discussed. It is then shown that acceptance of these definitions of sports medicine generates a problem in that if they are accepted, no necessary commitment to the defining goal of medicine is present within sports medicine. It seems to follow that sports medicine is not medicine. In the final part of the paper a critical response to that conclusion is presented and rebutted. The response is one which rejects the identification of the defining goal of medicine upon which our argument rests. (shrink)

Scholars have noted persistent high rates of agricultural health and safety incidents and the need to develop more effective interventions. Participatory research provides an avenue to broaden the prevailing research paradigms and approaches by allowing those most impacted to illuminate and work to solve those aspects of their lives. One such approach is photovoice, an emancipatory visual narrative approach. Yet, despite its broad appeal, photovoice can be hard to implement. In this article, we leverage our experience using photovoice for a (...) farm children safety project to describe and reflect on the ethical and methodological aspects broadly relevant to agricultural health and safety topics. We first contextualize the tensions of navigating between photovoice, the research ethics committees (RECs) regulatory frameworks, and competing views on visual representations in agriculture. We then discuss the sources of risks to participants and researchers, how we addressed these risks, and how these risks unfolded during the research phase of the photovoice activity. We conclude with three lessons we (re)learned: the importance of collaborating with RECs, the need to increase preparation to limit psychological risks to participants and researchers, and avenues to augment the emancipatory power of photovoice in a virtual environment. (shrink)

This volume provides a more exhaustive interpretation of Rene Descartes' medical views and its reception in the seventeenth century. Filling the gap in the recent scholarship, the contributions in the volume follow four axes: exegetical, textual, philosophical, and contextual. Authors in this book deal with Descartes' physiology, anatomy, and therapy by reconstructing Cartesian texts, detailing possible medical and philosophical sources, discussing medical collaborations and oppositions, and exploring obscurities and failures in Descartes' medicine. In laying bare the more promising issues (...) of Cartesian programme and discussing the reception and opposition in the seventeenth century, the volume also uncovers the limitations within his interpretation, ultimately revealing a more nuanced application of his methodology to a field of natural philosophy. While medical studies play a not secondary role in Descartes' entire work, the volume aims to discuss in detail the importance of medicine as a suitable field to understand Cartesian philosophy from a significant perspective in seventeenth-century Europe. (shrink)

This volume provides a more exhaustive interpretation of Rene Descartes' medical views and its reception in the seventeenth century. Filling the gap in the recent scholarship, the contributions in the volume follow four axes: exegetical, textual, philosophical, and contextual. Authors in this book deal with Descartes' physiology, anatomy, and therapy by reconstructing Cartesian texts, detailing possible medical and philosophical sources, discussing medical collaborations and oppositions, and exploring obscurities and failures in Descartes' medicine. In laying bare the more promising issues (...) of Cartesian programme and discussing the reception and opposition in the seventeenth century, the volume also uncovers the limitations within his interpretation, ultimately revealing a more nuanced application of his methodology to a field of natural philosophy. While medical studies play a not secondary role in Descartes' entire work, the volume aims to discuss in detail the importance of medicine as a suitable field to understand Cartesian philosophy from a significant perspective in seventeenth-century Europe. (shrink)

Dr Kottow in his paper Classical medicine v alternative medical practices (1) places the alternative/orthodox medicine debate within an historical context of anti-quackery literature. My paper explores the nature of science as it is applied to clinical practice and challenges the narrow view of the diagnostic process as outlined by Dr Kottow. Research methodologies more appropriate to 'whole person' medicine are suggested as having more ethical value than those based on the clinical trial.

This book collects most of the invited papers presented at the 12th International Congress of Logic, Methodology and Philosophy of Science in Oviedo, August 2003. It contains state of the art accounts of ongoing work by a selection of the most renowned researchers in the field. The papers in the Logic section deal with topics in mathematical logic, as well as philosophical logic, and the area of logic and computation. The section on General Methodology contains articles on models, (...) theories, probability, induction, causation, and other topics. A number of papers discuss Philosophical Issues of Particular Sciences, such as mathematics, physics, linguistics, psychology, biology, and medicine. There is also a section on Ethics of Science, and papers from a special symposium on the Emergence of Scientific Medicine in the 19th-20th Century. (shrink)

In this article, we analyse how researchers use the categories of race and ethnicity with reference to genetics and genomics. We show that there is still considerable conceptual “messiness” (despite the wide-ranging and popular debate on the subject) when it comes to the use of ethnoracial categories in genetics and genomics that among other things makes it difficult to properly compare and interpret research using ethnoracial categories, as well as draw conclusions from them. Finally, we briefly reconstruct some of the (...) biases of reductionism to which geneticists (as well as other researchers referring to genetic methods and explanations) are particularly exposed to, and we analyse the problem in the context of the biologization of ethnoracial categories. Our work constitutes a novel, in-depth contribution to the debate about reporting race and ethnicity in biomedical and health research. First, we reconstruct the theoretical background assumptions about racial ontology which researchers implicitly presume in their studies with the aid of a sample of recent papers published in medical journals about COVID-19. Secondly, we use the typology of the biases of reductionism to the problem of biologization of ethnoracial categories with reference to genetics and genomics. (shrink)

The often-emphasized tension between the singularity of the patient and technical–scientific reproducibility in medicine cannot be resolved without a discussion of the epistemological and methodological status of the human sciences. On the one hand, the rules concerning human action are analogous to the scientific laws of nature. They are de facto sufficiently stable to allow predictions and explanations similar to those of experimental sciences. From this point of view, it is only a trivial truth, but still a methodological irrelevancy, (...) that the patient and the doctor–patient relationship represent an ontologically irreproducible reality. On the other hand, however, one can never exclude that one can fail in the application of "laws" of the human sciences to the individual patient, for such laws are by no means wholly separated from a patient's personal-hermeneutic mediation, and can at any time be revoked by becoming aware of them. This requires a synergistic collaboration of clinical and statistical methods, and shows a methodologically relevant sense in which one cannot disregard the singularity of the patient. The reason for the crucial role of the patient's singularity in medicine is every individual patient's capacity to revoke, in principle, routines and quasi-automatisms, even though the personal mediation by the patient's consciousness de facto changes them in such a small degree that predictions and explanations modeled in experimental science remain possible. (shrink)

Purpose. Objectives of the study are as follows: to remove the reduction of women to a metaphysical subject, to the "castrated Other" through the correlation of postmodern strategies and gender medicine; to institutionalize gender medicine as knowledge and practical activities that improve the quality and span of life of women based on the methodological application of deconstruction, complementarity, differance, "double writing", X-subject treatment and biomedical innovations; the perspective of gender medicine development is the implementation of the concept (...) of "sovereign writing" of postmodern in individual treatment of a person. Theoretical basis. Shock value of the title means farewell to metaphysics in the complex of its derived concepts. The author criticizes the abstract, reduced, marginalized, deviant subject of classical metaphysics and its continuation in psychoanalysis, explores the correlation of postmodern philosophy strategies and biomedical innovations. The allusion to the masterpiece of world cinematography Pasolini’s "Ciao maschio" corresponds to the rhizomatic stylistics of the postmodern. Originality. After feminist transgressions, gender constructivism postmodern philosophy demonstrates a new subject and a new methodology, which formed gender medicine. Differance, distinction, complementarity, X-subject of treatment, chiasmatic movement, "double writing", "sovereign writing" organically turned over and reconstructed modern medicine in gender, biochemical, and hormonal innovative variations. Conclusions. 1. Based on the philosophy and biomedical innovations, a new direction has grown – gender medicine, which has removed the reduction of women to a metaphysical subject, "castrated Other", which has improved the quality of women’s health and span of life. 2. Gender medicine in organic combination with the strategies of deconstruction, complementarity, differance, distinction as hormonal distinction, "double writing" as a "dual protocol" of treatment for the same diseases of men and women, the treatment of X-subject turned out to be "new wisdom", which improves the quality of health and span of life in everyday practice. 3. The prospect of the gender medicine’s development is in the implementation of the "sovereign writing" as an individual treatment of a specific person. (shrink)

The rapid growth of human population and associated industrialisation creates strains on resources and climate. One way to understand the impact of human activity is to quantify the total environmental pressures by measuring the ‘footprint’. Footprints account for the total direct and/or indirect effects of a product or a consumption activity, which may be related to e.g. carbon, water or land use, and can be seen as a proxy for environmental responsibility. Footprints shape climate and resource debates, especially concerning environmental (...) strategies. However, in general, footprints hold a dichotomous producer–consumer perspective that is not unanimously accepted. In addition, the current footprinting system transmits a simplistic message about environmental responsibility that taints the justice debate and jeopardises the validity of policies based on them. Consequently, it is crucial to question who is accountable for adverse environmental effects. It is also critical to investigate how the methodological characteristics of footprints shape and affect the efficacy of policies on climate and natural resources. This article examines these challenges, focusing on negative justice and policy implications resulting from assigning environmental responsibility to a sole agent. The article proposes, and morally justifies, the development of a footprinting method that includes justice parameters in an attempt to render fair results that are more meaningful for environmental action. The second objective is to establish the potential of this new framework to promote environmental responsibility and justice while facilitating policymaking. The suggested justice elements aim at turning footprints into a concrete environmental policy instrument framed under the value of environmental fairness. (shrink)

In this essay, I look back at some of the earliest attempts by the first generation of literature-and-medicine scholars to answer the question: Why teach literature and medicine? Reviewing the development of the field in its early years, I examine statements by practitioners to see whether their answers have held up over time and to consider how the rationales they articulated have expanded or changed in the following years and why. Greater emphasis on literary criticism, narrative ethics, narrative (...) theory, and reflective writing has influenced current work in the field in ways that could not have been foreseen in the 1970s. The extraordinary growth of interest and work in the field nationally and, especially since 1996, internationally has included practitioners in many additional areas such as disability studies, film studies, therapeutic writing, and trauma studies. Along with the emergence of narrative medicine, this diverse community of scholars and practitioners—affiliated more through their use of narrative methodologies than the teaching of literature—makes the perennial challenge of evaluation and assessment even more complicated. (shrink)

The pluralism of methodologies and severe time constraints pose important challenges to pedagogy in clinical ethics. We designed a step-by-step student handbook to operate within such constraints and to respect the methodological pluralism of bioethics and clinical ethics. The handbook comprises six steps: Step 1: What are the facts of the case?; Step 2: What are your obligations to your patient?; Step 3: What are your obligations to third parties to your relationship with the patient?; Step 4: Do your obligations (...) converge or conflict?; Step 5: What is the strongest objection that could be made to the identification of convergence in step 4 or the arguments in step 4? How can this objection be effectively countered?; and Step 6: How could the ethical conflict, or perceived ethical conflict, have been prevented? (shrink)

This chapter brings some much-needed conceptual clarity to the debate about Locke’s scientific methodology. Instead of having to choose between the method of hypothesis and that of natural history (as most interpreters have thought), he would resist prescribing a single method for natural sciences in general. Following Francis Bacon and Robert Boyle, Locke separates medicine and natural philosophy (physics), so that they call for completely different methods. While a natural philosopher relies on “speculative” (causal-theoretical) hypotheses together with natural-history (...) making to explicate phenomena, a medical practitioner must prioritize collecting data about what remedies tend to cure what diseases over hypothesizing about the causes of the latter. (shrink)

Methodological concerns are moving to the top of the bioethics agenda for the next decade. This paper examines some of those concerns: (1) medical ethics as a subset of bioethics versus medical ethics as a subset of professional ethics; (2) a more in-depth examination of some methodological problems in treating medical ethics as professional ethics; (3) the senses in which bioethics constitutes an inquiry into secular undertakings in a pluralistic society; (4) ‘federal ethics’, the emergence to prominence of public commissions (...) and study groups; and (5) the institutional impact of bioethics on the relationship between medical schools and the liberal arts core of their sponsoring universities. Keywords: bioethics, medical ethics, methodology, pluralism, federal ethics CiteULike Connotea Del.icio.us What's this? (shrink)

My talk will be guided by the idea that there are some familiar scientific practices that are epistemically significant. I will argue that we can test for the success of these practices empirically by examining cases in the history of science. Specifically, I will reconstruct one particular episode in the history of medicine – John Snow's reasoning concerning the infectiousness of cholera – and offer this case as a concrete example of the sort of empirical research that needs to (...) be done in order to discover what kinds of methodological practices and rules are actually of epistemic interest. Analysing this case, I will explain how it (and other cases like it) can help us resolve specific cases of underdetermination. After exploring some possible anti-realist responses to this argument, I will conclude that, while the anti-realist is (more or less legitimately) able to construct underdetermination scenarios on a case-by-case basis, he will likely have to abandon the strategy of using algorithms to do so, thus losing the much needed guarantee that there will always be rival cases of the required kind. (shrink)

ZusammenfassungDer vorliegende Beitrag setzt sich mit der Frage nach angemessenen Methodologien und Methoden zur Erhebung und Integration empirischen Wissens in der Bio- und Medizinethik auseinander. Ausgehend von Überlegungen zum Haupt-Gegenstandsbereich der Ethik, dem Menschen als bio-psycho-sozialem Wesen und dessen Moral, wird argumentiert, dass die Sozialwissenschaften die zentralen empirischen Basiswissenschaften der Ethik darstellen. Im zweiten Abschnitt, der sich mit wissenschaftstheoretischen Überlegungen zum Verhältnis von Ethik, Empirie, Methodologien und Theorie und praktischen Beispielen der Integration empirischen Wissens befasst, wird nach den Ursachen für (...) das erkennbare Spannungsverhältnis zwischen Sozialwissenschaften, allgemeiner und angewandter Ethik gefragt, welches sich in der noch zu definierenden empirischen Ethik anders darstellt als in der traditionellen angewandten Ethik. Wie eine Bio- Ethik aussehen könnte, die diese Qualitätskriterien aufnimmt und in ihrem Feld fruchtbar macht, wird abschließend beschrieben. (shrink)

This paper focuses on the use of ‘black box’ AI in medicine and asks whether the physician needs to disclose to patients that even the best AI comes with the risks of cyberattacks, systematic bias, and a particular type of mismatch between AI’s implicit assumptions and an individual patient’s background situation.Pacecurrent clinical practice, I argue that, under certain circumstances, these risks do need to be disclosed. Otherwise, the physician either vitiates a patient’s informed consent or violates a more general (...) obligation to warn him about potentially harmful consequences. To support this view, I argue, first, that the already widely accepted conditions in the evaluation of risks, i.e. the ‘nature’ and ‘likelihood’ of risks, speak in favour of disclosure and, second, that principled objections against the disclosure of these risks do not withstand scrutiny. Moreover, I also explain that these risks are exacerbated by pandemics like the COVID-19 crisis, which further emphasises their significance. (shrink)

The philosophy of evidence-based medicine -- What is EBM? -- What is good evidence for a clinical decision? -- Ruling out plausible rival hypotheses and confounding factors : a method -- Resolving the paradox of effectiveness : when do observational studies offer the same degree of evidential support as randomized trials? -- Questioning double blinding as a universal methodological virtue of clinical trials : resolving the Philip's paradox -- Placebo controls : problematic and misleading baseline measures of effectiveness -- (...) Questioning the methodological superiority of "placebo" over "active" controlled trials -- Examining the paradox that traditional roles for mechanistic reasoning and expert -- Judgment have been up-ended by EBM -- A qualified defence of the EBM stance on mechanistic reasoning -- Knowledge that versus knowledge how : situating the EBM position on expert clinical judgment -- Moving EBM forward. (shrink)

There is a growing interest in comparison of international health care data with the hope that such studies will enable individual systems to learn from other systems. Such comparisons, however, presuppose that there exist common criteria for evaluating health care systems. The main thesis of this paper is that these comparative studies are misleading because they employ inappropriate operationalizations of these criteria because the operarionalizations are based upon mistaken global conceptualizations of the criteria in question. The essay provides a methodological (...) critique of what has been done and sets a new agenda for future research. (shrink)