Fredrik Svenaeus' book is a delight to read. Not only does he exhibit keen understanding of a wide range of topics and figures in both medicine and philosophy, but he manages to bring them together in an innovative manner that convincingly demonstrates how deeply these two significant fields can be and, in the end, must be mutually enlightening. Medicine, Svenaeus suggests, reveals deep but rarely explicit themes whose proper comprehension invites a careful phenomenological and hermeneutical explication. Certain philosophical approaches, on (...) the other hand - specifically, Heidegger's phenomenology and Gadamer's hermeneutics - are shown to have a hitherto unrealized potential for making sense of those themes long buried within Western medicine. Richard M. Zaner, Ann Geddes Stahlman Professor of Medical Ethics, Vanderbilt University. (shrink)
Exploring Renaissance humanists’ debates on matter, life and the soul, this volume addresses the contribution of humanist culture to the evolution of early modern natural philosophy so as to shed light on the medical context of the ...
In recent years, virtue theories have enjoyed a renaissance of interest among general and medical ethicists. This book offers a virtue-based ethic for medicine, the health professions, and health care. Beginning with a historical account of the concept of virtue, the authors construct a theory of the place of the virtues in medical practice. Their theory is grounded in the nature and ends of medicine as a special kind of human activity. The concepts of virtue, the virtues, and (...) the virtuous physician are examined along with the place of the virtues of trust, compassion, prudence, justice, courage, temperance, and effacement of self-interest in medicine. The authors discuss the relationship between and among principles, rules, virtues, and the philosophy of medicine. They also address the difference virtue-based ethics makes in confronting such practical problems as care of the poor, research with human subjects, and the conduct of the healing relationship. This book woith the author's previous volumes, A Philosophical Basis of Medical Practice and For the Patient's Good, are part of their continuing project of developing a coherent moral philosophy of medicine. (shrink)
The celebration of thirty years of publication of The Journal of Medicine and Philosophy provides an opportunity to reflect on how medical ethics has evolved over that period. The reshaping of the field has occurred in no small part because of the impact of branches of philosophy other than ethics. These have included influences from Kantian theory of respect for persons, personal identity theory, philosophy of biology, linguistic analysis of the concepts of health and disease, personhood theory, epistemology, and (...) political philosophy. More critically, medicine itself has begun to be reshaped. The most fundamental restructuring of medicine is currently occurring - stemming, in part, from the application of contemporary philosophy of science to the medical field. There is no journal more central to these critical events of the past three decades than The Journal of Medicine and Philosophy. (shrink)
Patients increasingly see physicians not as humane caregivers but as unfeeling technicians. The study of philosophy in medical school has been proposed to foster critical thinking about one's assumptions, perspectives and biases, encourage greater tolerance toward the ideas of others, and cultivate empathy. I suggest that the study of ethics and philosophy by medical students has failed to produce the humane physicians we seek because of the way the subject matter is quarantined in American medical education. First, (...) the liberal arts are seen as the province of undergraduate education, and not medical school. Second, philosophy, when taught in medical school, is seen by students as just one subject to be mastered along with many other more important ones, and not as a way to foster critical thinking and empathy. What is needed is a new pedagogy that combines both cognitive and affective elements to implant and nourish the liberal arts in students. Removing the quarantine of philosophy from other facets of medical education is an important first step. (shrink)
Doctor-patient interaction has gained increasing attention among sociologists and linguists during the last few decades. The problem with the studies performed so far, however, has been a lack of a theoretical framework which could bring together the various phenomena observed within medical consultations. Mikhail Bakhtin's philosophy of language offers us tools for studying medical practice as socio-cultural semiotic phenomenon. Applying Bakhtin's ideas of polyphonic, context-dependent and open-ended nature of human communication opens the possibilities to develop prevailing theoretical and (...) empirical approaches to the study of medical consultations. (shrink)
The presence of philosophy, amidst other humanities,within the body of medical education seems to raise no doubt nowadays. There are, however, some questions of a general nature to be discussed regarding the aforementioned fact. Three of them are of the greatest importance: (1) What image of medicine prevails in modern Western societies? (2)What ideals of medical professionals are commonly shared in these societies? (3) What is the intellectual background of the students of medico-related faculties? The real purposes and (...) goals ascribed to philosophy as a part of medical curricula, as well as methods of teaching philosophy depend on the answers given to these questions. An option to be presented here is influenced by the experience of teaching philosophy to students of medical faculties at the Jagiellonian University in Krakw. This approach is deliberately posed against mainstream medical education that is usually based on an unquestioned belief in the power of biomedical sciences. Such a model cannot, however,pretend to be a universal one to be implemented allover the world. In any case, it is the only thing a philosopher can do to improve the quality of a physician-patient encounter in facing a disease. (shrink)
What the philosophy of medicine is -- Philosophy of medicine: should it be teleologically or socially construed? -- The internal morality of clinical medicine: a paradigm for the ethics of the helping and healing professions -- Humanistic basis of professional ethics -- The commodification of medical and health care: the moral consequences of a paradigm shift from a professional to a market ethic -- Medicine today: its identity, its role, and the role of physicians -- From medical ethics (...) to a moral philosophy of the professions -- Moral choice, the good of the patient, and the patient's good -- The four principles and the doctor-patient relationship: the need for a better linkage -- Patient and physician autonomy: conflicting rights and obligations in the physician-patient relationship -- Character, virtue, and self-interest in the ethics of the professions -- Toward a virtue-based normative ethics for the health professions -- The physician's conscience, conscience clauses, and religious belief: a Catholic perspective -- The most humane of the sciences, the most scientific of the humanities -- The humanities in medical education: entering the post-evangelical era -- Agape and ethics: some reflections on medical morals from a catholic christian perspective -- Bioethics at century's turn: can normative ethics be retrieved? -- Hippocratic tradition -- Toward an expanded medical ethics: the Hippocratic ethic revisited -- Medical ethics: entering the post-Hippocratic era. (shrink)
: Medical ethics often is treated as applied ethics, that is, the application of moral philosophy to ethical issues in medicine. In an earlier paper, we examined instances of moral philosophy's influence on medical ethics. We found the applied ethics model inadequate and sketched an alternative model. On this model, practitioners seeking to change morality "appropriate" concepts and theory fragments from moral philosophy to valorize and justify their innovations. Goldilocks-like, five commentators tasted our offerings. Some found them too (...) cold, since they had already abandoned applied ethics; others too hot, since they still find the applied ethics model to their taste. We reply that the appropriation model offers an empirically testable account of the historical relationship between moral philosophy and medical ethics that explains why practitioners appropriate concepts and fragments from moral philosophy. In contrast, the now fashionable common morality theory neither explains moral change nor why practitioners turn to moral philosophy. (shrink)
In this commentary on the article by Arthur L. Caplan  the philosophy of medicine is viewed from a medical perspective. Philosophical studies have a long tradition in medicine, especially during periods of paradigmatic unrest, and they serve the same goal as other medical activities: the prevention and treatment of disease. The medical profession needs the help of professional philosophers in much the same way as it needs the cooperation of basic scientists. Philosophy of medicine may not (...) deserve the status of a philosophical subspecialty or field, but it so closely linked to the main trends of contemporary medical thinking that it must be regarded as an emerging (or reemerging) medical subdiscipline. (shrink)
In spite of the seminal work A Philosophical Basis of Medical Practice, the debate on the task and goals of philosophy of medicine still continues. From an European perspective it is argued that the main topics dealt with by Pellegrino and Thomasma are still particularly relevant to medical practice as a healing practice, while expressing the need for a philosophy of medicine. Medical practice is a discursive practice which is highly influenced by other discursive practices like science, (...) law and economics. Philosophical analysis of those influences is needed to discern their effect on the goals of medicine and on the ways in which the self-image of man may be changed. The nature of medical practice and discourse itself makes it necessary to include different philosophical disciplines, like philosophy of science, of law, ethics, and epistemology. Possible scenario's of euthanasia and the human genome project in the USA and Europe are used to exemplify how philosopy of medicine can contribute to a realistic understanding of the problems which are related to the goals of medicine and health care. (shrink)
The dearth of philosophical contributions to medicine has recently been discussed in a series of articles in this journal. The present article focuses on physicians' lack of training in philosophy as a part of the explanation of the scarcity of works in philosophy of medicine. In section I I outline two philosophy courses which would be reasonable additions to the medical school curriculum required of all medical students. In section II I suggest two other philosophy courses as electives (...) in a medical education. All four courses are in the fields of epistemology and metaphysics, and so will help others see the relevance to medicine of philosophical fields other than ethics. (shrink)
This book examines the extremely important issue of the consistency of medical involvement in ending lives in medicine, law and war. It uses philosophical theory to show why medical doctors may be involved at different stages of the capital punishment process. The author uses the theories of Emmanuel Kant and John S. Mill, combined with Gerwith's principle of generic consistency, to concretize ethics in capital punishment practice. This book does not discuss the moral justification of capital punishment, but (...) rather looks at the possible forms of involvement and shows why consistency would demand medical involvement. The author takes a general approach, using arguments that may apply universally. The book broaches different academic fields, such as medicine, ethics, business, politics and defense. The Ethics of Medical Involvement in Capital Punishment is of interest to students, teachers, lecturers and researchers working in the areas of capital punishment, medical, legal and business ethics, and political philosophy. (shrink)
Thus far in the development of the discipline of medical ethics, the overriding concern has been with solutions to specific problems. But discussion is hampered by lack of understanding of the scope and methodology of medical ethics, and its scientific and philosophical basis. In Underpinnings of Medical Ethics Edmond A. Murphy, James J. Butzow, and Edward L. Suarez-Murias offer much-needed clarification of the purview, ontological basis, and methodology of a medical ethics that is to be comprehensive (...) and yet readily accepted by all. The authors begin by describing the scope of the analysis and discussing possible ethical systems and paradigms. They then deal with the structures and concepts necessary in the formulation of a coherent philosophy: normality and disease, scientific and juridical law, certainty and certitude, decisions. Finally, they introduce particular human dimensions, such as quality of life, pain, and responsibility. Throughout, case examples illustrate the authors' theoretical framework. (shrink)
The effects of mental disorder are apparent and pervasive, in suffering, loss of freedom and life opportunities, negative impacts on education, work satisfaction and productivity, complications in law, institutions of healthcare, and more. With a new edition of the 'bible' of psychiatric diagnosis - the DSM - under developmental, it is timely to take a step back and re-evalutate exactly how we diagnose and define mental disorder. This new book by Derek Bolton tackles the problems involved in the definition and (...) boundaries of mental disorder. It addresses two main questions regarding mental illness. Firstly, what is the basis of the standards or norms by which we judge that a person has a mental disorder - that the person's mind is not working as it should, that their mental functioning is abnormal? Controversies about these questions have been dominated by the contrast between norms that are medical, scientific or natural, on the one hand, and social norms on the other. The norms that define mental disorder seem to belong to psychiatry, to be medical and scientific, but are they really social norms, hijacked and disguised by the medical profession? Secondly, what is the validity of the distinction between mental disorder and order, between abnormal and normal mental functioning? To what extent, notwithstanding appearances, does mental disorder involve meaningful reactions and problem-solving? These responses may be to normal problems of living, or to not so normal problems - to severe psycho-social challenges. Is there after all order in mental disorder? With the closing of asylums and the appearance of care in the community, mental disorder is now in our midst. While attempts have been made to define clearly a concept of mental disorder that is truly medical as opposed to social, there is increasing evidence that such a distinction is unviable - there is no clear line between what is normal in the population and what is abnormal. 'What is Mental Disorder?' reviews these various crucial developments and their profound impact for the concept and its boundaries in a provocative and timely book. (shrink)
Essential Philosophy of Psychiatry is a concise introduction to the growing field of philosophy of psychiatry. Divided into three main aspects of psychiatric clinical judgement, values, meanings and facts, it examines the key debates about mental health care, and the philosophical ideas and tools needed to assess those debates, in six chapters. In addition to outlining the state of play, Essential Philosophy of Psychiatry presents a coherent and unified approach across the different debates, characterized by a rejection of reductionism and (...) an emphasis on the ineliminability of uncodified skilled judgement. The first part, Values, outlines the debate about whether diagnosis of mental illness is essentially value-laden and argues that the prospects for reducing illness or disease to plainly factual matters are poor. It also explains the important role of skilled contextual judgement, rather than a principles-based deduction, in ethical judgement. The second part, Meanings, examines the central role of understanding and a shared first person perspective, both against attempts to reduce meaning to basic information-processing mechanisms and to explain away the difficulties of understanding psychopathology in recent models of delusion. The third part, Facts, shows the importance of uncodified clinical judgements, both in assessing the validity of psychiatric taxonomy and in the application of Evidence Based Medicine. Despite advances in the codifaction of practice and operationalism of diagnosis, an element of judgement remains in the assessment both of what, at one level, is good evidence for diagnosis and treatment and what, at a higher level, is good evidence for the validity of classification overall. (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)
In this unique study Fulford combines the disciplines of rigorous philosophy with an intimate knowledge of psychopathology to overturn traditional hegemonies. The patient replaces the doctor at the heart of medicine. Moral theory and the logic of evaluation replace epistemology as the focus of philosophical enquiry. Ever controversial, mental illness is at the interface of philosophy and medicine. Mad or bad? Dissident or diseased? Dr Fulford shows that it is possible to achieve new insights into these traditional dilemmas, insights at (...) once practically relevant and philosophically significant. (shrink)
This book offers a rich variety of thoughtful explorations on the nature of the human person especially as related to health care, medicine, and mental health. Rarely are so many different viewpoints collected in one place about the intriguing puzzle that is the concept of person, human dignity, and the special place human beings hold in the goals of healing and the social structures of medical delivery. Ramifications of the theory of personhood are presented for bioethics, genetics, individuality, uniqueness, (...) international law, feminism, and human rights in health care. Intended for professionals in the fields of philosophy of medicine, law, and bioethics, this book will also appeal to psychologists and medical anthropologists. (shrink)
Pt. I. Philosophy and cognitive-behavioral therapy (CBT) -- Ch. 1. The "philosophical origins" of CBT -- Ch. 2. The beginning of modern cognitive therapy -- Ch. 3. A brief history of philosophical therapy -- Ch. 4. Stoic philosophy and psychology -- Ch. 5. Rational emotion in stoicism and CBT -- Ch. 6 Stoicism and Ellis's rational therapy (REBT) -- Pt. II. The stoic armamentarium -- Ch. 7. Contemplation of the ideal stage -- Ch. 8. Stoic mindfulness of the "here and (...) now" -- Ch. 9. Self-analysis and disputation -- Ch. 10. Autosuggestion, premeditation, and retrospection -- Ch. 11. Preditatio malorum and mental rehearsal -- Ch. 12. Stoic fatalism, determination, and acceptance -- Ch. 13. The view from above and stoic metaphysics. (shrink)
A unique relationship exists between physicians and philosophers â one that expands on the constructive potential of the liaison between physicians and, for example, theologians, on the one hand, or, social workers on the other. This liaison should focus in the scientific aspects of medicine, not just the ethical aspects. Philosophers can provide physicians with a perspective on both the philosophy and the history of medicine through the ages â a sense of how medicine has adapted to the social cultural (...) and ethical needs of each period. This perspective, while emphasizing medicine asscience, should not be limited to matters of methodology, or to criteria for distinguishing science from other intellectual pursuits, but should be concerned also with the history, sociology and politics of science. Both physicians and philosophers stand to gain from a strengthening of their active liaison now as never before; but most of all, the public will be the beneficiary. (shrink)
Today the medical community faces a number of pressing issues. Molecular and high-tech medicine, despite their tremendous successes, also burden us with new ethical dilemmas: when and how to die, whose life to preserve, whether to modify genes and to create life, and how to pay for it all. Furthermore, alternative methods appear to work at least for certain disorders. They are popular and definitely cost less, while the spiraling costs of conventional medicine have led to the development of (...) managed care and health economy assessments with controversial consequences. An international symposium in Berlin, in September 1999, sought to address some of these issues by sparking an interdisciplinary discussion gathering leading experts in the field of genetics, robotic surgery, medical ethics, preventive health and health economics, history, and law. This book contains all the contributions and seeks to involve scholars and medical practitioners who are interested in shaping the future of medicine. (shrink)
This collection brings together original essays demonstrating the cutting edge of philosophical research in medical ethics. With contributions from a range of established and up-and-coming authors, it examines topics at the forefront of medical technology, such as ethical issues raised by developments in how we research stem cells and genetic engineering, as well as new questions raised by methodological changes in how we approach medical ethics.
Nature and Narrative is the launch volume in a new series of books entitled International Perspectives in Philosophy and Psychiatry. Nature(representing interest in the causes of a problem) and Narrative (for understanding its meanings) will introduce the field and the series, by touching on a range of issue relevant to this interdisciplinary 'border country'.
Doctor's Dilemmas, a fascinating study of the moral dilemmas confronting health professionals and patients alike, examines areas of health care where ethical conflicts often arise. Gorovitz illuminates these conflicts by clearly explaining and applying a broad range of philosophical concepts. He lays the groundwork for informed ethical decision-making and provides the general reader with a lucid overview of the complexities of medical practice. Written in accessible, conversational style and making extensive use of anecdotes, examples, and references to literature, Doctor's (...) Dilemmas offers profound insights into medical ethics for all those involved with the health professions--be they doctors, nurses, administrators, or patients. (shrink)
How is the concept of patient care adapting in response to rapid changes in healthcare delivery and advances in medical technology? How are questions of ethical responsibility and social diversity shaping the definitions of healthcare? In this topical study, scholars in anthropology, nursing theory, law and ethics explore questions involving the changing relationship between patient care and medical ethics. Contributors address issues that challenge the boundaries of patient care, such as: · HIV-related care and research · the impact (...) of new reproductive technologies · preventative healthcare · technological breakthroughs that are changing personal-caring relationships. Chapters range from a consideration of the practicalities of nursing and family healthcare to a debate about ‘universal human needs’ and patients’ rights. This book is a provocative exploration of the ways in which healthcare models are socially constructed. It will be of interest to policy-makers, medical practitioners and administrators, as well as students of sociology, anthropology and social policy. (shrink)
In the late twentieth century the impressive achievements of modern medicine are obvious, yet medicine seems to have failed to satisfy public expectation. Government regulation of hospitals and doctors is tightening in most Western countries and health funding is a divisive political issue. Medical complaints departments are increasingly busy. In the United States medical litigation has reached alarming levels, and a similar trend can be seen in other developed countries. Is there something wrong with medical research and (...) practice? This book, written by a surgeon with more than thirty years experience of clinical medicine, examines what it is that doctors do, and what it is that patients expect of them. It finds that in the face of uncertainty, expectation and reality ofen often diverge. Starting from the communication difficulties that exist between doctors and patients, Humane Medicine explores the roles of science, ethics and the humanities in medical practice. It forcefully argues that more science cannot heal this rift, nor can better education in ethics. To foster better communication, medical teachers must change their philosophy and methods, so that value-laden issues in clinical medicine are interwoven with the necessary science. Professor Little outlines some possible ways to achieve this. This important book will be of interest to medical students and their teachers, clinicians, health policy planners and other readers concerned about the direction of the medical profession. (shrink)
When first published twenty years ago, The Logic of Medicine presented a new way of thinking about clinical medicine as a scholarly discipline as well as a profession. Since then, advances in research and technology have revolutionized both the practice and theory of medicine. In this new, extensively rewritten edition, Dr. Murphy includes changes to show how these different areas of scholarship may affect details of "the logic of medicine" without compromising its fundamental coherence. New to this edition are discussions (...) of the challenge of the flood of new empirical data, new ideas in genetics, molecular biology, homeostasis, pathogenesis, cancer, aging, and Alzheimer's disease. Murphy also comments on such new theoretical topics as dynamic systems, chaos, and fractals and their impact on the burgeoning fields of philosophy and practice of medicine. Written with medical students in mind, the book includes a glossary, many new examples, and problems for solutions with comments on each. An entirely new chapter deals with modeling. Clinicians and researchers will also find the principles thought-provoking and illuminating. (shrink)
Most available resources for teachers and students in biomedical ethics are based on a notion of medicine and of how to understand and illuminate its ethical problems that is at least two decades old. Meaning and Medicine dramatically expands the repertoire of resources for teachers and students of bioethics. In addition to providing fresh perspectives on both traditional and emerging questions in bioethics, this Reader focuses on questions in social philosophy, epistemology, and metaphysics as they are raised by developments in (...) contemporary health care. A chief aim of this resource is to rekindle interest in seeing health care not solely as a set of practices so problematic as to require ethical analysis by philosophers and other scholars, but as a field whose scrutiny is richly rewarding for the traditional concerns of philosophy. (shrink)
Conceiving mental disorder -- Disorder of mental disorder -- On being skeptical about mental disorder -- Seeking norms for mental disorder -- An original position -- Addiction and responsibility for self -- Reality lost and found -- Minding the missing me.
The article offers an approach to inquiry about, the foundation of medical ethics by addressing three areas of conceptual presupposition basic to medical ethical theory. First, medical ethics must presuppose a view about the nature of medicine. it is argued that the view required by a cogent medical morality entails that medicine be seen both as a healing relationship and as a practical art. Three ways in which medicine inherently involves values and valuation are presented as (...) important, i.e., in being aimed at the good of health, in being a cognitive art evaluating towards that good, and as a manifestation of a virtuous disposition concerning that good. Finally, a value ontology drawn from these considerations is seen as necessarily underlying medical ethics. A set of three such basic values are promoted as crucial: the value of health; the value of the individual patient; and the value of altruism that mediates the class of potential patients. (shrink)
Health defined as the psychophysiological capacity to act or respond appropriately in a wide variety of situations, is enhanced by many means other than preventing and treating disease and injury. Therefore no choice of a particular medical intervention is likely to maximize health for all people with (or at risk for) a given disease. As a result, if medical practitioners are to be fully competent in the sense of knowing not only how to perform procedures but when and (...) when not to do so, they must be able to support patients (and those who know and care about them) in weighing all of the many factors which bear upon the decision as to which, if any, medical interventions are likely to improve the person''s health. (shrink)
Medicine, as Byron Good argues, reconstitutes thehuman body of our daily experience as a medical body,unfamiliar outside medicine. This reconstitution can be seen intwo ways: (i) as a salutary reminder of the extent to which thereality even of the human body is constructed; and (ii) as anarena for what Stephen Toulmin distinguishes as theintersection of natural science and history, in which many ofphilosophy''s traditional (and traditionally abstract) questionsare given concrete and urgent form.This paper begins by examining a number of (...) dualities between themedical body and the body familiar in daily experience. Toulmin''s epistemological analysis of clinical medicine ascombining both universal and existential knowledge is thenconsidered. Their expression, in terms of attention,respectively, to natural science and to personal history, isexplored through the epistemological contrasts between themedical body and the familiar body, noting the traditionalphilosophical questions which they in turn illustrate. (shrink)
This paper begins by examining the claim that the practice of medicine is essentially a moral endeavor. According to this view, all clinical practice has moral content, and each clinical situation has a moral dimension. I suggest that in order to recognize this moral dimension, clinicians must engage in an interpretive process, and that they must be able to interpret clinical data in ethical terms. However, clinicians often lack the ‘moral perception’ required to appreciate this moral dimension. I will argue (...) that physicians lack moral perception when the clinical data they are given do not offer sufficient opportunity for interpretation. This paper draws on the work of Merleau-Ponty to suggest that this loss of interpretation is, paradoxically, the result of the way that patients experience illness. This thesis may be productive, first, because it suggests opportunities to explore the process of moral perception. This thesis also suggests ways for ethicists and educators to enhance clinicians' perception of the ethical dimensions of clinical practice. Finally, the concept of moral perception, when grounded in the patient's experience of illness, creates a fruitful area of inquiry that warrants inclusion in what may someday be the philosophy of medicine's canon. (shrink)
Psychopharmacology - a remarkable development -- Philosophical questions raised by psychopharmacology -- How to think about science, language, and medicine : classical, critical, and integrated perspectives -- Conceptual questions about psychotropics -- Explanatory questions about psychotropics -- Moral questions about psychotropics.
Psychopharmacology : a remarkable development -- Philosophical questions raised by psychopharmacology -- How to think about science, language, and medicine : classical, critical, and integrated perspectives -- Conceptual questions about psychotropics -- Explanatory questions about psychotropics -- Moral questions about psychotropics.
The purpose of this paper is to introduce an approach to clinical practice aiming to resolve the dilemma of choosing between a mechanistic and a phenomenological model. The approach is an extension of Polanyi's epistemology. Michael Polanyi (1891–1976), devised an epistemology of science which overcomes the problem of detachment, inherent in the mechanistic approach, and resolves the problem of subjectivity troubling phenomenologists. His epistemology is known as Personal Knowledge. An extension (...) of this epistemology, a Neo-Polanyian proposal, is offered as a more successful model for clinical practice than previous suggestions addressing the dilemma. (shrink)
In this introductory paper, I try to give an overview of the concept of normativity in its philosophical history and its contemporary interpretations and uses in different fields. From philosophy of logic and mathematics to philosophy of language and mind, and to philosophy of medicine and care, normativity is found as a key concept pointing at the possibility of scientific and technical progress and improvement of human life in the interaction between the individual and his environment.
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)
How should medical services be distributed within society? Who should pay for them? Is it right that large amounts should be spent on sophisticated new technology and expensive operations, or would the resources be better employed in, for instance, less costly preventive measures? These and others are the questions addreses in this book. Norman Daniels examines some of the dilemmas thrown up by conflicting demands for medical attention, and goes on to advance a theory of justice in the (...) distribution of health care. The central argument is that health care, both preventive and acute, has a crucial effect on equality of opportunity, and that a principle guaranteeing equality of opportunity must underly the distribution of health-care services. Access to care, preventive measures, treatment of the elderly, and the obligations of doctors and medical administrations are fully discussed, and the theory is shown to underwrite various practical policies in the area. (shrink)
Decision making is a crucial element in the field of medicine. The physician has to determine what is wrong with the patient and recommend treatment, while the patient has to decide whether or not to seek medical care, and go along with the treatment recommended by the physician. Health policy makers and health insurers have to decide what to promote, what to discourage, and what to pay for. Together, these decisions determine the quality of health care that is provided. (...) Decision Making in Health Care is an up-to-date, comprehensive overview of the field of medical decision making. It includes quantitative theoretical tools for modeling decisions, psychological research on how decisions are actually made, and applied research on how physician and patient decision making can be improved. (shrink)
What are the final limits of medicine? What should we not try to cure medically, even if we had the necessary financial resources and technology? This book philosophically addresses these questions by examining two mirror-image debates in tandem. Members of certain groups, who are deemed by traditional standards to have a medical condition, such as deafness, obesity, or anorexia, argue that they have created their own cultures and ways of life. Curing their conditions would be a form of genocide. (...) Members of other groups are seeking to provide medical treatment to what would conventionally be deemed 'cultural conditions'. Mild neurotics who take anti-depressants to elevate their mood, runners who use steroids, or men and women seeking cosmetic surgery are asking for medical treatment for problems that might be solved culturally, by changing norms, pressures, or expectations in the broader culture. Each of these two debates endeavors to locate medicine's final frontier and to articulate what it is that we should not treat medically even if we could. This volume analyzes what these two contemporary debates have to say to each other and thus offers a new way of determining medicine's final limits. (shrink)
This textbook develops the issue of ethics to a philosophical level complex enough to be applicable to students of philosophy and applied ethics courses. It is the first book to address clinical problems from a classical perspective. This title available in eBook format. Click here for more information . Visit our eBookstore at: www.ebookstore.tandf.co.uk.