This study is based on a critique of Western medicine derived from the proposition that any system of medicine must necessarily embody a mysterious quality. What is meant by mystery is an all encompassing element of indeterminancy and so of uncertainty in both the theory and practice of medicine.

Experience and science, being the two sources of technology, have different focuses. In experiential technology, techniques and skills are emphasized while in scientific technology tool or equipment. Experiential technology is generally regarded as local knowledge, and scientific technology universal. Traditional Chinese medicine is an experiential technology. In contrast, Western medicine is set up as a scientific technology with great efforts. Through the comparison of these two medicines, this paper attempts to illustrate the difference between the two technologies (...) and in turn, the difference between these two medicines by defining these two technologies. Finally, this paper further investigates the special values of Chinese medicine. Making use of the SSK theory, this paper deconstructs the idea of universality of science, and argues that, the universality is the feature that science pursues, but not what it already has. With more historical evidence, experiential technology is more stable, while scientific technology is less stable because it updates quickly, and often changes reversely. (shrink)

Speakers of different languages perceive time differently depending on various factors such as age, pace of life, religion, time of day, and even pregnancy. In recent years, studies have shown that...

Mindfulness as a clinical and nonclinical intervention for a variety of symptoms has recently received a substantial amount of interest. Although the application of mindfulness appears straightforward and its effectiveness is well supported, the concept may easily be misunderstood. This misunderstanding may severely limit the benefit of mindfulness-based interventions. It is therefore necessary to understand that the characteristics of mindfulness are based on a set of seemingly paradoxical structures. This article discusses the underlying paradox by disentangling it into five dialectical (...) positions - activity vs. passivity, wanting vs. non-wanting, changing vs. non-changing, non-judging vs. non-reacting, and active acceptance vs. passive acceptance, respectively. Finally, the practical implications for the medical professional as well as potential caveats are discussed. (shrink)

Ancient medical and healing systems are currently attracting considerable interest. This issue includes interdisciplinary studies which focus on new perceptions of some ancient and medieval medical systems, exploring how they related to each other, and assessing their contribution to modern society. It is shown that pre-Greek medicine included some rational elements, and that Egyptian and Babylonian medical systems contributed to a tradition which led from classical antiquity through the Middle Ages and beyond. The reliability of sources of evidence is (...) considered, as well as the legacy of the ancient healing environments and disease treatments. Finally, where documentation survives, the legacy of social attitudes to health and disease is considered. Overarching principles directed policies of social medicine and healthcare in antiquity and the Middle Ages: for example, the causes and transmission routes of infectious diseases, as well as the basic principles of sterilization, were unknown, but nevertheless attempts were made to improve sanitation, provide clean water, and ensure access to trained physicians. In some cases, the need to limit the size of the population prompted the use of contraceptive measures, and surviving information also illuminates attitudes to deformity, disability and the treatment of the terminally ill. (shrink)

It is generally recognized that China, while attempting to develop modern scientific medicine in carrying out its national policy for modernization, has also made significant efforts to integrate traditional Chinese medicine into its health care system. For instance, the World Health Organization's first global strategy on traditional and alternative medicine lists China as one of only four of its member states to have attained an integrative health care system. However, medical integration can take many different forms and (...) involve quite different health care standards. A health care standard is a set of mechanisms by which distinct diagnostic and therapeutic practices and products are validated or accredited for use in health care delivery. Traditional Chinese medicine and modern scientific medicine adopt different sets of such mechanisms and thereby engage different health care standards. Accordingly, in appraising the Chinese integrative health care system, it is important to investigate which health care standard has been appealed to. (shrink)

Does it work? This question lies at the very heart of the kinds of controversies that have surrounded complementary and alternative medicines (such as herbal medicine) in recent decades. In this article, I argue that medical anthropology has played a pivotal and largely overlooked role in taking the sham out of the placebo effect with important implications for what it means to say a therapy or drug `works'. If pharmacologists and clinicians have corporeally located the concept of efficacy in (...) terms of bio-availability, pharmacodynamics and pharmacokinetics, and herbalists in terms of a herbal revitalizing of the body's own vis medicatrix naturae, from the early 20th century onwards medical anthropologists (especially those who became interested in the `savage mind') have built up an equally rigorous theory of symbolic efficacy in terms of narratives, symbols and a kind of cognitive homeostasis. It was precisely as a mediating link between the somatic and the symbolic that I suggest a decriminalized placebo effect (as opposed to suggestion) could emerge in the middle of the 20th century. Taking the example of St John's Wort, I go on to show how notions of symbolic efficacy, spillover placebo efficacy and bio-efficacy co-circulate in recent attempts by herbalists, clinicians and pharmacologists to address the question of whether or not this herbal remedy `works' in the treatment of depression. (shrink)

It is generally recognized that China, while attempting to develop modern scientific medicine in carrying out its national policy for modernization, has also made significant efforts to integrate traditional Chinese medicine into its health care system. For instance, the World Health Organization's first global strategy on traditional and alternative medicine lists China as one of only four of its member states to have attained an integrative health care system. However, medical integration can take many different forms and (...) involve quite different health care standards. A health care standard is a set of mechanisms by which distinct diagnostic and therapeutic practices and products are validated or accredited for use in health care delivery. Traditional Chinese medicine and modern scientific medicine adopt different sets of such mechanisms and thereby engage different health care standards. Accordingly, in appraising the Chinese integrative health care system, it is important to investigate which health care standard has been appealed to. (shrink)

Small, mundane technologies, such as stethoscopes, medicinal bottles, labels, cleaning and dispensing equipment, are integral to the practice of western herbal medicine in the UK. A focus on such technologies reveals the dynamic character and porousness of medical systems and allows us to identify cultural interactions. In this photo essay, based on long-term anthropological research, I explore an assemblage of everyday technologies used by WHM practitioners and the ways in which these technologies contribute to shaping diagnostic stories, to (...) performing medical legitimacy and invoking herbal traditions. The biomedical, herbal and domestic technologies-in-use come into view as vibrant and dynamic objects with highly contingent meanings and identities. Their absorption into this non-biomedical therapy supports the performance of medical legitimacy, authority, tradition and professionalism, while the use of everyday domestic objects may signal female-coded practices of care. This demonstrates the adaptability of a medical practice situated at the margin of mainstream healthcare and subject to ongoing technological and ideological influence. The strategic integration of this assemblage of everyday technologies into WHM contributes, I suggest, to evoking a competent, trustworthy and time-honoured medical practice, which is simultaneously inscribed with multiple tensions, ambiguities and contestations. (shrink)

ABSTRACTIn his commentary on Aceme Nyika’s paper ‘Ethical and Regulatory Issues Surrounding African Traditional Medicine in the Context of HIV/AIDS’,1 Godfrey B. Tangwa charges the author with inappropriately using expressions, terminology and criteria of evaluation appropriate in Western scientific medicine to judge African traditional medicine . He seriously frowns on Nyika’s suggestion that African TM needs to be incorporated into, and subjected to the canons of Western scientific medicine. Such a suggestion, he believes, is (...) a prescription for invasion, colonization and exploitation so characteristic of the relationship between Africa and the Western world. However, he thinks that African TM is quite compatible with Western scientific medicine. (shrink)

In Western literatures, "conflict" is a general term that refers to discord between two or more entities. In Islamic jurisprudence, however, in addition to the term "conflict", there is another term which is called tazāhum. The two terms, however, have different definitions. Conflict between two concepts, for instance, indicates that one is right and the other is wrong, while tazāhum does not necessarily have to be between right and wrong, and may appear between two equally right concepts. Moreover, conflict (...) exists on a legislative level, while tazāhum is a matter of obedience and adherence, meaning that in practice, both sides cannot continue to coexist. Conflict of interest is a known term in Western literatures, and according to D.F. Thompson, it refers to a situation where professional judgment regarding a primary interest is improperly and unjustifiably influenced by a secondary interest. Taking into account Thompson's definition and the distinction between "conflict" and "tazāhum", the English term "conflict of interest" translates to "tazāhum of interest" in Islamic jurisprudence as it refers to a person's action without reflecting right or wrong, and simply concerns priority of one interest over another. The resolution to tazāhum in Islamic jurisprudence lies in two principles: the principle of significance and the principle of choice. For instance, in case of conflict or tazāhum between the interests of patient and physician, the patient's interest should be the main concern based on the principle of significance. Although Western literatures propose methods such as disclosure or prohibition in order to resolve conflict of interest, the foundation for these solutions seems to have been the principle of significance. (shrink)

Sustainable Medicine is based on the premise that twenty-first century Western medicine--driven by vested interests--is failing to address the root causes of disease. Symptom-suppressing medication and "polypharmacy" have resulted in an escalation of disease and a system of so-called "health care," which more closely resembles "disease care." In this essential book, Dr. Sarah Myhill aims to empower people to heal themselves by addressing the underlying causes of their illness. She presents a logical progression from identifying symptoms, to (...) understanding the underlying mechanisms, to relevant interventions and tests and tools with which to tackle the root causes. As Myhill writes, "It's all about asking the question 'why?'" Sustainable Medicine covers a wide range of symptoms including inflammation (infection, allergy, autoimmunity), fatigue, pain, toxic symptoms, deficiency symptoms, and hormonal symptoms. And Dr. Myhill includes a toolbox of treatments for specific illnesses and ailments, as well as a general approach to avoiding and treating all disease. Finally, she offers a series of case histories to show how people have successfully taken control of their health and healed even in the face of the most discouraging symptoms--all without the harmful interventions of 21st century Western medicine. (shrink)

Hui medicine is originated from Muslim medicine through Silk Road. This medicine is a unique Chinese traditional medicine system formed by the integration of traditional Islamic Arabia medicine and traditional Chinese medicine. This ethnic medicine is Sinicization of Islamic culture. It is also the cream of ancient Eastern and Western traditional medicine of China. Religion is very important for the Islamic faith population such as Hui nationality. Although Halal food, restaurants and (...) schools are everywhere in Qinghai Xining city, there are not reports about the medical practice in the Muslim faith population. In this article, the in-patients are from Qinghai Kangle Hospital which is Hui medicine special hospital located in Hui majorities area in Qinghai Chengdong area. The data had been collected from January 1, 2020 to June 30, 2023 of COVID-19 period. This hospital served both Muslim and non-Muslim patients, and the medical doctors nurses and staffs are also come from Muslim and non-Muslim background, the education background is Western medicine and Traditional Chinese Medicine. Our results showed that there are no significant difference between the Muslim-believers and non Muslim-believers in their medical practice. The religion may not be important among the inpatients who served with Chinese Hui Medicine in Kangle Hospital. (shrink)

BackgroundPost-stroke depression is one of the most common neuropsychiatric diseases in patients with stroke, and it can increase the disability rate, mortality, and recurrence rate of stroke. Currently, many clinical studies have indicated that traditional Chinese medicine, such as acupuncture and herbs, Western medicine, rehabilitation, repeated transcranial magnetic stimulation, and other treatment methods, are effective in treating PSD. However, no study has formulated a comprehensive treatment plan that integrates TCM, Western medicine, and rehabilitation for PSD. (...) Thus, this trial aims to assess the efficacy and safety of integrative medicine for treating PSD.MethodsThis multicenter, prospective, randomized, controlled study aims to form a set of effective clinical treatment schemes that integrate TCM, Western medicine, and rehabilitation for PSD. A total of 202 participants recruited from four centers will be randomized into either the integrative medicine or standard care group. Standard care—basic treatment, general nursing care, and exercise therapy—will be provided to all participants. The integrative medicine group will also receive acupuncture, Chinese herbs, and repeated transcranial magnetic stimulation. Participants will receive acupuncture and rTMS treatments five times per week for 4 weeks and will be administered Chinese herbs, basic treatment, general nursing care, and exercise therapy for 4 weeks. The primary outcomes include the Hamilton Depression Scale, Self-Rating Depression Scale, and Activity of Daily Living Scale. And the secondary outcomes include the Montreal Cognitive Assessment Scale, the Fugl-Meyer Assessment Scale, and the Pittsburgh Sleep Quality Index. All outcome measures will be evaluated at baseline, week 4, and week 8. Safety assessments will be performed throughout the study.DiscussionThis study is expected to verify the efficacy and safety of integrative medicine for treating PSD, providing an evidence-based clinical reference for the future development of a standardized scheme.Clinical trial registrationClinicalTrials.gov, identifier: NCT05187975. (shrink)

The first part of a symposium devoted to Alex Broadbent's essay titled ‘Prediction, Understanding and Medicine’, this article notes the under-development of a variety of issues in the philosophy of medicine that transcend bioethics and the long-standing debates about the nature of health/illness and of evidence-based medicine. It also indicates the importance of drawing on non-Western, and particularly African, traditions in addressing these largely metaphysical and epistemological matters.

Complementary and alternative medicine is becoming increasingly popular in western countries, with estimates of CAM usage as high as 40%. This has prompted a change of attitude of the medical establishment: the initial dismissal of CAM is being replaced by a drive to integrate CAM into the mainstream. Two possible explanations for this integration thrust are considered. Firstly, integration could be motivated largely by cognitive interest in CAM. Secondly, integration could be mainly power-driven, aimed at controlling the alternative (...) movement and exploiting its capacity to make money. The second explanation seems more plausible, and is supported by data showing the paucity of research on CAM. The medical establishment does not sufficiently appreciate the challenge CAM poses, and does not consider its scientific appraisal to be a high priority. Instead, the allopathic community seems preoccupied with the opportunistic desire to protect its authority and social status. Such a discourse can become dogmatic, reluctant to revise critically the ‘accepted’ body of knowledge. Popper's critical rationalism could help to undercut dogmatism and encourage a critical, open-minded orientation of medical science. (shrink)

BackgroundLittle is known about teaching medical ethics across cultural and linguistic boundaries. This study examined two successive cohorts of first year medical students in a six year undergraduate MBBS program.MethodsThe objective was to investigate whether Arabic speaking students studying medicine in an Arabic country would be able to correctly identify some of the principles of Western medical ethical reasoning. This cohort study was conducted on first year students in a six-year undergraduate program studying medicine in English, their (...) second language at a medical school in the Arabian Gulf. The ethics teaching was based on the four-principle approach (autonomy, beneficence, non-malfeasance and justice) and delivered by a non-Muslim native English speaker with no knowledge of the Arabic language. Although the course was respectful of Arabic culture and tradition, the content excluded an analysis of Islamic medical ethics and focused on Western ethical reasoning. Following two 45-minute interactive seminars, students in groups of 3 or 4 visited a primary health care centre for one morning, sitting in with an attending physician seeing his or her patients in Arabic. Each student submitted a personal report for summative assessment detailing the ethical issues they had observed.ResultsAll 62 students enrolled in these courses participated. Each student acting independently was able to correctly identify a median number of 4 different medical ethical issues (range 2–9) and correctly identify and label accurately a median of 2 different medical ethical issues (range 2–7) There were no significant correlations between their English language skills or general academic ability and the number or accuracy of ethical issues identified.ConclusionsThis study has demonstrated that these students could identify medical ethical issues based on Western constructs, despite learning in English, their second language, being in the third week of their medical school experience and with minimal instruction. This result was independent of their academic and English language skills suggesting that ethical principles as espoused in the four principal approach may be common to the students' Islamic religious beliefs, allowing them to access complex medical ethical reasoning skills at an early stage in the medical curriculum. (shrink)

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)

This article sets out to explore the way in which Western science and technology was received in the Mbeere Mission of central Kenya since August 1912 when a medical missionary, Dr T.W.W. Crawford, visited the area. In his dalliance with ecclesiastical matters, Crawford, a highly trained Canadian medical doctor, was sent by the Church Missionary Society (CMS) at Kigari-Embu, in 1910, to pioneer the Anglican mission in the vast area that included Mbeereland, where Mbeere Mission is situated. Contending with (...) the African indigenous knowledge in medicine, environmental conservation, agriculture and other forms of indigenous science, the introduction of Western science and technology, 1912 to 1952, the article argues, did not erase the former; rather, it complimented it. Pockets of general resistance were evident, though Mbeereland, unlike its neighbouring Mutira Mission of 1912, did not offer elaborate opposition to the Western science and technology, partly because the locals could have learnt about it from their neighbours who had experienced it much earlier. Through a historico-narrative design, the research article endeavours to primarily review the coming of Western medicine in Mbeereland: Did it conflict with the African medicine? Methodologically, the data have been collected via archival sources, oral interviews and by reviewing applicable literature.Contribution: The input of this research article to the HTS Journal’s vision and scope is seen by appreciating its focus on the interface between African indigenous knowledge and the European science and technology. Although the main focus is. (shrink)

There is a prevailing conviction that if traditional medicine (TRM) or complementary and alternative medicine (CAM) are integrated into healthcare systems, modern scientific medicine (MSM) should retain its principal status. This paper contends that this position is misguided in medical contexts where TRM is established and remains vibrant. By reflecting on the Chinese policy on three entrenched forms of TRM (Tibetan, Mongolian and Uighur medicines) in western regions of China, the paper challenges the ideology of science (...) that lies behind the demand that all traditional forms of medicine be evaluated and reformed according to MSM standards. Tibetan medicine is used as a case study to indicate the falsity of a major premise of the scientific ideology. The conclusion is that the proper integrative system for TRM and MSM is a dual standard based system in which both TRM and MSM are free to operate according to their own medical standards. (shrink)

First published in 1992. Routledge is an imprint of Taylor & Francis, an informa company.

Chinese Hui medicine is a unique Chinese traditional medicine system formed by the integration of traditional Islamic Arabia medicine and China traditional Chinese medicine. It is also the cream of ancient Eastern and Western traditional medicine. Hui medicine is based on its unique concepts of Hui medical philosophy, such as the theory of Zhenyi Vitality and the theory of seven elements. It is the only traditional national medicine developed by inheriting Islamic Arab (...) medical philosophy and integrating Chinese traditional Chinese medical philosophy theory. Hui medicine likes to use the application method characterized by aromatic Hui medicine (also known as ship medicine). It has high traditional treatment effect in Hui orthopedics and traumatology, Hui medicine of brain, Hui medicine of gynecology, Hui medicine of ophthalmology, Hui medicine of dermatology, Hui medicine of anorectal, etc. There is a relatively complete traditional medical system of Hui medicine. The Sinicized Islamic philosophical system guides the philosophical concept of Hui medicine. Hui medicine absorbs and combines the essence of traditional Chinese medicine, which forms the theoretical system of “Zhenyi (True one)”, “Vitality”, “Yin and Yang”, “Qixing”, “Four natures”, “Four body fluids” “Viscera Qi activity” and “Four parts and seven diseases” systems, which have been formed in the diagnosis and treatment of diseases. The characteristics of Hui medicine application are based on the formulation of aromatic drugs, and the nature of cold, hot, dryness, and humidity is conducted for each drug, as well as the drug strength (toxicity) of each drug is graded in grades 1 - 4. Therefore, Hui medicine is a traditional ethnic medicine combined with Chinese and Western medicine. (shrink)

Melancholia is a commonly experienced feeling, and one with a long and fascinating medical history which can be charted back to antiquity. Avoiding the simplistic binary opposition of constructivism and hard realism, this book argues that melancholia was a culture-bound syndrome which thrived in the West because of the structure of Western medicine since the Ancient Greeks, and because of the West's fascination with self-consciousness. While melancholia cannot be equated with modern depression, Matthew Bell argues that concepts from (...) recent depression research can shed light on melancholia. Within a broad historical panorama, Bell focuses on ancient medical writing, especially the little-known but pivotal Rufus of Ephesus, and on the medicine and culture of early modern Europe. Separate chapters are dedicated to issues of gender and cultural difference, and the final chapter offers a survey of melancholia in the arts, explaining the prominence of melancholia - especially in literature. (shrink)

Medicine and morality in rural Haiti are shaped both by different local religious traditions and by biomedical and folk medicine practices. People who become ill may seek treatment from Western doctors, but also from herbalists and religious leaders. This study examines the decisions guiding such choices, and considers moral issues arising in a society where suffering is associated with guilt but where different, sometimes conflicting, ethical systems coexist. It also reveals how in the crisis of illness people (...) rework religious identities and are forced to address fundamental social and political problems. (shrink)

Basing ourselves on the writings of Hans Jonas, we offer to psychosomatic medicine a philosophy of life that surmounts the mind-body dualism which has plagued Western thought since the origins of modern science in seventeenth century Europe. Any present-day account of reality must draw upon everything we know about the living and the non-living. Since we are living beings ourselves, we know what it means to be alive from our own first-hand experience. Therefore, our philosophy of life, in (...) addition to starting with what empirical science tells us about inorganic and organic reality, must also begin from our own direct experience of life in ourselves and in others; it can then show how the two meet in the living being. Since life is ultimately one reality, our theory must reintegrate psyche with soma such that no component of the whole is short-changed, neither the objective nor the subjective. In this essay, we lay out the foundational components of such a theory by clarifying the defining features of living beings as polarities . We describe three such polarities: 1) Being vs. non-being: Always threatened by non-being, the organism must constantly re-assert its being through its own activity. 2) World-relatedness vs. self-enclosure: Living beings are both enclosed with themselves, defined by the boundaries that separate them from their environment, while they are also ceaselessly reaching out to their environment and engaging in transactions with it. 3) Dependence vs. independence: Living beings are both dependent on the material components that constitute them at any given moment and independent of any particular groupings of these components over time. We then discuss important features of the polarities of life: Metabolism; organic structure; enclosure by a semi-permeable membrane; distinction between "self" and "other"; autonomy; neediness; teleology; sensitivity; values. Moral needs and values already arise at the most basic levels of life, even if only human beings can recognize such values as moral requirements and develop responses to them. (shrink)

From organ transplants to genetic therapies by way of the manufacture of replacement tissue, regenerative medicine incarnates a biomedical reasoning that is unique to contemporary society. As a re-engineering of the body, regenerative medicine is the most accomplished manifestation of contemporary biopolitics: it concretely announces the emergence of what sociologist Karin Knorr Cetina calls the ‘culture of life’, in which individual existence is symbolically assimilated to biological conditions. This article will examine the symbolic and ethical issues of regenerative (...) medicine, notably regarding representations of the ageing body. In doing so, it will place this new branch of biomedical research back into the context from which it emerged, with the goal of grasping the social and cultural suppositions on which regenerative medicine is based. The growing number of elderly people in Western societies is one such central element. This article therefore intends to demonstrate how regenerative medicine is rooted in the modern biomedical deconstruction of death, which underlies the contemporary technoscientific fantasy of indefinitely extending longevity. (shrink)

Medicine is faced with a number of intractable modern challenges that can be understood in terms of hyper-intellectualization; a compassion crisis, burnout, dehumanization, and lost meaning. These challenges have roots in medical philosophy and indeed general Western philosophy by way of the historic exclusion of human emotion from human reason. The resolution of these medical challenges first requires a novel philosophic schema of human knowledge and reason that incorporates the balanced interaction of human intellect and human emotion. This (...) schema of necessity requires a novel extension of dual-process theory into epistemology in terms of both intellect and emotion each generating a distinct natural kind of knowledge independent of the other as well as how these two forms of mental process together construct human reason. Such a novel philosophic schema is here proposed. This scheme is then applied to the practice of medicine with examples of practical applications with the goal of reformulating medical practice in a more knowledgable, balanced, and healthy way. This schema’s expanded epistemology becomes the philosophic foundation for more fully incorporating the humanities in medicine. (shrink)

Background: Moral distress has been identified as a significant issue in nursing practice for many decades. However, most studies have involved American nurses or Western medicine settings. Cultural differences between Western and non-Western countries might influence the experience of moral distress. Therefore, the literature regarding moral distress experiences among non-Western nurses is in need of review. Aim: The aim of this integrative review was to identify, describe, and synthesize previous primary studies on moral distress experienced (...) by non-Western nurses. Review method: Whittemore and Knafl’s integrative review methodology was used to structure and conduct the review of the literature. Research context and data sources: Key relevant health databases included the Ovid MEDLINE, CINAHL, Web of Science, and Google Scholar databases. Two relevant journals, Nursing Ethics and Bioethics, were manually searched. Ethical consideration: We have considered and respected ethical conduct when performing a literature review, respecting authorship and referencing sources. Findings: A total of 17 primary studies published between 1999 and 2019 were appraised. There was an inconsistency with regard to moral distress levels and its relationship with demographic variables. The most commonly cited clinical causes of moral distress were providing futile care for end-of-life patients. Unit/team constraints (poor collaboration and communication, working with incompetent colleagues, witnessing practice errors, and professional hierarchy) and organizational constraints (limited resources, excessive administrative work, conflict within hospital policy, and perceived lack of support by administrators) were identified as moral distress’s stimulators. Negative impacts on nurses’ physical, psychological, and spiritual well-being were also reported. Conclusion: Further research is needed to investigate moral distress among other healthcare professions which may further build understanding. More importantly, interventions to address moral distress need to be developed and tested. (shrink)

In Chinese Confucian medical ethics, the principle of autonomy has not been recognized. Instead, the basic values of medical practice are compassion and humaneness. Patient autonomy however lies at the foundation of Western medical ethics in general and research ethics in particular. In the modern world of biotechnology, what happens when medical research is carried out in an East Asian society? Should the society adopt principles of Western medical ethics? Or can resources to ensure ethical research be found (...) in Confucian ethics? I consider answers to these questions in the context of a recent case of unethical research in Singapore. (shrink)

Much has been written about medicine and the market in recent years. This book is the first to include an assessment of market influence in both developed and developing countries, and among the very few that have tried to evaluate the actual health and economic impact of market theory and practices in a wide range of national settings. Tracing the path that market practices have taken from Adam Smith in the eighteenth century into twenty-first-century health care, Daniel Callahan and (...) Angela A. Wasunna add a fresh dimension: they compare the different approaches taken in the market debate by health care economists, conservative market advocates, and liberal supporters of single-payer or government-regulated systems. In addition to laying out the market-versus-government struggle around the world -- from Canada and the United States to Western Europe, Latin America, and many African and Asian countries -- they assess the leading market practices, such as competition, physician incentives, and co-payments, for their economic and health efficacy to determine whether they work as advertised. This timely and necessary book engages new dimensions of a development that has urgent consequences for the delivery of health care worldwide. (shrink)