Wilkinson D. What has philosophy got to do with it? ….

Traditional medicines -- Modern medicine -- Disease -- Diagnosis -- Drug -- Trial -- Treatment -- Prevention -- Iatroethics -- Science or technology, craft or service?

A physician and spokesman for the French Ideologues, Pierre-JeanGeorges Cabanis (1757-1808) stands at the crossroads of several influential developments in modern culture--Enlightenment optimism about human perfectibility, the clinical method in medicine, and the formation and adaptation of liberal social ideals in the French Revolution. This first major study of Cabanis in English traces the influences of these developments on his thought and career. Originally published in 1980. The Princeton Legacy Library uses the latest print-on-demand technology to again make available previously (...) out-of-print books from the distinguished backlist of Princeton University Press. These editions preserve the original texts of these important books while presenting them in durable paperback and hardcover editions. The goal of the Princeton Legacy Library is to vastly increase access to the rich scholarly heritage found in the thousands of books published by Princeton University Press since its founding in 1905. (shrink)

Introduction I The Portrait of an Ideal II The Rise of Galenism as a Medical Philosophy III Authority and Challenge IV Fall and Afterlife.

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)

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 ...

The mind is not structured anatomically, as emphasized by modern pathology. Instead, it is expanded as a whole in a subtle form behind the physical body. In the Indian system of medical philosophy, the mind is considered as the astral nerves made third body, which identified as the ‘Manomaya-sharira’ (subconscious mind). The mind is composed of millions of astralnadis, through which Pranic-energies circulate freely into the astral anatomy of mind. Seven-chakras are found parallel to the spine, serving as (...) the major seven innovation centres in the body. These Chakras facilitate the connection of the mind with the seven dimensions of the inner world. From these dimensions the Pranic-energies including Sattva, Raja, Tama are exported to the mind and its Nadi-tantras, influencing both the outer and inner subconscious minds. Subsequently, these elements, viz., Sattva, Raja and Tama are thrown from the mind to the outer world through the seven sense organs, manifesting as either constructive or destructive activities. Thus the mind exists due to ‘Prana’, (energy of Omkara) which increases through deeper meditation, sound sleep, and breathing exercises (O2). The positional behaviour of the mind shifts according to the physical and mental temperament, namely Triguna and Tridosha, or Panchavikara. The negative energy (Tama-guna) of the fourth dimension enters the astral Nadis-system of the mind via the interspace of the solar plexus, which crushes the mind’s structures, and consequently, all the Chakras are corrupted and the Nadis are blocked, so it generates a break in the circulation of ‘Prana’ into the Nadis. As a result, many socio-economic challenges and psychosomatic disorders occur. (shrink)

Archibald Pitcairne’s medical writings are inspired by Newton’s Principia mathematica, as the Scottish physician assumed Newtonian physics as a model for scientific inquiry that should be applied to other branches of natural philosophy, including physiology and pathology. The ideal of a comprehensive mathematical science was very appealing to late seventeenth-century intellectuals, including physicians. This essay focuses on how Pitcairne tried to implement these ideas. In particular, I argue that Pitcairne’s medical thinking is based on three philosophical assumptions: (...) first, a methodological assumption, for which medical knowledge should be sought in the form of a deductive system; second, an epistemological assumption, that is, that our knowledge of physiological processes is sound only when we reduce them to a set of mathematical laws; and, third, an ontological assumption that identifies blood as the substance on which animal life most directly depends. I also suggest that such ideas should be studied against the backdrop of Pitcairne’s general mindset, including his personal sympathy for political conservativism. I further argue that his insistence on the reduction of natural processes to mathematical relations and his search for the universal order of nature also connect to his religious and political ideals. (shrink)

It is a brave scholar who ventures into the murky world of Late Antique medicine in search of information on earlier theories. Not only may the opinions of a Herophilus or a Galen be distorted by their distant interpreters, but frequently the texts themselves present serious challenges to understanding. Nowhere is this more apparent than in the Latin versions made from Greek philosophical and medical commentaries, which interpose an additional linguistic barrier before one can make sense of sometimes complex (...) arguments. Yet as R. J. Hankinson has shown in his recent note on John of Alexandria, there is much to be gained from these forbidding works. But while he has succeeded in elucidating much of the technical terminology and argument that lies behind one of these translations, his lack of familiarity with the textual basis of the relevant commentary has both led him into error and prevented him from resolving still more of its difficulties. His ignorance is easily pardonable, for, as will be shown, modern editors have unwittingly conspired to block the way to the truth, and the essential secondary literature has been published in journals and theses rarely accessible to the classicist. (shrink)

Philosophy textbooks typically treat bioethics as a form of "applied ethics"-i.e., an attempt to apply a moral theory, like utilitarianism, to controversial ethical issues in biology and medicine. Historians, however, can find virtually no cases in which applied philosophical moral theory influenced ethical practice in biology or medicine. In light of the absence of historical evidence, the authors of this paper advance an alternative model of the historical relationship between philosophical ethics and medical ethics, the appropriation model. They (...) offer two historical case studies to illustrate the ways in which physicians have "appropriated" concepts and theory fragments from philosophers, and demonstrate how appropriated moral philosophy profoundly influenced the way medical morality was conceived and practiced. (shrink)

Empiricism has many different faces. As the contributions to this volume demonstrate, in the 17th and 18th century demonstrate medical and philosophical empiricism is less about an "essence" and more a series of specifically modern "acts" or "gestures.".

This is the first book to explore the epistemology and ethics of advanced imaging tests, in order to improve the critical understanding of the nature of knowledge they provide and the practical consequences of their utilization in healthcare. Advanced medical imaging tests, such as PET and MRI, have gained center stage in medical research and in patients’ care. They also increasingly raise questions that pertain to philosophy: What is required to be an expert in reading images? How (...) are standards for interpretation to be fixed? Is there a problem of overutilization of such tests? How should uncertainty be communicated to patients? How to cope with incidental findings? This book is of interest and importance to scholars of philosophy of medicine at all levels, from undergraduates to researchers, to medical researchers and practitioners (radiologists and nuclear physicians) interested in a critical appraisal of the methodology of their discipline and in the ethical principles and consequences of their work. -/- . (shrink)

After considering two of Pellegrino’s papers that address the relation between philosophy of medicine and medical ethics, I identify several overarching problems in his account that revolve around his self-described essentialism and the lack of a systematic attempt to relate clinical medicine to biomedicine and public health. I address these from the critical realist position of Bernard Lonergan, who grounds both metaphysics and ethics on the normative structure of human inquiry and seeks to understand historical development, such as (...) we are witnessing in health science and health care, in terms of the dynamic structure of the human good. I conclude that Lonergan’s generalized empirical method and hierarchical account of world order provide a potentially dynamic framework on which to build a more comprehensive philosophy of medicine than one whose foundations rest primarily on a phenomenology of the clinical encounter and the telos of medicine. (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)

In this commentary on the article by Arthur L. Caplan [1] 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)

Ethical issues are inherent in medicine. Morally appropriate forms of medical behaviour, the thorough communication of diagnosis and prognosis, and carefully evaluated treatment promising recovery have been among the standards of medical ethics down to the present day. The testimonies of a lively tradition, which since antiquity has contributed to the permanent critical reflection of medicine, constitute the cultural background of contemporary bioethics. They demonstrate how fertile the dialogue between medicine and philosophy on ethical questions can be. (...) This also includes the critical examination of the objects, aims, methods and boundaries of the physicians profession and of medical research. These boundaries have had throughout history to be constantly renegotiated and defined, and not only in the 21st century. --- Eine Reflexion uber die moralischen Fragen und Probleme, die die arztliche Praxis begleiten, ist der Medizin immanent. Die sittlich angemessene arztliche Haltung, die "gute" und hilfreiche Behandlung und das arztliche Ethos stehen im Zentrum zahlreicher Schriften, die zwischen Humanismus und fruher Neuzeit verfasst wurden. Es sind Zeugnisse einer lebhaften Tradition, die ununterbrochen seit der Antike zur Selbstvergewisserung der Medizin beigetragen hat. Zwischen Mittelalter und Humanismus sahen sich Mediziner den Herausforderungen des mannigfaltigen und lebhaften Heilkunde-Marktes ausgesetzt und dementsprechend verpflichtet, sich umso starker zu behaupten. Die hier prasentierten Beitrage befassen sich mit der uber sich selbst reflektierenden Medizin. Dazu gehoren die kritische Auseinandersetzung mit Gegenstand, Ziel, Methoden und Grenzen des arztlichen Berufes und der medizinischen Forschung. Diese mussten - nicht anders als heute - immer wieder neu definiert und verhandelt werden. (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)

This volume of papers, arising from the Royal Institute of Philosophy Conference on Philosophy and Medical Welfare, includes contributions from doctors, nurses, and administrators in the field of health care as well as academics in the disciplines of philosophy, economics, and politics.

John White; The Medical Condition of Philosophy of Education, Journal of Philosophy of Education, Volume 21, Issue 2, 30 May 2006, Pages 155–162, https://doi.or.

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: as a salutary reminder of the extent to which thereality even of the human body is constructed; and as anarena for what Stephen Toulmin distinguishes as theintersection of natural science and history, in which many ofphilosophy''s traditional 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)

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)

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)

This is a fundamental re-assessment of the world-view of the alchemists, natural philosophers and intelligencers of the mid 17th century. Based almost entirely upon the extensive and hitherto little-researched manuscript archive of Samuel Hartlib, it charts and contextualises the personal and intellectual history of Johann Moriaen (c.1592-1668), a Dutch-German alchemist and natural philosopher. Moriaen was closely acquainted with many of the leading thinkers and experimenters of his time, including René Descartes, J.A. Comenius, J.R. Glauber and J.S. KÃ1⁄4ffler. His detailed reports (...) of relations with these figures and his response to their work provide a uniquely informed insight into the world of alchemy and natural philosophy. This study also illuminates the nature and mechanisms of intellectual and technological exchanges between Germany, The Netherlands and England. (shrink)

Contemporary medical education must train skilled and compassionate health care professionals who are rigorous in their approach to patient care and their pursuit of knowledge and solutions. Problem-based learning has been widely introduced, but there is no evidence that it leads to better outcomes than more traditional programs, and fundamental gaps in conceptual knowledge may result. Recently, emphasis has been placed on a solid grounding in underlying concepts combined with a systems-based approach, and ability to transfer information and solve (...) problems. Integrating traditional scientific and clinical disciplines with progressive and continuous assessment, may be a better means of achieving the combined aims of clinically relevant curriculum design, vertical integration of medical knowledge, and facilitation of the continuum of training. Being adaptable and flexible, cognisant of costs, and driven by evidence are key features of delivering medical education and contemporary medical practice. Educational research should lead to continuous improvement, but innovation without evaluation and attention to costs may create as many, or more, problems as are solved. (shrink)