About this topic
Summary

The philosophy of medicine is a subset of the philosophy of science that examines medical science and practice. Such reflection invites consideration of the nature of medicine—is it a rule-governed science or does the contingency of medical practice make it more of an art? Most would agree that medical science lacks the explanatory power of the physical sciences, but its grounding in robust bodies of life and health science research suggests something more systematic than praxis. As an alternative, medical science and medical practice can be regarded as distinct, as the goal of practice is to improve health while scientific study aims to achieve theoretical understanding. The insurgence of evidence-based methods to medical research over the past two decades, however, has challenged the framing of the goals of medical science. With its focus on outcomes research, clinical research has been largely redirected towards practical end of improving human health.  Philosophy of medicine is typically distinguished from biomedical ethics, although the distinction frequently blurs since it is often normative issues that motivate investigation into more theoretical questions. Fundamental questions addressed by philosophers of medicine tend to be epistemological and ontological by nature--analysis of meta-scientific concepts like reduction, models, theories, mechanisms, and causal inference and inquiry into the nature of health and disease. This humane orientation permitted a fruitful subset of late 20th century philosophy of medicine to diverge from the analytic orientation of Anglo-American philosophy of science to explore phenomenological investigation into the embodied experience of illness and dis-ease. The weighty human and social impact of medical science and practice also encouraged consideration of ethical and policy considerations in close tandem with the epistemic, ontological, and methodological debates that characterize the philosophy of medicine.

Key works

On the concepts of health and disease see Boorse 1977 's claim that they are descriptive concepts. This view is countered by Canguilhem 1989 normative account. On randomization in clinical trials,  see Papineau 1994 on the virtues of randomization versus Worrall 2007 and Vandenbrouke 2004. Evidence-based medicine, which champions randomized controlled trials as the gold standard, has been challenged by Feinstein & Horwitz 1997, Tonelli 1998, and Goldenberg 2006. On causal inference, see the classical debate between Hill 1965 and Fisher 1958, as well as McKay et al 2011. On Bayesian versus frequentist statistics in medicine, see Ashby 2006, Berry 1993, Whitehead 1993 On phenomenological investigations into the experience of illness and suffering, see Cassell 2004, Toombs 2001. On discovery and explanation, see Schaffner 1993 and Thagard 1999. On clinical judgment, see Feinstein 1967, Montgomery 2006.See Engel 1977 ’s influential biopsychosocial model of medicine.

Introductions

Marcum 2010 Gifford 2011

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  1. System, Holons, and Persons: A Critique of Systems Philosophy.Joseph L. Esposito - 1976 - International Philosophical Quarterly 16 (2):219-236.
  2. Etiologic Factors in Obesity and Leanness.Jay Tepperman - 1958 - Perspectives in Biology and Medicine 1 (3):293-306.
  3. Subjectivity and the Possibility of Psychiatry.U. K. Harre - - 2003 - In Bill Fulford, Katherine Morris, John Z. Sadler & Giovanni Stanghellini (eds.), Nature and Narrative: An Introduction to the New Philosophy of Psychiatry. Oxford University Press.
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  4. Psychiatry and the Law.Robinson - Usa - 2003 - In Bill Fulford, Katherine Morris, John Z. Sadler & Giovanni Stanghellini (eds.), Nature and Narrative: An Introduction to the New Philosophy of Psychiatry. Oxford University Press.
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  5. La medicine au Quebec. Naissance et evolution d'une profession.Jacques Bernier & Jacalyn Duffin - 1994 - History and Philosophy of the Life Sciences 16 (1):155.
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  6. Le clinicien et le chercheur. Des maladies de la carence a la medecine moleculaire.Christiane Sinding & Ilana Lowy - 1994 - History and Philosophy of the Life Sciences 16 (2):355.
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  7. Nosologische und therapeutische Konzeptionen in der romantischen Medizin.Hans-Uwe Lammel & Claudia Wiesemann - 1994 - History and Philosophy of the Life Sciences 16 (1):155.
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  8. Farmacopea araba medievale. Codice Ayasofia 3703.Alain Touwaide & Mirko D. Grmek - 1994 - History and Philosophy of the Life Sciences 16 (2):355.
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  9. Medicine at the Courts of Europe, 1500-1837.Vivian Nutton & Hans-Uwe Lammel - 1994 - History and Philosophy of the Life Sciences 16 (2):355.
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  10. Medicinas, drogas y alimentos vegetales del Nuevo Mundo. Textos e imágenes españolas que los introdujeron en Europa.José M. López Pinero, Jose Luis Fresquet Febrer, Maria Luz Lopez Terradas, José Pardo Tomás & Francisco Guerra - 1994 - History and Philosophy of the Life Sciences 16 (3):493.
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  11. Medical Technology and Society: An Interdisciplinary Perspective.Joseph D. Bronzino, Vincent H. Smith, Maurice L. Wade & Russell C. Maulitz - 1994 - History and Philosophy of the Life Sciences 16 (3):493.
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  12. Doctor of Society. Thomas Beddoes and the Sick Trade in Late-Enlightenment England.Roy Porter & Guenter B. Risse - 1994 - History and Philosophy of the Life Sciences 16 (1):155.
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  13. [Education or Constraint: Measles Vaccination in France During the Belle Epoque].L. Murard & P. Zylberman - 1994 - History and Philosophy of the Life Sciences 17 (1):31-53.
  14. Doctor's Stories. The Narrative Structure of Medical Knowledge.Kathryn Montgomery Hunter & Volker Hess - 1994 - History and Philosophy of the Life Sciences 16 (1):155.
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  15. [Historical Development of Vaccines. Introduction: Hazards and Rationality in the Vaccinal Approach].A. M. Moulin - 1994 - History and Philosophy of the Life Sciences 17 (1):5-29.
  16. The Laboratory Revolution in Medicine.Andrew Cunningham, Perry Williams & Bernardino Fantini - 1994 - History and Philosophy of the Life Sciences 16 (2):355.
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  17. To the Ends of the Earth: Women's Search for Education in Medicine.Thomas Neville Bonner & Michele S. Kohler - 1994 - History and Philosophy of the Life Sciences 16 (2):355-406.
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  18. Greek Rational Medicine. Philosophy and Medicine From Alcmaeon to the Alexandrians.James Longrigg & Danielle Gourevitch - 1994 - History and Philosophy of the Life Sciences 16 (3):493.
  19. Canadian Medical Schools: Two Centuries of Medical History, 1882 to 1992.N. Tait McPhedran & Terrie M. Romano - 1994 - History and Philosophy of the Life Sciences 16 (3):493.
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  20. British Medicine in an Age of Reform.Roger French, Andrew Wear & Guenter B. Risse - 1994 - History and Philosophy of the Life Sciences 16 (1):155.
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  21. Opening the Door: Non-Veterinarians and the Practice of Complementary and Alternative Veterinary Medicine. Schommer - 2012 - Journal of Animal Ethics 2 (1):43.
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  22. Practice and Protocol Analyses of Cost- Effectiveness: An Inconvenient Distinction.Abraham Schwab - 2010 - Ethics in Biology, Engineering and Medicine 1 (3):187-197.
    Using four examples of cost-effectiveness analyses, I argue that discussions of and research on cost-effectiveness in medical practice should clearly delineate between protocol and practice cost-effectiveness analyses. Failure to do so risks confusing conclusions that warrant substantial confidence and limited applicability with conclusions with broader applicability but more limited confidence. Further, these different types of analyses incorporate different sets of values. I argue that some favor should be shown for those analyses that include a wider array of values.
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  23. The Appropriation of Suffering.Vieda Skultans - 2007 - Theory, Culture and Society 24 (3):27-48.
    This study brings together socio-theoretical and ethnographic approaches to psychiatry, demonstrating the role of the clinic as a major consolidator of ideologies as well as the site where personal miseries are registered as markers of social failure. It focuses on innovation in psychiatric taxonomies, changes in the figurative language of the emotions, changes in conceptualizations of the self and how all of these relate to changing socio-economic events and circumstances.
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  24. Legal Issues Related to Complementary and Alternative Medicine. &Na - 2009 - Jona's Healthcare, Law, Ethics, and Regulation 11 (2):52-53.
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  25. Aging and Identity in Dementia Narratives.Joe Moran - 2001 - Cultural Values 5 (2):245-260.
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  26. Supporters and Survivors: The People Without AIDS.M. R. Chandler - 1990 - Perspectives in Biology and Medicine 35 (1):105-115.
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  27. Recommendations on the Bonding of Physicians to Medical Institutions.J. G. Gamble - 1990 - Perspectives in Biology and Medicine 34 (2):226-228.
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  28. In Defense of Abortion: Issues of Pragmatism Regarding the Institutionalization of Killing.Robert T. Muller - 1990 - Perspectives in Biology and Medicine 34 (3):315-325.
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  29. The Doctor as Dramatic Hero.D. Heyward Brock - 1990 - Perspectives in Biology and Medicine 34 (2):279-295.
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  30. Plato Physician Model.Wb Naso - 1990 - Perspectives in Biology and Medicine 33 (4):589-597.
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  31. Coccydynia and Lumbar Disk Disease--Historical Correlations and Clinical Cautions.D. A. Nelson - 1990 - Perspectives in Biology and Medicine 34 (2):229-238.
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  32. Subjective Boundaries and Combinations in Psychiatric Diagnoses.John Mirowsky - 1990 - Journal of Mind and Behavior 11 (3-4):407-424.
    This distinctions embodied in official psychiatric diagnoses represent arbitrary and subjective views of patients' problems. Historically, individual psychiatrists were free to superimpose their own distinctions and categories. In recent decades, a uniform set of concepts has been negotiated, promoted, and enforced. The uniform diagnoses improve descriptive communication and meet administrative needs. However, they remain arbitrary. This essay argues that a descriptive theory of psychiatric problems should distinguish the objective pattern of correlation among the thoughts, feelings, and behaviors in question from (...)
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  33. The Name Game: Toward a Sociology of Diagnosis.Phil Brown - 1990 - Journal of Mind and Behavior 11 (3-4):385-406.
    Although diagnosis is integral to the theory and practice of psychiatry, social scientists have not developed a comprehensive approach to diagnosis. This paper presents a preliminary outline of the issues which a sociology of diagnosis should integrate. These include bias and social control in psychiatric diagnosis, diagnosis as part of a new extension of the biopsychiatric medical model, and flaws in contemporary diagnostic categorization. These issues are then viewed in terms of professional practice styles, diagnostic biases, psychiatry's professional dominance over (...)
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  34. Incorporating New Medical Information Into Clinical Practice.E. D. Burgess - 1995 - Journal of Law, Medicine and Ethics 23 (2):211.
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  35. Acquisition and Use of Clinical Data for Audit and Research.J. Wyatt - 1995 - Journal of Evaluation in Clinical Practice 1 (1):15-27.
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  36. Health Services Research: An Expanding Field of Inquiry.M. J. Field & K. N. Lohr - 1995 - Journal of Evaluation in Clinical Practice 1 (1):61.
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  37. De l'art medical.Hippocrate de Cos & Ivan Garofalo - 1995 - History and Philosophy of the Life Sciences 17 (1):173.
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  38. Practical Medicine From Salerno to the Black Death.Luis Garcia Ballester, Roger French, Jon Arrizabalaga, Andrew Cunnigham & Piero Morpurgo - 1995 - History and Philosophy of the Life Sciences 17 (1):173.
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  39. Medicine as Biology: Neuropsychiatry at the University of Chicago, 1928–1939.B. Blustein - 1993 - Perspectives on Science 1:416-444.
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  40. Dr. Martin Arrowsmith: Scientist and Medical Hero.H. Gest - 1991 - Perspectives in Biology and Medicine 35 (1):116.
  41. Curies, Cure, and Culture.S. Hellman - 1991 - Perspectives in Biology and Medicine 36 (1):39-45.
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  42. The Impact of Philanthropy on Medicine and Health.R. J. Glaser - 1991 - Perspectives in Biology and Medicine 36 (1):46-56.
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  43. The Care of the Doctor.L. R. Kass - 1991 - Perspectives in Biology and Medicine 34 (4):553-560.
  44. Fashions in Pathogenetic Concepts During the Present Century: Autointoxication, Focal Infection, Psychosomatic Disease, and Autoimmunity.Paul B. Beeson - 1991 - Perspectives in Biology and Medicine 36 (1):13-23.
  45. Christian Science Healing and the Health Care of Children.Norman Gevitz - 1991 - Perspectives in Biology and Medicine 34 (3):421.
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  46. Aging and Disease: Proteins as the Molecular Link.Suresh Rattan - 1991 - Perspectives in Biology and Medicine 33 (4):526-533.
  47. The Neglected Organ: Bacterial Flora has a Crucial Immunostimulatory Role.V. Bocci - 1991 - Perspectives in Biology and Medicine 35 (2):251-260.
  48. Confusion in the Determination of Death: Distinguishing Philosophy From Physiology.Jeffrey R. Botkin & Stephen G. Post - 1991 - Perspectives in Biology and Medicine 36 (1):129-138.
  49. Attempts to Use Computers as Diagnostic Aids in Medical Decision Making: A Thirty-Year Experience.R. L. Engle Jr - 1991 - Perspectives in Biology and Medicine 35 (2):207-219.
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  50. The Total Healthcare Audit System: A Systematic Methodology for Auditing the Totality of Patient Care.A. Miles, D. P. Bentley, N. Price, A. Polychronis, J. E. Grey & J. E. Asbridge - 1996 - Journal of Evaluation in Clinical Practice 2:37-64.
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