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 1991, 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 2008 Gifford 2011

Related categories

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  1. There is Cause to Randomize.Cristian Larroulet Philippi - forthcoming - Philosophy of Science.
    While practitioners think highly of randomized studies, some philosophers argue that there is no epistemic reason to randomize. Here I show that their arguments do not entail their conclusion. Moreover, I provide novel reasons for randomizing in the context of interventional studies. The overall discussion provides a unified framework for assessing baseline balance, one that holds for interventional and observational studies alike. The upshot: practitioners’ strong preference for randomized studies can be defended in some cases, while still offering a nuanced (...)
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  2. Meaning and Affect in the Placebo Effect.Daniele Chiffi, Ahti-Veikko Pietarinen & Alessandro Grecucci - 2021 - Journal of Medicine and Philosophy 46 (3):313-329.
    This article presents and defends an integrated view of the placebo effect, termed “affective-meaning-making” model, which draws from theoretical reflection, clinical outcomes, and neurophysiological findings. We consider the theoretical limitations of those proposals associated with the “meaning view” on the placebo effect which leave the general aspects of meaning unspecified, fail to analyze fully the role of emotions and affect, and establish no clear connection between the theoretical, physiological, and psychological aspects of the effect. We point out that a promising (...)
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  3. Pharmacovigilance as Personalized Evidence.Francesco De Pretis, William Peden, Jürgen Landes & Barbara Osimani - forthcoming - In Chiara Beneduce & Marta Bertolaso (eds.), Personalized Medicine in the Making. Springer.
    Personalized medicine relies on two points: 1) causal knowledge about the possible effects of X in a given statistical population; 2) assignment of the given individual to a suitable reference class. Regarding point 1, standard approaches to causal inference are generally considered to be characterized by a trade-off between how confidently one can establish causality in any given study (internal validity) and extrapolating such knowledge to specific target groups (external validity). Regarding point 2, it is uncertain which reference class leads (...)
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  4. Reasons for Endorsing or Rejecting ‘Self-Binding Directives’ in Bipolar Disorder: A Qualitative Study of Survey Responses From UK Service Users.Tania Gergel, Preety Das, Lucy Stephenson, Gareth Owen, Larry Rifkin, John Dawson, Alex Ruck Keene & Guy Hindley - 2021 - The Lancet Psychiatry 8.
    Summary Background Self-binding directives instruct clinicians to overrule treatment refusal during future severe episodes of illness. These directives are promoted as having potential to increase autonomy for individuals with severe episodic mental illness. Although lived experience is central to their creation, service users’ views on self-binding directives have not been investigated substantially. This study aimed to explore whether reasons for endorsement, ambivalence, or rejection given by service users with bipolar disorder can address concerns regarding self-binding directives, decision-making capacity, and human (...)
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  5. Ethical Issues of Using Umbilical Cord Blood Stem Cell Therapy of John Stuart Mill Perspective.Pattamawadee Sankheangaew - 2021 - Ethics, Value Theory.
    This academic paper on Ethical issues of using umbilical cord blood stem cell therapy of John Stuart Mill perspective aim to investigate the new approaches in the treatment of diseases by using umbilical cord blood stem cells. And also to study ethical issues from the use of umbilical cord blood stem cells in the treatment of diseases considered by Mill’s utilitarianism. 21st century, the medical industry was interested in organ transplantation from stem cells especially stem cells from the umbilical cord (...)
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  6. What Must Research Subjects Be Told Regarding the Results of Completed Randomized Trials?Maurie Markman - 2004 - IRB: Ethics & Human Research 26 (3):8.
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  7. Do Psychiatric Diagnoses Explain? A Philosophical Investigation.Hane Htut Maung - 2017 - Dissertation,
    This thesis is a philosophical examination of the explanatory roles of diagnoses in psychiatry. In medicine, diagnoses normally serve as causal explanations of patients’ symptoms. Given that psychiatry is a discipline whose practice is shaped by medical traditions, it is often implied that its diagnoses also serve such explanatory functions. This is evident in clinical texts that portray psychiatric diagnoses as referring to diseases that cause symptoms. However, there are problems which cast doubt on whether such portrayals are justified. I (...)
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  8. The Functions of Diagnoses in Medicine and Psychiatry.Hane Htut Maung - 2019 - In Şerife Tekin & Robyn Bluhm (eds.), The Bloomsbury Companion to Philosophy of Psychiatry. London, UK: pp. 507-526.
    Diagnoses are central to the practice of medicine, where they serve a variety of functions for clinicians, patients, and society. They aid communication, explain symptoms, inform predictions, guide therapeutic interventions, legitimize sickness, and authorize access to resources. Insofar as psychiatry is a discipline whose practice is shaped by medical conventions, its diagnoses are sometimes presented as if they serve the same sorts of function as diagnoses in bodily medicine. However, there are philosophical problems that cast doubt on whether the functions (...)
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  9. Philosophy and Life Sciences in Dialogue. [REVIEW]Vassil Vidinsky - 2020 - Философия 29:91-94.
    The volume Philosophy and Life Sciences in Dialogue is a result of the IV. International Summer School Bioethics in Context, organized by Sofia University “St. Kliment Ohridski” and FernUniversität in Hagen. The book is exemplary in many ways. It contains 11 high-quality articles on fundamental themes and concepts with real philosophical depth – nature, autonomy, the future of trans- and post-humanism, the meta-topic of bioethics and its relations with life sciences. The authors present illuminating historical backgrounds as a context to (...)
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  10. Hilary A. Smith. Forgotten Disease: Illnesses Transformed in Chinese Medicine. (Studies of the Weatherhead East Asian Institute, Columbia University.) X + 232 Pp., Notes, Bibl., Index. Stanford, Calif.: Stanford University Press, 2017. £20.99 (Paper); ISBN 9781503603448. [REVIEW]Eric I. Karchmer - 2021 - Isis 112 (1):170-171.
  11. The Giant Remains: Mesoamerican Natural History, Medicine, and Cycles of Empire.Mackenzie Cooley - 2021 - Isis 112 (1):45-67.
  12. Nadine Ehlers; Shiloh Krupar. Deadly Biocultures: The Ethics of Life-Making. Ix + 242 Pp., Notes, Index. Minneapolis: University of Minnesota Press, 2019. $27 (Paper); ISBN 9781517905071. Cloth and E-Book Available. [REVIEW]Nancy D. Campbell - 2021 - Isis 112 (1):208-209.
  13. How to Interpret Covid-19 Predictions: Reassessing the IHME’s Model.S. Andrew Schroeder - 2021 - Philosophy of Medicine 1 (2).
    The IHME Covid-19 prediction model has been one of the most influential Covid models in the United States. Early on, it received heavy criticism for understating the extent of the epidemic. I argue that this criticism was based on a misunderstanding of the model. The model was best interpreted not as attempting to forecast the actual course of the epidemic. Rather, it was attempting to make a conditional projection: telling us how the epidemic would unfold, given certain assumptions. This misunderstanding (...)
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  14. Matter is Not Enough. Georg Ernst Stahl, Friedrich Hoffmann and the Issue of Animism.Francesco Paolo de Ceglia - forthcoming - Hopos: The Journal of the International Society for the History of Philosophy of Science.
  15. Talking Therapy: The Allopathic Nihilation of Homoeopathy Through Conceptual Translation and a New Medical Language.Lyn Brierley-Jones - forthcoming - History of the Human Sciences:095269512096787.
    The 19th century saw the development of an eclectic medical marketplace in both the United Kingdom and the United States, with mesmerists, herbalists and hydrotherapists amongst the plethora of medical ‘sectarians’ offering mainstream medicine stiff competition. Foremost amongst these competitors were homoeopaths, a group of practitioners who followed Samuel Hahnemann in prescribing highly dilute doses of single-drug substances at infrequent intervals according to the ‘law of similars’. The theoretical sophistication of homoeopathy, compared to other medical sectarian systems, alongside its institutional (...)
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  16. Putting History Back Into Mechanisms.Justin Garson - forthcoming - British Journal for the Philosophy of Science.
    Mechanisms, in the prominent biological sense of the term, are historical entities. That is, whether or not something is a mechanism for something depends on its history. Put differently, while your spontaneously-generated molecule-for-molecule double has a heart, and its heart pumps blood around its body, its heart does not have a mechanism for pumping, since it does not have the right history. My argument for this claim is that mechanisms have proper functions; proper functions are historical entities; so, mechanisms are (...)
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  17. De la collecte à la collection : le cas croisé de la collection Dupuytren et de la Société d’anatomie de Paris au XIXe siècle.Juliette Ferry-Danini - forthcoming - In Claire Crignon, Julie Cheminaud & Danielle Seilhean (eds.), La collection Dupuytren, entre art et science. Paris, France:
    Aujourd’hui délaissées, parfois devenues gênantes, les collections médicales furent pourtant à l’avant-garde du renouveau de la médecine au début du XIXe siècle, avant que celle-ci ne devienne la médecine telle que nous la connaissons aujourd’hui. Selon une vision courante de l’histoire de la médecine, les collections médicales auraient perdu de leur utilité lorsque la médecine a accédé au statut de science expérimentale, les musées d’anatomie faisant alors place aux laboratoires. Les collections d’anatomie-pathologie comme le musée Dupuytren ne seraient que le (...)
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  18. Recommendation Algorithms, a Neglected Opportunity for Public Health.Lê Nguyên Hoang, Louis Faucon & El-Mahdi El-Mhamdi - 2021 - Revue Médecine et Philosophie 4 (2):16-24.
    The public discussion on artificial intelligence for public health often revolves around future applications like drug discovery or personalized medicine. But already deployed artificial intelligence for content recommendation, especially on social networks, arguably plays a far greater role. After all, such algorithms are used on a daily basis by billions of users worldwide. In this paper, we argue that, left unchecked, this enormous influence of recommendation algorithms poses serious risks for public health, e.g., in terms of misinformation and mental health. (...)
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  19. Hannah Murphy. A New Order of Medicine: The Rise of Physicians in Reformation Nuremberg. X + 262 Pp., Notes, Bibl., Index. Pittsburgh: University of Pittsburgh Press, 2019. $50 (Cloth); ISBN 9780822945604. E-Book Available. [REVIEW]Alisha Rankin - 2020 - Isis 111 (4):875-876.
  20. Alex Broadbent: Philosophy of Medicine. New York: Oxford University Press 2019, 278 Pp., £19.99, ISBN: 978019061214. [REVIEW]Alexander Mebius - 2021 - Journal for General Philosophy of Science / Zeitschrift für Allgemeine Wissenschaftstheorie 52 (1):185-189.
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  21. Experiment and Quantification of Weight: Late-Renaissance and Early Modern Medical, Mineralogical and Chemical Discussions on the Weights of Metals.Silvia Manzo - 2020 - Early Science and Medicine 25 (4):388-412.
    This paper explores how a set of observations on the weight of lead were interpreted and assessed between the 1540s and the 1630s across three different interconnecting disciplines: medicine, mineralogy and chemistry. The epistemic import of these discussions will be demonstrated by showing: 1) the changing role and articulation of experience and quantification in the investigation of metals; and 2) the notions associated with weight in different disciplinary frameworks. In medicine and mineralogy, weight was not considered as a specific subject (...)
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  22. What is Interpretability?Adrian Erasmus, Tyler D. P. Brunet & Eyal Fisher - 2020 - Philosophy and Technology.
    We argue that artificial networks are explainable and offer a novel theory of interpretability. Two sets of conceptual questions are prominent in theoretical engagements with artificial neural networks, especially in the context of medical artificial intelligence: Are networks explainable, and if so, what does it mean to explain the output of a network? And what does it mean for a network to be interpretable? We argue that accounts of “explanation” tailored specifically to neural networks have ineffectively reinvented the wheel. In (...)
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  23. Towards a Contextual Approach to Data Quality.Stefano Canali - 2020 - Data 4 (5):90.
    In this commentary, I propose a framework for thinking about data quality in the context of scientific research. I start by analyzing conceptualizations of quality as a property of information, evidence and data and reviewing research in the philosophy of information, the philosophy of science and the philosophy of biomedicine. I identify a push for purpose dependency as one of the main results of this review. On this basis, I present a contextual approach to data quality in scientific research, whereby (...)
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  24. From Obesity to Energy Metabolism: Ontological Perspectives on the Metrics of Human Bodies.Davide Serpico & Andrea Borghini - 2020 - Topoi:1-10.
    In this paper, we aim at rethinking the concept of obesity in a way that better captures the connection between underlying medical aspects, on the one hand, and an individual’s developmental history, on the other. Our proposal rests on the idea that obesity is not to be understood as a phenotypic trait or character; rather, obesity represents one of the many possible states of a more complex phenotypic trait that we call ‘energy metabolism.’ We argue that this apparently simple conceptual (...)
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  25. Household Medicine in Seventeenth-Century England, Written by Anne Stobart, 2016.Joanne Edge - 2019 - Early Science and Medicine 24 (3):307-309.
  26. George Berkeley’s Tar-Water Medicine.Mirek Tobiáš Hošman - 2020 - Early Science and Medicine 25 (2):173-193.
    In his last major book, Siris, the philosopher George Berkeley proposed tar-water as a universal medicine, suggesting that he had found a panacea. Shortly after its publication, Siris became immensely popular and tar-water spread all around Europe and even reached America. The aim of this article is to present Berkeley’s ideas about tar-water as a medicine with a particular focus on the origins of tar-water in Berkeley’s thinking and its alleged medical effects. Berkeley conceived of tar-water as at one end (...)
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  27. Doubly Disadvantaged: The Recruitment of Diverse Subjects for Clinical Trials in Latin America.Manuela Fernández Pinto - 2019 - Tapuya 1 (2):391-407.
    Due to its allegedly diverse population and strong doctor–patient relations, Latin America has become one of the most attractive locations for international clinical trials. In the paper, I examine the case of recruitment of women and minority patients to serve as subjects of international clinical trials, through CROs operating in Latin America. In particular, the paper examines some of the strategies that CROs use to expand their services in the Latin American medical market, illuminating the mechanisms through which the current (...)
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  28. The Cochrane Case: An Epistemic Analysis on Decision-Making and Trust in Science in the Age of Information.F. Boem, S. Bonzio, B. Osimani & A. Sacco - forthcoming - Foundations of Science.
    In this study we analyze a recent controversy within the biomedical world, concerning the evaluation of safety of certain vaccines. This specific struggle took place among experts: the Danish epidemiologist Peter Gøtzsche on one side and a respected scientific institution, the Cochrane, on the other. However, given its relevance, the consequences of such a conflict invest a much larger spectrum of actors, last but not least the public itself. Our work is aimed at dissecting a specific aspect happening in this (...)
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  29. Medicine and the Inquisition in Portugal : People and Books.Hervé Baudry - 2018 - Early Science and Medicine 23 (1-2):92-113.
  30. Medicine and the Inquisition in the Early Modern World: Introduction.Maria Pia Donato - 2018 - Early Science and Medicine 23 (1-2):1-13.
  31. Overcoming Expert Disagreement In A Delphi Process. An Exercise In Reverse Epistemology.Elisabetta Lalumera - 2015 - Humana Mente 8 (28).
    Disagreement among experts is a central topic in social epistemology. What should an expert do when confronted with the different opinion of an epistemic peer? Possible answers include the steadfast view, the abstemious view, and moderate conciliatory views, which specify criteria for belief change when a peer’s different opinion is encountered. The practice of Delphi techniques in healthcare, medicine, and social sciences provides a real-life case study of expert disagreement, where disagreement is gradually transformed into consensus. An analysis of Delphi (...)
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  32. History and Her Siblings: Law, Medicine and Theology.Stephen Bann - 1988 - History of the Human Sciences 1 (1):5-21.
  33. Paternalism and Factitious Disorder: Medical Treatment in Illness Deception.Anthony Fry & Tania L. Gergel - 2016 - Journal of Evaluation in Clinical Practice 22 (4):565-574.
    The primary aims are to consider whether a range of paternalistic medical interventions can be justified in the treatment of factitious disorder (FD) and to show that the particularities of FD and its management make it an ideal phenomenon to highlight the difficulties of balancing respect for self‐determination, responsibility and duty of care in psychiatry. FD is usually classified as a mental disorder involving deliberate and hidden feigning or inducement of illness, in order to achieve patient status. Both the nature (...)
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  34. System, Holons, and Persons: A Critique of Systems Philosophy.Joseph L. Esposito - 1976 - International Philosophical Quarterly 16 (2):219-236.
  35. Early Modern Medicine and Natural Philosophy.Peter Distelzweig, Evan Ragland & Benjamin Goldberg (eds.) - 2016 - Springer.
    This essay discusses the role of new mechanical devices put forward in the seventeenth century in anatomy and pathology, showing how several of those devices were promptly deployed in anatomical investigations. I also discuss the role of dead bodies as boundary objects between living bodies and machines, highlighting their problematic status in experimentation and vivisection.
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  36. Big Data, Epistemology and Causality: Knowledge in and Knowledge Out in EXPOsOMICS.Stefano Canali - 2016 - Big Data and Society 3 (2).
    Recently, it has been argued that the use of Big Data transforms the sciences, making data-driven research possible and studying causality redundant. In this paper, I focus on the claim on causal knowledge by examining the Big Data project EXPOsOMICS, whose research is funded by the European Commission and considered capable of improving our understanding of the relation between exposure and disease. While EXPOsOMICS may seem the perfect exemplification of the data-driven view, I show how causal knowledge is necessary for (...)
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  37. Turning Refracting Into a Science: F. C. Donders' ‘Scientific Reform’ of Lens Prescription.Bert Theunissen - 2000 - Studies in History and Philosophy of Science Part C: Studies in History and Philosophy of Biological and Biomedical Sciences 31 (4):557-578.
  38. Singularity and Medicine: Is There a Place for Heteronomy in Medical Ethics?Ignaas Devisch & Stijn Vanheule - 2014 - Journal of Evaluation in Clinical Practice 20 (6):965-969.
  39. Two Decades of Experimental and Clinical Orthotopic Homotransplantation of the Heart.Norman E. Shumway & Edward B. Stinson - 1979 - Perspectives in Biology and Medicine 22 (2-2):S81-S88.
  40. Musings on Walter B. Cannon, the Life and Times of a Young Scientist. [REVIEW]Jerome Lettvin - 1990 - Perspectives in Biology and Medicine 33 (2):304-310.
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  41. Science for Development.Brian Williams & Gavin Williams - 1992 - Perspectives in Biology and Medicine 36 (1):64-78.
  42. The Saga and the Science of the Gonadotrophins.Roy O. Greep - 1968 - Perspectives in Biology and Medicine 12 (1):124-134.
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  43. Ii Physiological Theory in Greek Medicine Before Aristotle.Theodore James Tracy - 1969 - In Physiological Theory and the Doctrine of the Mean in Plato and Aristotle. De Gruyter. pp. 22-76.
  44. Evaluation and Explanation in the Biomedical Sciences. [REVIEW]Caroline Whitbeck - 1978 - British Journal for the Philosophy of Science 29 (4):399-406.
  45. Maurice Arthus' Philosophy of Scientific Investigation: Preface to de l'Anaphylaxie Á l'Immunité, Paris, L921.Maurice Arthus & Henry E. Sigerist - 1943 - Johns Hopkins University Press.
  46. Nutrition: The Chemistry of Life by Lafayette B. Mendel. [REVIEW]R. May - 1924 - Isis 6:447-448.
  47. 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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  48. 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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  49. 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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  50. 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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