Descartes' works were not allowed to be read at Leiden University, even his name could not be pronounced. Read the compelling story about how his pupil Johannes de Raey has had the opportunity to preach Descartes fully in philosophy, but also in medicine, in a hostile anti-Cartesian climate during 20 years (1647-1668). This book is not only meant for philosophers and medical historians, but for all who want to take a look at the extensive menu of Cartesian cuisine. The (...) 17th-century philosopher René Descartes turned established science upside down by doubting all certainties. His critical mind rejected statements that could not be proven by the Ratio. The Ratio was the metaphor for the roots, the physics for the trunk and the medicine for the branches and leaves of the Cartesian tree. This premise was directly opposed to the established aristotelian theory in which observation formed the basis of knowledge. De Raey, who once called Descartes his best student, synthesized a hybrid model of the old Aristotelian and the new Cartesian concept. From 1658 to 1662 he gave private lessons in medicine at Leiden University and tried to use his model as a basis for explaining human physiology. Until now, nothing was known about the content of these lectures. The author recently found a dispute. It is a new dish on the Cartesian menu. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Dutch Cartesianism and the Birth of Philosophy of Science by Andrea StrazzoniAaron SpinkAndrea Strazzoni. Dutch Cartesianism and the Birth of Philosophy of Science. Berlin: Walter de Gruyter, 2019. Pp. ix + 245. Hardback, $124.99.Andrea Strazzoni's Dutch Cartesianism and the Birth of Philosophy of Science is a clear step forward in our understanding of the rise and fall of Cartesianism. The work, limited to the (...) Dutch context with one notable German excursion, covers roughly one hundred years starting from the 1630s. While the time frame is rather large in scope, the majority of the work is narrower in focus, with a heavy emphasis on the academic circles in mid-to-late seventeenth-century Leiden and Utrecht. It is thus a welcome addition to the growing body of literature dealing with the unique political, religious, and academic contexts in which Dutch Cartesians found themselves. While much of the book deals with the philosophy of Descartes and then Newton, Strazzoni is not concerned with giving any novel interpretations of either figure; instead, he sheds a great deal of light on a cast of characters who are only now coming to be appreciated for their contributions and influence on philosophical movements of the seventeenth and early eighteenth centuries. The book has two main explicit goals. First, Strazzoni wants to show why foundationalism came to play such a prominent role in Dutch Cartesian circles and what foundationalism's effects were. Second, through this examination, Strazzoni hopes to show that the multiplication of worldviews [End Page 154] shaped a new function for metaphysics and logic as tools for examining principles, which in turn determined a change in the function of philosophy itself that eventually gave birth to a kind of philosophy of science familiar to us today.Strazzoni divides this project into eight chapters, with a focus on six figures: Henricus Regius, Johannes Clauberg, Johannes de Raey, Arnold Geulincx, Burchard de Volder, and Willem Jacob's Gravesande. In addition to a brief overview of the goals and structure of the work, the first chapter includes a survey of how methodologies have changed in the history of philosophy and the history of the philosophy of science, which will be helpful background for those less familiar with the fields.The following two chapters deal with the crises that emerged in Utrecht and Leiden over the spread of Cartesian philosophy. In chapter 2, building on Theo Verbeek's work, Regius takes center stage. While some context of the Utrecht crisis is given, Strazzoni spends much of the chapter detailing how Regius's medical background led to a more empirical approach and lack of metaphysical foundation. While Regius's own controversial positions embroiled both himself and Descartes in the Utrecht Crisis, ripple effects spread to Leiden, resulting in prohibitions against discussions of Cartesian philosophy. In the third chapter, Strazzoni highlights a group of anti-Cartesians, with Jacob Revius as the primary antagonist, and the responses from De Raey and Clauberg. Clauberg, the subject of Strazzoni's only sustained discussion of Cartesianism from Germany, coordinated with de Raey on both a positive campaign of promotion and strategizing responses to the anti-Cartesian front. Outside of discussing Clauberg's explicit role in Leiden, Strazzoni studies his logic and Ontosophia, neatly explaining his shift to more metaphysical foundations.Chapters 4, 5, and 6 continue exploring the various approaches and roles for foundational philosophy in more detail, delving into how these controversies motivated renewed analysis of core Cartesian principles with integration into an academic curriculum in mind. Apart from de Raey's efforts to show that Cartesianism was aligned with Aristotelianism, Strazzoni claims a period of Cartesian physics without an explicit preoccupation with metaphysical questions, especially in light of the restrictions imposed by the curators of Leiden's university. However, as Spinoza and Hobbes came to prominence, multiplying the number of philosophical worldviews, foundational arguments were needed to combat them. Strazzoni highlights how varied these responses could be, as Geulincx's own take on foundations leaned heavily toward ethics rather than epistemology, metaphysics, or logic. However, the discussion of Geulincx is much broader, also including illuminating expositions of Geulincx's theology, epistemology, and metaphysics.Chapter 5 expounds further... (shrink)

The Oxford Handbook of Descartes and Cartesianism comprises fifty specially written chapters on Rene Descartes and Cartesianism, the dominant paradigm for philosophy and science in the seventeenth century, written by an international group of leading scholars of early modern philosophy. The first part focuses on the various aspects of Descartes's biography and philosophy, with chapters on his epistemology, method, metaphysics, physics, mathematics, moral philosophy, political thought, medical thought, and aesthetics. The chapters of the second part are devoted (...) to the defense, development and modification of Descartes's ideas by later generations of Cartesian philosophers in France, the Netherlands, Italy, and elsewhere. The third and final part considers the opposition to Cartesian philosophy by other philosophers, as well as by civil, ecclesiastic, and academic authorities. This handbook provides an extensive overview of Cartesianism - its doctrines, its legacies and its fortunes - in the period based on the latest research. (shrink)

This is the first volume to systematically explore the range of contemporary thought concerning the body and draw out its crucial implications for medicine.

This essay examines Descartes’s impact on medical faculties in the German Reformed context, focusing on the case of the Marburg physician Johann Jakob Waldschmidt (1644–89). It first surveys the wider backdrop of Descartes-reception in German universities, and highlights its generally conciliatory character. Waldschmidt appears as a counterpoint to this tendency. The essay then situates Waldschmidt’s work in the context of confessional politics at the University of Marburg, and specifically of the heightened controversy in Hesse around the teaching of Descartes (...) in the last years of Waldschmidt’s life. The second half of the essay details Waldschmidt’s ambitious program to reform medicine along Cartesian lines, in physiology, pathology, and therapy, and evaluates its merits and limits. (shrink)

This essay argues that Japan's resistance to the practice of transplanting organs from persons deemed “brain dead” may not be the result, as some claim, of that society's religions being not yet sufficiently expressive of love and altruism. The violence to the body necessary for the excision of transplantable organs seems to have been made acceptable to American Christians at a unique historical “window of opportunity” for acceptance of that new form of medical technology. Traditional reserve about corpse mutilation (...) had weakened and, especially as presented by the theologian Joseph Fletcher, organ donation was touted as both expressive of agape and a way of “updating” Christianity via the ethics of Utilitarianism. Many Japanese, largely Buddhist and Confucian in their orientation, view these changed valorizations as neither necessary nor patently more ethical than those of their own traditions. (shrink)

This paper is prompted by the charge that the prevailing Western paradigm of medical knowledge is essentially Cartesian. Hence, illness, disease, disability, etc. are said to be conceived of in Cartesian terms. The paper attempts to make use of the critique of Cartesianism in medicine developed by certain commentators, notably Leder (1992), in order to expose Cartesian commitments in conceptions of disability. The paper also attempts to sketch an alternative conception of disability — one partly inspired by the (...) work of Merleau-Ponty. In particular, three key Cartesian claims are identified and subjected to criticism. These are as follows: (a) The claim that the body is an object, (b) what is termed here ‘the modularity thesis’, and (c) the claim that the body cannot be constitutive of the self (i.e. since the soul/mind/brain is). In opposition to these claims, it is argued that the body is properly viewed as a subject; that there are neither purely mental, nor purely physical disabilities; and that selves are constituted, at least in part, by their bodies. (shrink)

The second chapter is devoted to the analysis of the first introduction of and quarrels over Cartesianism at the University of Utrecht, as determined by the teaching of a Cartesian natural philosophy and physiology by Henricus Regius. First, it is shown how his teaching gave rise to the querelle d’Utrecht (1641), in which two main issues were debated: the rejection of substantial forms, and the characterisation of man as ens per accidens. During the quarrel, questions were raised about the (...) consistency of the new philosophy with theology and – insofar as it raised the problem of the individuation of bodies and species by substantial forms – of the unity of man. Secondly, it is shown how Regius’s peculiar approach to natural philosophy (and physiology) led him to quarrel with Descartes himself in 1645–1648, with regard to two main questions: the nature of mind, and the method of natural philosophy, which Regius interprets in both cases from an empirical standpoint, as he maintains that the nature of mind may consist in matter (according to medical evidence), and that all knowledge has a sensory origin. Accordingly, he paved the way for ‘radical’ interpretations of Descartes which rejected his metaphysics, but also for an approach to a natural philosophy more open to the use of experience. In this chapter, I scrutinise the reasons behind Regius’s approach to physics and metaphysics by paying attention, on the one hand, to his quarrel with Descartes, and on the other to the sources of his methodology, which he largely borrows from medical authors. In conclusion, I show that Cartesianism, in the hands of Regius, might serve as the basis for medicine but could not yet become a full-fledged alternative to Aristotelianism. (shrink)

This paper is prompted by the charge that the prevailing Western paradigm of medical knowledge is essentially Cartesian. Hence, illness, disease, disability, etc. are said to be conceived of in Cartesian terms. The paper attempts to make use of the critique of Cartesianism in medicine developed by certain commentators, notably Leder (1992), in order to expose Cartesian commitments in conceptions of disability. The paper also attempts to sketch an alternative conception of disability — one partly inspired by the (...) work of Merleau-Ponty. In particular, three key Cartesian claims are identified and subjected to criticism. These are as follows: (a) The claim that the body is an object, (b) what is termed here ‘the modularity thesis’, and (c) the claim that the body cannot be constitutive of the self (i.e. since the soul/mind/brain is). In opposition to these claims, it is argued that the body is properly viewed as a subject; that there are neither purely mental, nor purely physical disabilities; and that selves are constituted, at least in part, by their bodies. (shrink)

Highlighting early modern medicine's program of explanation and intervention, I claim that there are two distinctive features of the physician's naturalism. These are, first, an explicit recognition that each patient had her own individual and highly particularized nature and, second, a self-conscious use of normative descriptions when characterizing a patient's nature as healthy (ordered) or unhealthy (disordered). I go on to maintain that in spite of the well documented Cartesian rejection of Aristotelian natures in favor of laws of nature, Descartes (...) and his most important medical disciple accepted both features of the physician's naturalism where human medicine was concerned. Thus, in this article I critically engage with standard portraits of Cartesianism and naturalism by integrating the histories of science, medicine and philosophy, but especially medicine and philosophy. (shrink)

This chapter contains sections titled: Epicurean Empiricism Critiques of Cartesianism Conclusion.

We write in response to the original article by Rennie and Rudland published in the April 2003 edition of this journal.1 Current and former Dundee Medical School students are concerned at the media misinterpretation of the study and the consequences that this branding of “dishonesty” will have on Dundee Medical School’s reputation and also on individuals embarking on their ….

Winner of the Los Angeles Times Book Prize With a new preface by the author In his most powerful and important book, renowned psychiatrist Robert Jay Lifton presents a brilliant analysis of the crucial role that German doctors played in the Nazi genocide. Now updated with a new preface, The Nazi Doctors remains the definitive work on the Nazi medical atrocities, a chilling exposé of the banality of evil at its epitome, and a sobering reminder of the darkest side (...) of human nature. (shrink)

This code of practice for health professionals was prepared by a multi-professional group and reflects good clinical practice in encouraging dialogue about individuals' wishes concerning their future treatment. It has a broad practical approach, considers a range of advance statements, advises of dangers and benefits of making treatment decisions in advance and combines annotated code of practice with a quick pull out guide for easy reference.

Summary Principles Timely support for patients and people close to them, and effective, sensitive communication are essential. Decisions must be based on the individual patient's circumstances and reviewed regularly. Sensitive advance discussion should always be encouraged, but not forced. Information about CPR and the chances of a successful outcome needs to be realistic. Practical matters Information about CPR policies should be displayed for patients and staff. Leaflets should be available for patients and people close to them explaining about CPR, how (...) decisions are made and their involvement in decisions. Decisions about attempting CPR must be communicated effectively to relevant health professionals. In emergencies If no advance decision has been made or is known, CPR should be attempted unless: the patient has refused CPR; the patient is clearly in the terminal phase of illness; or the burdens of the treatment outweigh the benefits. Advance decision making Competent patients should be involved in discussions about attempting CPR unless they indicate that they do not want to be. Where patients lack competence to participate, people close to them can be helpful in reflecting their views. Legal issues Patients' rights under the Human Rights Act must be taken into account in decision making. Neither patients nor relatives can demand treatment which the health care team judges to be inappropriate, but all efforts will be made to accommodate wishes and preferences. In England, Wales and Northern Ireland relatives and people close to the patient are not entitled in law to take health care decisions for the patient. In Scotland, adults may appoint a health care proxy to give consent to medical treatment. Health professionals need to be aware of the law in relation to decision making for children and young people.IntroductionWhy policies are neededCardiopulmonary resuscitation can be attempted on any person whose cardiac or respiratory functions cease. Failure of these functions is part of dying and thus …. (shrink)

Phenomenology has a rich tradition of interpreting technology, medicine, and the life sciences. It has not yet had much to say about the medical devices which have always been central to bioethics. In this chapter, I outline what is meant by medical devices, and connect the sense of intention in made-object design with the notion of intentionality in phenomenology. I survey three basic ways of characterising medical devices grounded in the phenomenological literature: Albert Borgmann’s device paradigm, Don (...) Ihde’s human-machine relations, and Merleau-Ponty’s body-subject. Engaging with these approaches could help bring to analyses of medical devices the uniquely whole-of-context view of which phenomenology is capable, and better inform all stakeholders about their phenomenal consequences. (shrink)

This article presents an analysis of contractual relations in sport from the standpoint of the Croatian legislative system. Due to the complexity of the subject matter, the author considers only a small fragment of it - the significance and the role of sport in Croatian society and the law of contracts „as a cornerstone on which „sports law“ has been built and which is of primary importance in most areas where there is an interface between sport and the law, irrespective (...) of whether the sport is being played at an elite level or at a more humble one“. Bearing in mind the limited extent of this article, the autor tries to provide some clarifications and some guidance on how to deal with the designation and the determination of the applicable law for contracts in the sporting context. Considering that there are different legal regimes which may come into play with regard to the designation of the law applicable to contracts in the sporting context, the author first presents the determination of the applicable law according to the Rome I Regulation and then according to the Croatian Arbitration Act, Swiss Private International Law Act and the CAS Code of Sports-related Arbitration, as the most common in sports practice. Then, the author deals with contracts concluded with minor athletes and the determination of the law applicable to some preliminary questions. Finally, the author presents her perception of the problems encountered and some suggestions for the improvement of the existing legal framework. (shrink)

When talking about personal identity in the context of medical ethics, ethicists tend to borrow haphazardly from different philosophical notions of personal identity, or to abjure these abstract metaphysical concerns as having nothing to do with practical questions in medical ethics. In fact, however, part of the moral authority for respecting a patient’s self-regarding decisions can only be made sense of if we make certain assumptions that are central to a particular, psychological picture of personal identity, namely, that (...) patients will remain psychologically connected to a certain degree with their future selves. I draw this out, show problems with approaches in medical ethics based on alternate theories of personal identity that do not recognise this, and explore some important implications. Namely, I show how this recognition can better explain the circumstances under which we should respect advance directives and why, and how it can better make sense of patient fears that they will not "survive" personality-altering deep brain stimulation procedures, and provide guidance on approaching patient decisions concerning this type of procedure in a manner that captures and addresses such concerns. (shrink)

In 1997, when Oregon became the first U.S. jurisdiction authorizing medical aid in dying (MAID), its law included a requirement that patients be legal residents of the state. Other U.S. jurisdictions legalizing MAID followed Oregon in adopting residency requirements. Recent litigation challenges the legality, as well as the justification, for such requirements. Facing such challenges, Oregon and Vermont eliminated their MAID residency requirements. More states could follow this move, for, in certain circumstances, the U.S. Constitution's privileges and immunities clause (...) protects citizens’ right to travel to secure medical care. Policy considerations could also motivate states to reexamine whether such requirements are justified in light of existing evidence of how MAID laws have been applied. (shrink)

During the last decades, shared decision making (SDM) has become a very popular model for the physician-patient relationship. SDM can refer to a process (making a decision in a shared way) and a product (making a shared decision). In the literature, by far most attention is devoted to the process. In this paper, I investigate the product, wondering what is involved by a medical decision being shared. I argue that the degree to which a decision to implement a (...) class='Hi'>medical alternative is shared should be determined by taking into account six considerations: (i) how the physician and the patient rank that alternative, (ii) the individual preference scores the physician and the patient (would) assign to that alternative, (iii) the similarity of the preference scores, (iv) the similarity of the rankings, (v) the total concession size, and (vi) the similarity of the concession sizes. I explain why shared medical decisions are valuable, and sketch implications of the analysis for the physician-patient relationship. (shrink)

1. Aim of the guidelines2. Principles of good practice3. Circumcision for medical purposes4. Non-therapeutic circumcision 4.1. The law 4.1.1. Summary: the law 4.2. Consent and refusal 4.2.1. Children’s own consent 4.2.2. Parents’ consent 4.2.3. Summary: consent and refusal 4.3. Best interests 4.3.1. Summary: best interests 4.4. Health issues 4.5. Standards 4.6. Facilities 4.7. Charging patients 4.8. Conscientious objection5. Useful addresses.

Thus far in the development of the discipline of medical ethics, the overriding concern has been with solutions to specific problems. But discussion is hampered by lack of understanding of the scope and methodology of medical ethics, and its scientific and philosophical basis. In Underpinnings of Medical Ethics Edmond A. Murphy, James J. Butzow, and Edward L. Suarez-Murias offer much-needed clarification of the purview, ontological basis, and methodology of a medical ethics that is to be comprehensive (...) and yet readily accepted by all. The authors begin by describing the scope of the analysis and discussing possible ethical systems and paradigms. They then deal with the structures and concepts necessary in the formulation of a coherent philosophy: normality and disease, scientific and juridical law, certainty and certitude, decisions. Finally, they introduce particular human dimensions, such as quality of life, pain, and responsibility. Throughout, case examples illustrate the authors' theoretical framework. (shrink)

Biological sex should be “acknowledged” and “accepted”—but which responses to gender dysphoria might this preclude? Trans-identified people may factually acknowledge their biological sex and regard transition as purely palliative. While generally some level of self-deception and even a high level of nonlying deception of others are sometimes justified, biological sex is important, and there is a nontrivial onus against even palliative, nonsexually motivated cross-dressing. The onus is higher against co-opting the body, even in a minor and/or reversible way, to make (...) a false communication concerning one’s sex. Hardest to defend is the destruction of sexual–reproductive functions and causally downstream functions such as lactation: due to the transcendent nature of sexual–reproductive functions, an appeal to the “principle of totality” here is misplaced. This is not to say that social, and milder medical, transition is absolutely excluded even for severe unmanageable dysphoria, nor that subsequent to any transition, detransition is necessarily required. (shrink)

Modern health care relies extensively on the use of technologies forassessing and treating patients, so it is important to be certain that health care technologies (i.e., pharmaceuticals, devices, procedures, and organizational systems) perform their professed functions in an effective and safe manner. Philosophers of technology have developed methods to assign and evaluate the functions of technological products, the major elements of which are described in the ICE theory. This paper questions whether the standard of evidence advocated by the ICE theory (...) is adequate for ascribing and assessing technologies employed in health care. The paper proposes that the general problem with the standard of evidence embodied in the ICE theory (i.e.,testimony and evidence of mechanisms) is too permissive for assessing medical technologies, in that it does not take into account the relative benefit and harm of medical technologies in ensuring safe functional performance in patients. The paper illustrates how evidence-based medicine (EBM) has demonstrated the value of clinical research methods, including observational studies, randomized and non-randomized clinical trials, and formal techniques, such as meta-analysis, to measure therapeutic effectiveness. I argue, therefore, that evidence from clinical research studies should take precedence over the testimonial evidence and other types of non-clinical evidence, inproviding justification for health technologies. (shrink)

Various publications claim that medical AI systems perform as well, or better, than clinical experts. However, there have been very few controlled trials and the quality of existing studies has been called into question. There is growing concern that existing studies overestimate the clinical benefits of AI systems. This has led to calls for more, and higher-quality, randomized controlled trials of medical AI systems. While this a welcome development, AI RCTs raise novel methodological challenges that have seen little (...) discussion. We discuss some of the challenges arising in the context of AI RCTs and make some suggestions for how to meet them. (shrink)

Chasing Medical Miracles" is the first book to give readers a behind-the-scenes look at the complicated world of clinical trials, revealing how a multibillion-dollar industry of private companies conducting them with little oversight has taken root and quietly become a major part of the American medical establishment.

Without doctors being able to explain medical decisions to patients, I argue their use of black box AIs would erode the effective and respectful care they provide patients. In addition, I argue that physicians should use AI black boxes only for patients in dire straits, or when physicians use AI as a “co-pilot” (analogous to a spellchecker) but can independently confirm its accuracy. I respond to A.J. London’s objection that physicians already prescribe some drugs without knowing why they work.

Medical practitioners are duty-bound to tell their patients the truth about their medical conditions, along with the risks and benefits of proposed treatments. Some patients, however, would rather not receive medical information. A recent response to this tension has been to argue that that the disclosure of medical information is not optional. As such, patients do not have permission to refuse medical information. In this paper I argue that, depending on the context, the disclosure of (...) medical information can undermine the patient’s ability to exercise her autonomy or have therapeutically detrimental effects. In the light of these insights I go on to develop a context-sensitive approach to medical disclosure. The advantage of this account is that it addresses concerns on both sides of the debate; whilst it acknowledges that patients do not have an exercisable ‘right not to know,’ it allows that in some cases medical information ought to be withheld. (shrink)

Medical assistance in dying, which includes voluntary euthanasia and assisted suicide, is legally permissible in a number of jurisdictions, including the Netherlands, Belgium, Switzerland and Canada. Although medical assistance in dying is most commonly provided for suffering associated with terminal somatic illness, some jurisdictions have also offered it for severe and irremediable psychiatric illness. Meanwhile, recent work in the philosophy of psychiatry has led to a renewed understanding of psychiatric illness that emphasises the role of the relation between (...) the person and the external environment in the constitution of mental disorder. In this paper, I argue that this externalist approach to mental disorder highlights an ethical challenge to the practice of medical assistance in dying for psychiatric illness. At the level of the clinical assessment, externalism draws attention to potential social and environmental interventions that might have otherwise been overlooked by the standard approach to mental disorder, which may confound the judgement that there is no further reasonable alternative that could alleviate the person’s suffering. At the level of the wider society, externalism underscores how social prejudices and structural barriers that contribute to psychiatric illness constrain the affordances available to people and result in them seeking medical assistance in dying when they otherwise might not have had under better social conditions. (shrink)

Some patients, following brain injury, do not outwardly respond to spoken commands, yet show patterns of brain activity that indicate responsiveness. This is “cognitive-motor dissociation” (CMD). Recent research has used machine learning to diagnose CMD from electroencephalogram (EEG) recordings. These techniques have high false discovery rates, raising a serious problem of inductive risk. It is no solution to communicate the false discovery rates directly to the patient’s family, because this information may confuse, alarm and mislead. Instead, we need a procedure (...) for generating case-specific probabilistic assessments that can be communicated clearly. This article constructs a possible procedure with three key elements: (1) a shift from categorical “responding or not” assessments to degrees of evidence; (2) the use of patient-centred priors to convert degrees of evidence to probabilistic assessments; and (3) the use of standardized probability yardsticks to convey those assessments as clearly as possible. (shrink)

A reply to David Hamlyn's critique of current philosophy of education.

Medical student and resident participation in global health experiences (GHEs) has significantly increased over the last decade. In response to growing student interest and the proven impact of such experiences on the education and career decisions of resident physicians, many medical schools have begun to establish programmes dedicated to global health education. For the innumerable benefits of GHEs, it is important to note that medical students have the potential to do more harm than good in these settings (...) when they exceed their actual capabilities as physicians-in-training. While medical training programmes are beginning to provide students with the knowledge to put their GHEs in context, they must remember that they also bear the responsibility of training their students in a framework to approach these experiences in a principled and professional way. It is necessary that these institutions provide adequate and formalised preparation for both clinical and ethical challenges of working in resource-poor settings. This paper outlines potential benefits and risks of GHEs and delineates recommendations to some of the current issues. (shrink)

Medical practice should evolve alongside medical ethics. As our understanding of the ethical implications of physician-patient interactions becomes more nuanced, physicians should integrate those lessons into practice. As early as the 1930s, epidemiological studies began to identify that the rates of medical procedures varied significantly along geographic and socioeconomic lines. Dr. J. Alison Glover recognized that tonsillectomy rates in school children in certain school districts in England and Wales were in some cases eight times the rates of (...) children in other districts, with the only significant predictive factors being the current chief medical officer in the area and the socioeconomic well-being of the child's parents. Unfortunately, Dr. Glover's work revealed that the increase in tonsillectomies did not improve the health of adolescent patients and appeared to be performed “as a routine prophylactic ritual for no particular reason and with no particular result.”. (shrink)