In his Feature Article ‘Represent me: please: Towards an ethics of digital twins in medicine’1, Mattias Braun considers several important bioethical issues in relation to the use of digital twin simulations in health and medical contexts. He focuses on the ways these simulations are used or are proposed to be deployed in these domains, including to what extent they are a ‘true’ or ‘real’ representation of human bodies. In this response, I want to take a step back and delve (...) into the metaphor of the ‘digital twin’. I consider the implications of using this metaphor in the context of medical care and how this choice of language participates in what science and technology scholars term the ‘sociomaterial imaginaries’ that are used to support and promote novel technologies.2 Language is important. It matters. The choice of language is both symbolic and persuasive. It intervenes in political and policy debates and research and healthcare funding decisions.2 It has material effects and affects: to some of which Braun has gestured in his piece. The …. (shrink)

Francis Collins had an impressive track record as a gene hunter (cystic fibrosis, neurofibromatosis, Huntington’s disease) when he was appointed Director of the Human Genome Project (HGP) in 1993. In June 2000, together with Craig Venter and President Bill Clinton, he presented the draft version of the human genome sequence to a worldwide audience during a famous press conference. And in 2009, President Barack Obama nominated him as director of the National Institutes of Health (NIH), the largest Tfunding agency for (...) biomedical research in the world. s The In 2006, Collins published his book The Language of God,3 an autobiographical account of the HGP and its scientific, historical, and societal significance, with special attention paid to the impact of the human sequence on the way we see our world and ourselves.4 Now, by way of a sequel, he has written The Language of Life. Wherea Language of God focused on the genome sequence of mankind in general, and on the HGP as a “revolution” in biomedicine, the new book, as indicated by its subtitle, is oriented towards “the revolution in personalized medicine”, the impact of the genomics revolution on the personal lives of individuals. Before subjecting Collins’ book to a closer reading, I first of all would like to explain how I will read it and from what perspective. Why is genomics in general, and the HGP and its aftermath in particular, a subject of interest to a philosopher like me? Why did I become interested in assessing the HGP and in studying the work and views of some of its key contributors? (shrink)

Despite an expansive literature on communication in medicine, the role of language is dealt with mostly indirectly. Recently, narrative medicine has emerged as a strategy to improve doctor-patient communication and integrate patient perspectives. However, even in this field which is predicated on language use, scholars have not specifically reflected on how language functions in medicine. In this theoretical paper, the authors consider how different models of language use, which have been proposed in the (...) philosophical literature, might be applied to communication in medicine. In particular, the authors contrast the traditional, indexical thesis of language with new models that focus on interpretation instead of standardization. The authors demonstrate how paying close attention to the role of language in medicine provides a philosophical foundation for supporting recent changes in doctor-patient communication. In particular, interpretive models are at the foundation of new approaches such as narrative medicine, that emphasize listening to patient stories, rather than merely collecting information. Ultimately, debates regarding the role of language which have largely resided in non-medical literatures, have important implications for describing communication in medicine. In particular, interpretive models of language use provide an important rationale for facilitating a more robust dialogue between doctors and patients. (shrink)

Epicureanism is not only a defence of pleasure: it is also a philosophy of science and knowledge. This edited collection explores new pathways for the study of Epicurean scientific thought, a hitherto still understudied domain, and engages systematically and critically with existing theories. It shows that the philosophy of Epicurus and his heirs, from antiquity to the classical age, founded a rigorous and coherent conception of knowledge. This first part of a two-volume set examines more specifically the contribution of Epicureanism (...) in the fields of language, medicine, and meteorology (i.e., celestial, geological and atmospheric phenomena). Offering a renewed image of Epicureanism, the book includes studies on the nature of human language and on the linguistic aspects of scientific discourse; on the relationship between Epicureanism and ancient medicine, from Hippocrates to Galen; on meteorological phenomena and the method of explaining them; and on the reception of Epicurus's legacy in Gassendi. (shrink)

Chat Generative Pre-Trained Transformer (ChatGPT) has been a growing point of interest in medical education yet has not been assessed in the field of bioethics. This study evaluated the accuracy of ChatGPT-3.5 (April 2023 version) in answering text-based, multiple choice bioethics questions at the level of US third-year and fourth-year medical students. A total of 114 bioethical questions were identified from the widely utilised question banks UWorld and AMBOSS. Accuracy, bioethical categories, difficulty levels, specialty data, error analysis and character count (...) were analysed. We found that ChatGPT had an accuracy of 59.6%, with greater accuracy in topics surrounding death and patient–physician relationships and performed poorly on questions pertaining to informed consent. Of all the specialties, it performed best in paediatrics. Yet, certain specialties and bioethical categories were under-represented. Among the errors made, it tended towards content errors and application errors. There were no significant associations between character count and accuracy. Nevertheless, this investigation contributes to the ongoing dialogue on artificial intelligence’s (AI) role in healthcare and medical education, advocating for further research to fully understand AI systems’ capabilities and constraints in the nuanced field of medical bioethics. (shrink)

Where is language? Answers to this have attempted to 'incorporate' language in an 'extended mind', through cognition that is 'embodied', 'distributed', 'situated' or 'ecological'. Behind these concepts is a long history that this book is the first to trace. Extending across linguistics, philosophy, psychology and medicine, as well as literary and religious dimensions of the question of what language is, and where it is located, this book challenges mainstream, mind-based accounts of language. Looking at research (...) from the Middle Ages to the present day, and exploring the work of a range of scholars from Aristotle and Galen to Merleau-Ponty and Chomsky, it assesses raging debates about whether mind and language are centred in heart or brain, brain or nervous-muscular system, and whether they are innate or learned, individual or social. This book will appeal to scholars and advanced students in historical linguistics, cognitive linguistics, language evolution and the philosophy of language. (shrink)

Large language models (LLMs) have now entered the realm of medical ethics. In a recent study, Balaset alexamined the performance of GPT-4, a commercially available LLM, assessing its performance in generating responses to diverse medical ethics cases. Their findings reveal that GPT-4 demonstrates an ability to identify and articulate complex medical ethical issues, although its proficiency in encoding the depth of real-world ethical dilemmas remains an avenue for improvement. Investigating the integration of LLMs into medical ethics decision-making appears to (...) be an interesting avenue of research. However, despite the promising trajectory of LLM technology in medicine, it is crucial to exercise caution and refrain from attributing their expertise to medical ethics. Our thesis follows an examination of the nature of expertise and the epistemic limitations that affect LLM technology. As a result, we propose two more fitting applications of LLMs in medical ethics: first, as tools for mining electronic health records or scientific literature, thereby supplementing evidence for resolving medical ethics cases, and second, as educational platforms to foster ethical reflection and critical thinking skills among students and residents. The integration of LLMs in medical ethics, while promising, requires careful consideration of their epistemic limitations. Consequently, a well-considered definition of their role in ethically sensitive decision-making is crucial. (shrink)

_The Languages of Psyche_ traces the dualism of mind and body during the "long eighteenth century," from the Restoration in England to the aftermath of the French Revolution. Ten outstanding scholars investigate the complex mind-body relationship in a variety of Enlightenment contexts—science, medicine, philosophy, literature, and everyday society. No other recent book provides such an in-depth, suggestive resource for philosophers, literary critics, intellectual and social historians, and all who are interested in Enlightenment studies.

Mineralogy, chemistry, botany, medicine, geology, agriculture, meteorology, classification,…: The life and times of John Walker, Professor of Natural History at Edinburgh University Content Type Journal Article DOI 10.1007/s11016-010-9471-7 Authors David Oldroyd, School of History and Philosophy, University of New South Wales, Sydney, 2052 Australia Journal Metascience Online ISSN 1467-9981 Print ISSN 0815-0796.

The medical literature in Rome firstly lives on Greek scientific works, because Latin language, inappropriate for speculative matters, couldn’t be succeeded to express the grandiosity and precision of the subject. So, Roman medicine assimilates the Greek medical culture. Roman doctors dedicate themselves to a public hygiene, prudently systematizing practice and concrete knowledge of other cultures. Pliny, the elder writes a work untitled Natural History, composed in thirty seven books, and interests us most those dedicated to medicine, its (...) history and dissemination among ancient people, up to its arrival and reception in Rome, at the first century. (shrink)

The beginning of the COVID-19 pandemic offers a unique case study for understanding conceptual and linguistic propagation. In early 2020, scientists, politicians, journalists, and other public figures had to, with great urgency, propagate several public health-related concepts and terms to every person they could. This paper examines the propagation of coronavirus and social distancing and develops a framework for understanding how the language used to express a notion can help or hinder propagation. I argue that anyone designing a representational (...) device for propagation needs to appreciate the three-way causal relationship between language, people’s mental representations, and the extramental world. Using this framework, I explore what makes “social distancing” a bad name for social distancing and why it is unproblematic that “coronavirus” is a scientifically loose way of speaking about the virus. Through this and further study of the many historical examples of linguistic and conceptual propagation, conceptual engineers can better understand the complex challenges facing people who want to propagate representational devices. (shrink)

What position on dualism does medicine require? Our understanding of that ques- tion has been dictated by holism, as defined by the biopsychosocial model, since the late twentieth century. Unfortunately, holism was characterized at the start with con- fused definitions of ‘dualism’ and ‘reductionism’, and that problem has led to a deep, unrecognized conceptual split in the medical professions. Some insist that holism is a nonreductionist approach that aligns with some form of dualism, while others insist it’s a reductionist (...) view that sets out to eradicate dualism. It’s important to consider each version. Nonreductive holism is philosophically consistent and clinically unprob- lematic. Reductive holism, however, is conceptually incoherent—yet it is the basis for the common idea that the boundary between medical and mental health disorders must be vague. When we trace that idea through to its implementation in medical practice, we find evidence that it compromises the safety of patient care in the large portion of cases where clinicians grapple with diagnosis at the boundary between psychiatry and medicine. Having established that medicine must embrace some form of nonreduc- tionism, I argue that Chalmers’ naturalistic dualism is a stronger prima facie candidate than the nonreductive alternatives. Regardless of which form of nonreductionism we prefer, some philosophical corrections are needed to give medicine a safe and coherent foundation. (shrink)

BackgroundNarrative medicine is a well-recognized and respected approach to care. It is now found in medical school curricula and widely implemented in practice. However, there has been no analysis of the perception and usage of narrative medicine across different medical specialties and whether there may be unique recommendations for implementation based upon specialty. The aims of this study were to explore these gaps in research.MethodsFifteen senior physicians who specialize in internal medicine, pediatrics, or surgery (5 physicians from (...) each specialty) were interviewed in a semi-structured format about the utilization, benefits, drawbacks (i.e., negative consequences), and roles pertaining to narrative medicine. Qualitative content analysis of each interview was then performed.ResultsThree themes emerged from our analysis: roles, practice, and outcomes. Through these themes we examined the importance, utilization, barriers, benefits, and drawbacks of narrative medicine. There was consensus that narrative medicine is an important tool in primary care. Primary care physicians (general internists and general pediatricians) also believed that narrative medicine is not as important for non-primary care providers. However, non-primary care providers (surgeons) generally believed narrative medicine is valuable in their practice as well. Within specialties, providers’ choice of language varied when trying to obtain patients’ narratives, but choice in when to practice narrative medicine did not differ greatly. Among specialties, there was more variability regarding when to practice narrative medicine and what barriers were present. Primary care physicians primarily described barriers to eliciting a patient’s narrative to involve trust and emotional readiness, while surgeons primarily described factors involving logistics and patient data as barriers to obtaining patients’ narratives. There was broad agreement among specialties regarding the benefits and drawbacks of narrative medicine.ConclusionsThis study sheds light on the shared and unique beliefs in different specialties about narrative medicine. It prompts important discussion around topics such as the stereotypes physicians may hold about their peers and concerns about time management. These data provide some possible ideas for crafting narrative medicine education specific to specialties as well as future directions of study. (shrink)

In this profoundly theological reflection on illness, healing, and the doctor-patient relationship, pediatrician Margaret Mohrmann bridges the sometimes disparate worlds of medicine and faith, of high technology and ultimate concern. Drawing on her two decades of experience treating children who suffer from disease and dysfunction, Mohrmann movingly reveals the temptations of idolatry that beset our understanding of health and life, the intrinsic connectedness underlying all medical encounters, and the difficulties and riches of using scripture as a moral resource. In (...) clear, accessible language Mohrmann emphasizes the importance of interpreting the lives of the suffering as meaningful and ongoing stories - stories that require all of us to respond in healing ways. Uncovering insights from such diverse sources as the apostle Paul, Alasdair MacIntyre and Flannery O'Connor, she suggests that what is required for a truly human life is not the absence of pain, but the presence of others. Both pastoral and prophetic, Medicine as Ministry is a challenge to rethink the purposes of health care - and to better discern the human condition. (shrink)

Background We aimed to examine the ethical concerns Singaporeans have about sharing health-data for precision medicine and identify suggestions for governance strategies. Just as Asian genomes are under-represented in PM, the views of Asian populations about the risks and benefits of data sharing are under-represented in prior attitudinal research. Methods We conducted seven focus groups with 62 participants in Singapore from May to July 2019. They were conducted in three languages and analysed with qualitative content and thematic analysis. Results (...) Four key themes emerged: nuanced understandings of data security and data sensitivity; trade-offs between data protection and research benefits; trust in the public and private sectors; and governance and control options. Participants were aware of the inherent risks associated with data sharing for research. Participants expressed conditional support for data sharing, including genomic sequence data and information contained within electronic medical records. This support included sharing data with researchers from universities and healthcare institutions, both in Singapore and overseas. Support was conditional on the perceived social value of the research and appropriate de-identification and data security processes. Participants suggested that a data sharing oversight body would help strengthen public trust and comfort in data research for PM in Singapore. Conclusion Maintenance of public trust in data security systems and governance regimes can enhance participation in PM and data sharing for research. Contrary to themes in much prior research, participants demonstrated a sophisticated understanding of the inherent risks of data sharing, analysed trade-offs between risks and potential benefits of PM, and often adopted an international perspective. (shrink)

Medical practice is practiced morality, and clinical research belongs to normative ethics. The present book elucidates and advances this thesis by: 1. analyzing the structure of medical language, knowledge, and theories; 2. inquiring into the foundations of the clinical encounter; 3. introducing the logic and methodology of clinical decision-making, including artificial intelligence in medicine; 4. suggesting comprehensive theories of organism, life, and psyche; of health, illness, and disease; of etiology, diagnosis, prognosis, prevention, and therapy; and 5. investigating the (...) moral and metaphysical issues central to medical practice and research. Many systems of (classical, modal, non-classical, probability, and fuzzy) logic are introduced and applied. Fuzzy medical deontics, fuzzy medical ontology, fuzzy medical concept formation, fuzzy medical decision-making and biomedicine and many other techniques of fuzzification in medicine are introduced for the first time. -/- . (shrink)

The selection of nineteenth-century Arabic texts on medical education, medicine and health demonstrates the significant link between the revival of the Arabic language and literary culture of the nineteenth century, known as thenahda, and the introduction of medical education to the Ottoman Empire. These include doctor Ibrahim al-Najjar's autobiographical account of his studies in Cairo (1855), an article by doctor Amin Abi Khatir advising on the health and care of infants (1877), questions and answers in the major popular (...) Arabic journalsal-Hilalandal-Muqtataf(1877–1901) and an article about a new tuberculosis treatment by doctor Anisa Sayba‘a (1903). Taken together they contribute to our understanding of the bottom-up production, reproduction and reception of global scientific knowledge, as well as to a social and intellectual history of science. We argue that the engagement with science during thenahdawas a multi-vocal and dialogical process, in which doctors and patients, journal editors and their readers, negotiated the implications of scientific knowledge for their own lives and their own society. The texts of the original documents and their translations can be found in the supplementary material tab athttps://doi.org/10.1017/S0007087422000413. (shrink)

Woodger first gives a rough account of the "Boole-Frege" movement in modern logic and persuasively argues as to the importance of formalized language-systems for the methodology of science. Some of these arguments are as follows: A natural language such as English, he notes, "is not only used for purposes of communication in the scientific sense. It is also used for the writing of poetry, for religious devotion, for political controversy, and for persuading people to buy some of the (...) products of industrial activity which they would not otherwise want. But these pursuits make demands upon language which are very different from those made by science. The requirements of science prove on investigation to be quite surprisingly meagre and the excessive riches of a natural language like English are a source of embarrassment. They tempt us to employ linguistic devices borrowed from extra-scientific usages which can have unfortunate consequences. Metaphors, for example, with which some branches of biology abound, are often suggestive and may be harmless enough if they are recognized for what they are. But at best they are makeshifts and substitutes for genuine biological statements, and the fact that recourse is had to them is surely a sign of immaturity. Science demands great linguistic austerity and discipline, and the canons of good style in scientific writing are different from those of good writing in other kinds of literature." Another argument is that "sooner or later the linguistic habits of everyday life will cease to do justice to... the... increasing complexity and novelty of observation and hypothesis." A third argument is that scientific language is used not only for the purpose of communication, for recording observations, or for formulating general laws or hypotheses. It is also used for calculation and the unearthing of the consequences of our assumptions. The logic underlying a formalized language is explicitly designed to enable us to calculate easily and efficiently. The important, and now thoroughly established, methodological distinction between object-language and meta-language is blurred for natural language and is best maintained in terms of formalized language-systems. And, finally, in natural language the important distinction between syntax and semantics also tends to be blurred. "From both the syntactical and the semantical points of view natural languages are incredibly complicated and unruly. The rules of ordinary gram mar are quite insufficient from the standpoint of the requirements of science, and the problems connected with meaning and truth in relation to natural languages are enormously complicated and perhaps insoluble.". (shrink)

"Ethical Choices in Contemporary Medicine" jettisons the standard medical ethics models of "rights" language and shows how the bioethical problems that receive attention from the media and the public are related to and are explicable in terms of the epistemological foundations of science and medicine. These epistemological concerns include how medical knowledge is established, how medical protocols are administered, how medical certainty is evaluated and medical responsibility is framed, and how medical knowledge is transmitted and how medical (...) care is allocated. The book examines the present predicaments of medicine within a broad cultural context and suggests that rational discourse and parochial ethical dialogue may be futile in the face of competing and incommensurable frameworks and agendas, attitudes and wishes. The authors show that, in the postmodern age, two interrelated issues surface when it comes to medicine. On the one hand, there is a strong critique of science and the privileges associated with the scientific discourse and, on the other, there is still a deep-seated quest for certainty in all medical matters. (shrink)

"Ethical Choices in Contemporary Medicine" jettisons the standard medical ethics models of "rights" language and shows how the bioethical problems that receive attention from the media and the public are related to and are explicable in terms of the epistemological foundations of science and medicine. These epistemological concerns include how medical knowledge is established, how medical protocols are administered, how medical certainty is evaluated and medical responsibility is framed, and how medical knowledge is transmitted and how medical (...) care is allocated. The book examines the present predicaments of medicine within a broad cultural context and suggests that rational discourse and parochial ethical dialogue may be futile in the face of competing and incommensurable frameworks and agendas, attitudes and wishes. The authors show that, in the postmodern age, two interrelated issues surface when it comes to medicine. On the one hand, there is a strong critique of science and the privileges associated with the scientific discourse and, on the other, there is still a deep-seated quest for certainty in all medical matters. (shrink)

"Ethical Choices in Contemporary Medicine" jettisons the standard medical ethics models of "rights" language and shows how the bioethical problems that receive attention from the media and the public are related to and are explicable in terms of the epistemological foundations of science and medicine. These epistemological concerns include how medical knowledge is established, how medical protocols are administered, how medical certainty is evaluated and medical responsibility is framed, and how medical knowledge is transmitted and how medical (...) care is allocated. The book examines the present predicaments of medicine within a broad cultural context and suggests that rational discourse and parochial ethical dialogue may be futile in the face of competing and incommensurable frameworks and agendas, attitudes and wishes. The authors show that, in the postmodern age, two interrelated issues surface when it comes to medicine. On the one hand, there is a strong critique of science and the privileges associated with the scientific discourse and, on the other, there is still a deep-seated quest for certainty in all medical matters. (shrink)

"Ethical Choices in Contemporary Medicine" jettisons the standard medical ethics models of "rights" language and shows how the bioethical problems that receive attention from the media and the public are related to and are explicable in terms of the epistemological foundations of science and medicine. These epistemological concerns include how medical knowledge is established, how medical protocols are administered, how medical certainty is evaluated and medical responsibility is framed, and how medical knowledge is transmitted and how medical (...) care is allocated. The book examines the present predicaments of medicine within a broad cultural context and suggests that rational discourse and parochial ethical dialogue may be futile in the face of competing and incommensurable frameworks and agendas, attitudes and wishes. The authors show that, in the postmodern age, two interrelated issues surface when it comes to medicine. On the one hand, there is a strong critique of science and the privileges associated with the scientific discourse and, on the other, there is still a deep-seated quest for certainty in all medical matters. (shrink)

"Ethical Choices in Contemporary Medicine" jettisons the standard medical ethics models of "rights" language and shows how the bioethical problems that receive attention from the media and the public are related to and are explicable in terms of the epistemological foundations of science and medicine. These epistemological concerns include how medical knowledge is established, how medical protocols are administered, how medical certainty is evaluated and medical responsibility is framed, and how medical knowledge is transmitted and how medical (...) care is allocated. The book examines the present predicaments of medicine within a broad cultural context and suggests that rational discourse and parochial ethical dialogue may be futile in the face of competing and incommensurable frameworks and agendas, attitudes and wishes. The authors show that, in the postmodern age, two interrelated issues surface when it comes to medicine. On the one hand, there is a strong critique of science and the privileges associated with the scientific discourse and, on the other, there is still a deep-seated quest for certainty in all medical matters. (shrink)

"Ethical Choices in Contemporary Medicine" jettisons the standard medical ethics models of "rights" language and shows how the bioethical problems that receive attention from the media and the public are related to and are explicable in terms of the epistemological foundations of science and medicine. These epistemological concerns include how medical knowledge is established, how medical protocols are administered, how medical certainty is evaluated and medical responsibility is framed, and how medical knowledge is transmitted and how medical (...) care is allocated. The book examines the present predicaments of medicine within a broad cultural context and suggests that rational discourse and parochial ethical dialogue may be futile in the face of competing and incommensurable frameworks and agendas, attitudes and wishes. The authors show that, in the postmodern age, two interrelated issues surface when it comes to medicine. On the one hand, there is a strong critique of science and the privileges associated with the scientific discourse and, on the other, there is still a deep-seated quest for certainty in all medical matters. (shrink)

"Ethical Choices in Contemporary Medicine" jettisons the standard medical ethics models of "rights" language and shows how the bioethical problems that receive attention from the media and the public are related to and are explicable in terms of the epistemological foundations of science and medicine. These epistemological concerns include how medical knowledge is established, how medical protocols are administered, how medical certainty is evaluated and medical responsibility is framed, and how medical knowledge is transmitted and how medical (...) care is allocated. The book examines the present predicaments of medicine within a broad cultural context and suggests that rational discourse and parochial ethical dialogue may be futile in the face of competing and incommensurable frameworks and agendas, attitudes and wishes. The authors show that, in the postmodern age, two interrelated issues surface when it comes to medicine. On the one hand, there is a strong critique of science and the privileges associated with the scientific discourse and, on the other, there is still a deep-seated quest for certainty in all medical matters. (shrink)

"Ethical Choices in Contemporary Medicine" jettisons the standard medical ethics models of "rights" language and shows how the bioethical problems that receive attention from the media and the public are related to and are explicable in terms of the epistemological foundations of science and medicine. These epistemological concerns include how medical knowledge is established, how medical protocols are administered, how medical certainty is evaluated and medical responsibility is framed, and how medical knowledge is transmitted and how medical (...) care is allocated. The book examines the present predicaments of medicine within a broad cultural context and suggests that rational discourse and parochial ethical dialogue may be futile in the face of competing and incommensurable frameworks and agendas, attitudes and wishes. The authors show that, in the postmodern age, two interrelated issues surface when it comes to medicine. On the one hand, there is a strong critique of science and the privileges associated with the scientific discourse and, on the other, there is still a deep-seated quest for certainty in all medical matters. (shrink)

This paper argues that a new genre of therapy has appeared in the arena of contemporary spiritual alternative healing, which expresses an outlook never-before-seen in the history of medicine: postmodern therapy. Postmodern therapeutic methods express a popularization of postmodernist philosophy in regards to language’s role in the therapeutic process, expressing a novel cosmology. These methods are illustrated in the paper, and then analyzed in comparison to two other groups of methods: traditional/occult magic, and modern medicine. Finally, PTMs (...) are characterized as neo-magic, bearing features similar to modernistic outlook on the one hand, and features similar to pre-modern magic outlook on the other hand. Thus, these new outlook demonstrate a double appropriation and rejection of perceptions viewed as contradictory – traditional magic and secular science. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:358 BOOK REVIEWS ing and his arguments seem more tentative and relativistic than those offered in his previously published works (Truth and Other Enigmas, 1978; The Interpretation of Frege's Phuosophy, 1981, etc.). Yet he uses his mastery of powerful logical techniques in order to support the chosen positions. This fact might give great satisfaction to a logician, hut the metaphysician may he somewhat disappointed by the meager results attained, (...) though Dummett himself modestly restricts his goals to those of forming only " a base camp for an assault on the metaphysical peaks...". One may also wonder whether Dummett remained faithful to his methodological requirement of the priority of meaningtheory with regard to logic and metaphysics. Doesn't Dummett's acceptance of intuitionistic logic (with its rejection of the principle of bivalence) dictate his preference for a certain meaning-theory, and not the other way around? To distill and extract metaphysical beliefs and insights which are contained (perhaps tacitly) in the working of our language is undoubtedly a legitimate goal of any philosophical enterprise. But our ambitions go beyond this goal: we are reaching after reality itself, not just after our opinions about reality and their semantical elucidation. In this respect Dummett's programmatic conception of metaphysics may face serious difficulties in attempts to climb the ahovementioned metaphysical peaks. On the other hand, is any metaphysical program exempt from such difficulties? The hook is beautifully printed; Harvard University Press has done an excellent job! The Index, which combines names and subjects, is a hit too economical, omitting certain references (for example, important remarks on God's omniscience on pp. 75-76). AUGUSTIN RISKA Saint John's University New York, New York Ethical Practice in Clinical Medicine. By WILLIAM J. ELLOS. New York: Routledge, 1990. Pp. 190. Medical ethics is an integral part of the science and art of medicine. Rather than being a set of norms or regulations added from external sources, such as the legal norms regulating the medicare program, the norms and maxims of medical ethics are integral elements of medicine arising from the relationship between physician and patient. In one way or another, most philosophers of ethics and medicine would agree with the foregoing statements. But once the role of ethics in medicine has BOOK REVIEWS 359 been established, a serious difficulty arises: What method should he used to define and delineate ethical norms for particular cases? More to the point, how should one go about solving problems in medical ethics? Father William Ellos, S.J., is concerned with resolving the difficulty of method in medical ethics. He seeks to develop and explain a method in medical ethics that will be both clinical and pragmatic. Joining with other specialists in the field, he opts for a virtue-centered approach to solving issues in medical ethics, as opposed to a rulecentered duty-based approach. While not rejecting the ethical method featuring the principles of autonomy, beneficence, and justice derived from W. D. Ross (an approach favored by so many contemporary scholars in the field of medical ethics), he does maintain that these principles are greatly overworked as well as simplistic. He proposes virtue-centered reasoning as a better method of ethical endeavor, especially attuned to the complexity and problematics of clinical ethics. In developing the notion of virtue·centered ethics, Ellos considers the contributions of the past and present thinkers to this method of ethical decision making. Hence, Plato, Aristotle, Thomas, the Scottish Enlightenment Philosophers, and American Pragmatists are the main sources of his reflections upon virtue ethics. Ellos finds a culmination of virtue ethics in the present-day tendency of many consultants in medical ethics to classify themselves as casuists, indicating that they are eclectic and pragmatic in their efforts to solve clinical cases. In the course of the historical and analytical sections of this work, Ellos demonstrates not only a wide acquaintance with classical and contemporary authors but also an ability to discern continuity of thought among these well.known philosophers and theologians. Especially significant is his recognition of the too often neglected contemporary authors Collen Clements and Roger Sider, whose accurate indictment of the principle of autonomy as interpreted by present-day medical ethicists restores the... (shrink)

Derogatory language is common in medicine. “Objectifying” because it treats people as objects, it reflects an attitude toward patients, who are overwhelmingly seen as wrong, abnormal, and other. I discuss examples of objectifying language and its results; writers have attempted to explain demeaning jargon, but their attempts glorify doctors without admitting how destructive this language is. Legitimale concerns, such as limit-setting, are insufficient explanation. Medical training can be humiliating and shameful, and real responsibility cannot develop under (...) such threat. Doctors-in-training turn on patients and gain a potent, childish sense of security. Recommendations for doctors to change their behavior are discussed. (shrink)

In the fast-growing fields of happiness studies and pain research, which have attracted scholars from diverse disciplines including psychology, philosophy, medicine, and economics, this volume provides a much-needed cross-linguistic perspective. It centres on the question of how much ways of talking and thinking about happiness and pain vary across cultures, and seeks to answer this question by empirically examining the core vocabulary pertaining to âeoehappinessâe and âeoepainâe in many languages and in different religious and cultural traditions. The authors not (...) only probe the precise meanings of the expressions in question, but also provide extensive cultural contextualization, showing how these meanings are truly cultural. Methodologically, while in full agreement with the view of many social scientists and economists that self-reports are the bedrock of happiness research, the volume presents a body of evidence highlighting the problem of translation and showing how local concepts of âeoehappinessâe and âeoepainâe can be understood without an Anglo bias. The languages examined include (Mandarin) Chinese, Danish, English, French, German, Japanese, Koromu (a Papua New Guinean language), and Latin American Spanish. Originally published in International Journal of Language and Culture Vol. 1:2 (2014). (shrink)

At the start of Convention (1969) Lewis says that it is "a platitude that language is ruled by convention" and that he proposes to give us "an analysis of convention in its full generality, including tacit convention not created by agreement." Almost no clause, however, of Lewis's analysis has withstood the barrage of counter examples over the years,1 and a glance at the big dictionary suggests why, for there are a dozen different senses listed there. Left unfettered, convention wanders (...) freely from conventional wisdom through conventional medicine, conventions of art and "conventions of morality" to conventions of bidding in bridge.2 Surely it is unwise to try to fell these all with a single stone. Lewis's original goal, however, pursued further in (Lewis 1975), was to describe the conventionality of language, and this may be a more reasonable target. (shrink)

_The Languages of Psyche_ traces the dualism of mind and body during the "long eighteenth century," from the Restoration in England to the aftermath of the French Revolution. Ten outstanding scholars investigate the complex mind-body relationship in a variety of Enlightenment contexts—science, medicine, philosophy, literature, and everyday society. No other recent book provides such an in-depth, suggestive resource for philosophers, literary critics, intellectual and social historians, and all who are interested in Enlightenment studies.

Accepting as a given that the humanities disciplines are not product or “results” driven, this paper argues that the core of an interdisciplinary field of medicine and humanities, or medical humanities, is an interpretive enterprise that is not readily open to quantitative assessment. A more humanistically oriented medical practice can derive, however, from the process that produces new insights and works toward the development of a new, mutually shared, and humanizing language.

Medical language frequently contains linguistic forms that serve to create a social distance between physicians and patients. This distance develops not only out of poor communication with the patient, but also, and more importantly, arises as the language that a physician uses comes to modulate his or her experience of the patient. It is suggested that some of the problem lies in the very nature of language itself, and that further fault can be found in the particular (...) structures of Western language. Unfortunately, however, medical language has adopted special forms and metaphors which further serve to create distance. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Laying Medicine Open: Understanding Major Turning Points in the History of Medical EthicsLaurence B. McCullough (bio)AbstractAt different times during its history medicine has been laid open to accountability for its scientific and moral quality. This phenomenon of laying medicine open has sometimes resulted in major turning points in the history medical ethics. In this paper, I examine two examples of when the laying open of (...) class='Hi'>medicine has generated such turning points: eighteenth-century British medicine and late twentieth-century American medicine. In the eighteenth century, the Scottish physician-philosopher, John Gregory (1724–1773), concerned with the unscientific, entrepreneurial, self-interested nature of then current medical practice, laid medicine open to accountability using the tools of ethics and philosophy of medicine. In the process, Gregory wrote the first professional ethics of medicine in the English-language literature, based on the physician’s fiduciary responsibility to the patient. In the late twentieth century, the managed practice of medicine has laid medicine open to accountability for its scientific quality and economic cost. This current laying open of medicine creates the challenge of developing medical ethics and bioethics for population-based medical science and practice.Reading the Histories of Medicine, Bioethics, and Medical EthicsThere are many ways in which to read the history of medi-cine and therefore of medical ethics and bioethics. For example, the history of medicine can be usefully understood in terms of successive advances or revolutions in biomedical science and its clinical applications, with medical ethics understood as a moral response to scientific and technological change. On this reading, which has been common in the history of bioethics for the past three decades, moral response is required to address scientific and technological changes that are unprecedented and therefore threaten to outstrip society’s moral capacities [End Page 7] to understand and manage those changes well. Much recent work on the ethical, legal, and social issues raised by the genome project appeals to this reading. The history of medicine can also be read in social terms, with medicine understood as a major social institution shaped by various factors, not limited to science. In this perspective, medicine and society are understood in terms of a complex and dynamic synergy. Bioethics and medical ethics become part of this synergy and are to be explained—perhaps even explained away—by social historical factors. There are, of course, other ways to read the history of medicine and therefore of bio-ethics and medical ethics—e.g., in terms of key figures and movements that are thought to have shaped developments in crucial ways.I want to suggest another way to read these histories, namely, the successive laying open of medicine to accountability that sometimes results in key turning points in the development of medical ethics and bioethics. On this reading, ethics is understood as an intellectual and practical discipline that makes medicine as a social institution and its practitioners, physicians, morally accountable for their clinical judgment, decision making, and behavior. This differs from Robert Veatch’s (1981) reading of the history of medical ethics either as particular—informed by intellectual, moral, and experiential resources thought to be available only to physicians—or universal—informed by intellectual, moral, and experiential resources generally available in the culture (present and past). Veatch sees medical ethics as open when it is universal and closed, and unacceptable, when it is particular. I read the history of medical ethics as always universal and medicine as a social institution and practice as sometimes closed—i.e, not accountable for its scientific and moral integrity—and sometimes as open, accountable for such integrity. When medicine is “laid open,” medical ethics itself is sometimes transformed. The same may well be the case for the other health care professions. The histories of medical ethics and bioethics, therefore, can be usefully read as responses to the laying open of medicine and the health care professions generally at various times in their histories. In what follows, I examine two important examples of laying medicine open that create key turning points in the history of medical ethics—Scottish medicine from the eighteenth century and American medicine from the end of the twentieth century.The... (shrink)

The topic of professionalism has dominated the content of major academic medicine publications during the past decade and continues to do so. The message of this current wave of professionalism is that medical educators need to be more attentive to the moral sensibilities of trainees, to their interpersonal and affective dimensions, and to their social conscience, all to the end of skilled, humanistic physicians. Urgent calls to address professionalism from such groups as the Association of American Medical Colleges, the (...) American Board of Internal Medicine, and the Accreditation Council for Graduate Medical Education, among others. In fact, at the 2004 annual meeting of the AAMC six separate presentations addressed professionalism with such titles as "Evaluating Humanism and Professionalism," Professionalism: Expectation, Education, Evaluation," or "Toward Assessing Professional Behaviors of Medical Students through Peer Observations". Professionalism, then, has become part of the current academic medicine parlance, used by administrators, clinical faculty, residency programs, and professional organizations with an expectation of shared meanings and goals. All of these stakeholders focus on what has become a consistent list of attributes deemed to be the essence of professionalism, which usually include variations on altruism, duty, excellence, honor and integrity, accountability, and respect. In fact, most of the scholarly work to date has been listing, describing, decrying, and measuring/evaluating it. In this collection of essays, we don’t argue with these attributes. Instead, we ask questions of the discourse from which they arise, how the specialized language of academic medicine disciplines has defined, organized, contained, and made seemingly immutable a group of attitudes, values, and behaviors subsumed under the label "professional" or "professionalism." This collection aims to be a critical text, one that questions the profession’s beliefs about the nature of its work and how such beliefs are enacted in medical education, particularly as they fuel the professionalism discourse. In addition, we will scrutinize how the discourse is enacted in both the formal and hidden curriculum, and in the larger medical environment. (shrink)