I introduce the concept pathophobia, to capture the range of morally objectionable forms of treatment to which somatically ill persons are subjected. After distinguishing this concept from sanism and ableism, I argue that the moral wrongs of pathophobia are best analysed using a framework of vice ethics. To that end I describe five clusters of pathophobic vices and failings, illustrating each with examples from three influential illness narratives.

The distinction between explanation and understanding was foundational to Jaspers’ ‘phenomenological’ approach to psychiatry. It makes sense that those now calling for a phenomenological approach to psychiatry would look to Jaspers for inspiration, and that in doing so, they would take up this distinction. However, I argue that it is and was a mistake to use the distinction in work on psychiatry: adhering to the distinction now would undermine, rather than support, the goals of those advocating a phenomenological approach to (...) psychiatry; furthermore, if the distinction had been adhered to, then contemporary psychiatry and its patients would be worse off. (shrink)

This editorial presents a special issue gathering four contributions about the patient’s lived experience in the context of deep-brain stimulation. It aims at clarifying the meaning of such an experience and its scope for medical practice, the health system and its legal frame.

Une médecine plus humaniste serait une médecine où les professionnels de santé feraient preuve de plus d’empathie envers leurs patients. Or s’il est difficile d’attester un déclin de l’empathie en médecine en l’attribuant au modèle biomédical, l’empathie n’est pas sans défaut. Cela ne signifie pas la mort de l’humanisme médical. Il est possible de le faire reposer sur un concept minimal de compassion et de lui intégrer une approche basée sur les systèmes de santé. L’humanisme ainsi défendu n’est plus empathique, (...) mais il est aussi plus convaincant. (shrink)

Plusieurs aspects du modèle biopsychosocial promeuvent une approche humaniste en médecine. Cependant, Engel a explicitement rejeté un humanisme médical qui s’opposerait à la science. En adoptant une approche fondée sur la science des systèmes pour étudier les êtres humains, la santé et la maladie, Engel défend une approche scientifique pour améliorer la qualité des soins cliniques, ou autrement dit, une approche qui se prête à un examen scientifique de cette question.

Selon l’une des thèses les plus répétées de la médecine narrative, la théorie littéraire, ou plus largement, la narration, permettrait aux membres du personnel médical d’appréhender les récits des patients et par là, de prendre en considération leurs expériences dans leur singularité absolue. Dans ma contribution, je soulignerai quelques limites de cette thèse. J’appuierai mon analyse sur un exemple de récit dominant de maladie, les récits portant sur le cancer du sein aux États-Unis au XXe siècle, à partir des analyses (...) féministes qui en ont été faites. Ainsi je montrerai d’une part qu’il est peu plausible que les récits des patients soient absolument singuliers et uniques, en un sens pertinent, et d’autre part que certains récits peuvent devenir dominants et marginaliser des récits qui voudraient s’en démarquer. (shrink)

The philosophy of medicine is an area that has experienced significant growth and change in the last decade or so. While usually thought to be distinct from bioethics, the philosophy of medicine addresses a wide range of questions having to do with epistemology, metaphysics, and values. In this survey, I use the concept of the reference class to draw connections between a number of questions of longstanding and of more recent concern in the philosophy of medicine. By focusing on the (...) way in which the reference class plays a role in questions and approaches that sometimes seem to be at odds with one another, I hope to illustrate the ways in which these oppositions are less complete than they might at first appear, and to show how the connections between different problems are being redrawn. (shrink)

BackgroundAdvances in biomedicine can substantially change human life. However, progress is not always followed by ethical reflection on its consequences or scientists’ responsibility for their creations. The humanities can help health sciences students learn to critically analyse these issues; in particular, literature can aid discussions about ethical principles in biomedical research. Mary Shelley’sFrankenstein; or, the modern Prometheus(1818) is an example of a classic novel presenting complex scenarios that could be used to stimulate discussion.Main textWithin the framework of the 200th anniversary (...) of the novel, we searched PubMed to identify works that explore and discuss its value in teaching health sciences. Our search yielded 56 articles, but only two of these reported empirical findings. Our analysis of these articles identified three main approaches to usingFrankensteinin teaching health sciences: discussing the relationship between literature and science, analysing ethical issues in biomedical research, and examining the importance of empathy and compassion in healthcare and research. After a critical discussion of the articles, we propose usingFrankensteinas a teaching tool to prompt students to critically analyse ethical aspects of scientific and technological progress, the need for compassion and empathy in medical research, and scientists’ responsibility for their discoveries.ConclusionFrankensteincan help students reflect on the personal and social limits of science, the connection between curiosity and scientific progress, and scientists’ responsibilities. Its potential usefulness in teaching derives from the interconnectedness of science, ethics, and compassion.Frankensteincan be a useful tool for analysing bioethical issues related to scientific and technological advances, such as artificial intelligence, genetic engineering, and cloning. Empirical studies measuring learning outcomes are necessary to confirm the usefulness of this approach. (shrink)