This inspirational book provides the philosophical backbone tocountless courses for health professionals. It poses twofundamental questions - "What is health?" and "How can more healthbe achieved?" - and answers them at a depth unmatched by any othertext in this field. David Seedhouse shows that these questions lieat the heart of health practice, and explains why all healthworkers should ponder them deeply. This second edition retains the freshness and enthusiasm of thefirst, while making the foundations theory and its practicalapplications clearer and (...) more accessible than ever. The bookincludes additional material and discussion, new case studies andrevised illustrations. * Describes and explores competing theories of health * Establishes a practical and ethical foundation for healthpromotion and education * Explains the foundations theory - a novel and comprehensive wayto understand health * Shows how the foundations theory might be used to create morehumane health services. (shrink)

We claim that if a complete philosophy of evidence-based practice is intended, then attention to the nature of causation in health science is necessary. We identify how health science currently conceptualises causation by the way it prioritises some research methods over others. We then show how the current understanding of what causation is serves to constrain scientific progress. An alternative account of causation is offered. This is one of dispositionalism. We claim that by understanding causation from a dispositionalist stance, many (...) of the processes within an evidence-based practice framework are better accounted for. Further, some of the problems associated with the health research, e.g. external validity of causal findings, dissolve. (shrink)

Discussions of diagnosis in mental illness are still beset by the suspicion that ‘value judgements’ are in some special sense ‘subjective’. The history of the debate about the reality of mental illness has seen a divide between those who accept that diagnosis is ‘value-laden’ and therefore accept a relativist/subjectivist account of mental illness, and those who feel the need to deny the value-laden nature of diagnosis to defend the reality of mental illness. More nuanced analyses note that all medical diagnosis (...) is arguably value-laden & this does not imply that medical conditions are unreal. All judgement requires a subject, but it does not follow that it is ‘subjective’ in any sense implying ontological relativity. The implications are substantial: either all medical judgement is relative or realism about value is true. To justify our claims in diagnosis, we need to discuss and defend our value-judgements. We must reject ‘scientism’ for an openly value-laden account of human functioning. Medical epistemology requires value-realism. The contentious nature of the value-judgements in the case of mental illness should not mislead us into concluding they are relative. (shrink)

The crisis of our times is that we have science without wisdom. Modern science and technology lead to modern industry and agriculture which in turn lead to all the great benefits of the modern world and to the global crises we face, from population growth to climate change. The fault lies, not with science, but with science dissociated from a more fundamental concern with problems of living. We urgently need to bring about a revolution in academia so that the fundamental (...) task becomes to help humanity learn how to tackle problems of living in increasingly cooperatively rational ways, so that we may gradually discover how to make progress towards a better, wiser world. (shrink)

Kerry et al. criticize our discussion of causal knowledge in evidence-based medicine (EBM) and our assessment of the relevance of their dispositionalist ontology for EBM. Three issues need to be addressed in response: (1) problems concerning transfer of causal knowledge across heterogeneous contexts; (2) how predictions about the effects of individual treatments based on population-level evidence from RCTs are fallible; and (3) the relevance of ontological theories like dispositionalism for EBM.

This “open letter” to Christopher Boorse is a response to his influential naturalist analysis of disease from the perspective of linguistic-analytic value theory. The key linguistic-analytic point against Boorse is that, although defining disease value free, he continue to use the term with clear evaluative connotations. A descriptivist analysis of disease would allow value-free definition consistently with value-laden use: but descriptivism fails when applied to mental disorder because it depends on shared values whereas the values relevant to mental disorders are (...) highly diverse. A part-function analysis, similarly, although initially persuasive for physical disorders, fails with the psychotic mental disorders because these, characteristically, involve disturbances of the rationality of the person as a whole. The difficulties encountered in applying naturalism to mental disorders point, linguistic-analytically, to the possibility that there is, after all, an evaluative element of meaning, deeply hidden but still logically operative, in the concept of disease. (shrink)

On the 13th June 2014, the Centre for the Humanities and Health (CHH) at King’s College London hosted a one-day workshop on ‘Parentalism and Trust.’ This workshop was the sixth in a series of workshops whose aim is to provide a new model for high-quality open interdisciplinary engagement between medical professionals and philosophers. The term ‘Parentalism’ rather than paternalism is chosen and used throughout because of some of the derisory and unfortunate gender connotations associated with paternalism (and/or its counterpart ‘maternalism’). (...) Medical Parentalism is the position that unwanted interference with a patient’s choices and actions in order to protect and promote her best interests is morally justified. Whilst there are many problems with its justification and implementation, the workshop addressed how such interference depends on a trusting relationship between the doctor and patient, and the extent to which parentalist interferences might undermine this trust. (shrink)