Rationale and objectives: Medical humanities are becoming increasingly recognized as positively impacting medical education and medical practice. However, the extent of medical humanities teaching in medical schools is largely unknown. We reviewed medical school curricula in Canada, the UK and the US. We also explored the relationship between medical school ranking and the inclusion of medical humanities in the curricula. -/- Methods: We searched the curriculum websites of all accredited medical schools (...) in Canada, the UK and the US to check which medical humanities topics were taught, and whether they were mandatory or optional. We then noted rankings both by Times Higher Education and U.S. News and World Report and calculated the average rank. We formally explored whether there was an association between average medical school ranking and medical humanities offerings using Spearman's correlation and inverse variance weighting meta-analysis. -/- Results: We identified 18 accredited medical school programmes in Canada, 41 in the UK, and 154 in the US. Of these, nine (56%) in Canada, 34 (73%) in the UK and 124 (80%) in the US offered at least one medical humanity that was not ethics. The most common medical humanities were medical humanities (unspecified), history, and literature (Canada); sociology and social medicine, medical humanities (unspecified), and art (UK); and medical humanities (unspecified), literature and history (US). Higher ranked medical schools appeared less likely to offer medical humanities. -/- Conclusions: The extent and content of medical humanities offerings at accredited medical schools in Canada, the UK and the US varies, and there appears to be an inverse relationship between medical school quality and medical humanities offerings. Our analysis was limited by the data provided on the Universities' websites. Given the potential for medical humanities to improve medical education and medical practice, opportunities to reduce this variation should be exploited. (shrink)

The case study presented by Winch and Sinnott (2011) shows not only how difficult it is for clinicians and researchers to identify conflicts of interest (COI), but also how damaging it can be when there are unin- formed and uncoordinated policy responses by senior administrators.

One of the best-known principles of halakha is that Shabbat is violated to save a life. Who does this saving and how do we know that a life is in danger? What categories of illness violate Shabbat and who decides? A historical-sociological analysis of the roles played by Jew, non-Jew, and physician according to the approach of “medical cosmology” can help us understand the differences in the approach of the Shulchan Aruch compared to later decisors (e.g., the Mishnah Berurah). (...) Such differences illuminate how premodern medical triage coexisted with a different halakhic understanding than that of the biomedical age. (shrink)

The human soul has been believed to be immaterial and immortal element which exclusively inheres in the human body. Ukpugho ukpong (soul transplant) is an ancient meta-medical science of the Annang and Ibibio people, which is hinged on the belief that the human soul is transcendent and it exclusively inheres in proxy animal; that the soul is mortal, and can be surgically transplanted in the likeness of somatic tissue transplant. This study aimed at carrying out a philosophical critique of (...) this belief in order to determine its significance as a metaphysical concept. It also aimed at critically examining the philosophical as well as sociological discussions on the subject of ukpuho ukpong. The study was discussed on the framework of African concept of mind which holds that the soul has dual nature, namely – the Active Principle and the Quiescent Counterpart. The paper debunks the doctrines of metempsychosis and transmigration as alien to African metaphysics. The method of ordinary language analysis was employed to analyze the concepts ukpong and mbukpong. In conclusion, the paper made the following observations that: the soul is transcendent but perishable substance, the mind has dual nature, the soul does not transmigrate and the science of ukpuho ukpong is not a pseudo-metaphysical concept but was founded on African logic of dualistic mind. The paper notes that the science of ukpuho ukpong is bugged with a number of unresolved philosophical problems. Despite that the paper discovered that the science of ukpuho ukpong can contribute significantly to meta-medicine and sustainable environmental values. (shrink)

The following is a mock debate on schizophrenia set in the 1960s at the Sorbonne in Paris, France, between two fictional characters, Dr. Brian L. Zacou, a qualitative sociologist and Institute Professor Emeritus at the University of Prague; Dr. Wytt Thomas, a professor of psychology at Harvard University; two notable historical figures: Dr. Michel Foucault [20th-century philosopher, historian, academic and theorist] and Dr. R. D. Laing [20th-century psychiatrist and experimental researcher and author] and the writer of this compendium [artist and (...) writer Alexej Savreux; himself a diagnosed schizophrenic]. We model it as a transcription of a debate held at that juncture. It explores the historical framework of schizophrenia, the deep-seated aspects and reality of psychosis, a critique of psychiatry, and a sociological perspective on psychosis. We devote the first chapter to the historical framework and an explanation of the reality of schizophrenia. The second chapter is a critique of mainstream psychiatry, and the third chapter is a resolution between the mock debaters on the social framework and how best to come out unscathed in post-modernity. The remarks from Foucault and Laing are paraphrased from the works “Madness and Civilization: A History of Insanity in the Age of Reason” (Foucault) and “The Divided Self: An Existential Study in Sanity and Madness” (Laing) and are annotated with footnotes along with a few other sources. The writer has taken great liberties in constructing this mock debate, including the usage of anachronisms, and also determines his findings based on what we refer to as the anti-symmetry underpinning the biopsychosocial reality of schizophrenia and the social framework that ensues, generated by popular responses to abstract disease concepts associated with insanity. (shrink)

Vigorous debate over the moral propriety of cognitive enhancement exists, but the views of the public have been largely absent from the discussion. To address this gap in our knowledge, four experiments were carried out with contrastive vignettes in order to obtain quantitative data on public attitudes towards cognitive enhancement. The data collected suggest that the public is sensitive to and capable of understanding the four cardinal concerns identified by neuroethicists, and tend to cautiously accept cognitive enhancement even as they (...) recognize its potential perils. The public is biopolitically moderate, endorses both meritocratic principles and the intrinsic value of hard work, and appears to be sensitive to the salient moral issues raised in the debate. Taken together, these data suggest that public attitudes toward enhancement are sufficiently sophisticated to merit inclusion in policy deliberations, especially if we seek to align public sentiment and policy. (shrink)

The “Human Brain Project” (HBP) is a large-scale European neuroscience and information communication technology (ICT) project that has been a matter of heated controversy since its inception. With its aim to simulate the entire human brain with the help of supercomputing technologies, the HBP plans to fundamentally change neuroscientific research practice, medical diagnosis, and eventually the use of computers itself. Its controversial nature and its potential impacts render the HBP a subject of crucial importance for critical studies of science (...) and society. In this paper, we provide a critical exploratory analysis of the potential mid- to long-term impacts the HBP and its ICT infrastructure could be expected to have, provided its agenda will indeed be implemented and executed to a substantive degree. We analyse how the HBP aspires to change current neuroscientific practice, what impact its novel infrastructures could have on research culture, medical practice and the use of ICT, and how, given a certain degree of successful execution of the project’s aims, potential clinical and methodological applications could even transform society beyond scientific practice. Furthermore, we sketch the possibility that research such as that projected by the HBP may eventually transform our everyday world, even beyond the scope of the HBP’s explicit agenda, and beyond the isolated ‘application’ of some novel technological device. Finally, we point towards trajectories for further philosophical, historical and sociological research on the HBP that our exploratory analysis might help to inspire. Our analysis will yield important insights regardless of the actual success of the HBP. What we drive at, for the most part, is the broader dynamics of scientific and technological development of which the HBP agenda is merely one particularly striking exemplification. (shrink)

The discipline of knowledge translation (KT) emerged as a way of systematically understanding and addressing the challenges of applying health and medical research in practice. In light of ongoing and emerging critique of KT from the medical humanities and social sciences disciplines, KT researchers have become increasingly aware of the complexity of the translational process, particularly the significance of culture, tradition and values in how scientific evidence is understood and received, and thus increasingly receptive to pluralistic notions of (...) knowledge. Hence, there is now an emerging view of KT as a highly complex, dynamic, and integrated sociological phenomenon, which neither assumes nor creates knowledge hierarchies and neither prescribes nor privileges scientific evidence. Such a view, however, does not guarantee that scientific evidence will be applied in practice and thus poses a significant dilemma for KT regarding its status as a scientific and practice-oriented discipline, particularly within the current sociopolitical climate. Therefore, in response to the ongoing and emerging critique of KT, we argue that KT must provide scope for relevant scientific evidence to occupy an appropriate position of epistemic primacy in public discourse. Such a view is not intended to uphold the privileged status of science nor affirm the “scientific logos” per se. It is proffered as a counterbalance to powerful social, cultural, political and market forces that are able to challenge scientific evidence and promote disinformation to the detriment of democratic outcomes and the public good. (shrink)

Religion constitutes an important element in every society as regards coping with the demands as well as vicissitudes of life. Mental health issues are becoming a recurrent decimal in societies overwhelmed by stress and other social factors. This paper examines how the presence of religious beliefs affects how some Christians respond to cases that have to do mental health. At the same time, it surveys how a near absence of religious attitude, that is, clinical medicine approach to mental health issues (...) betters the state of those suffering from these psychopathologies. This work sees participatory partnership approach as an effective means of correcting unhealthy biases that prevent a better understanding of mental health care. Sociological theory of structural functionalism will be used in assessing how religion can reinvent itself in areas that are associated with mental health. Ethnographic methodology through quantitative analysis of administered questionnaire is used as a research tool for this research. Three persons were also interviewed. The research findings show that religion is a crucial agent of socialization that can change how religious beliefs impact on mental health and there is need for medical professionals to collaborate with pastoral agents. (shrink)

Scientisationisagrowingtrendasindividualsworldwideharnessscientific tools and knowledge to solve problems. This phenomenon is evident in biomedical research, which has increased across sub-Saharan Africa, and when encountering bioethical issues arising during the course of such research. This research synthesis considers how the constructs of culture, actors, and resources in the region shape undergraduate bioethics education. Using a lens of sociological neo-institutionalism, taken-for-granted bioethical scripts, like informed consent and medical confidentiality, are evident in this education; however, actual implementation demonstrates the way they are often (...) adapted and contextualised, with implications for students and instructors, and ultimately patients and research participants. The education considered is that for undergraduates in health sciences and medicine because they are prominent actors in research and clinical practice across the region. In considering insights from this literature, the aim is to positively impact health across sub-Saharan Africa. (shrink)

Omnicide: Mania, Fatality and Future-in-Delirium (2019) finds Iranian-American philosopher and comparative literature theorist Jason Bahbak Mohaghegh carving the figure of the diffracted neo-Bedouin wanderer, whose mania we tail through the book’s haunted pages. The book’s namesake, “omnicide,” refers to the complete and total erasure of the Earth--the term has most recently been generally applied in ecological contexts, most markedly in regards to the Anthropocene and futurology. However, it is the explicitly poetic and literary intersection between mania and the grotesque that (...) Mohaghegh inches us towards, lifting omnicide from its proscriptive use in the Western philosophical/sociological tradition and goading it towards an unfamiliar cryptic terrain. Surveying ten contemporary Middle Eastern poets and fiction writers, including Sadeq Hedayat (Iran), Réda Bensmaia (Algeria), Samuel Adonis (Syria), Joyce Mansour (Egypt), Forugh Farrokhzad (Iran), Ibrahim al-Koni (Libya), Ahmad Shamlu (Iran), Ghada Samman (Lebanon), Mahmoud Darwish (Palestine) and Hassim Blasim (Iraq), Mohaghegh parses curious stanzas and plucks spectral paragraphs from myriad texts so as to navigate the largely occluded and excised narratives of the contemporary Middle Eastern philosophical-literary canon. Not only does Mohaghegh acuminate the multifaceted question of mania and its variegated networks, chambers, byways and sunken burrows--so as to juxtapose two different world literatures (East and West)--but Mohaghegh also illuminates this oeuvre to affront the Western psychoanalytic treatment of mania as an exclusionary vessel. Thus, despite Mohaghegh avoiding any explicit references to Western philosophers and scientists, both the codified dictum of the medical decree and the hyper-genealogical superlative tradition of Georges Canguilhem, Michel Foucault and their contemporaries rankle Omnicide’s annals. (shrink)

In her book, Illness as Metaphor, Susan Sontag focuses on metaphors and myths on diseases such as cancer and tuberculosis, which occur in different historical periods. Sontag argues that the metaphors produced related to illness overhaul illness and the things that define illness now have become metaphors produced related to them rather than their concrete and physical aspects. Illness becomes not just an illness, but a phenomenon defined by evil, mystery, fear, evil, madness, passions, wealth and poverty, temporal loginess or (...) speed, and a set of metaphors or myths that are spatially identified with the space. Metaphors and myths turn into means of socially stigmatizing the illness itself rather than giving a meaning to illness. The disease literally turns into a situation that needs to be hidden in order to avoid social stigma. The explanation of mass diseases through metaphors and myths has been seen since ancient times and this understanding of mass diseases continues to exist today. As a matter of fact, the Covid-19 pandemic has also ceased to be the subject of only medical science since it first emerged, and it has turned into an issue that concerns many areas from politics to economics, from sociology to psychology. The metaphors generated on the Covid-19 disease, which we have witnessed its reflections in many areas from the discourses of daily life to the discourse of politicians, from art to literature, have a similar function with the metaphors attributed to diseases like cancer and tuberculosis that Sontag discussed. Covid-19 is not only seen as a disease, but as a disease defined by a series of metaphors such as mysterious, evil, invisible enemy, insidious danger, and democratic virus. The metaphors generated on the disease cause the struggle against the disease itself to be explained with various metaphors. The metaphors derived from Covid-19 such as "invisible enemy" and "biological war" cause the struggle against it to be turned into a military terminology, and the metaphor of "Chinese virus" is a means of social stigmatization / marginalization by racializing the virus directly. This study tackles the issue of how Covid-19, which is the subject of medical science, has become the subject of unscientific myths and metaphors attributed to the disease, and that the disease is perceived through metaphors rather than itself in the context of Susan Sontag's thought. In the study, answers for the questions of what kind of effects appeared due to the stigmatizing power of metaphors derived from the Covid-19 and whether the metaphors are the outcomes of the strategy for coping with the pandemic will be sought. (shrink)

This review aims to identify (1) sources of knowledge and (2) important themes of the ethical debate related to surgical alteration of facial features in East Asians. This article integrates narrative and systematic review methods. In March 2014, we searched databases including PubMed, Philosopher’s Index, Web of Science, Sociological Abstracts, and Communication Abstracts using key terms “cosmetic surgery,” “ethnic*,” “ethics,” “Asia*,” and “Western*.” The study included all types of papers written in English that discuss the debate on rhinoplasty and blepharoplasty (...) in East Asians. No limit was put on date of publication. Combining both narrative and systematic review methods, a total of 31 articles were critically appraised on their contribution to ethical reflection founded on the debates regarding the surgical alteration of Asian features. Sources of knowledge were drawn from four main disciplines, including the humanities, medicine or surgery, communications, and economics. Focusing on cosmetic surgery perceived as a westernising practice, the key debate themes included authenticity of identity, interpersonal relationships and socio-economic utility in the context of Asian culture. The study shows how cosmetic surgery of ethnic features plays an important role in understanding female identity in the Asian context. Based on the debate themes authenticity of identity, interpersonal relationships, and socio-economic utility, this article argues that identity should be understood as less individualistic and more as relational and transformational in the Asian context. In addition, this article also proposes to consider cosmetic surgery of Asian features as an interplay of cultural imperialism and cultural nationalism, which can both be a source of social pressure to modify one’s appearance. (shrink)

The question of how psychiatric classifications are made up and to what they refer has attracted the attention of philosophers in recent years. In this paper, I review the claims of authors who discuss psychiatric classification in terms referring both to the philosophical tradition of natural kinds and to the sociological tradition of social constructionism — especially those of Ian Hacking and his critics. I examine both the ontological and the social aspects of what it means for something to be (...) a mental disorder, and how the ontological status of these disorders hinges on social causation. Finally, I conclude by suggesting a way in which the biological and the social may be reconciled in an integrative model of variation in psychiatric disorder. (shrink)

Background There has been debate on whether a global or unified field of bioethics exists. If bioethics is a unified global field, or at the very least a closely shared way of thinking, then we should expect bioethicists to behave the same way in their academic activities anywhere in the world. This paper investigates whether there is a 'global bioethics' in the sense of a unified academic community. Methods To address this question, we study the web-linking patterns of bioethics institutions, (...) the citation patterns of bioethics papers and the buying patterns of bioethics books. Results All three analyses indicate that there are geographical and institutional differences in the academic behavior of bioethicists and bioethics institutions. Conclusion These exploratory studies support the position that there is no unified global field of bioethics. This is a problem if the only reason is parochialism. But these regional differences are probably of less concern if one notices that bioethics comes in many not always mutually understandable dialects. (shrink)

Based on a critical interpretative review of existing qualitative research investigating accounts of ‘lived experience’ of surrogates and intended parents from a relational perspective, this article proposes a typology of surrogacy arrangements. The review is based on the analysis of 39 articles, which belong to a range of different disciplines (mostly sociology, social psychology, anthropology, ethnology, and gender studies). The number of interviews in each study range from as few as seven to over one hundred. Countries covered include Australia, (...) Canada, Greece, India, Iran, Israel, Italy, Mexico, Norway, Russia, Sweden, UK, Ukraine, and the USA. Most studies focus only on surrogacy practices in one country (although often with intended parents from other countries), and some include several countries (e.g. interviewees from several countries or fieldwork in different field-sites). The proposed typology goes beyond the division between altruistic versus commercial, and traditional versus gestational surrogacy, in order to inform further research and to contribute to bioethical and policy debates on surrogacy in a transnational context. Four types of relations are identifiable: open, restricted, structured, and enmeshed. The criteria which influence these relationships are: the frequency and character of contact pre- and post-birth; expectations of both parties; the type of exchange involved in surrogacy arrangements; and cultural, legal, and economic contexts. The theoretical contribution of the article is to further the development of a relational justice approach to surrogacy. (shrink)

In this article, we address an existing lacuna in the sociology of the senses, by employing sociological phenomenology to illuminate the under-researched sense of temperature, as lived by a social group for whom water temperature is particularly salient: competitive pool swimmers. The research contributes to a developing ‘sensory sociology’ that highlights the importance of the socio-cultural framing of the senses and ‘sensory work’, but where there remains a dearth of sociological exploration into senses extending beyond the ‘classic five’ (...) sensorium. Drawing on data from a three-year ethnographic study of competitive swimmers in the UK, our analysis explores the rich sensuousities of swimming, and highlights the role of temperature as fundamentally affecting the affordances offered by the aquatic environment. The article contributes original theoretical perspectives to the sociology of the senses and of sport in addressing the ways in which social actors in the aquatic environment interact, both intersubjectively and intercorporeally, as thermal beings. (shrink)

Pharmaceuticals or other emerging technologies could be used to enhance (or diminish) feelings of lust, attraction, and attachment in adult romantic partnerships. While such interventions could conceivably be used to promote individual (and couple) well-being, their widespread development and/or adoption might lead to “medicalization” of human love and heartache—for some, a source of serious concern. In this essay, we argue that the “medicalization of love” need not necessarily be problematic, on balance, but could plausibly be expected to have either good (...) or bad consequences depending upon how it unfolds. By anticipating some of the specific ways in which these technologies could yield unwanted outcomes, bioethicists and others can help direct the course of love’s “medicalization”—should it happen to occur—more toward the “good” side than the “bad.”. (shrink)

Sociology, as conceived by Comte, was to put an end to the anarchy of opinions characteristic of liberal democracy by replacing opinion with the truths of sociology, imposed through indoctrination. Later sociologists backed away from this, making sociology acceptable to liberal democracy by being politically neutral. The critics of this solution asked 'whose side are we on?' Burawoy provides a novel justification for advocacy scholarship in sociology. Public sociology is intended to have political effects, but (...) also to be funded by the politically neutral state. He argues that public sociology is institutionally neutral, but that committing to an organic relation with a social movement is legitimate as a matter of the sociologist's personal value choice. Although this produces side-taking sociology, by improving the case for particular standpoints it serves to improve democratic discussion generally, which is an appropriately neutral public aim. (shrink)

: The Islamic jurists utilized the discipline of maqāṣid al-sharīʿah,in its capacity as the philosophy of Islamic law, in their legal and ethicalinterpretations, with added interest in addressing the issues of modern times.Aphoristically subsuming the major themes of the Sharīʿah, maqāṣid play apivotal role in the domain of decision-making and deduction of rulings onunprecedented ethical discourses. Ethics represent the infrastructure of Islamiclaw and the whole science of Islamic jurisprudence operates in the lightof maqāṣid to realize the ethics in people’s lives. (...) Scrutinizing the key themesof maqāṣid-based ijtihād and scope of ethics in maqāṣid, this article delvesinto the discourse on the application of maqāṣid to medical ethics. As a casestudy, this research analyses the extent of medical confidentiality in the light ofmaqāṣid and arrives at the conclusion that limited confidentiality goes more inline with the maxims of maqāṣid. (shrink)

Medicalisation is a social phenomenon in which conditions that were once under legal, religious, personal or other jurisdictions are brought into the domain of medical authority. Low sexual desire in females has been medicalised, pathologised as a disease, and intervened upon with a range of pharmaceuticals. There are two polarised positions on the medicalisation of low female sexual desire: I call these the mainstream view and the critical view. I assess the central arguments for both positions. Dividing the two (...) positions are opposing models of the aetiology of low female sexual desire. I conclude by suggesting that the balance of arguments supports a modest defence of the critical view regarding the medicalisation of low female sexual desire. (shrink)

The phenomenon of medical overtesting in general, and specifically in the emergency room, is well-known and regarded as harmful to both the patient and the healthcare system. Although the implications of this problem raise myriad ethical concerns, this paper explores the extent to which overtesting might mitigate race-based health inequalities. Given that medical malpractice and error greatly increase when the patients belong to a racial minority, it is no surprise that the mortality rate similarly increases in proportion to (...) white patients. For these populations, an environment that emphasizes medical overtesting may well be the desirable medical environment until care evens out among races and ethnicities; additionally, efforts to lower overtesting in conjunction with a high rate of racist medical mythology may cause harm by lower testing when it is actually warranted. Furthermore, medical overtesting may help to assuage racial distrust. This paper ultimately concludes that an environment of medical overtesting may be less pernicious than the alternative. (shrink)

This chapter provides a historical reconstruction of how Alfred Schutz’s American writings were critically engaged by the feminist sociologists Dorothy E. Smith and Patricia Hill Collins. Schutz’s articulation of a phenomenological sociology in relation to, among others, the sociology of Talcott Parsons and the philosophies of science of Ernest Nagel and Carl G. Hempel proved fruitful to Smith in the development of her feminist standpoint theory in her 1987 The Everyday World as Problematic: A Feminist Sociology. Collins (...) likewise draws on Schutz’s writing in the development of her own standpoint theory in her 1986 paper “Learning from the Outsider Within: The Sociological Significance of Black Feminist Thought,” but in a way that addresses some of her own concerns with Smith’s feminist sociology. As I hope to show with the recovery of this underappreciated history, the critical insights of Smith and Collins with regard to the possible uses and limits of phenomenology for feminist theorizing, are still valuable today. (shrink)

In her debate with Michael Blake, Gillian Brock sets out to justify emigration restrictions on medical workers from poor states on the basis of their free-riding on the public investment that their states have made in them in form of a publicly funded education. For this purpose, Brock aims to isolate the question of emigration restrictions from the larger question of responsibilities for remedying global inequalities. I argue that this approach is misguided because it is blind to decisive factors (...) at play in the problem of medical brain drain and consequently distorts the different responsibilities this problem generates. Brock’s strategy, if successful, would effectively lead to punishing emigrating workers from poor states for the free-riding and exploitation that is committed by affluent states – which is a counter-intuitive result. (shrink)

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.

I introduce a distinction between health need and medical need, and raise several questions about their interaction. Health needs are needs that relate directly to our health condition. Medical needs are needs which bear some relation to medical institutions or processes. I suggest that the question of whether medical insurance or public care should cover medical needs, health needs, or only needs which fit both categories is a political question that cannot be resolved definitionally. I (...) also argue against an overly strict definition of medical need on the grounds that this presupposes, wrongly, that medical intervention should always be a last resort. (shrink)

In this paper, I defend a version of the medical model of disability, which defines disability as an enduring biological dysfunction that causes its bearer a significant degree of impairment. We should accept the medical model, I argue, because it succeeds in capturing our judgments about what conditions do and do not qualify as disabilities, because it offers a compelling explanation for what makes a condition count as a disability, and because it justifies why the federal government should (...) spend hundreds of billions of dollars, annually, on aid and accommodations for disabled people. After responding to a pair of objections Elizabeth Barnes has raised against the medical model, I contrast it with Guy Kahane and Julian Savulescu's welfarist account of disability, and with Barnes's own mere-difference view. Both of these accounts face serious challenges, although elements of Barnes's view can—and, in my opinion, should—be adopted by proponents of the medical model. (shrink)

Author's response to: Raphael Sassower, 'Heidegger and the Sociologists: A Forced Marriage?,' Social Epistemology Review and Reply Collective 7, no. 5 (2018): 30-32. -- Part of a book-review symposium on: Jeff Kochan (2017), Science as Social Existence: Heidegger and the Sociology of Scientific Knowledge (Cambridge UK: Open Book Publishers).

From the temporal perspective, this article examines shifts in the productionof sociological knowledge. It identifies two kinds of rhythms of sociology: 1) that of sociological standpoints and techniques of investigation and 2) that of contemporary academic life and culture. The article begins by discussing some of the existing research strategies designed to "chase"high-speed society. Some, predominantly methodological, currents are explored and contrasted with the "slow" instruments of sociological analysis composed of different, yet complementary, modes of inquiry. Against this background, (...) the article stresses that it is through the tension between fast and slow modes of inquiry that sociology reproduces itself. The subsequent part explores the subjective temporal experience in contemporary academia. It is argued that increasing administration and auditing of intellectual work significantly coshapes sociological knowledge production not only by requiring academics to work faster due to an increasing volume of tasks, but also by normalizing time-pressure.The article concludes by considering the problem as to whether the increasing pace of contemporary academic life has detrimental consequences for the more organic reproductive rhythms of sociology. (shrink)

This article focuses on two developments in nineteenth-century (philosophy of) social science: Moritz Lazarus’s and Heymann Steinthal’s Völkerpsychologie and Georg Simmel’s early sociology of knowledge. The article defends the following theses. First, Lazarus and Steinthal wavered between a “strong” and a “weak” program for Völkerpsychologie. Ingredients for the strong program included methodological neutrality and symmetry; causal explanation of beliefs based on causal laws; a focus on groups, interests, tradition, culture, or materiality; determinism; and a self-referential model of social institutions. (...) Second, elements of the weak program were the blurring of explanatory and normative interests, an emphasis on freedom of the will, and antirelativism and antimaterialism. Third, later research projects keeping the label “Völkerpsychologie” followed the weak program. Fourth, in the 1880s and 1890s, Simmel tried to build on some of the elements of the strong program. Finally, and fifth, part of the explanation for why Simmel did not succeed in his attempt had to do with the social-political situation of German academia around 1900. (shrink)

The article examines recent debates surrounding public sociology in the context of a UK based Department of Applied Social Sciences. Three areas of work within the department form the focus of the article: violence against women and children; community-based oral history projects and health ethics teaching. The article draws on Micheal Burawoy’s typology comprising public, policy, professional and critical sociology, and argues that much of the work described in the case studies more often lies somewhere in between, in (...) the interstices, rather than within one or other of the four types. The result is not without its tensions and dilemmas, some of which are identified and explored, notably those arising from attempts to appeal to diverse audiences and meet the sometimes conflicting expectations of each. (shrink)

I discuss an influential argument put forward by Hatherley in theJournal of Medical Ethics. Drawing on influential philosophical accounts of interpersonal trust, Hatherley claims that medical artificial intelligence is capable of being reliable, but not trustworthy. Furthermore, Hatherley argues that trust generates moral obligations on behalf of the trustee. For instance, when a patient trusts a clinician, it generates certain moral obligations on behalf of the clinician for her to do what she is entrusted to do. I make (...) three objections to Hatherley’s claims: (1) At least one philosophical account of interagent trust implies that medical AI is capable of being trustworthy. (2) Even if this account should ultimately be rejected, it does not matter much because what we care mostly about is that medical AI is reliable. (3) It is false that trust in itself generates moral obligations on behalf of the trustee. (shrink)

In medical settings, machines are in close proximity with human beings: with patients who are in vulnerable states of health, who have disabilities of various kinds, with the very young or very old, and with medical professionals. Machines in these contexts are undertaking important medical tasks that require emotional sensitivity, knowledge of medical codes, human dignity, and privacy. -/- As machine technology advances, ethical concerns become more urgent: should medical machines be programmed to follow a (...) code of medical ethics? What theory or theories should constrain medical machine conduct? What design features are required? Should machines share responsibility with humans for the ethical consequences of medical actions? How ought clinical relationships involving machines to be modeled? Is a capacity for empathy and emotion detection necessary? What about consciousness? -/- The essays in this collection by researchers from both humanities and science describe various theoretical and experimental approaches to adding medical ethics to a machine, what design features are necessary in order to achieve this, philosophical and practical questions concerning justice, rights, decision-making and responsibility, and accurately modeling essential physician-machine-patient relationships. -/- This collection is the first book to address these 21st-century concerns. (shrink)

In contemporary healthcare, medical image categorization is essential for illness prediction, diagnosis, and therapy planning. The emergence of digital imaging technology has led to a significant increase in research into the use of machine learning (ML) techniques for the categorization of images in medical data. We provide a thorough summary of recent developments in this area in this review, using knowledge from the most recent research and cutting-edge methods.We begin by discussing the unique challenges and opportunities associated with (...) medical image classification, including the complexity of anatomical structures, variability in imaging modalities, and the need for interpretability and reliability in clinical settings. Subsequently, we survey a wide range of ML algorithms and techniques employed for medical image classification, including traditional methods such as support vector machines and k-nearest neighbors, as well as deep learning approaches like convolutional neural networks (CNNs) and recurrent neural networks (RNNs). Furthermore, we examine key considerations in dataset preparation, feature extraction, and model evaluation specific to medical image classification tasks. We highlight the importance of large, annotated datasets, transfer learning, and data augmentation techniques in enhancing model performance and generalization. (shrink)

Many hold that distributing healthcare according to medical need is a requirement of equality. Most egalitarians believe, however, that people ought to be equal on the whole, by some overall measure of well-being or life-prospects; it would be a massive coincidence if distributing healthcare according to medical need turned out to be an effective way of promoting equality overall. I argue that distributing healthcare according to medical need is important for reducing individuals' uncertainty surrounding their future (...) class='Hi'>medical needs. In other words, distributing healthcare according to medical need is a natural feature of healthcare insurance; it is about indemnity, not equality. (shrink)

In this article, following on from earlier debates in the journal regarding the ‘thorny issue’ of epochē and bracketing in sociological phenomenological research, we consider more generally the challenges of engaging in reflexivity and bracketing when undertaking ethnographic ‘insider’ research, or research in familiar settings. We ground our discussion and illustrate some of the key challenges by drawing on the experience of undertaking this research approach with a group of competitive swimmers, who were participating in a British university performance swimming (...) programme at the time of the doctoral study. The primary researcher was highly familiar with the phenomenon of competitive swimming, having been both a competitive swimmer and swimming coach. Some of the key elements of a sociological phenomenological approach to studying physical-cultural embodiment are first delineated, before addressing the considerable challenges of engaging in sustained reflexivity and bracketing, using the swimming research for illustrative purposes. We suggest some practical ways in which researchers in sport and physical cultures might approach epochē and bracketing in ethnographic ‘insider’ research. -/- KEYWORDS: Sociological phenomenology, competitive swimming, insider research, epochē/bracketing. (shrink)

In this article I propose to reframe debates about ideals of emotion in medicine, abandoning the current binary setup of this debate as one between ‘clinical detachment’ and empathy. Inspired by observations from my own field work and drawing on Sky Gross’ anthropological work on rituals of practice as well as Henri Lefebvre’s notion of rhythm, I propose that the normative drive of clinical practice can be better understood through the notion of attunement. In this framework individual types of emotions (...) are not, as such, appropriate or inappropriate, but are evaluated depending on their synchronicity with the specific rhythms of the practice. To set up this proposal, I show how typical arguments about emotions in medicine—what I call emotion-entity focused frameworks—are insufficient. I then draw on ethnographic observations from two orthopaedic departments and interviews with medical practitioners to show (1) how clinical practice is driven by rhythmicity, shaped in the case of orthopaedic surgery by a clinical aim of efficient, controlled intervention, and (2) how clinicians continuously refer to this drive and the flow of rhythms when evaluating inappropriate or problematic emotion. I argue that the use of a rhythm framework rather than ideals of detachment or empathy allows for a sensitivity to the complexity and situation-dependent elements of emotional ideals in clinical practice; and I end by proposing the term ‘attuned concern’—which stresses the importance of regulation and adjustment to circumstances rather than of maintaining a constant distance/involvement—as a more fitting alternative to ‘clinical detachment’. (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)

This paper argues that epistemic errors rooted in group- or identity- based biases, especially those pertaining to disability, are undertheorized in the literature on medical error. After sketching dominant taxonomies of medical error, we turn to the field of social epistemology to understand the role that epistemic schemas play in contributing to medical errors that disproportionately affect patients from marginalized social groups. We examine the effects of this unequal distribution through a detailed case study of ableism. There (...) are four primary mechanisms through which the epistemic schema of ableism distorts communication between nondisabled physicians and disabled patients: testimonial injustice, epistemic overconfidence, epistemic erasure, and epistemic derailing. Measures against epistemic injustices in general and against schema-based medical errors in particular are ultimately issues of justice that must be better addressed at all levels of health care practice. (shrink)

To assess whether UK and US health care professionals share the views of medical ethicists about medical futility, withdrawing/withholding treatment, ordinary/extraordinary interventions, and the doctrine of double effect. A 138-item attitudinal questionnaire completed by 469 UK nurses studying the Open University course on "Death and Dying" was compared with a similar questionnaire administered to 759 US nurses and 687 US doctors taking the Hastings Center course on "Decisions near the End of Life". Practitioners accept the relevance of concepts (...) widely disparaged by bioethicists: double effect, medical futility, and the distinctions between heroic/ordinary interventions and withholding/withdrawing treatment. Within the UK nurses' group a "rationalist" axis of respondents who describe themselves as having "no religion" are closer to the bioethics consensus on withholding and withdrawing treatment. Professionals' beliefs differ substantially from the recommendations of their professional bodies and from majority opinion in bioethics. Bioethicists should be cautious about assuming that their opinions will be readily accepted by practitioners. (shrink)

Most people are completely oblivious to the danger that their medical data undergoes as soon as it goes out into the burgeoning world of big data. Medical data is financially valuable, and your sensitive data may be shared or sold by doctors, hospitals, clinical laboratories, and pharmacies—without your knowledge or consent. Medical data can also be found in your browsing history, the smartphone applications you use, data from wearables, your shopping list, and more. At best, data about (...) your health might end up in the hands of researchers on whose good will we depend to avoid abuses of power.2 Most likely, it will end up with data brokers who might sell it to a future employer, or an insurance company, or the government. At worst, your medical data may end up in the hands of criminals eager to commit extortion or identity theft. In addition to data harms related to exposure and discrimination, the collection of sensitive data by powerful corporations risks the creation of data monopolies that can dominate and condition access to health care. -/- This chapter aims to explore the challenge that big data brings to medical privacy. Section I offers a brief overview of the role of privacy in medical settings. I define privacy as having one’s personal information and one’s personal sensorial space (what I call autotopos) unaccessed. Section II discusses how the challenge of big data differs from other risks to medical privacy. Section III is about what can be done to minimise those risks. I argue that the most effective way of protecting people from suffering unfair medical consequences is by having a public universal healthcare system in which coverage is not influenced by personal data (e.g., genetic predisposition, exercise habits, eating habits, etc.). (shrink)

If medical complicity is understood as compliance with a directive to act against the professional's best medical judgment, the question arises whether it can ever be justified. This paper will trace the contours of what would legitimate a directive to act against a professional's best medical judgment (and in possible contravention of her oath) using Joseph Raz's service conception of authority. The service conception is useful for basing the legitimacy of authoritative directives on the ability of the (...) putative authority to enable subjects to comply better with reasons that already apply to them. Hence, the service conception bases the legitimacy of practical authority on a certain kind of greater knowledge or expertise. This helps to focus the conundrum regarding complicity on the clash of expertise between the medical expert and the governing body tasked with coordinating behaviour and otherwise devising rules for the social good. The ethical dilemma presented by a hypothetically legitimate directive to act against a professional's best medical judgment also serves to highlight the moral dimension of one's duty to obey a legitimate authority. (shrink)

Background: Critically ill patients often require complex clinical care by highly trained staff within a specialized intensive care unit (ICU) with advanced equipment. There are currently limited data on the costs of critical care in low-and middle-income countries (LMICs). This study aims to investigate the direct-medical costs of key infectious disease (tetanus, sepsis, and dengue) patients admitted to ICU in a hospital in Ho Chi Minh City (HCMC), Vietnam, and explores how the costs and cost drivers can vary between (...) the different diseases. -/- Methods: We calculated the direct medical costs for patients requiring critical care for tetanus, dengue and sepsis. Costing data (stratified into different cost categories) were extracted from the bills of patients hospitalized to the adult ICU with a dengue, sepsis and tetanus diagnosis that were enrolled in three studies conducted at the Hospital for Tropical Diseases in HCMC from January 2017 to December 2019. The costs were considered from the health sector perspective. The total sample size in this study was 342 patients. -/- Results: ICU care was associated with significant direct medical costs. For patients that did not require mechanical ventilation, the median total ICU cost per patient varied between US$64.40 and US$675 for the different diseases. The costs were higher for patients that required mechanical ventilation, with the median total ICU cost per patient for the different diseases varying between US$2,590 and US$4,250. The main cost drivers varied according to disease and associated severity. -/- Conclusion: This study demonstrates the notable cost of ICU care in Vietnam and in similar LMIC settings. Future studies are needed to further evaluate the costs and economic burden incurred by ICU patients. The data also highlight the importance of evaluating novel critical care interventions that could reduce the costs of ICU care. (shrink)

The process of medicalization has been analyzed in the medical humanities with disapprobation, with much emphasis placed on its ability to reinforce existing social power structures to ill effect. While true, this is an incomplete picture of medicalization. I argue that medicalization can both reinforce and disrupt existing social hierarchies within the clinic and outside of it, to ill or good effect. We must attend to how this takes place locally and globally lest we misunderstand how medicalization mediates power (...) and justice. I provide concrete examples of how this occurs by considering dysesthesia ethiopsis, autism, chronic fatigue syndrome, depression, and HIV/AIDS. (shrink)

Thesis --University of Stellenbosch, 2004 Acceptance of the concept of medical futility facilitates a paradigm shift from curative to palliative medicine, accommodating a more humane approach and avoiding unnecessary suffering in the course of the dying process. This should not be looked upon as abandoning the patient but rather as providing the patient and family with an opportunity to come to terms with the dying process. It also does not entail withdrawal or passivity on the part of the health (...) care professional. In addition to medical skills, the treating physician is responsible for guiding this process by demonstrating sensitivity and compassion, respecting the values of patients, their families and the medical staff. The need for training to equip medical staff to take responsibility as empathetic participants in end-of-life decision-making is underscored. S Afr Med J 2008; 98: 284-286. (shrink)

When are we obligated to believe someone? To what extent are people authorities about their own experiences? What kind of harm might we enact when we doubt? Questions like these lie at the heart of many debates in social and feminist epistemology, and they’re the driving issue behind a key conceptual framework in these debates—gaslighting. But while the concept of gaslighting has provided fruitful insight, it's also proven somewhat difficult to adjudicate, and seems prone to over-application. In what follows, I (...) argue that Katherine Hawley's theory of trust can provide a useful alternative lens for looking at contested testimony. To do this, I focus on a particularly complex—but increasingly popular—application of gaslighting: the physician/patient relationship, and the idea of ‘medical gaslighting’. I argue that, even though patients can experience harm when they are disbelieved, there are nevertheless good reasons for physicians not to trust patients about at least some of their own narratives. (shrink)

Miracle Max, it seems, is the only remaining miracle worker in all of Florin. Among other things, this means that he (unlike anyone else) can resurrect the recently dead, at least in certain circumstances. Max’s peculiar talents come with significant perks (for example, he can basically set his own prices!), but they also raise a number of ethical dilemmas that range from the merely amusing to the truly perplexing: -/- How much about Max’s “methods” does he need to reveal to (...) his patients? Is it really OK for Max to lie about Valerie’s being a witch, even though she really isn’t? Just how much of the “truth” does Max have to tell his patients? -/- Let’s suppose that Humperdinck had offered Max his old job back. Would it have been OK for Max to accept this offer? What about if Humperdinck wanted him to do experiments at “the Zoo”? -/- Is Max obligated to offer his services to everyone who needs them, such as the (mostly) dead Westley and friends? Or is he free to pick and choose? -/- In this chapter, I’ll consider how these questions might be addressed using concepts of medical ethics. As it turns out, Max’s dilemmas are not too different from the sorts of dilemmas that many medical professionals encounter in their daily lives, and exploring how Max could (or should) respond to them can help us figure out what we can do here in the “real” world. (shrink)

Consensus statement by UK teachers of medical ethics and law.

Physicians in Islamic countries might be requested to participate in the Islamic legal code of qiṣāṣ, in which the victim or family has the right to an eye-for-an-eye retaliation. Qiṣāṣ is only used as a punishment in the case of murder or intentional physical injury. In situations such as throwing acid, the national legal system of some Islamic countries asks for assistance from physicians, because the punishment should be identical to the crime. The perpetrator could not be punished without a (...) physician’s participation, because there is no way to guarantee that the sentence would be carried out without inflicting more injury than the initial victim had suffered. By examining two cases of acid throwing, this paper discusses issues related to physicians’ participation in qiṣāṣ from the perspective of medical ethics and Islamic Shari’a law. From the standpoint of medical ethics, physicians’ participation in qiṣāṣ is not appropriate. First, qiṣāṣ is in sharp contrast to the Hippocratic Oath and other codes of medical ethics. Second, by physicians’ participation in qiṣāṣ, medical practices are being used improperly to carry out government mandates. Third, physician participation in activities that cause intentional harm to people destroys the trust between patients and physicians and may adversely affect the patient–physician relationship more generally. From the standpoint of Shari’a, there is no consensus among Muslim scholars whether qiṣāṣ should be performed on every occasion. We argue that disallowing physician involvement in qiṣāṣ is necessary from the perspectives of both medical ethics and Shari’a law. (shrink)