The purpose of this chapter is to describe what we see as several important new directions for philosophy of medicine. This recent work (i) takes existing discussions in important and promising new directions, (ii) identifies areas that have not received sufficient and deserved attention to date, and/or (iii) brings together philosophy of medicine with other areas of philosophy (including bioethics, philosophy of psychiatry, and social epistemology). To this end, the next part focuses on what we call the (...) “epistemological turn” in recent work in the philosophy of medicine; the third part addresses new developments in medical research that raise interesting questions for philosophy of medicine; the fourth part is a discussion of philosophical issues within the practice of diagnosis; the fifth part focuses on the recent developments in psychiatric classification and scientific and ethical issues therein, and the final part focuses on the objectivity of medical research. (shrink)

In this paper, findings from research in neuroscience of morality will be reviewed to consider the purposes of moral education. Particularly, I will focus on two main themes in neuroscience, novel neuroimaging and experimental investigations, and Bayesian learning mechanism. First, I will examine how neuroimaging and experimental studies contributed to our understanding of psychological mechanisms associated with moral functioning while addressing methodological concerns. Second, Bayesian learning mechanism will be introduced to acquire insights about how moral learning occurs in human brains. (...) Based on the reviewed neuroscientific research on morality, I will examine how evidence can support the model of moral education proposed by virtue ethics, Neo-Aristotelian moral philosophy in particular. Particularly, two main aims of virtue ethics-based moral education, the habituation of virtues and the cultivation of phronesis, will be discussed as the important purposes of moral education based on neuroscientific evidence. (shrink)

Part of a symposium devoted to ‘Prediction, Understanding, and Medicine’, in which Alex Broadbent argues that the nature of medicine is determined by its competences, i.e., which things it can do well. He argues that, although medicine cannot cure well, it can do a good job of enabling people not only to understand states of the human organism and of what has caused them, but also to predict future states of it. From this Broadbent concludes that (...) class='Hi'>medicine is (at least in part) essentially a practice of understanding and predicting, not curing. In reply to this bold position, I mount two major criticisms. First, I maintain that the reasons Broadbent gives for doubting that medicine can cure provide comparable reason for doubting that medicine can provide an understanding; roughly, the best explanation of why medicine cannot reliably cure is that we still lack much understanding of health and disease. Second, I object to the claim that a practice is medical only if it facilitates understanding and prediction. Although Broadbent has brought to light certain desirable purposes of medicine that are under-appreciated, my conclusion is that he has not yet provided enough reason to think that understanding and prediction are essential to it. Instead of supposing that medicine has an essence, in fact, I suggest that its nature is best understood in terms of a property cluster. (shrink)

This paper begins the last instalment of a six-part project correlating the key aspects of Kant’s architectonic conception of philosophy with a special version of the Chinese Book of Changes that I call the “Compound Yijing”, which arranges the 64 hexagrams (gua) into both fourfold and threefold sets. I begin by briefly summarizing the foregoing articles: although Kant and the Yijing employ different types of architectonic reasoning, the two systems can both be described in terms of three “levels” of elements. (...) Starting at an unnumbered level devoid of any element (the tao or thing in itself), the system proceeds by elaborating a key fourfold distinction (or “quaternity”) on the first level, a twelvefold distinction on the second level, and twelve quaternities (grouped in four quadrants, each with a set of three quaternities) on the third level. Each set of three quaternities (i.e., each quadrant) on the third level corresponds to one of the four “faculties” of the university, as elaborated in Kant’s book, The Conflict of the Faculties. Previous papers have examined the correlations between three key quaternities that Kant defends in relation to each of three faculties (philosophy, theology, and law) and the 12 gua that correspond to that faculty in the Compound Yijing. The final step is to explore the fourth quaternity on the third level, the 12 gua corresponding to the medical faculty. The “idea of reason” in Kant’s metaphysics that guides this wing of the comparative analysis is freedom, and the ultimate purpose of this faculty of the university is to train doctors to care for people’s physical well-being, as free agents imbedded in nature. But this paper will focus only on the four gua that correspond to four basic concepts in Kant’s theory of medicine. The two quaternities in the “yin-yang” (medical) quadrant of the Compound Yijing that will be skipped here are as follows. First, Kant’s account of the idea of freedom itself, which gives rise to the area of traditional metaphysics known as rational cosmology, comes in the first Critique’s Dialectic, in the section on the Antinomy of Reason (CPR A405-567/B432- 595). There he examines four irresolvable issues: whether the world has a beginning in time; whether composite substances consist of simple parts; whether a causality of freedom operates in the natural world; and whether an absolutely necessary being exists. Later I will argue that these correspond to the quaternity consisting of gua 15, 22, 36, and 52. (shrink)

Ong, Caroline Whilst the reason and purpose of suffering may never be fully understood, there are ways of enduring, transcending and growing resilience to how it affects us. Our experience of suffering lies in the web of perceptions that involve our physical, spiritual and cosmological beliefs. Referencing Pain Seeking Understanding: Suffering, Medicine and Faith, edited by Margaret E. Mohrmann and Mark J. Hanson, this article gives a brief exploration of some propositions as to why an all-powerful, good God (...) would allow suffering to exist. From these various perspectives and using examples cited in the book, the article proposes that the healing art of medicine, honed through years of experience, knowledge and wisdom, can help individual patients endure and transcend suffering, and be whole once again. (shrink)

This paper aims to offer a new argument in defence bacterial species pluralism. To do so, I shall first present the particular issues derived from the conflict between the non-theoretical understanding of species as units of classification and the theoretical comprehension of them as units of evolution. Secondly, I shall justify the necessity of the concept of species for the bacterial world, and show how medicine and endosymbiotic evolutionary theory make use of different concepts of bacterial species due to (...) their distinctive purposes. Finally, I shall show how my argument provides a new source of defence for bacterial pluralism. (shrink)

The cashew nut is essential for physical and emotional well-being. It is an energetic diet and the best food medication for many illnesses. Nuts protects from malignant growth, coronary illness, circulatory strain, and various degenerative infirmities connected to aging. It can be used for several medicinal purposes. Every part of cashew has some important medicinal properties. Cashew kernel contains proteins, carbohydrates, vitamins, and fats which help gain energy. Cashew nuts are used for many purposes like blood sugar, weight loss, cancer, (...) cold and flu, aging, urinary disorders, digestive disorders, and bone relaxation. In comparing cashew with other nuts, Cashew kernels have good properties, including proteins, carbohydrates, fibers, and minerals, then almond, hazelnut, and walnuts. Cashew kernels contain the highest number of proteins (21%) when compared with Almonds (20.8%), Hazelnuts (15.6%), and Macadamia Nuts (60.9%). Cashew contain large amount of carbohydrate (22%) compared to other nuts like almonds, walnuts, etc. There are some strong benefits of Cashew for health. They boost the immune system, act as an antioxidant, remove gallstones, and beneficial for anemia. They are good sources of healthy fats that are necessary for our body to absorb fat-soluble vitamins. Its bark is known as the antihypertensive and glucose-lowering part. It has beneficial effect on the eyes and skin. This is rich in vitamin C, so it can be used for skin problems like acne, flawless freckles, skin lines and protects from aging. (shrink)

Definition of the problem: The connection between time and the good life has already been worked out for a number of medical specialties and practices. However, what role does the temporality of the good life play for medicine as a whole? That is the central question of this article. Arguments: The good life is here understood as a meaningful life. Living meaningfully is only possible through present action. A fulfilled presence in this sense is therefore an essential aspect of (...) the temporality of the good life. Illness tends to prevent a fulfilled presence. In this respect, medical treatments aim to enable a fulfilled presence. A second structure of time, that is central to the good life, consists in the chronobiological rhythms, upon the maintenance and restoration of which health is critically dependent. Conclusion: The temporality of the good life has a twofold relevance for medicine as a whole. First, the purpose of medical treatment is to enable a fulfilled present. Second, this can and should be done by maintaining and restoring chronobiological rhythms. ++++ Der Zusammenhang von Zeit und gutem Leben wurde bereits für eine Reihe medizinischer Disziplinen und Praktiken herausgearbeitet. Doch welche Rolle spielt die Zeitlichkeit des guten Lebens für die Medizin insgesamt? Das ist die leitende Frage dieses Artikels. Dabei wird das gute Leben als sinnvolles Leben verstanden. In diesem Sinne wird für eine zweifache medizinische Relevanz der Zeitlichkeit des guten Lebens argumentiert: Erstens besteht der Sinn medizinischer Behandlungen in der Ermöglichung erfüllter Gegenwart. Zweitens kann und sollte ebendies u. a. durch die Wahrung und Wiederherstellung der chronobiologischen Rhythmen geschehen. (shrink)

Last year saw the 20th anniversary edition of JECP, and in the introduction to the philosophy section of that landmark edition, we posed the question: apart from ethics, what is the role of philosophy ‘at the bedside’? The purpose of this question was not to downplay the significance of ethics to clinical practice. Rather, we raised it as part of a broader argument to the effect that ethical questions – about what we should do in any given situation – (...) are embedded within whole understandings of the situation, inseparable from our beliefs about what is the case, what it is that we feel we can claim to know, as well as the meaning we ascribe to different aspects of the situation or to our perception of it. Philosophy concerns fundamental questions: it is a discipline requiring us to examine the underlying assumptions we bring with us to our thinking about practical problems. Traditional academic philosophers divide their discipline into distinct areas that typically include logic: questions about meaning, truth and validity; ontology: questions about the nature of reality, what exists; epistemology: concerning knowledge; and ethics: how we should live and practice, the nature of value. Any credible attempt to analyse clinical reasoning will require us to think carefully about these types of question and the relationships between them, as they influence our thinking about specific situations and problems. So, the answers to the question we posed, about the role of philosophy at the bedside, are numerous and diverse, and that diversity is illustrated in the contributions to this thematic edition. (shrink)

Health data processing fields face ethical and legal problems regarding fundamental rights. As we know, patients can benefit in the Digital Era from having health or medical information available, and medical decisions can be more effective with a better understanding of clinical histories, medical and health data thanks to the development of Artificial Intelligence, Internet of Things and other Digital technologies. However, at the same time, we need to guarantee fundamental rights, including privacy ones. The complaint about ethical and legal (...) requirements – including constitutional ones – is particularly relevant in the processing of health data. This paper is focused on the problem of the consent required to the processing of health data and the exceptions established in the new European Union General Data Regulation, which cover the processing of this special data -within other aims- for scientific, historical and statistical research as legitimate purposes, which include biomedical research. The conclusion is that these open concepts are problematic both for the protection of privacy rights and for the legal security/certainty of research. On one hand there are several interpretation problems, regarding the processing of health data and the protection of information privacy. On the other hand, professionals must follow the Multilevel legal framework and to guarantee fundamental rights in the processing of health data, so there are also problems of interpretation for researchers. Therefore, we need a clearer legal framework for biomedical research. (shrink)

This paper aims to analyze the ethical challenges in experimental drug use during the early stage of the COVID-19 pandemic, using Germany as a case study. In Germany uniform ethical guidelines were available early on nationwide, which was considered as desirable by other states to reduce uncertainties and convey a message of unity. The purpose of this ethical analysis is to assist the preparation of future guidelines on the use of medicines during public health emergencies. The use of hydroxychloroquine, (...) remdesivir and COVID-19 convalescent plasma in clinical settings was analyzed from the perspective of the ethical principles of beneficence, non-maleficence, justice and autonomy. We observed that drug safety and drug distribution during the pandemic affects all four ethical principles. We therefore recommend to establish ethical guidelines (i) to discuss experimental treatment options with patients from all population groups who are in urgent need, (ii) to facilitate the recording of patient reactions to drugs in off-label use, (iii) to expand inclusion criteria for clinical studies to avoid missing potentially negative effects on excluded groups, and (iv) to maintain sufficient access to repurposed drugs for patients with prior conditions. (shrink)

This paper explores how a set of observations on the weight of lead were interpreted and assessed between the 1540s and the 1630s across three different interconnecting disciplines: medicine, mineralogy and chemistry. The epistemic import of these discussions will be demonstrated by showing: 1) the changing role and articulation of experience and quantification in the investigation of metals; and 2) the notions associated with weight in different disciplinary frameworks. In medicine and mineralogy, weight was not considered as a (...) specific subject of inquiry in itself, but as a “sign” indicating other relevant properties of metals. In contrast, the chemistry tradition was increasingly concerned with the specific investigation of weight as a property of matter, as seen in the debates that took place in the “chemical revolution.” In addition, this study will reveal the versatility, polysemy, and parallel purposes of the recourse to experiential knowledge in different contexts, where the same “facts” operate within different disciplines. (shrink)

Our present day knowledge in the area of medicine in Ancient Egypt has been severally sourced from medical papyri several of which have been deduced and analyzed by different scholars. For educational purposes it is always imperative to consult different literature or sources in the teaching of ancient Egypt and medicine in particular. To avoid subjectivity the author has found the need to re-engage the efforts made by several scholars in adducing evidences from medical papyri. In the quest (...) to re-engage the efforts of earlier writers and commentaries on the medical papyri, we are afforded the opportunity to be informed about the need to ask further questions to enable us to construct or reconstruct both past and modern views on ancient Egyptian medical knowledge. It is this vocation the author sought to pursue in the interim, through a preliminary review, to highlight, comment and reinvigorate in the reader or researcher the need for a continuous engagement of some pertinent documentary sources on Ancient Egyptian medical knowledge for educational and research purposes. The study is based on qualitative review of published literature. The selection of those articles as sources was based on the focus of the review, in order to purposively select and comment on articles that were published based either on information from a medical papyrus or focused on medical specialization among the ancient Egyptians as well as ancient Egyptian knowledge on diseases and medicine. It was found that the Egyptians developed relatively sophisticated medical practices covering significant medical fields such as herbal medicine, gynecology and obstetrics, anatomy and physiology, mummification and even the preliminary form of surgery. These practices, perhaps, were developed as remedies for the prevailing diseases and the accidents that might have occurred during the construction of their giant pyramids. It must be stated that they were not without flaws. Also, the key issues raised from these literatures are but a few among the Egyptian medical corpus across the academic and publishing world. It should therefore afford researchers, students and readers the opportunity to continue the educational dialogue on the medical practices of the Ancient Egyptians. (shrink)

Abstract: This article explores the medical theories of the Dutch philosopher and physician Henricus Regius (1598-1679), who sought to provide clearer notions of medicine than the traditional theories of Jean Fernel, Daniel Sennert and Vopiscus Plempius. To achieve this, Regius overtly built upon the natural philosophy of René Descartes, in particular his theories of mechanical physiology and the corpuscular nature of matter. First, I show that Regius envisaged a novel partitioning of medicine, intended to make it independent in (...) exposition but conceptually grounded in natural philosophy. This served his overall purpose of making medicine a ‘clearer’ discipline. To this end Regius detaches the general notion of physiology as the study of the human body (which pertains to natural philosophy) from a medical physiology that concerns only health. Secondly, I show that Regius’s notions of health, disease, temperament and medicaments were the product of a Cartesian interpretation of traditional concepts, which was influenced by Santorio Santorio’s project of practicing medicine without occult elements. As a consequence, Regius’s classification of these notions is largely traditional. In conclusion, I show that Regius’s method of investigation in the area of natural philosophy consisted of a problem-solving procedure based on sensorial ideas. This approach can be traced back to Descartes, but was grounded on a purely empirical theory of knowledge, by which he rejected Descartes’s metaphysics. Regius’s order of exposition in natural philosophy and medicine, on the other hand, proceeds by definitions and divisions, and omits proofs. The reasons why Regius adopted this order were: 1) his rejection of Descartes’s metaphysical interpreta-tion of physics, and 2) his wish to emphasize the conceptual clarity and continuity of natural philosophy and medicine. (shrink)

Because we tend to study fight books in isolation, we often forget how difficult it is to understand the precise place they occupy in the sociocultural and historical fabric of their time, and spill the many clues they inevitably contain on their owner, their local society, their precise purpose. In order to unlock that information, we need to study them in their broader sociocultural and historical context. This requires a background and research skills that are not always easily accessible (...) to everyone. To illustrate the point, in this paper I show in some detail what is required to make sense of the claim that Aristotelian philosophy and science influenced the medieval fight books in relevant ways, and that understanding this influence helps us to better understand the fight books per se. I give an outline of the general historical framework, and apply it to a testcase: Talhoffer’s Thott 290 2° Ms., with some interesting results. My hope is that this framework may be of some use to other researchers in HEMA Studies who want to dig deeper in sources of interest to them. (shrink)

Introduction: The having extremely detailed macroscopic anatomy knowledge of the present medicine literature has been result of the information accumulation throughout the hundreds years. The numerous science hero have contributed for this purpose. The scientists being ahead of his time by their knowledge and scientific perspective have contributed worthy to development process of medicine. -/- Materials and Methods: The chapters related to the kidney anatomy in El-Kânûn Fi’t-Tıbb was written by İbn-i Sînâ in the 11th century, Kitab-ı (...) Teşrihü’l-Ebdan Min e’t-Tıb is one of the first illustrated anatomy books that was written by Mansur b. Muhammed b. Ahmed in 14th century, Teşrih-ülEbdan ve Tercümânı Kıbale-i Feylesûfan is the first illustrated Turkish anatomy book that was written by Şemseddîn-i İtâkî in 17th century were evaluated. -/- Results: The informations were compared in three books and were interpreted by the present informations. These books have contributed to development of anatomy although some of the informations in them are faulted. -/- Conclusion: All three books are valuable in point of showing the development of medicine. The extensive evaluation of books which have important place in history of medicine will give valuable information about development process of medicine. (shrink)

Self-tracking-technologies can serve as a prominent example of how digital technologies put to test established practices, institutions, and structures of medicine and healthcare. While proponents emphasize the potentials, e.g., for individualized healthcare and new research data, opponents stress the risk that these technologies will reinforce gender-related inequalities. -/- While this has been made clear from—often intersectional—feminist perspectives since the introduction of such technologies, we aim to provide a queer-feminist perspective on self-tracking applications in healthcare by analyzing three concrete cases. (...) In this way, we want to show why such a perspective is helpful in assessing self-tracking technologies and how such a perspective might contribute to a queering of healthcare. -/- After a short introduction to self-tracking in healthcare and the corresponding risks of reproducing gender-related inequalities, we introduce queer bioethics as a methodology to examine structural discrimination and marginalization in bioethical research. We apply this framework in the analysis of three exemplary self-tracking applications from the areas of nutrition/fitness, reproductive health, and mental health. In the subsequent discussion of these results against the backdrop of already existing queer-sensitive technologies, we identify an equal access, a subversive design, an inclusive database, and a diversity-sensitive and discriminatory-critical definition of purposes as well as individualized usage possibilities as first possible starting points for a queering of self-tracking applications. Finally, we draw conclusions, how such a critical perspective on self-tracking applications might also contribute to a queering of the healthcare system at a structural level. (shrink)

The need to better balance the promotion of scientific and technological innovation with risk management for consumer protection has inspired several recent reforms attempting to make regulations more flexible and adaptive. The pharmaceutical sector has a long, established regulatory tradition, as well as a long history of controversies around how to balance incentives for needed therapeutic innovations and protecting patient safety. The emergence of disruptive biotechnologies has provided the occasion for regulatory innovation in this sector. This article investigates the regulation (...) of advanced biotherapeutics in the European Union and shows that it presents several defining features of an adaptive regulation regime, notably institutionalized processes of planned adaptation that allow regulators to gather, generate, and mobilize new scientific and risk evidence about innovative products. However, our in-depth case analysis highlights that more attention needs to be paid to the consequences of the introduction of adaptive regulations, especially for critical stakeholders involved in this new regulatory ecosystem, the capacity and resource requirements placed on them to adapt, and the new tradeoffs they face. In addition, our analysis highlights a deficit in how we currently evaluate the performance and public value proposition of adaptive regulations vis-à-vis their stated goals and objectives. (shrink)

Objective: Evaluating study environments, attention–motivation levels while studying, and studying methods of students is ex-tremely important for obtaining purposed results. This study aimed to determine study environments, attention–motivation levels while studying, and studying methods of medicine faculty students. -/- Methods: Gaziantep University School of Medicine students completed the questionnaire that included questions regarding study environments, attention–motivation levels, and studying methods. The students were asked 11 open-ended questions and 29 Likert-type questions. Statistical analyses of these questions were performed, and (...) some of the questions correlated among them. -/- Results: The statistically significant differences were determined between the average grade and questions: “I have difficulty in focusing on the subject before starting to study,” “I easily lose concentration while studying,” “I use some pharmaceuticals (except vitamins) for increasing my motivation while studying,” “I use some pharmaceuticals (except vitamins) for increasing my attention while study,” and “I only study during exams.” A significant association was also observed between the average grade and the accommodation of students. -/- Conclusion: Improving the physical conditions of the study environment of medicine faculty students will contribute to increas-ing their academic success. Making students aware of the components that negatively affect attention and motivation will also positively affect the academic success of students. In addition, determining studying methods of medicine faculty students will contribute to improving personal education strategies. (shrink)

Socrates engages his audience in Phaedrus with speeches that include revised or newly composed myths that express his theory of philosophical eros. The aim of the speeches is to generate a love for truth that spills over into dialogue. Speeches are a starting point for dialogue, just like physical attraction is the beginning of love. In the case of Phaedrus, the beginning of philosophy is portrayed using playful and rhetorically rich speeches that serve as "love potions" awakening the novice's soul, (...) and ultimately leading Phaedrus to higher rungs on the ladder of love through the palinode, a medicinal speech. It is thinking about speeches, not the speeches themselves, which moves Socrates' student Phaedrus from the love of speeches to the love of Beauty itself. This is a stark contrast to the purpose of speechmaking for the sophist. The sophist seeks to enchant the soul, while the philosopher seeks to charm the soul into loving wisdom through stimulating discussions. Socrates also uses role reversals in the lover-beloved relationship to model the soul's ascent, contrasting the traditional roles with the way the lover and beloved are presented in Socrates' speeches. The novice must actively recollect Beauty itself in order to ascend, rather than passively listening to speeches that provide an image of beauty. Socrates' interlocutors must move themselves up the ladder of love from their own philosophical eros; wisdom is not attained by merely being pushed all the way up the ladder of love. (shrink)

Considering that the visual dimension of anatomy cannot be ignored and an anatomy education without the visual part will make a doctor imperfect in their profession, it may be seen that pictorial anatomy books written in previous periods are highly valuable. The purpose of this study is to investigate the spinal nerve anatomy included in the work titled Teşrihü’l-Ebdan min e’t-Tıb written in the XIVth century and compare the information at that period to the information of our time. The (...) nervous system was analyzed under a separate title in the book. Firstly, general information was provided about nerves, and then cranial and spinal nerves were described. The author stated in his work that there are two differences between humans and animals as feeling and movement. He stated that the center for feeling and movement is the brain and all nerves converge in the brain. Although there are insufficient or incorrect information in historical books of medicine, such books are highly valuable as they show the scientific progress. It is apparent that Mansur’s work titled Teşrihü’l-Ebdan min e’t-Tıb has a significant place in the history of anatomy, and its influence was reflected in the following periods. Despite the occasions of insufficient or incorrect information in the piece, we think it contributed to the historical development of anatomy. (shrink)

The principle of self-organization has acquired a fundamental significance in the newly emerging field of computational philosophy. Self-organizing systems have been described in various domains in science and philosophy including physics, neuroscience, biology and medicine, ecology, and sociology. While system architecture and their general purpose may depend on domain-specific concepts and definitions, there are (at least) seven key properties of self-organization clearly identified in brain systems: 1) modular connectivity, 2) unsupervised learning, 3) adaptive ability, 4) functional resiliency, 5) (...) functional plasticity, 6) from-local-to-global functional organization, and 7) dynamic system growth. These are defined here in the light of insight from neurobiology, cognitive neuroscience and Adaptive Resonance Theory (ART), and physics to show that self-organization achieves stability and functional plasticity while minimizing structural system complexity. A specific example informed by empirical research is discussed to illustrate how modularity, adaptive learning, and dynamic network growth enable stable yet plastic somatosensory representation for human grip force control. Implications for the design of “strong” artificial intelligence in robotics are brought forward. (shrink)

Purpose Prescription stimulant use as “cognitive enhancers” has been described among undergraduate college students. However, the use of prescription stimulants among future health care professionals is not well characterized. This study was designed to determine the prevalence of prescription stimulant misuse among students at an academic health sciences center. -/- Method Electronic surveys were e-mailed to 621 medical, pharmacy, and respiratory therapy students at East Tennessee State University for four consecutive weeks in fall 2011. Completing the survey was voluntary (...) and anonymous. Surveys asked about reasons for, frequency of, and side effects of nonprescription misuse of prescription stimulants. Given the sensitive material, an opportunity to win one of ten $50 gift cards was used as an incentive. -/- Results Three hundred seventy-two (59.9%) students completed the survey from three disciplines (47.6% medical, 70.5% pharmacy, and 57.6% respiratory therapy). Overall, 11.3% of responders admitted to misusing prescription stimulants. There was more misuse by respiratory therapy students, although this was not statistically significant (10.9% medicine, 9.7% pharmacy, 26.3% respiratory therapy; P = .087). Reasons for prescription stimulant misuse included to enhance alertness/ energy (65.9%), to improve academic performance (56.7%), to experiment (18.2%), and to use recreationally/get high (4.5%). -/- Conclusions Prescription stimulant misuse was prevalent among participating students, but further research is needed to describe prevalence among future health care workers more generally. The implications and consequences of such misuse require further study across professions with emphasis on investigating issues of academic dishonesty (e.g., “cognitive enhancement”), educational quality, and patient safety or health care quality. (shrink)

Since its inception in the early 1990s, evidence-based medicine (EBM) has become the dominant epistemic framework for Western medical practice. However, in light of powerful criticisms against EBM, alternatives such as casuistic medicine have been gaining support in both the medical and philosophical community. In the absence of empirical evidence in support of the claim that EBM improves patient outcomes, and in light of considerations that it is unlikely that such evidence will be forthcoming, another standard is needed (...) to assess EBM against its alternatives. In this paper, I propose a set of criteria for this purpose based on Helen Longino's criteria for assessing the objectivity of a knowledge productive community. I then apply these criteria to assess EBM against a casuistic framework for medical knowledge. I argue that EBM's strict adherence to a hierarchical organization of knowledge can reasonably be expected to block it from fulfilling a high level of objectivity. A casuistic framework, on the other hand, because it emphasizes critical evaluation in conjunction with the flexibility of a case-based approach, could be expected to better facilitate a more optimal epistemic community. (shrink)

It is very well known that from the late-1960s onwards Feyerabend began to radically challenge some deeply-held ideas about the history and methodology of the sciences. It is equally well known that, from around the same period, he also began to radically challenge wider claims about the value and place of the sciences within modern societies, for instance by calling for the separation of science and the state and by questioning the idea that the sciences served to liberate and ameliorate (...) human societies. But what is less known is how, if at all, these two sets of challenges were connected, and why Feyerabend felt it important to raise them at all. In this chapter, my aim is to explore these issues by considering why Feyerabend used radical strategies to challenge the authority of science, and what purpose, if any, they were supposed to serve. Why, for instance, did Feyerabend defend alternative medicine, psychical abilities, astrology, magic and witchcraft and why did he argue that ‘Western science’ is complicit in environmental destruction, intellectual imperialism, social oppression, and spiritual destitution. Located in their historical and political context, such defences and arguments seem peculiar, not least because science was recognised not only as a central site of the intellectual and ideological competition between the West and the Soviet Union, but also because Western victory in that site was considered inevitable. What, then, did Feyerabend think he was trying to achieve by raising radical challenges to a central component of the cultural and intellectual prestige of the Western world grounded in appeals to practices and traditions which most would regard as eccentric at best and absurd at worst? My suggestion is that Feyerabend was making a subtler point than one might suppose. For the purpose of these radical challenges was to determine if the members of Western societies would in fact honour the epistemic standards – of tolerance, critical enquiry – which were identified as being characteristic of science and definitive of the social and political values of Western liberal democracy. I suggest that Feyerabend was trying to demonstrate that scientists were, too often, guilty of the same intolerant and dogmatic attitudes which were, according to prevailing propaganda, the property of illiberal totalitarian societies. Science does not reflect the superior epistemic and political values of Western societies but are, in fact, reflective of the same vices ascribed to the Soviet Union. If that is the case, then the sciences are not symbols of our epistemic and political values, but quite the reverse, hence Feyerabend’s talk of the ‘dogmatic’, ‘totalitarian’, ‘ratiofascist’ nature of modern science. But there is a positive upshot to Feyerabend’s challenge. For even if the sciences do not yet reflect the epistemic and political values of liberal democratic Western societies, they might yet be reformed so that they are. And there is a parallel between Feyerabend’s strategy and that of many of the other radicals of the time – student activists, environmentalists, and pacifists – namely to test the commitment to tolerance and deliberative debate of the establishment by asking it to seriously engage with ideas and convictions opposed to its own. For both science and society can become ‘tyrannical’ through the same means: by exempting themselves from critical scrutiny, by promoting self-serving ‘myths’ about themselves, and by derogating and excluding alternatives, including the ‘outsider’ perspectives they offer. The chapter concludes by suggesting that Feyerabend is distinctive in virtue of his willingness to offer radical criticisms of the authority of science such that it can fulfil its legitimate ideological role – namely, of symbolising and instantiating our core epistemic and political values – such that we can offer a sincere and meaningful answer to Feyerabend’s question ‘what’s so great about science?’. (shrink)

BACKGROUND Patients with chronic pain face significant barriers in finding clinicians to manage long-term opioid therapy (LTOT). For patients on LTOT, it is increasingly common to have them sign opioid treatment agreements (OTAs). OTAs enumerate the risks of opioids, as informed consent documents would, but also the requirements that patients must meet to receive LTOT. While there has been an ongoing scholarly discussion about the practical and ethical implications of OTA use in the abstract, little is known about how clinicians (...) use them and if OTAs themselves modify clinician prescribing practices. OBJECTIVE To determine how clinicians use OTAs and the potential impacts of OTAs on opioid prescribing. DESIGN We conducted qualitative analysis of four focus groups of clinicians from a large Midwestern academic medical center. Groups were organized according to self-identified prescribing patterns: two groups for clinicians who identified as prescribers of LTOT, and two who did not. PARTICIPANTS 17 clinicians from General Internal Medicine, Family Medicine, and Palliative Care were recruited using purposive, convenience sampling. APPROACH Discussions were recorded, transcribed, and analyzed for themes using reflexive thematic analysis by a multidisciplinary team. KEY RESULTS Our analysis identified three main themes: (1) OTAs did not influence clinicians’ decisions whether to use LTOT generally but did shape clinical decision-making for individual patients; (2) clinicians feel OTAs intensify the power they have over patients, though this was not uniformly judged as harmful; (3) there is a potential misalignment between the intended purposes of OTAs and their implementation. CONCLUSION This study reveals a complicated relationship between OTAs and access to pain management. While OTAs seem not to impact the clinicians’ decisions about whether to use LTOT generally, they do sometimes influence prescribing decisions for individual patients. Clinicians shared complex views about OTAs’ purposes, which shows the need for more clarity about how OTAs could be used to promote shared decision-making, joint accountability, informed consent, and patient education. (shrink)

According to the PubMed resource from the U.S. National Library of Medicine, over 750,000 scientific articles have been published in the ~5000 biomedical journals worldwide in the year 2007 alone. The vast majority of these publications include results from hypothesis-driven experimentation in overlapping biomedical research domains. Unfortunately, the sheer volume of information being generated by the biomedical research enterprise has made it virtually impossible for investigators to stay aware of the latest findings in their domain of interest, let alone (...) to be able to assimilate and mine data from related investigations for purposes of meta-analysis. While computers have the potential for assisting investigators in the extraction, management and analysis of these data, information contained in the traditional journal publication is still largely unstructured, free-text descriptions of study design, experimental application and results interpretation, making it difficult for computers to gain access to the content of what is being conveyed without significant manual intervention. In order to circumvent these roadblocks and make the most of the output from the biomedical research enterprise, a variety of related standards in knowledge representation are being developed, proposed and adopted in the biomedical community. In this chapter, we will explore the current status of efforts to develop minimum information standards for the representation of a biomedical experiment, ontologies composed of shared vocabularies assembled into subsumption hierarchical structures, and extensible relational data models that link the information components together in a machine-readable and human-useable framework for data mining purposes. (shrink)

Since 2004, it has been mandated by law that all Danish undergraduate university programmes have to include a compulsory course on the philosophy of science for that particular program. At the Faculty of Science and Technology, Aarhus University, the responsibility for designing and running such courses were given to the Centre for Science Studies, where a series of courses were developed aiming at the various bachelor educations of the Faculty. Since 2005, the Centre has been running a dozen different courses (...) ranging from mathematics, computer science, physics, chemistry over medical chemistry, biology, molecular biology to sports science, geology, molecular medicine, nano science, and engineering. -/- We have adopted a teaching philosophy of using historical and contemporary case studies to anchor broader philosophical discussions in the particular subject discipline under consideration. Thus, the courses are tailored to the interests of the students of the particular programme whilst aiming for broader and important philosophical themes as well as addressing the specific mandated requirements to integrate philosophy, some introductory ethics, and some institutional history. These are multiple and diverse purposes which cannot be met except by compromise. -/- In this short presentation, we discuss our ambitions for using case studies to discuss philosophical issues and the relation between the specific philosophical discussions in the disciplines and the broader themes of philosophy of science. We give examples of the cases chosen to discuss various issues of scientific knowledge, the role of experiments, the relations between mathematics and science, and the issues of responsibility and trust in scientific results. Finally, we address the issue of how and why science students can be interested in and benefit from mandatory courses in the philosophy of their subject. (shrink)

The internet of things is increasingly spreading into the domain of medical and social care. Internet-enabled devices for monitoring and managing the health and well-being of users outside of traditional medical institutions have rapidly become common tools to support healthcare. Health-related internet of things (H-IoT) technologies increasingly play a key role in health management, for purposes including disease prevention, real-time tele-monitoring of patient’s functions, testing of treatments, fitness and well-being monitoring, medication dispensation, and health research data collection. H-IoT promises many (...) benefits for health and healthcare. However, it also raises a host of ethical problems stemming from the inherent risks of Internet enabled devices, the sensitivity of health-related data, and their impact on the delivery of healthcare. This paper maps the main ethical problems that have been identified by the relevant literature and identifies key themes in the on-going debate on ethical problems concerning H-IoT. (shrink)

“Excited Delirium Syndrome” (ExDS) is a controversial diagnosis. The supposed syndrome is sometimes considered to be a potential cause of death. However, it has been argued that its sole purpose is to cover up excessive police violence because it is mainly used to explain deaths of individuals in custody. In this paper, we examine the epistemic conditions giving rise to the controversial diagnosis by discussing the relation between causal hypotheses, evidence, and data in forensic medicine. We argue that (...) the practitioners’ social context affects causal inquiry through background assumptions that enter inquiry at multiple stages. This analysis serves to better understand the wide usage of the controversial diagnosis of ExDS. (shrink)

The purpose of cultural competence education for medical professionals is to ensure respectful care and reduce health disparities. Yet as Berger and Miller (2021) show, the cultural competence framework is dated, confused, and self-defeating. They argue that the framework ignores the primary driver of health disparities—systemic racism—and is apt to exacerbate rather than mitigate bias and ethnocentrism. They propose replacing cultural competence with a framework that attends to two social aspects of structural inequality: health and social policy, and institutional-system (...) activity; and two psychological aspects of structural inequality: the clinical encounter, and the epistemic. -/- We agree with the structural approach. To that end, we think it would be fruitful to include attention to physical contributors to structural inequality, namely the material artifacts used in medicine. Devices, tools, and technologies can materialize biases, perpetuate oppression, and contribute to health disparities. Granted, not everything that interests philosophers can be squeezed into medical education. Nevertheless, there are compelling reasons for including the study of material artifacts in education designed to reduce health disparities. First, devices and tools often carry forward biases from the past, and keep biases hidden from plain sight. Second, by studying these artifacts, future clinicians can begin to see themselves as part of a larger sociotechnical system. Finally, as medicine becomes increasingly tech-laden, it’s important for clinicians to see how material artifacts (including algorithms) connect individuals to structures. This will help to undermine oversimplified narratives according to which objective tools and technologies can correct for the bias and subjectivity of flawed human beings. (shrink)

This article argues that actor-network theory, as an alternative to critical theory, has lost its critical impetus when examining commodification in healthcare. The paper claims that the reason for this, is the way in which actor-network theory’s anti-essentialist ontology seems to black box 'intentionality' and ethics of human agency as contingent interests. The purpose of this paper was to open the normative black box of commodification, and compare how Marxism, Habermas and ANT can deal with commodification and ethics in (...) healthcare. Moreover, a new account of 'intentionality' in critical thinking was elaborated. Using Strawson's analysis of 'reactive attitudes and resentment,' the ethical implications of commodification in health care were examined as an assessment of intentions. Synthesizing critical theory with the relational materialism of actor-network theory, this article advances a new approach that seeks to bridge interdisciplinary boundaries, and guide actor-network theory in a critical and humanist direction. Providing new theoretical insights on commodification and 'intentionality' in health care. (shrink)

Sports physicians are continuously confronted with new biotechnological innovations. This applies not only to doping in sports, but to all kinds of so-called enhancement methods. One fundamental problem regarding the sports physician's self-image consists in a blurred distinction between therapeutic treatment and non-therapeutic performance enhancement. After a brief inventory of the sports physician's work environment I reject as insufficient the attempts to resolve the conflict of the sports physician by making it a classificatory problem. Followed by a critical assessment of (...) some ideas from the US President's Council on Bioethics, the formulation of ethical codes and attempts regarding a moral topography, it is argued that the sports physician's conflict cannot be resolved by the distinction between therapy and enhancement. Instead, we also have to consider the possibility that the therapy-based paradigm of medicine cannot do justice to the challenges of the continuously increasing technical manipulability of the human body and even our cognitive functions as well. At the same time we should not adhere to transhumanist ideas, because non-therapeutic interventions require clear criteria. Based on assistive technologies an alternative framework can be sketched that allows for the integration of therapeutic and non-therapeutic purposes. After a thorough definition of standards and criteria, the role of the sports physician might be defined as that of an assistant for enhancement. Yet the process of defining such an alternative framework is a societal and political task that cannot be accomplished by the sports physicians themselves. Until these questions are answered sports physicians continue to find themselves in a structural dilemma that they partially can come to terms with through personal integrity. (shrink)

Research in pharmacogenomics and precision medicine has recently introduced the concept of Polygenic Scores (PGSs), namely, indexes that aggregate the effects that many genetic variants are predicted to have on individual disease risk. The popularity of PGSs is increasing rapidly, but surprisingly little attention has been paid to the idealisations they make about phenotypic development. Indeed, PGSs rely on quantitative genetics models and methods, which involve considerable theoretical assumptions that have been questioned on various grounds. This comes with epistemological (...) and ethical concerns about the use of PGSs in clinical decision-making. In this paper, I investigate to what extent idealisations in genetics models can impact the data gathering and clinical interpretation of genomics findings, particularly the calculation and predictive accuracy of PGSs. Although idealisations are considered ineliminable components of scientific models, they may be legitimate or not depending on the epistemic aims of a model. I thus analyse how various idealisations have been introduced in classical models and progressively readapted throughout the history of genetic theorising. Notably, this process involved important changes in the epistemic purpose of such idealisations, which raises the question of whether they are legitimate in the context of contemporary genomics. (shrink)

This paper aims to outline the foundations for an ethics of digital touch. Digital touch refers to hardware and software technologies, often collectively referred to as ‘haptics’, that provide somatic sensations including touch and kinaesthesis, either as a stand-alone interface to users, or as part of a wider immersive experience. Digital touch has particular promise in application areas such as communication, affective computing, medicine, and education. However, as with all emerging technologies, potential value needs to be considered against potential (...) risk. We therefore identify some areas where digital touch raises ethical concerns, and we identify why these concerns arise, based on the distinctive physiological and functional properties of the human somatosensory system. Most scientific research in digital touch has focused on user interaction with external objects (active touch). However, the most pressing ethical concerns with digital touch technologies arise when users are being passively touched. Our analysis identifies several important questions about control, transparency, and epistemic procedure in digital touch scenarios. First, human somatosensation is “always on”, and many digital touch technologies take advantage of this (e.g., alerting systems). As a result, digital touch technologies can undermine individuals’ sensory autonomy (i.e., the right to choose what sensations one experiences). Second, users may reasonably want to know who or what is touching them, and for what purpose. Consent for digital touch will therefore need to be carefully and transparently transacted. Third, because touch gives us a special, direct experience of interacting with our physical environment, digital touch technologies that manipulate this interaction could potentially provide a major epistemic challenge, by changing a user’s basic understanding of reality and their relation to it. Informed by this discussion, we conclude by suggesting a basis for an ethical design framework for digital touch systems. (shrink)

Cancer biology features the ascription of normal functions to parts of cancers. At least some ascriptions of function in cancer biology track local normality of parts within the global abnormality of the aberration to which those parts belong. That is, cancer biologists identify as functions activities that, in some sense, parts of cancers are supposed to perform, despite cancers themselves having no purpose. The present paper provides a theory to accommodate these normal function ascriptions—I call it the Modeling Account (...) of Normal Function (MA). MA comprises two claims. First, normal functions are activities whose performance by the function-bearing part contributes to the self-maintenance of the whole system and, thereby, results in the continued presence of that part. Second, MA holds that models of system-level activities that are (partly) constitutive of self-maintenance are improved by including a representation of the relevant function-bearing part and by making reference to the activity/activities that part performs which contribute(s) to those system-level activities. I contrast MA with two other accounts that seek to explicate the ascription of normal functions in biology, namely, the organizational account and the selected effects account. Both struggle to extend to cancer biology. However, I offer ecumenical readings which allow them to recover some ascriptions of normal function to parts of cancers. So, though I contend that MA excels in this respect, the purpose of this paper is served if it provides materials for bridging the gap between cancer biology, philosophy of cancer, and the literature on function. (shrink)

Metformin hydrochloride is the first-line anti-diabetic drug used to treat type 2 diabetes mellites and helps to control blood sugar levels. Various brands of metformin are available in the Libyan market which makes it challenging to select, an effective and economical one. This study aimed to compare different brands of metformin available in the Misurata and evaluate the quality parameter according to the British Pharmacopoeia. Six brands of metformin tablets (850 mg) were taken from the market and assessed. To achieve (...) this purpose five tests were done on each brand, the uniformity of weight test shows the average weight and 5.0% deviation, the friability test gives how much the tablet can stand attrition, the disintegration time test shows the time taken by the tablet to disintegrate, dissolution test to confirm the rate of drug release, weight variation and friability test of all brands was within the specified limit. Disintegration time for all the brands was within 30 minutes. All six brands of metformin hydrochloride tablets fulfilled the in-vitro dissolution rate test specification not less than 80% of the drug is released within 45 minutes. Using Ultraviolet-visible (UV) spectroscopy, UV analysis of different samples shows that the percentage content of active ingredients of five brands of metformin hydrochloride tablets was within the monograph specification (95%-105%) of drug content but one brand failed this test. The study indicated that strict quality control of imported drugs should enforced to ensure effective and safe medicines in the Libyan market. (shrink)

Purpose: The purpose of the discussion is to call for an experimental trial in order to optimize the sociology of knowledge in the astronomical and cosmological sciences from a cognitive science and developmental psychology perspective. The potential of such experimental trial may also correlate developmental psychology with cosmology and astrophysics, therefore, contribute to public health from an astrobiological perspective. -/- Method: The discussion adopts a philosophizing method for the multidisciplinary and trans-disciplinary proposal, with the hypothesis that proton decay (...) in cosmology is correlative to neuronal development in human biochemistry. The method adopts a humanitarian paradigm of pragmatism in natural mutation from cosmic changes, in an exploratory heuristics for hydro-sampling of mutational potentials from environmental factors in cosmological large-scale structure. -/- Result: With an initial assessment on existing technologies, the potentials of the big data trend in astronomy and astrophysics can be applied to data analysis with solid-state electrolytes in sensor baselines to nuclear medicine methods. (shrink)

I will open the first part of this paper by trying to elucidate the frequentist foundations of RCTs. I will then present a number of methodological objections against the viability of these inferential principles in the conduct of actual clinical trials. In the following section, I will explore the main ethical issues in frequentist trials, namely those related to randomisation and the use of stopping rules. In the final section of the first part, I will analyse why RCTs were accepted (...) for regulatory purposes. I contend that their main virtue, from a regulatory viewpoint, is their impartiality, which is grounded in randomisation and fixed rules for the interpretation of the experiment. Thus the question will be whether Bayesian trials can match or exceed the achievements of frequentist RCTs in all these respects. In the second part of the paper, I will first present a quick glimpse of the introduction of Bayesianism in the field of medical experiments, followed by a summary presentation of the basic tenets of a Bayesian trial. The point here is to show that there is no such thing as “a” Bayesian trial. Bayesianism can ground many different approaches to medical experiments and we should assess their respective virtues separately. Thus I present two actual trials, planned with different goals in mind, and assess their respective epistemic, ethical and regulatory merits. In a tentative conclusion, I contend that, given the constraints imposed by our current regulatory framework, impartiality should preside over the design of clinical trials, even at the expense of many of their inferential and ethical virtues. (shrink)

Defining the purposes of engineering ethics education (EEE) is paramount for the engineering education community, and understanding the purposes of EEE can be a catalyst for actively involving students in the learning process. This chapter presents a conceptual framework for systematically describing and comparing various approaches to the purposes of EEE. Such a framework is inherently embedded with a tension between a normative approach and a pragmatic approach regarding the purposes of EEE. The normative approach focuses on what the purposes (...) of EEE should be, an ‘ideal world’ scenario, given the needs of the engineering profession and of society at large. Conversely, the pragmatic approach starts from the question ‘What can be achieved through educational practice?‘ and results from ‘actual world’ situated outcomes of stakeholder negotiations. The authors’ framework balances these. They – scholars from diverse cultural backgrounds – assert that the purposes of EEE are socially constructed and vary from country to country based on unique historical, political, and cultural contexts. Their framework embraces both the individualistic and holistic aspects of EEE, incorporating perspectives from both Western and non-Western traditions. It identifies six purposes of EEE (knowledge, actions, personal traits, relationships, etc.), aligning these with examples (e.g., moral knowledge, desirable actions, ethical skills or competencies, care ethics, etc.) and theoretical frameworks (moral epistemology, moral psychology, virtue ethics, objects or qualities of relations, etc.). It is problematic and potentially dangerous when engineering educators design ethics-learning activities without critically examining the purposes of these activities and assessing whether these purposes are justified for educating ethically and professionally competent engineers. This chapter provides tools to help avoid such pitfalls. (shrink)

The fact that Internet companies may record our personal data and track our online behavior for commercial or political purpose has emphasized aspects related to online privacy. This has also led to the development of search engines that promise no tracking and privacy. Search engines also have a major role in spreading low-quality health information such as that of anti-vaccine websites. This study investigates the relationship between search engines’ approach to privacy and the scientific quality of the information they (...) return. We analyzed the first 30 webpages returned searching “vaccines autism” in English, Spanish, Italian, and French. The results show that not only “alternative” search engines but also other commercial engines often return more anti-vaccine pages (10–53%) than Google (0%). Some localized versions of Google, however, returned more anti-vaccine webpages (up to 10%) than Google. Health information returned by search engines has an impact on public health and, specifically, in the acceptance of vaccines. The issue of information quality when seeking information for making health-related decisions also impact the ethical aspect represented by the right to an informed consent. Our study suggests that designing a search engine that is privacy savvy and avoids issues with filter bubbles that can result from user-tracking is necessary but insufficient; instead, mechanisms should be developed to test search engines from the perspective of information quality (particularly for health-related webpages) before they can be deemed trustworthy providers of public health information. (shrink)

Innovative practice involves medical interventions that deviate from standard practice in significant ways. For many patients, innovative practice offers the best chance of successful treatment. Because little is known about most innovative treatments, clinicians who engage in innovative practice might consider including extra procedures, such as scans or blood draws, to gather information about the innovation. Such information-gathering interventions can yield valuable information for modifying the innovation to benefit future patients and for designing scientific studies of the innovation. However, existing (...) guidelines do not say when or whether it is appropriate to add potentially risky information-gathering interventions for these purposes. As a result, clinicians may assume that information-gathering interventions are ethically inappropriate and should not be used in innovative practice. This assumption can lead to seriously negative consequences, such as increasing the likelihood that harmful or ineffective innovations will be adopted and creating new barriers to the development of genuinely beneficial treatments. We argue that health care institutions need to promote the responsible use of information-gathering interventions as an adjunct to innovative practice, and that these interventions are not clinical research and should not be subject to research oversight. (shrink)

I. Introduction Siris, Berkeley's last major work, is undeniably a rather odd book. It could hardly be otherwise, given Berkeley's aims in writing it, which are three-fold: 'to communicate to the public the salutary virtues of tar-water,'1 to provide scientific background supporting the efficacy of tar-water as a medicine, and to lead the mind of the reader, via gradual steps, toward contemplation of God.2 The latter two aims shape Berkeley's extensive use of contemporary natural science in Siris. In particular, (...) Berkeley's focus on what he calls fire (or aether or light) as a quasiuniversal 'cause' of natural change3 serves these purposes, for the 'activity' of the aether, in his view, can both explain the miraculous virtues of a certain medicine, i.e. tar-water, and reveal God's action and his divine order.4 Berkeley's corpuscular speculations, including his use of fire-theory, are not especially idiosyncratic as natural philosophy. In his theorizing, as Jessop and other have noted, he is heavily indebted to the work of Hermann Boerhaave, the Dutch chemist, botanist, and physician whose teachings were highly influential in mid-eighteenth century Britain.5 Boerhaave, along with other Dutch natural philosophers cited by Berkeley, assigned a central role in accounting for physio-chemical activity to fire, a subtle, insensible particulate substance, sometimes identified with light. (shrink)

Anja Karnein has suggested that because of the importance of respect for persons, law and policy should require some human embryos created in vitro to be available for adoption for a period of time. If no one comes forward to adopt the embryos during that time, they may be destroyed (in the case of embryos left over from fertility medicine) or used in research (in the case of embryos created for that purpose or left over from fertility (...) class='Hi'>medicine). This adoption option would increase the number of embryos available for couples looking for help in having children, but that effect is less important—Karnein argues—than the observance of respect for human persons. As possible persons, she holds that embryos ought to be treated, as if they will become children, if only for a while. If enacted as a matter of law and policy, an ‘adoption option’ would wrongly interfere with the dispositional rights women and men ought to have over embryos they create in the course of trying to have children. Karnein's proposal would also deprive researchers of certainty that the embryos they create for research would actually be available that way, leading to increased burdens of time and money and maybe even to more embryos than would otherwise be produced. Karnein's analysis does not show, moreover, that any duty of rescue applies to embryos. No woman is required to adopt any embryo, which significantly undercuts the justification for an obligatory adoption period. (shrink)

This paper explores Plato’s views on the purpose of rhetorical form by surveying the way in which Socrates engages in speechmaking at several points in the Gorgias. I argue that Socrates has nothing in principle against the use of a long speech as part of the practice of philosophical inquiry and argument, provided that the speech is geared toward understanding. This reflects a key and relatively unremarked distinction that Socrates makes in the Gorgias between persuasion that comes from being (...) convinced and persuasion that comes from being taught. The kind of long speeches that Socrates objects to are those that have a conviction-based purpose. However, this leaves open the use of a wide variety of rhetorical techniques—pieces of argument, speechifying, analogy, myth, and exhortation—that have a teaching-based purpose, which is precisely the sort of rhetoric that Socrates licenses in the dialogue. (shrink)

Purpose: The objective of this study is to determine the importance of supplementary medical ethics course for resident physicians. In this study, we assessed the current state of their knowledge of medical ethics and aimed to improve and deepen their understanding of clinical scenarios to increase their awareness of the link between the practice of medicine and ethical issues. Methods: The course was held for groups of 10-12 people for 3 days a week for a total of 6 (...) hours. Tests given prior to and following completion of the course were used to assess the effectiveness of a medical ethics training course in which 120 resident physicians completed. The evaluation was made on the basis of the same pre-and post-tests (14 scenarios) and direct observation of participants. Result and Discussion: The average age was 28.23 ± 4.08 and 25% were female and 75% were male. Of the participants, 68.3% were training to be internists, 24.2% were training to be surgeons, and 7.5% were training in laboratory medicine. There was a significant statistical difference between the mean total scores of both tests (p=0.00). After completing the course, residents took into account the medical ethical principles while discussing ethical decisions. Conclusion: After finishing the course, participants defended their responses in regard to issues of medical ethics more carefully and articulated their thoughts more clearly. Our experience demonstrated that the trainees benefited from a structured curriculum in medical ethics. We believe that the development and implementation of our course may serve as a case study for training resident physicians in medical ethics. (shrink)

The present article is a primary introduction to the semi-structured interviewing method SMILE_PH, an acronym for Sense-Making Interviews Looking at Elements of Philosophical Health. Beyond grounding this new methodology theoretically (a work that is started here but will in the future necessitate several developments), the main motivation here is pragmatic: to provide the recent philosophical health movement with a testable method and show that philosophically-oriented interviews are possible in a manner that can be reproduced, compared, tested and used systematically with (...) a population that has received no training in philosophy. The SMILE_PH approach was conceived by the author during an ethically approved pilot study focused on the philosophy of life of persons living with spinal cord injury (SCI), with the intention of rectifying the epistemic obstacles generated by rationalist, Socratic or unstructured ways of in-depth interviewing. The six-step structure of the method is also inspired by hundreds of individual dialogue sessions with philosophical counselees, led by the author between 2018 and 2022: the SMILE_PH method progressively gathers phenomenological data about 1 – our bodily sense, 2 – our sense of self, 3 – our sense of belonging, 4 – our sense of the possible, 5 – our sense of purpose and 6 – our philosophical sense. (shrink)

The current debate on closed-loop brain devices (CBDs) focuses on their use in a medical context; possible criminal justice applications have not received scholarly attention. Unlike in medicine, in criminal justice, CBDs might be offered on behalf of the State and for the purpose of protecting security, rather than realising healthcare aims. It would be possible to deploy CBDs in the rehabilitation of convicted offenders, similarly to the much-debated possibility of employing other brain interventions in this context. Although (...) such use of CBDs could in principle be consensual, there are significant differences between the choice faced by a criminal offender offered a CBD in the context of criminal justice, and that faced by a patient offered a CBD in an ordinary healthcare context. Employment of CBDs in criminal justice thus raises ethical and legal intricacies not raised by healthcare applications. This paper examines some of these issues under three heads: autonomy, human rights, and accountability. (shrink)

In the debates regarding the ethics of human organoid biobanking, the locus of donor autonomy has been identified in processes of consent. The problem is that, by focusing on consent, biobanking processes preclude adequate engagement with donor autonomy because they are unable to adequately recognise or respond to factors that determine authentic choice. This is particularly problematic in biobanking contexts associated with organoid research or the clinical application of organoids because, given the probability of unforeseen and varying purposes for which (...) a donor’s organoids could be employed and given the different ways in which a donor can relate to her biospecimens, a donor can value her organoids differently in different contexts and her reasons for autonomously permitting use of her cells and tissues in one case may not support an autonomous decision in another. In response, this paper has three aims: firstly, to make the case for why organoid biobanks ought to respect donor autonomy conceived as authentic choice; secondly, to explore the autonomy-respecting limits of established and widely prevalent models of biobank consent; and thirdly, to propose certain conditions that organoid biobanks ought to support or facilitate in order to respect donor autonomy. (shrink)