From antiquity, Galenic physicians extensively discussed the active powers of simple and compound drugs. In their views, simple drugs, that is, single ingredients, acted according to their material qualities and the properties of their substance. As for compound drugs, their efficacy resulted from the mutual interaction of their ingredients and their modes of preparation. In the late Renaissance, Galenic physicians and naturalists, such as Leonhart Fuchs and Pietro Andrea Mattioli, attempted to explain these pharmacological properties or “faculties” at the (...) intersection of medicine, botany, and natural philosophy. This chapter examines the case of the Italian physician and botanist Andrea Cesalpino. His pharmacological treatise De medicamentorum facultatibus [On the Faculties of Drugs, 1593] was particularly significant for its reception of ancient and medieval texts on drug properties, materia medica, and the role of the senses in the knowledge of bodies. (shrink)

In late Renaissance medicine, the example of digestion was frequently invoked to prove the elemental composition of the human body. Food was considered as being decomposed in its first elements by the stomach, and digested into a thick juice, which was assimilated by the liver and the body parts. Such a process points to the structure of the human body into four elements that are transformed into different types of humors during several stages of “concoction”. This chapter examines (...) the Galenic interpretation of digestion expounded by the French physician Jean Fernel (1497–1558) in his Physiologia (1567). In this treatise, Fernel states the body composition into elemental portions, while stressing the role of the “innate heat” as the physiological counterpart of the body’s essence or “substantial form”. He applies this view in his account of digestion, where he states that the conversion of food follows the rule of “mixture”. This chapter aims to explore how Fernel applies his interpretation of elements and innate heat to the process of digestion, as well as his sources in Galen’s De facultatibus naturalibus, Avicenna’s Canon and Aristotle’s Meteorologica. It first examines the role of the natural soul and its “nourishing” faculties in nutrition as a physiological function. It then considers the role of elements, humors and innate heat during the “concoction” of food in the stomach, liver and veins. (shrink)

Ian Hacking defines a “style of scientific thinking” loosely as a “way to find things out about the world” characterised by five hallmark features of a number of scientific template styles. Most prominently, these are autonomy and “self-authentication”: a scientific style of thinking, according to Hacking, is not good because it helps us find out the truth in some domain, it itself defines the criteria for truth-telling in its domain. I argue that Renaissance medicine, Mediaeval “demonology”, and magical (...) thinking pass muster as scientific according to Hacking's criteria. However, application of these thought styles to the entities they introduce generates statements that logically imply a set of “ordinary” statements—or what Bernard Williams calls “plain truths”—which, contra the claims of autonomy and self-authentication, allows styles to be assessed from a style- independent perspective. Using Williams’ notion of plain truth, I show that Renaissance medicine, demonology, and magical thinking, in reality issue in many plain falsehoods. This confronts us with what I call Hacking's dilemma: either define stricter necessary conditions on being a style of scientific thinking, or concede that some styles albeit scientific are not as good at finding things out about the world as others. I make three suggestions to deal with the dilemma. (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)

This chapter examines the use of vegetal analogy in late Renaissance physiology through the case of the German physician Daniel Sennert. It is centered on Sennert’s explanation of generation, in particular the transmission of life through the vegetative soul within the seed, as developed in his early works on medicine and alchemy, the _Institutionum medicinae libri V_ and _De chymicorum…liber_. This chapter first summarizes Sennert’s account of generation and the seed’s “formative force” according to Aristotle and Galen, as (...) well as his appraisal of the medical debates on the origin of the seed’s soul and form. Then, the next part explores Sennert’s own interpretation of the origin of forms, for which plant physiology served as a common denominator of his medical, alchemical and theological inclinations. Finally, this chapter considers how Sennert attempted to harmonize his reasoning with the Paracelsian account of generation, seed and life. (shrink)

The fascinating Journey of the Renaissance Medicine.

The psychedelic renaissance did not emerge from a void. While a tremendous upswell of interest in psychedelics can be observed today, there is scant acknowledgment of the current spiritual crisis that has led to this burgeoning enthusiasm. Having lost our sense of the sacred, we have—with disastrous consequences—become alienated from ourselves, others, and the natural environment. Secular psychotherapy and psychiatry have failed to address the myriad mental health problems that are prevalent right now, which has compelled people to desperately (...) look for alternatives to fill the void in their lives. Sacred medicines have been used for millennia in humanity’s traditional cultures as part of their spiritual practices. Now that psychedelic-assisted psychotherapy (PAT) is being developed, we must avoid repeating the mistakes of modern psychology, which misguidedly seeks to situate entheogenic therapy on a desacralized foundation of materialism, reductionism, and scientism. Nevertheless, although the full benefit of entheogens can likely be gained only in the context of a sacred tradition, they may still have some measure of therapeutic value even when used in conjunction with secular psychotherapy. This article examines the metaphysical foundations of sacred psychology and argues that entheogenic therapy needs to be grounded on the same basis. The framework employed here is a “transpersonal” perspective that applies the insights found in the world’s great wisdom traditions. It will be argued that the adoption of psychedelics in mental health treatment presupposes a fully integrated psychotherapy that is possible only when it is rooted in a spiritually informed ontology. (shrink)

Starting from texts and data collected during the installation of the online database DArIL (Digital Archive of Inaugural Lectures at Renaissance and Early Modern Universities), the paper presents some results of this work. It is divided in two sections: in the first one, Marco Forlivesi describes DArIL, its structure, content, aims, and potential. In the second part, Iolanda Ventura attempts to distinguish the various types of lectiones inaugurales by focusing on specific texts dealing with medicine produced at the (...) Universities of Padua, Jena, and Helmstedt during the Eighteenth Century. -/- . (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)

In a "parenthesis of fascinated horror" before "the complete discovery and subjection of the body to science", Renaissance anatomists and poets shared peculiar emotions of dread and desire towards the bodies they dissected and described. Jonathan Sawday's ambitious project is to evoke the common taboos, resistances, and fears which the human body provoked in its various early modern investigators, while telling "stories of terrible cruelty, which are tinged by a form of dark eroticism". He is justifiably proud of the (...) historical range of his study, across medicine, cartography, literature, the law, myth, art, theology, social history, and philosophy. But he seeks more than a synthesis of these disparate domains, hoping also both to sketch a new grand narrative about conceptual, practical, and phenomenological changes regarding the body, and further "if not to dispel, then at least to explain" our own multiple, ambiguous feelings about our innards. Thus he marvellously maintains simultaneous attention to culture and psychology, combining high theory with historical precision in rare and risky fashion. (shrink)

A short reconstruction of the transformations of the Greek classical analogy between the body and the city through the Arabic philosophy, the Renaissance political thought, and the origins of modern science up to Adam Smith and the shaping of political economy.

The paper seeks to show that the period between the years 756 and 1031, a period officially recognized as the domination of the Umayyad dynasty in the Iberian Peninsula, saw the emergence of the most important movement for the recovery of classical Greek works known, and offered the foundations for the second Renaissance, the Italian. It also shows that translation is a process that can fundamentally alter original works, as they depend on the translator's interpretation, as well as the (...) existence of equivalent words and concepts in the language to be translated. Both problems were identified in the recovery of classical Greek works by the Toledo School of Translators. The result was that Italian Renaissance was, in fact based on what had been made available by the Toledo School of Translators, which confirms the thesis that the first Renaissance was the Islamic one and that the Italian Renaissance was a later movement. (shrink)

The article focuses on a philosophical issue of the Renaissance humanism in William Shakespeare's Hamlet. The humanist tradition originated in Greece with the famous statement “Of all things man is the measure” (Protagoras of Abdera, 485-415 BCE), but it was not until the Renaissance that it reached its peak and became a doctrine. The article focuses on the humanism of the Renaissance, with its glorification of the image of the "giant man," which is mainly expressed in the (...) work of William Shakespeare. By pointing out the nature of Renaissance humanism, the article emphasizes Hamlet's play as a typical work of Renaissance humanism. (shrink)

The success of precision medicine depends on obtaining large amounts of information about at-risk populations. However, getting consent is often difficult. Why? In this commentary I point to the differentials in social status involved. These differentials are inevitable once personal information is surrendered, but are particularly intense when the studied populations are socioeconomically or socioculturally disadvantaged and/or ethnically stigmatized groups. I suggest how the deep distrust of the latter groups can be partially justified as a lack of confidence that (...) their core values or interests will sufficiently be taken into account. Hence, the ethical challenge here lies not in avoiding status differentials, but in dealing with them appropriately. Scientists should not assume trust from others but adopt a norm of “demonstrating trustworthiness”. (shrink)

Since the 19th century Renaissance studies gained gradually autonomy from the Medieval and the Early Modern studies. In countries like Greece, where the traditional view was that no Renaissance occurred in the Balkan Peninsula during the 14th -16th century as a result of the Turkish occupation, Renaissance studies had to struggle to gain autonomy and distinct presence in the curricula of Greek universities. This article aims to present the current status of the Renaissance studies in the (...) Greek universities and to give a critical account of it. The interest for Renaissance studies in Greece is not increased. Usually, Greek scholars and students feel awkward towards that period because they think of Renaissance as something alien to their culture. It is common among scholars of humanities when they refer to the period from 1450-1600, to use the term “post-byzantine” instead of Renaissance. Also, Renaissance studies do not have a rich tradition in Greek universities. There were no major academic figures who were experts in the period so as to promote Renaissance studies and leave a legacy of students and written works. Other Greek scholars hold that the Renaissance is not a distinct period and should be studied in the pattern of the Modern European period. (shrink)

The renaissance of epistemology between the two world wars forms a bridge between early modern and contemporary philosophy of knowledge. This paper traces the resurgence of interest in epistemology at the turn of the century, as a reaction against the nineteenth-century development of Neo-Kantian and Neo-Hegelian idealism, through the interwar renaissance of epistemology, prompted by major advances in mathematics, logic, and physics, and its ultimate transformation from a theory of ideas and judgement into a theory of propositional attitudes, (...) sentences, and meanings. (shrink)

Even in the increasingly individualized American medical system, advocates of 'personalized medicine' claim that healthcare isn't individualized enough. With the additional glamour of new biotechnologies such as genetic testing and pharmacogenetics behind it, 'Me Medicine'-- personalized or stratified medicine-- appears to its advocates as the inevitable and desirable way of the future. Drawing on an extensive evidence base, this book examines whether these claims are justified. It goes on to examine an alternative tradition rooted in communitarian ideals, (...) that of the common good as a goal in medicine. (shrink)

The renaissance of epistemology between the two world wars forms a bridge between early modern and contemporary philosophy of knowledge. This paper traces the resurgence of interest in epistemology at the turn of the century, as a reaction against the nineteenth-century development of Neo-Kantian and Neo-Hegelian idealism, through the interwar renaissance of epistemology, prompted by major advances in mathematics, logic, and physics, and its ultimate transformation from a theory of ideas and judgement into a theory of propositional attitudes, (...) sentences, and meanings. (shrink)

The concept of impetus denoted the transmission of a power from the mover to the object moved. Many authors resorted to this concept to explain why a projectile keeps on moving when no longer in contact with its initial mover. But its application went further, as impetus was also appealed to in attempts to explain the acceleration of falling bodies or the motion of the heavens. It was widely applied in Renaissance natural philosophy, but it also raised a number (...) of ontological questions concerning its precise nature. (shrink)

In this paper, I argue that the concept of normality in medical research and clinical practice is inextricable from the concept of ambiguity. I make this argument in the context of Edmund Pellegrino's call for a renewed reflection on medicine’s basic concepts and by drawing on work in critical disability studies concerning Deafness and body integrity identity disorder. If medical practitioners and philosophers of medicine wish to improve their understanding of the meaning of medicine as well as (...) its concrete practice, I contend that they should take seriously the import and centrality of ambiguity for biomedicine. (shrink)

ABSTRACT: Abstract Most modern knowledge is not science. The physical sciences have successfully validated theories to infer they can be used universally to predict in previously unexperienced circumstances. According to the conventional conception of science such inferences are falsified by a single irregular outcome. And verification is by the scientific method which requires strict regularity of outcome and establishes cause and effect. -/- Medicine, medical research and many “soft” sciences are concerned with individual people in complex heterogeneous populations. These (...) populations cannot be tested to demonstrate strict regularity of outcome in every individual. Neither randomised controlled trials nor observational studies in medicine are science in the conventional conception. Establishing and using medical and other “soft science” theories cannot be scientific. It requires conceptually different means: requiring expert judgement applying all available evidence in the relevant available factual matrix. -/- The practice of medicine is observational. Prediction of outcomes for the individual requires professional expertise applying available medical knowledge and evidence. Expertise in any profession can only be acquired through experience. Prior cases are the fundament of knowledge and expertise in medicine. Case histories, studies and series can provide knowledge of extremely high reliability applicable to establishing reliable general theories and falsifying others. Their collation, study and analysis should be a priority in medicine. Their devaluation as evidence, the failure to apply their lessons, the devaluation of expert professional judgement and the attempt to emulate the scientific method are all historic errors in the theory and practice of modern medicine. (shrink)

Loneliness in medicine is a serious problem not just for patients, for whom illness is intrinsically isolating, but also for physicians in the contemporary condition of medicine. We explore this problem by investigating the ideal physician-patient relationship, whose analogy with friendship has held enduring normative appeal. Drawing from Talbot Brewer and Nir Ben-Moshe, we argue that this appeal lies in a dynamic form of companionship incompatible with static models of friendship-like physician-patient relationships: a mutual refinement of embodied virtue (...) that draws both persons together. The ideal physician-patient relationship has a dialectical character that fosters each member's improvement of phenomenologically recognizing and embodying moral virtues. A key component of this dynamic is a commitment to the common goal of the patient's health, realized through joint interactivities and conversations over time. The physician's presence to the patient's suffering—understood best as an alienating phenomenological condition for the patient—orients and discloses possibilities for virtuous caregiving by structuring the meanings of the goals, conversations, and joint narrative constitutive of their relationship. Presence to suffering, paradoxically, is perhaps an important prerequisite for this dynamic partnership. These activities dialectically build an interpretive horizon of understanding through which moral goods and character refinement—in and for the other—may become revealed for both persons in their shared being-in-the-world. This analysis of suffering, mood, and revealing of (possible) moral goods has implications for addressing the modern problem of loneliness for patients and physicians, who are increasingly inhibited from building flourishing relationships with each other. (shrink)

The issue of how to incorporate the individual's first‐hand experience of illness into broader medical understanding is a major question in medical theory and practice. In a philosophical context, phenomenology, with its emphasis on the subject's perception of phenomena as the basis for knowledge and its questioning of naturalism, seems an obvious candidate for addressing these issues. This is a review of current phenomenological approaches to medicine, looking at what has motivated this philosophical approach, the main problems it faces (...) and suggesting how it might become a useful philosophical tool within medicine, with its own individual, but interrelated, contribution to make to current medical debates. After the general background, there is a brief summary of phenomenological ideas and their current usage in a medical context. Next is a critique of four key claims within current phenomenological medical works, concerning both the role phenomenology plays and the supposedly clear divide between phenomenology and other approaches. There are significant problems within these claims, largely because they overlook the complexity of the questions they consider. Finally, there is some more in‐depth examination of phenomenology itself and the true complexity of phenomenological debate concerning subjectivity. The aim is to show that it will be both more productive and truer to phenomenology itself, if we use phenomenology as a philosophical method for explicating and gaining deeper understanding of complex and fundamental problems, which are central to medicine, rather than as providing simple, but flawed solutions. (shrink)

As opposed to a ‘one size fits all’ approach, precision medicine uses relevant biological, medical, behavioural and environmental information about a person to further personalize their healthcare. This could mean better prediction of someone’s disease risk and more effective diagnosis and treatment if they have a condition. Big data allows for far more precision and tailoring than was ever before possible by linking together diverse datasets to reveal hitherto-unknown correlations and causal pathways. But it also raises ethical issues relating (...) to the balancing of interests, viability of anonymization, familial and group implications, as well as genetic discrimination. This article analyses these issues in light of the values of public benefit, justice, harm minimization, transparency, engagement and reflexivity and applies the deliberative balancing approach found in theEthical Framework for Big Data in Health and Research to a case study on clinical genomic data sharing. Please refer to that article for an explanation of how this framework is to be used, including a full explanation of the key values involved and the balancing approach used in the case study at the end. Our discussion is meant to be of use to those involved in the practice as well as governance and oversight of precision medicine to address ethical concerns that arise in a coherent and systematic manner. (shrink)

We can read about the morality of that time in works by authors who describe or criticize the conduct and activity of the members of those classes taking the lead in the morality of that time. Thus, we can find a lot of information about ancient Greece and its morality in Plato’s presentation of Socrates, Peter Abelard presenting the Middle Ages, Erasmus of Rotterdam, Niccolo Machiavelli, Baldesar Castiglione, but even also Slovak authors such as Martin Rakovský and Juraj Koppay presenting (...) very interesting contemporary facts about the Renaissance. (shrink)

This is a volume of twelve essays concerning the fundamental tension in personalised medicine between individual choice and the common good.

If one had to identify the biggest change within the philosophical tradition in the twenty-first century, it would certainly be the rapid rise of experimental philosophy to address differences in intuitions about concepts. It is, therefore, surprising that the philosophy of medicine has so far not drawn on the tools of experimental philosophy in the context of a particular conceptual debate that has overshadowed all others in the field: the long-standing dispute between so-called naturalists and normativists about the concepts (...) of health and disease. In this paper, I defend and advocate the use of empirical methods to inform and advance this and other debates within the philosophy of medicine. (shrink)

Recent criticisms of medicine converge on fundamental questions about the aim of medicine. The main task of this paper is to propose an account of the aim of medicine. Discussing and rejecting the initially plausible proposal according to which medicine is pathocentric, the paper presents and defends the Autonomy Thesis, which holds that medicine is not pathocentric, but sanocentric, aiming to promote health with the final aim to enhance autonomy. The paper closes by considering the (...) objection that the Autonomy Thesis is overly permissive and allows many highly controversial procedures as legitimate parts of medicine. (shrink)

Amid criticism of medicine's scientific rigor and patient care, this book offers a philosophical examination of the nature and aims of medicine, and new perspectives on how these challenges can be addressed. It offers input for rethinking the agenda of medical research, healthcare delivery, and the education of healthcare personnel.

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 book focuses on the intellectual relations between the Byzantine world and Renaissance Italy in the 15th century. The book consists of five independent chapters, which aim to present the complex ways the two cultures interacted. In the first chapter I present the way Modern Greek identity is attached to philosophical discussions and debates among the Byzantine scholars of the 15th century. In the following two chapters I focus on the transmission of knowledge from Western Europe and the Arabic (...) culture to the Byzantine philosophical community and its reactions. The last two chapters are dedicated to George of Trebizond and his efforts to transfer the Byzantine philosophical and scientific research to Renaissance Europe in order to renew philosophy and science. In sum, I support that, besides mutual reservations and skepticism, the two worlds, Byzantine and Renaissance, interacted in mutual benefit. (shrink)

The connections between medicine and well-being are myriad. This paper focuses on the place of well-being in clinical medicine. It is here that different views of well-being, and their connection to concepts like “autonomy” and “authenticity”, both illuminate and are illuminated by looking closely at the kinds of interactions that routinely take place between clinicians, patients, and family members. -/- In the first part of the paper, I explore the place of well-being in a paradigmatic clinical encounter, one (...) where a competent patient interacts with a clinician. The main question here is how, or even whether, the pursuit of patient well-being – however we construe it – figures into a paradigmatic clinical encounter. In the second part of the paper, I consider what I will call a marginal clinical encounter – one where the patient is, as Agnieska Jaworska (1999) puts it, at the “margins of agency” – to theorize about the nature of well-being and to show how different theories of well-being can have dramatic consequences for clinical decision-making. (shrink)

The term ‘heat’ originates from the Old English word hǣtu, a word of Germanic origin; related to the Dutch ‘hitte’ and German ‘Hitze’. Today, we distinguish three different meanings of the word ‘heat’. First, ‘heat’ is understood in colloquial English as ‘hotness’. There are, in addition, two scientific meanings of ‘heat’. ‘Heat’ can have the meaning of the portion of energy that changes with a change of temperature. And finally, ‘heat’ can have the meaning of the transfer of thermal energy (...) from a hotter to a colder system or body. By contrast, for the Ancients and Scholastics, ‘heat’ was a manifest, real quality of bodies and there was an ontological distinction between biological or innate heat (which was regarded as an innate principle of life for warm-blooded animals) and the physical manifest heat of external objects, which is potentially harmful. During the late Renaissance period, however, both views changed fundamentally and evolved - via the application of physical and mechanical analogies - into the foundations for today’s unified mechanistic theory of heat. (shrink)

Physicians frequently ask whether they should give patients what they want, usually when there are considerations pointing against doing so, such as medicine’s values and physicians’ obligations. It has been argued that the source of medicine’s values and physicians’ obligations lies in what has been dubbed “the internal morality of medicine”: medicine is a practice with an end and norms that are definitive of this practice and that determine what physicians ought to do qua physicians. In (...) this paper, I defend the claim that medicine requires a morality that is internal to its practice, while rejecting the prevalent characterization of this morality and offering an alternative one. My approach to the internal morality of medicine is constructivist in nature: the norms of medicine are constructed by medical professionals, other professionals, and patients, given medicine’s end of “benefitting patients in need of prima facie medical treatment and care.” I make the case that patients should be involved in the construction of medicine’s morality not only because they have knowledge that is relevant to the internal morality of medicine—namely, their own values and preferences—but also because medicine is an inherently relational enterprise: in medicine the relationship between physician and patient is a constitutive component of the craft itself. The framework I propose provides an authoritative morality for medicine, while allowing for the incorporation, into that very morality, of qualified deference to patient values. (shrink)

Medicine is increasingly subject to various forms of criticism. This paper focuses on dominant forms of criticism and offers a better account of their normative character. It is argued that together, these forms of criticism are comprehensive, raising questions about both medical science and medical practice. Furthermore, it is shown that these forms of criticism mainly rely on standards of evaluation that are assumed to be internal to medicine and converge on a broader question about the aim of (...) medicine. Further work making medicine’s internal norms explicit and determining the aim of medicine would not only help to clarify to what extent the criticism is justified, but also assist an informed deliberation about the future of medicine. To illustrate some of the general difficulties associated with such a task, the paper concludes by critically engaging Edmund Pellegrino’s account of the aim of medicine as well as the Hastings Center’s consensus report. (shrink)

Proponents of evidence-based medicine have argued convincingly for applying this scientific method to medicine. However, the current methodological framework of the EBM movement has recently been called into question, especially in epidemiology and the philosophy of science. The debate has focused on whether the methodology of randomized controlled trials provides the best evidence available. This paper attempts to shift the focus of the debate by arguing that clinical reasoning involves a patchwork of evidential approaches and that the emphasis (...) on evidence hierarchies of methodology fails to lend credence to the common practice of corroboration in medicine. I argue that the strength of evidence lies in the evidence itself, and not the methodology used to obtain that evidence. Ultimately, when it comes to evaluating the effectiveness of medical interventions, it is the evidence obtained from the methodology rather than the methodology that should establish the strength of the evidence. (shrink)

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

The controversy around the accommodation of conscientious objections in medicine persists, especially for such contentious services as abortions. COs are typically considered in their negativ...

The introduction of laws of nature is often seen as one of the hallmarks of the Scientific Revolution of the seventeenth century. The new sciences are thought to have introduced the revolutionary idea that explanations of natural phenomena have to be grounded in exceptionless regularities of universal scope, i. e. laws of nature. The use of legal terminology to talk about natural regularities has a longer history, though. This article traces these earlier uses.

In this chapter, we consider ethical and philosophical aspects of trust in the practice of medicine. We focus on trust within the patient-physician relationship, trust and professionalism, and trust in Western (allopathic) institutions of medicine and medical research. Philosophical approaches to trust contain important insights into medicine as an ethical and social practice. In what follows we explain several philosophical approaches and discuss their strengths and weaknesses in this context. We also highlight some relevant empirical work in (...) the section on trust in the institutions of medicine. It is hoped that the approaches discussed here can be extended to nursing and other topics in the philosophy of medicine. (shrink)

En este texto se presenta un espacio de intercambio de conocimientos desde una perspectiva científica, técnica y jurídica, para contribuir a la protección de los recursos naturales. Debido a la importancia de establecer mecanismos para proteger la biodiversidad y posibilitar la preservación de los conocimientos asociados especialmente al uso de la flora medicinal, la Línea de Investigación en Política y Legislación, del Grupo de Estudios en Sistemas Tradicionales de Salud de la Facultad de Medicina, y la Línea de Derecho Ambiental (...) y Grupos Étnicos, del Grupo de Derechos Humanos de Jurisprudencia de la Universidad del Rosario, desarrollaron este libro a través del cual la Universidad se propone profundizar en el panorama actual de la reglamentación y política –Internacional, nacional y local—respecto a la flora medicinal y al patrimonio cultural inmaterial asociado a ésta. (shrink)

The Formalist tradition in late-scholastic philosophy has gone unnoticed in standard historiography. This article’s overall objective is to add the Formalist tradition to what we know about Renaissance philosophy. I first show how the Formalist tradition was born out of some innovative considerations of hierarchies of distinctions in the wake of the Franciscan John Duns Scotus’s teaching on the formal distinction in the beginning of the fourteenth century (especially Francis of Meyronnes’s model of four distinctions and Petrus Thomae’s more (...) elaborate doctrine of seven kinds of distinctions). I then trace how Formalist literature developed from being an exclusively Franciscan affair to becoming a much more widespread phenomenon. Thus, from the decades up to 1500 and onwards, authors from various late-scholastic schools (Thomism, Lullism, Averroism, and others) produced Formalist literature, i.e., treatises on multiple kinds of distinctions. I highlight particularly how one Franciscan philosopher of the sixteenth century, Jean Du Douet, proposed to view the Formalist preoccupation with distinctions as a discipline in its own right, a proper scientia formalitatum. I finally argue that while this proposal met with dismissive reactions, Du Douet’s idea does in fact reflect the role Formalism played in the scholastic curriculum in the late sixteenth century, at least in Franciscan milieus. (shrink)

According to recent approaches in the philosophy of medicine, biomedicine should be replaced or complemented by a humanistic medical model. Two humanistic approaches, narrative medicine and the phenomenology of medicine, have grown particularly popular in recent decades. This paper first suggests that these humanistic criticisms of biomedicine are insufficient. A central problem is that both approaches seem to offer a straw man definition of biomedicine. It then argues that the subsequent definition of humanism found in these approaches (...) is problematically reduced to a compassionate or psychological understanding. My main claims are that humanism cannot be sought in the patient–physician relationship alone and that a broad definition of medicine should help to revisit humanism. With this end in view, I defend what I call an outcomes-oriented approach to humanistic medicine, where humanism is set upon the capacity for a health system to produce good health outcomes. (shrink)

The birth of the African Renaissance was articulated by Cheikh Anta Diop who believed that the challenges of the African continent shall overcome through the confrontation of cultural, scientific and economic renewal. Former president of South Africa, Thabo Mbeki populated it with an intention of advocating for self-determination, unity, identity, development, and transformation of political and economy of the continent. The envisioned statement was to see Africa as a unitary continent that could fight imperialism and capitalism which were seen (...) as enemies of development from an Africanism perspective. The dream was however not realized due to the influence exerted by the western on other states in Africa and that affected development in Africa. From this premise, the study will start by outlining the African Renaissance quest for unity, followed by how the dream of Mbeki was thwarted away by the suspicion and doubt among the African states and how African Union was seen as an entity to promote Africanism and African Renaissance. From that, the study will suggest a plan that could be implemented to resuscitate the African Renaissance from a development perspective. (shrink)

A novel advantage of the use of machine learning (ML) systems in medicine is their potential to continue learning from new data after implementation in clinical practice. To date, considerations of the ethical questions raised by the design and use of adaptive machine learning systems in medicine have, for the most part, been confined to discussion of the so-called “update problem,” which concerns how regulators should approach systems whose performance and parameters continue to change even after they have (...) received regulatory approval. In this paper, we draw attention to a prior ethical question: whether the continuous learning that will occur in such systems after their initial deployment should be classified, and regulated, as medical research? We argue that there is a strong prima facie case that the use of continuous learning in medical ML systems should be categorized, and regulated, as research and that individuals whose treatment involves such systems should be treated as research subjects. (shrink)

In this thesis, I give a metascientific account of causality in medicine. I begin with two historical cases of causal discovery. These are the discovery of the causation of Burkitt’s lymphoma by the Epstein-Barr virus, and of the various viral causes suggested for cervical cancer. These historical cases then support a philosophical discussion of causality in medicine. This begins with an introduction to the Russo- Williamson thesis (RWT), and discussion of a range of counter-arguments against it. Despite these, (...) I argue that the RWT is historically workable, given a small number of modifications. I then expand Russo and Williamson’s account. I first develop their suggestion that causal relationships in medicine require some kind of evidence of mechanism. I begin with a number of accounts of mechanisms and produce a range of consensus features of them. I then develop this consensus position by reference to the two historical case studies with an eye to their operational competence. In particular, I suggest that it is mechanistic models and their representations which we are concerned with in medicine, rather than the mechanism as it exists in the world. -/- I then employ these mechanistic models to give an account of the sorts of evidence used in formulating and evaluating causal claims. Again, I use the two human viral oncogenesis cases to give this account. I characterise and distinguish evidence of mechanism from evidence of difference-making, and relate this to mechanistic models. I then suggest the relationship between types of evidence presents us with a means of tackling the reference-class problem. This sets the scene for the final chapter. Here, I suggest the manner in which these two different classes of evidence become integrated is also reflected in the way that developing research programmes change as their associated causal claims develop. (shrink)