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)

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)

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)

The fascinating Journey of the Renaissance Medicine.

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)

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)

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)

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.

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)

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)

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)

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 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)

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)

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 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)

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)

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)

“Classic”, serotonergic psychedelic drugs such as LSD and psilocybin are the objects of renewed attention in science and psychiatry. A recent spate of research has produced evidence that psychedelics might be safe and effective adjuncts to the treatment of mood and addictive disorders, agents of positive psychological change in healthy subjects, and valuable tools for studying the neural mechanisms of perception and cognition. This chapter surveys three philosophical debates that have arisen in response to this “renaissance” of psychedelic research. (...) The first concerns the mechanisms of psychedelic-assisted psychotherapy (“psychedelic therapy”): How, exactly, does psychedelic administration in controlled conditions cause lasting psychological benefits? The second concerns the implications of psychedelic research for the philosophy of mind: Does psychedelic evidence show that there can be conscious mental states lacking all forms of self-consciousness? The third concerns the epistemic status of the psychedelic state: Is it possible that certain kinds of knowledge, or other epistemic benefits, could be gained by undergoing a psychedelic experience? (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)

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)

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

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)

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)

Through this contribution I aim to explore the horizons and limits of digital medicine in light of an embodied approach to the issue of care. I will sketch the historical background of digital medicine and show the contemporary status of this interdisciplinary field, as well as its applications and outcomes. Then, I will address a critique of the computational theory of mind (CTM) upon which many contemporary mental health apps are designed. This approach to the mind is inscribed (...) into the modern trend of neuromania, which conceives the embodied, living human being as a mere series of data analyses and algorithms, with the brain as the seat of the person. Drawing on continental philosophy and classical phenomenology I will develop a notion of health conceived as a moral enterprise, showing how wellbeing and vitality are not reducible to a product made by technologies or doctors, but rather they are the results of an embodied encounter. As such, empathy and person-centered care cannot be achieved by digital medicine. They are the result of a journey into the regions of recognition, embodied presence and the aliveness constituting the person. Finally, I will show how the issue of care cannot be separated from an embodied encounter between people, especially in case of dementia. (shrink)

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)

David Tomasi presents new, groundbreaking research on the science and application of Mind-Body Medicine strategies to improve clinical outcomes in inpatient psychiatry settings. Much more than a list of therapeutic recommendations, this book is a thorough description of how Mind-Body Medicine can be successfully applied, from a therapeutic as well as from an organizational, cost-effective analysis viewpoint, to the full spectrum of psychiatric treatments. Furthermore, this study examines the role of multidisciplinary and interdisciplinary treatment teams, with a special (...) focus on the profession and the role of psychotherapists and group therapists, thereby providing solid scientific evidence of the benefits of patient-provider therapeutic alliances. In this sense, this book serves as a guide for professionals and institutions both in the private and the public sphere, to learn effective treatment and management strategies. About the Author Psychotherapist, Researcher, and Philosopher Dr. David Låg Tomasi is the author of Medical Philosophy (ibidem, 2016) and the co-author of Positive Patient Response to a Structured Exercise Program Delivered in Inpatient Psychiatry (Global Advances in Health and Medicine, 2019), the most-read research item from the University of Vermont (Researchgate, 2019). A member of several national and international Academies of Sciences, Dr. Tomasi works in the Inpatient Psychiatry Unit at the UVM Medical Center, and teaches at the University of Vermont and the Community College of Vermont. ---- Ibidem / Columbia University Press. (shrink)

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.

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)

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...

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)

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 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)

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)

Throughout the 20th century, philosophers have criticized the scientific understanding of the human body. Instead of presenting the body as a meaningful unity or Gestalt, it is regarded as a complex mechanism and described in quasi-mechanistic terms. In a phenomenological approach, a more intimate experience of the body is presented. This approach, however, is questioned by Jacques Lacan. According to Lacan, three basic possibilities of experiencing the body are to be distinguished: the symbolical (or scientific) body, the imaginary (or ideal) (...) body and the real body. Whereas the symbolical body is increasingly objectified (and even digitalized) by medical science, the phenomenological perception amounts to an idealization of the body. The real body cannot be perceived immediately. Rather, it emerges in the folds and margins of our efforts to symbolize or idealize the body, which are bound to remain incomplete and fragile. In the first part of the article (1-3), Lacan's conceptual distinction between the symbolical, the imaginary and the real body will be explained. In the second part (4-5), this distinction will be further clarified by relying on crucial chapters in the history of anatomy (notably Mundinus, Vesalius, Da Vinci and Descartes). (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)

Recently, dramatic price increases by several pharmaceutical companies have provoked public outrage. These scandals raise questions both about how pharmaceutical firms should be regulated and about how pharmaceutical executives ethically ought to make pricing decisions when drug prices are largely unregulated. Though there is an extensive literature on the regulatory question, the ethical question has been largely unexplored. This article defends a Kantian approach to the ethics of pharmaceutical pricing in an unregulated market. To the extent possible, pharmaceutical companies must (...) price drugs so that those who genuinely need them can get them without financial ruin. This requirement is an ethical side constraint, like the moral prohibitions on deception and theft, that takes precedence over a business’s interest in maximizing profit. That said, the requirement’s application is sensitive to the need to recoup the costs of research and to produce a return that financially justifies the original investment. It may not be either feasible or desirable for government to attempt to enforce the ethical requirements concerning just pharmaceutical pricing. Either price regulation or subsidy could fulfill government’s obligation to protect patients from being objectionably vulnerable to pricing decisions by private companies. (shrink)

In this chapter we will argue, firstly, that Bacon’s engages in a pecu-liar form of mathematization of nature that develops a quali-quantitative methodology of measurement. Secondly, we will show that medicine is one of the disciplines where that dual way of measurement is practiced. In the first section of the chapter, we will expose the ontology involved in the Baconian proposal of measurement of nature. The second section will address the place that mixed mathematics occupies in Bacon’s scheme of (...) scientific branches and will suggest that a proper advancement of medicine can generate a new branch of mixed mathematics. The next section will reconstruct Bacon’s approach to measurement and expose its quali-quantitative import. In the last section, we will show some examples of medicine in which this quali-quantitative measurement is applied. (shrink)