In this article, part of a special issue on meaning in life and medical ethics, I argue that several issues encountered in a bioethical context are not adequately addressed only with values such as morality and welfare. I maintain, more specifically, that the value of what makes a life meaningful is essential to being able to provide conclusive judgements about which decisions to make. After briefly indicating how meaningfulness differs from rightness and happiness, I point out how it is plausibly (...) central to making decisions in six ‘life and death’ matters. My aim is not to draw any firm conclusions about what to do when it comes to these topics, but rather to show that in order to arrive at any, one cannot plausibly ignore the category of life’s meaning that has, until recently, been nearly absent from Western bioethics since its inception. (shrink)

Racial disparities in health outcomes have recently become a flashpoint in the debate about the value of race as a biological concept. What role, if any, race has in the etiology of disease is a philosophically and scientifically contested topic. In this article, I expand on the insights of the new mechanistic philosophy of science to defend a mechanism discovery approach to investigating epidemiological racial disparities. The mechanism discovery approach has explanatory virtues lacking in the populational approach typically employed in (...) the study of race and biomedicine. The explanatory constraints that form an integral part of the new mechanistic approach enable mechanism discovery to avoid the epistemic and normative shortcomings of the populational approach. The methodology of mechanism discovery can fruitfully be extended to the treatment and reversal of epidemiological racial disparities. (shrink)

Women have always been central concerning the provision of healthcare. The transitions into the modern world have been very slow for women because of how societies classify women. Starting from lay care, women provided healthcare for their family and sometimes to the members of the community in which they lived. With no formal education, women served as midwives and served in other specialised fields in medicine. They usually treated their fellow women because they saw ‘women’s medicine’ as women’s (...) business. They were discriminated against by the opposite sex and by the church, which regarded it as a taboo to allow women to practice medicine. This study points to a Ghanaian context on how the charismas of women have made them excel in their efforts to provide healthcare for their people. The study also focused on the role of indigenous practitioners who are mostly found in the rural areas and modern practitioners who are mostly found in the peri-urban, urban areas and larger cities in Ghana. (shrink)

The articles in the special issue "Experience in natural philosophy and medicine" discuss the roles and notions of experience in the works of a range of early modern authors, including Galileo Galilei, Francis Bacon, the Dutch atomist David Gorlaeus, William Harvey, and Christian Wolff. The articles extend the evidential basis on which we can rely to identify trends, changes and continuities in the roles and notions of experience in the period of the Scientific Revolution. They shed light on the (...) longstanding influence of traditional views and the emergence of early modern experimental philosophy. This introduction highlights the benefits of considering medicine in connection with natural philosophy when studying early modern views on experience and summarizes the articles. (shrink)

This paper is about the history of a question in ancient Greek philosophy and medicine: what holds the parts of a whole together? The idea that there is a single cause responsible for cohesion is usually associated with the Stoics. They refer to it as the synectic cause (αἴτιον συνεκτικόν), a term variously translated as ‘cohesive cause,’ ‘containing cause’ or ‘sustaining cause.’ The Stoics, however, are neither the first nor the only thinkers to raise this question or to propose (...) a single answer. Many earlier thinkers offer their own candidates for what actively binds parts together, with differing implications not only for why we are wholes rather than heaps, but also why our bodies inevitably become diseased and fall apart. This paper assembles, up to the time of the Stoics, one part of the history of such a cause: what is called ‘the synechon’ (τὸ συνέχον) – that which holds things together. Starting with our earliest evidence from Anaximenes (sixth century BCE), the paper looks at different candidates and especially the models and metaphors for thinking about causes of cohesion which were proposed by different philosophers and doctors including Empedocles, early Greek doctors, Diogenes of Apollonia, Plato and Aristotle. My goal is to explore why these candidates and models were proposed and how later philosophical objections to them led to changes in how causes of cohesion were understood. (shrink)

Medical ethics would be better if people were taught to think more clearly about well-being or the concept of what is good for a person. Yet for a variety of reasons, bioethicists have generally paid little attention to this concept. Here, I argue, first, that focusing on general theories of welfare is not useful for practical medical ethics. I argue, second, for what I call the “theory-without-theories approach” to welfare in practical contexts. The first element of this approach is a (...) focus on examining important and relatively uncontroversial constituents of welfare as opposed to general theories. The second key element is a framework for thinking about choice in relation to welfare, a framework I refer to as “the mild objectivity framework.” I conclude with illustrations of the way in which the “theory without theories approach” can improve thinking in 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)

Bioethics, neuroscience, medicine are contributing to a debate on the definition and criteria of death. This topic is very controversial, and it demonstrates clashing views on the meaning of human life and death. Official medical and legal positions agree upon a biological definition of death as irreversible cessation of integrated functioning of the organism as a whole, and whole-brain criterion to ascertain death. These positions have to face many criticisms: some scholars speak of logical and practical inconsistency, some others (...) of invalid scientific theory about the supreme integrator. In this paper some criticisms are exposed and discussed in order to reconstruct the state of the art in bioethical debate. -/- . (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)

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.

This paper aims to deal with the disputes on transferring demonstration between the various sciences in the context of the medicine-geometry relationship. According to Aristotle’s metabasis-prohibition, these two sciences should be located in separate compartments due to the characteristics of their subject-matter. However, a thorough analysis of the critical passage in Aristotle’s Posterior Analytics on circular wounds forces a revision of the boundaries of the interactions between sciences, since subsequently Avicenna, on the grounds of this passage, would widen the (...) area of the transference of demonstration. Furthermore, the fact that Avicenna and Ibn al-Nafīs continued to use geometrical demonstrations in their anatomical investigations shows the need to understand kind-crossing prohibition as a reminder to take into account the present scientific infrastructure and logical rules before proceeding onto a scientific investigation instead of accepting it as a mere nominal doctrine. Therefore, whether kind-crossing was possible or not depended on the extent to which the conclusion derived at the end of the scientific investigation, using a different method after taking into account all these reminders, had contributed to the solution of a particular proposition or the achievement of an approximate truth. (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)

This article argues that Novalis's philosophy of magical idealism essentially consists of three central elements: a theory of the creative or productive imagination, a conception of love, and a doctrine of transcendental medicine. In this regard, it synthesizes two adjacent, but divergent contemporary philosophical sources - J. G. Fichte's idealism and Friedrich Schiller's classicism - into a new and original philosophy. It demonstrates that Novalis's views on both magic and idealism, not only prove to be perfectly rational and comprehensible, (...) but even more philosophically coherent and innovative than have been recognised up to now. (shrink)

This paper summarizes the seminar AI in Medicine in Context: Hopes? Nightmares? that was held at the Centre for Ethics at the University of Toronto on October 17, 2017, with special guest assistant professor and neurosurgeon Dr. Sunit Das. The paper discusses the key points from Dr. Das' talk. Specifically, it discusses about Dr. Das' perspective on the ethical and moral issues that was experienced from applying artificial intelligence (AI) in law and how such issues can also arise when (...) applying AI to medicine, and concludes with a brief discussion on how such issues can be prevented. (shrink)

I have argued that the central Christian doctrine of general resurrection (with particular reference to the Pauline corpus) can and should be understood in a scientifically and philosophically informed context, and have proposed a personalist-phenomenological model of general resurrection as a personally continuous transformative re-embodiment by the grace of God within an interpretative framework that respects the methods and findings of science while rejecting scientism and associated physicalist metaphysical claims. I have considered and rejected the re-assembly model of resurrection on (...) theological, philosophical and scientific grounds. (shrink)

Recently, a friend of one of these writers told her story of using one of a healthcare product to activate her stem cells as part of regenerative medicine. Regenerative medicine is a field of medicine that seeks to repair or replace damaged or diseased tissues and organs. This can be done through a variety of methods, including stem cell therapy, tissue engineering, and gene therapy. This is a short review article on this rapid field called regenerative (...) class='Hi'>medicine, in particular via a new method called photobiomodulation, especially by virtue of low-intensity laser pen treatment. Hopefully it will attract more research in this interesting direction, both for laser/photobiomodulation to boost plant growth as well as in healthcare (see also: Christianto & Smarandache, 2022; Christianto, 2023). (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)

The idea of personalised medicine (PM) has gathered momentum recently, attracting funding and generating hopes as well as scepticism. As PM gives rise to differing interpretations, there have been several attempts to clarify the concept. In an influential paper published in this journal, Schleidgen and colleagues have proposed a precise and narrow definition of PM on the basis of a systematic literature review. Given that their conclusion is at odds with those of other recent attempts to understand PM, we (...) consider whether their systematic review gives them an edge over competing interpretations. We have found some methodological weaknesses and questionable assumptions in Schleidgen and colleagues’ attempt to provide a more specific definition of PM. Our perplexities concern the lack of criteria for assessing the epistemic strength of the definitions that they consider, as well as the logical principles used to extract a more precise definition, the narrowness of the pool from which they have drawn their empirical data, and finally their overlooking the fact that definitions depend on the context of use. We are also worried that their ethical assumption that only patients’ interests are legitimate is too simplistic and drives all other stakeholders’ interests—including those that are justifiable—underground, thus compromising any hope of a transparent and fair negotiation among a plurality of actors and interests. As an alternative to the shortcomings of attempting a semantic disciplining of the concept we propose a pragmatic approach. Rather than considering PM to be a scientific concept in need of precise demarcation, we look at it as an open and negotiable concept used in a variety of contexts including at the level of orienting research goals and policy objectives. We believe that since PM is still more an ideal than an achieved reality, a plurality of visions is to be expected and we need to pay attention to the people, reasons and interests behind these alternative conceptions. In other words, the logic and politics of PM cannot be disentangled and disagreements need to be tackled addressing the normative and strategic conflicts behind them. (shrink)

This paper has a dual character, combining a philosophical ontological exploration with a conceptual modeling approach in systems and software engineering. Such duality is already practiced in software engineering, in which the current dominant modeling thesis is object orientation. This work embraces an anti-thesis that centers solely on the process rather than emphasizing the object. The approach is called occurrence-only modeling, in which an occurrence means an event or process where a process is defined as an orchestrated net of events (...) that form a semantical whole. In contrast to object orientation, in this occurrence-only modeling objects are nothing more than long events. We apply this paradigm to (1) a UML/BPMN inventory system in simulation engineering and (2) an event-based system that represents medical occurrences that occur on a timeline. The aim of such a venture is to enhance the field of conceptual modeling by adding yet a new alternative methodology and clarifying differences among approaches. Conceptual modeling’s importance has been recognized in many research areas. An active research community in simulation engineering demonstrates the growing interest in conceptual modeling. In the clinical domains, temporal information elucidates the occurrence of medical events (e.g., visits, laboratory tests). These applications give an opportunity to propose a new approach that includes (a) a Stoic ontology that has two types of being, existence and subsistence; (b) Thinging machines that limit activities to five generic actions; and (c) Lupascian logic, which handles negative events. With such a study, we aim to substantiate the assertion that the “occurrence only” approach is a genuine philosophical base for conceptual modeling. The results in this paper seem to support such a claim. (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)

The Pneumatist school of medicine has the distinction of being the only medical school in antiquity named for a belief in a part of a human being. Unlike the Herophileans or the Asclepiadeans, their name does not pick out the founder of the school. Unlike the Dogmatists, Empiricists, or Methodists, their name does not pick out a specific approach to medicine. Instead, the name picks out a belief: the fact that pneuma is of paramount importance, both for explaining (...) health and disease, and for determining treatments for the healthy and sick. In this paper, we re-examine what our sources say about the pneuma of the Pneumatists in order to understand what these physicians thought it was and how it shaped their views on physiology, diagnosis and treatment. (shrink)

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

Narrations have been able to influence medicine, giving rise to a new approach call " narrative medicine ". In this paper we consider the patient as a text, such is, an open book that the physician intervenes, but also from which the physician may and need to learn a lot. To deepen a little in the narrative perspective of patient understanding and his/her situation helps us to discover how the patient is object of compassion by physicians, but also (...) how he/she turns into subject of compassion. We conclude that it is important for physicians to dedicate time in their initial medical training, as well as in their permanent training, to explore and exploit the value of narrations, that help them to categorize their living experiences and that of the patients. -/- As narrativas estão chegando a influenciar na medicina, dando origem a uma nova abordagem chamada " medi-cina narrativa ". Neste trabalho consideramos o paciente como um texto, em outras palavras, um livro aberto que o médico intervém, mas também, que deve aprender muito. Aprofundar-se um pouco na perspectiva narrativa da compreensão do paciente e de sua situação ajuda a descobrir como o paciente é objeto da compaixão dos médicos, embora também como se converte em sujeito desta compaixão. Concluímos que é importante que os médicos dediquem mais tempo em sua formação médica inicial, bem como em sua formação permanente, para explorar o valor das narrativas que ajudam a categorizar suas experiências e a dos pacientes. -/- Las narraciones han llegado a influir en la medicina, dando lugar a un nuevo enfoque llamado " medicina narrativa ". En este trabajo consideramos al paciente como un texto, es decir, un libro abierto que el médico interviene, pero también del que el médico puede y necesita mucho aprender. Ahondar un poco en la perspectiva narrativa de la comprensión del paciente y de su situación nos ayuda a descubrir cómo el paciente es objeto de la compasión de los médicos, pero también cómo se convierte en sujeto de esa compasión. Concluimos que es importante que los médicos dediquen tiempo en su formación médica inicial, así como en su formación permanente, a explorar y explotar el valor de las narraciones, que les ayuden a categorizar sus experiencias vividas y las de los pacientes. (shrink)

Taking people’s longevity as a measure of good life, humankind can proudly say that the average person is living a much longer life than ever before. The AIDS epidemic has however for the first time in decades stalled and in some cases even reverted this trend in a number of countries. Climate change is increasingly becoming a major challenge for food security and we can anticipate that hunger caused by crop damages will become much more common. -/- Since many of (...) the challenges humanity faced in the past were overcome by inventive solutions coming from the life sciences, we are compelled to reconsider how we incentivize science and technology development so that those in need can benefit more broadly from scientific research. There is a huge portion of the world population that is in urgent need for medicines to combat diseases that are currently neglected by the scientific community and could immensely benefit from agricultural research that specifically targets their environmental conditions. At the same time efforts have to be made to make the fruits of current and future research more widely accessible. These changes would have to be backed by a range of moral arguments to attract people with diverging notions of global justice. This article explores the main ethical theories used to demand a greater share in the benefits from scientific progress for the poor. Since life sciences bring about a number of special concerns, a short list of conflictive issues is also offered. (shrink)

The reemergence of the question of suicide in the medical context of physician-assisted suicide seems to me one of the most interesting and fertile facets of late modernity. Aside from the disruption which this issue may cause in the traditional juridical relationship between individuals and the state, it may also help to transform the dominant conception of subjectivity that has been erected upon modernity's medicalized order of death. To enhance this disruptive potential, I am going to examine the perspectives on (...) death offered by two contemporary writers: Zygmunt Bauman and Jean Baudrillard. Each of these writers recognizes the centrality of death to modern culture, as Heidegger did, but they also go beyond him in specifying the ways in which death maintains a presence in late modernity, despite efforts to conceal it. In particular, both of these writers recognize the important role that medicine has played in ordering the modern conception of death. After situating these two perspectives in relation to each other, and in relation to Heidegger, who will serve here as a sort of benchmark, I will return to the issue of suicide. Given the differences in their readings of the role that death and medicine play in modern culture, these post-Heideggerians take strikingly different positions on this issue. By engaging these perspectives, I intend not only to point out the tremendous potential which this issue holds for a fundamental rethinking of modern subjectivity, but also reveal some of the dangers that may beset any naive optimism about the right to die. (shrink)

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)

According to Aristotle, the medical art aims at health, which is a virtue of the body, and does so in an unlimited way. Consequently, medicine does not determine the extent to which health should be pursued, and “mental health” falls under medicine only via pros hen predication. Because medicine is inherently oriented to its end, it produces health in accordance with its nature and disease contrary to its nature—even when disease is good for the patient. Aristotle’s politician (...) understands that this inherent orientation can be systematically distorted, and so would see the need for something like the Hippocratic Oath. (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)

In Deep Medicine, Eric Topol argues that the development of artificial intelligence (AI) for healthcare will lead to a dramatic shift in the culture and practice of medicine. Topol claims that, rather than replacing physicians, AI could function alongside of them in order to allow them to devote more of their time to face-to-face patient care. Unfortunately, these high hopes for AI-enhanced medicine fail to appreciate a number of factors that, we believe, suggest a radically different picture (...) for the future of healthcare. Far from facilitating a return to “the golden age of doctoring”, the role of economic and institutional considerations in determining how medical AI will be used mean that it is likely to further erode therapeutic relationships and threaten professional and patient satisfaction. (shrink)

The human being has selected a variety of domesticated plants that gives a benefit, and also significant in food production. The origin of these plants mostly in Central Asia such as China having great variety of crops such as oats, barley, sesame, pumpkin, sorghum, asparagus, pear, apple and citrus etc. While centers of origin such as Mexico and Central America have great diversity in corn, beans, squash, maguey, nopal, sunflower, avocado, cocoa etc. In many countries poor nutrition is a current (...) trend, due to lifestyle and impure food. This is a time to invest in preparation the triggered consumption of highly processed products, rich in calories, saturated fat, sugar and salt, but poor in protein content, fiber and micronutrients. It is necessary to return a more diversified diet. It is well known that ancient cultures included cultivated and wild plants in their diet, from which they consumed their stems, leaves, roots, flowers and fruits, whose nutritional and medicinal benefits were known through experience and also transmitted from generation to generation. (shrink)

The first part of a symposium devoted to Alex Broadbent's essay titled ‘Prediction, Understanding and Medicine’, this article notes the under-development of a variety of issues in the philosophy of medicine that transcend bioethics and the long-standing debates about the nature of health/illness and of evidence-based medicine. It also indicates the importance of drawing on non-Western, and particularly African, traditions in addressing these largely metaphysical and epistemological matters.

Medicine is a space to meet the weak and the defenseless. Its environment,professional object and the agents that participate directly or indirectly in the exercise of medicine have a potential generator of culture of life opposing the prevailing culture of death in today's world. In this paper we have described how the exercise of a profession, in this case of medicine, has the potential to evangelize culture. To do this, we delved into the concept of culture, its (...) current context, the generalities of the evangelization of culture, andthen to consider different angles in which medicine demonstrates its potential to evangelize culture. This potential is highlighted to sensitize young people who want to be doctors, who by being fully integrated, scientifically sound and based on ethical, moral and evangelical principles, have a significant impact on society. On the other hand, by generating a culture of solidarity, always seeking to heal escape from pain and suffering, attending mainly to the poorest and most needy. Finally, by generating spaces and initiatives to transmit ideas,reflections, knowledge and disseminating values in the exercise of the profession. -/- La medicina es un espacio para salir al encuentro del débil y el indefenso. Su entorno, objeto profesional y los agentes que participan directa o indirectamente en el ejercicio de la medicina posee un potencial generador de cultura de vida oponiéndose a la cultura de muerte imperante en el mundo de hoy. En este trabajo hemos descrito de qué manera el ejercicio de una profesión, en este caso de la medicina, tiene potencial para evangelizar la cultura. Para ello, se ahondó en el concepto de cultura, su contexto actual, las generalidades de la evangelización de la cultura, para luego al considerar diferentes ángulos en los que la medicina evidencia su potencial para evangelizar la cultura. Se destaca dicho potencial para sensibilizar a los jóvenes que quieren ser médicos, quienes, al formarse integralmente, científicamente sólidos y fundamentados en principios éticos, morales yevangélicos, ejercen un impacto significativo en la sociedad. Por otro lado, al generar una cultura de solidaridad, buscando salir siempre al encuentro del dolor y el sufrimiento,atendiendo principalmente a los más pobres y necesitados. Finalmente, al generar espacios e iniciativas para trasmitir ideas, reflexiones, conocimientos y difundiendo valores en el ejercicio de la profesión. (shrink)

In its recent statement 'Sex Selection and Preimplantation Genetic Diagnosis', the Ethics Committee of the American Society of Reproductive Medicine concluded that preimplantation genetic diagnosis for sex selection for non-medical reasons should be discouraged because it poses a risk of unwarranted gender bias, social harm, and results in the diversion of medical resources from genuine medical need. We critically examine the arguments presented against sex selection using preimplantation genetic diagnosis. We argue that sex selection should be available, at least (...) within privately funded health care. (shrink)

What does Artificial Intelligence (AI) have to contribute to health care? And what should we be looking out for if we are worried about its risks? In this paper we offer a survey, and initial evaluation, of hopes and fears about the applications of artificial intelligence in medicine. AI clearly has enormous potential as a research tool, in genomics and public health especially, as well as a diagnostic aid. It’s also highly likely to impact on the organisational and business (...) practices of healthcare systems in ways that are perhaps under-appreciated. Enthusiasts for AI have held out the prospect that it will free physicians up to spend more time attending to what really matters to them and their patients. We will argue that this claim depends upon implausible assumptions about the institutional and economic imperatives operating in contemporary healthcare settings. We will also highlight important concerns about privacy, surveillance, and bias in big data, as well as the risks of over trust in machines, the challenges of transparency, the deskilling of healthcare practitioners, the way AI reframes healthcare, and the implications of AI for the distribution of power in healthcare institutions. We will suggest that two questions, in particular, are deserving of further attention from philosophers and bioethicists. What does care look like when one is dealing with data as much as people? And, what weight should we give to the advice of machines in our own deliberations about medical decisions? (shrink)

A precise overview of pediatric emergencies would require taxological considerations around the differences between strictly neurological factors, as modulated both via neuroanatomical differentiation in the context of normal vs. abnormal biological development, and underlying neurofunctional mechanisms, and the connection with such processes with the neuromodulated activation of digestive processes. Furthermore, an important distinction between nephrological considerations and urological considerations is necessary, more specifically, by focusing on the treatment of diseases affecting the kidneys and their ability to function in the first (...) case, and on the treatment of diseases affecting the urinary tract in the latter. In this paper, we will present a general overview of the most important aspects of each category, starting with the brief description of neurological emergencies as indicating a general (system-based vs. localized) deterioration of mental capacity, with added possible partial or full loss of cognitive capacities and/or impaired perceptual modalities and consciousness, with or without response to stimuli. (shrink)

This paper explores how transformative experience generates decision-making problems of particular seriousness in medical settings. Potentially transformative experiences are especially likely to be encountered in medicine, and the associated decisions are confronted jointly by patients and clinicians in the context of an imbalance of power and expertise. However in such scenarios the principle of informed consent, which plays a central role in guiding clinicians, is unequal to the task. We detail how the principle’s assumptions about autonomy, rationality and information (...) handle transformative experiences poorly, appealing to several difficult cases for medical decision-making to illustrate the resulting problem, and we consider how the existing literature on complications with consent fails to offer a resolution. We argue that recognition of the problem has a role to play in achieving a more effective response to transformative decisions. In Sect. 1 we introduce several representative cases of challenging patient decision-making that clinicians might face. In Sect. 2 we detail how transformative experience has been analysed in the recent literature, before outlining in Sect. 3 the theoretical basis of the principle of informed consent, which plays a central role in how clinicians are expected to support decision-making. In Sect. 4, having laid the groundwork for a clear description, we return to the cases given in Sect. 1 to confirm how their transformative nature presents a problem: either clinicians treat the decisions faced by these patients as ‘normal’, encouraging them to focus on information provision that patients may be unable to act on, or they treat them as transformative, in which case they lack the resources to recognise whether they are helping patients make (subjectively) good decisions. In Sect. 5 we argue that the existing literature does not offer any escape from this problem. We close in Sect. 6 by noting the significant impact that appreciating the problem of transformative experience could have on supporting transformative decisions in medicine and briefly suggesting how we might aim to develop new approaches to dealing with these. (shrink)

The evidence-based medicine (EBM) movement is touted as a new paradigm in medical education and practice, a description that carries with it an enthusiasm for science that has not been seen since logical positivism flourished (circa 1920–1950). At the same time, the term ‘‘evidence-based medicine’’ has a ring of obviousness to it, as few physicians, one suspects, would claim that they do not attempt to base their clinical decision-making on available evidence. However, the apparent obviousness of EBM can (...) and should be challenged on the grounds of how ‘evidence’ has been problematised in the philosophy of science. EBM enthusiasm, it follows, ought to be tempered. The post-positivist, feminist, and phenomenological philosophies of science that are examined in this paper contest the seemingly unproblematic nature of evidence that underlies EBM by emphasizing different features of the social nature of science. The appeal to the authority of evidence that characterizes evidence-based practices does not increase objectivity but rather obscures the subjective elements that inescapably enter all forms of human inquiry. The seeming common sense of EBM only occurs because of its assumed removal from the social context of medical practice. In the current age where the institutional power of medicine is suspect, a model that represents biomedicine as politically disinterested or merely scientific should give pause. (shrink)

There is disagreement among physicians and medical ethicists on the precise goals of Hospice and Palliative Medicine (HPM). Some think that HPM's goals should differ from those of other branches of medicine and aim primarily at lessening pain, discomfort, and confusion; while others think that HPM's practices should, like all other branches of medicine, aim at promoting health. I take the latter position: using the ars moriendi to set a standard for what it means to die well, (...) I argue that if HPM's practices were to aim at mitigating suffering with little regard to promoting health, some patients would die worse deaths than if HPM's practices were to aim at health. According to the ars moriendi, flourishing at the end of one's life requires that one exercise her agency and pursue the goods most important to her. On this view, HPM's practices should promote patients’ health to enable them to pursue these goods. (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)

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)