The notion that the family is the unit of care for family doctors has been enigmatic and controversial. Yet systems theory and the biopsychosocial model that results when it is imported into medicine make the family system an indispensable and important component of family medicine. The challenge, therefore, is to provide a coherent, plausible account of the role of the family in family practice. Through an extended case presentation and commentary, we elaborate (...) two views of the family in family medicine — treating the patient in the family and treating the family in the patient — and defend both as appropriate foci for care by family doctors. The practical problem that arises when the family is introduced into health care is deciding when to concentrate on the family system. The moral problems that arise concern how extensively doctors may become involved in the personal lives of their patients and families. The patient-centered clinical method provides a strategy for handling both problems. Thus, making the family a focus of care in family medicine can be justified on theoretical, practical, and moral grounds. (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)

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)

Tristram Engelhardt, Jr. offers erudite and compelling arguments for the view that all families should try to realize the traditional family. Although I tend to agree with him from my personal standpoint, I doubt that this view can be justified to those with whom we are in reasonable disagreement about the family. I make three critical points. First, though Engelhardt stops short of saying that the state should encourage people to form traditonal families, or discourage those who do (...) not, some state perfectionists might do so. From the perspective of public reason, it is unjust for the state to favor some conceptions of the good over others, if these conceptions are all reasonable. Moreover, those whose conceptions of the good are not favored would feel that they are disrespected. Second, insofar as Engelhardt thinks that all families should try to realize the traditional families, the traditional family would not be a good to those who do not like children. Moreover, it would be difficult to persuade those who have decided not to have children for reasons of career, burden, or more altruistic concern. Third, against Engelhardt’s stance against the “egalitarian aspirations” of liberalism, I argue that too often women sacrifice their possible careers for the sake of the family, even should they hold advanced degrees from prestigious universities, or professional qualifications. This kind of injustice is too uncomfortable to ignore. (shrink)

Due to the outbreak of COVID-19 many families experience the threat of the COVID-19. This study aims to explore the lived experiences, challenges, and coping mechanisms of COVID-19 Family Survivors. The study employed the Interpretative Phenomenological Analysis with ten (10) participants. Based on the findings, the following conclusions were drawn: (1) Most of the participants consulted health professionals for their medications and advised herbal medicines in boosting their immune system. (2) Family survivors had to make adaptations to their (...) daily routines and established stringent health standards in their homes, such as separating the parents' and children's rooms, using disposable utensils, and ensuring that every surface of their homes was clean. (3) They were able to meet their necessities due to the generosity of their neighbors. These people were helped financially by their employers, neighbors, churchmates, and loved ones. Similarly, the government offered a different forum for the COVID-19 Family survivors to receive help and assistance. (4) Despite the hardships they faced, COVID-19 family survivors did not lose hope that they would be cured of COVID-19. These people tried their hardest to maintain their health by eating good meals, sleeping early, obtaining enough sunlight in the morning, and carefully selecting the vitamins they took. (5) Finally, despite the difficult battle against COVID19, these individuals grew resilient by building their spiritual lives, exercising their faith, and being brave for the sake of their loved ones. (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)

Several influential organisations have attempted to quantify the costs and benefits of expanding access to interventions-like contraceptives-that are expected to decrease the number of pregnancies. Such health economic evaluations can be invaluable to those making decisions about how to allocate scarce resources for health. Yet how the benefits should be measured depends on controversial value judgments. One such value judgment is found in recent analyses from the Disease Control Priority Network (DCPN) and the Study Group for the Global Investment Framework (...) for Women's and Children's Health. Noting the decrease in the number of pregnancies expected to result from providing access to family planning, DCPN and the Study Group claim that a substantial benefit of such interventions is averting the stillbirths and child deaths that would have resulted from those pregnancies. We argue that health economic analyses should not count such averted deaths as benefits in the same way as saved lives. First, by counting averted stillbirths and child deaths as a benefit but not counting as a cost the lives of babies who survive, DCPN and the Study Group implicitly commit themselves to antinatalism. Second, this method for calculating the benefits of family planning interventions implies that infertility treatments are harmful. Determining how potential people should be treated in health economic analyses will require grappling with population ethics. (shrink)

Trust is a core feature of the physician-patient relationship, and risk is central to trust. Patients take risks when they trust their providers to care for them effectively and appropriately. Not all patients take these risks: some medical relationships are marked by mistrust and suspicion. Empirical evidence suggests that some patients and families of color in the United States may be more likely to mistrust their providers and to be suspicious of specific medical practices and institutions. Given both historical and (...) ongoing oppression and injustice in American medical institutions, such mistrust can be apt. Yet it can also frustrate patient care, leading to family and provider distress. In this paper, I propose one way that providers might work to reestablish trust by taking risks in signaling their own trustworthiness. This interpersonal step is not meant to replace efforts to remedy systemic injustice, but is an immediate measure for addressing mistrust in occurrent cases. (shrink)

A brain death case is presented and reinterpreted using the narrative approach. In the case, two Japanese parents face a dilemma about whether to respect their daughter’s desire to donate organs even though, for them, it would mean literally killing their daughter. We argue that the ethical dilemma occurred because the parents were confronted with two conflicting narratives to which they felt a “narrative responsibility,” namely, the responsibility that drives us to tell, retell, and coauthor the (often unfinished) narratives of (...) loved ones. We suggest that moral dilemmas arise not only from conflicts between moral justifications but also from conflicts between narratives and human relationships. (shrink)

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

Objective: Primary care, which is often the first level of contact for patients with various communicable diseases (CDs) and noncommunicable diseases (NCDs), might exhibit patterns of injectable drug utilization different from hospitals. We aimed to examine injection prescribing to adults with CD or NCD in primary care. -/- Methods: In this retrospective study, single-diagnosis injectable drug-containing prescription data from Family Medicine Information System comprising 32 provinces of Turkey were analysed. The prescriptions were grouped by diagnosis as “CD” (n=3848) (...) and “NCD” (n=9338). Injectable drug utilization patterns in these groups were analysed by demographics, diagnoses, and drug subgroups. -/- Results: Out of 13186 prescriptions, 70.8% were issued for NCDs. NCD prescriptions were mostly generated for women and elderly (p<0.05 for both). About 63.3% (n=2948) of injectable drugs in CD prescriptions were antibiotics and 12.6% were analgesics. Cefazolin (15.2%) was the most commonly prescribed antibiotic for acute pharyngitis and acute sinusitis, and benzathine benzylpenicillin (12.8%) was the top-choice for acute tonsillitis and rheumatic fever. In NCD prescriptions, 34.0% (n=4214) of injectable agents were analgesics and 16.9% were muscle relaxants. The most frequently encountered drug in NCD prescriptions was thiocolchicoside (16.3%), which was the top-choice in all seven common musculoskeletal diagnoses. -/- Conclusion: Muscle relaxants and analgesics were the most commonly prescribed injectable drugs for NCDs, musculoskeletal diseases in particular. Antibiotics were frequently encountered in CD prescriptions, mostly as broad-spectrum for lower respiratory tract infections (RTIs) and narrow-spectrum for upper RTIs. These findings may elucidate the issues to especially focus on regarding excessive use of injections. (shrink)

Today, there is a family of celebrated police strategies that teach the importance of cracking down on petty crime and urban nuisance as the key to effective crime control. Under the “broken windows” appellation, this strategy is linked in the public mind with New York City and the alleged successes of its police department in reducing the rate of crime over the past two decades. This paper is critical of such order maintenance approaches to policing: I argue that infringements (...) of civil liberty by such departments could be reduced if the departments looked at law more as a good to be served for its own sake and less as an instrument for the promotion of order. In other words, a shot of legalism is the correct medicine to reduce police misconduct that pierces the law’s protections of citizen freedom. -/- This Article contributes to the critical literature on broken windows policing by reassessing the work of the famous Harvard scholar (James Q. Wilson) who fathered it. The Article takes Wilson’s work and turns it on its head, drawing very different prescriptive conclusions than he did himself. (shrink)

Despite its prevalence today, the practice of purely performative resuscitation (PPR)—paradigmatically, the ‘slow code’—has attracted more critics in bioethics than defenders. The most common criticism of the slow code is that it’s fundamentally deceptive or harmful, while the most common justification offered is that it may benefit the patient’s loved ones, by symbolically honoring the patient or the care team’s relationship with the family. I argue that critics and defenders of the slow code each have a point. Advocates of (...) the slow code are right that not all PPR is wrongly deceptive or harmful to the patient or his family, and that the symbolic aspect of medicine is itself morally significant. But the critics are also correct: slow codes are prima facie wrong. I argue that pursuing a slow code amounts to treating the patient as a tool for others’ benefit—hence, treating him as an object—and that this instrumentalizing quality constitutes one core prima facie wrong of the practice. I also build a case for the idea that the slow code may not always be all-things-considered wrong, specifying certain limited conditions under which acts of PPR might ultimately be permissible. Thus, the symbolic dimension of medical treatment is indeed morally important, both in morally favorable and in morally problematic respects—namely, in its symbolic denial of the patient’s humanity. (shrink)

One of the most unpredictable things the pandemic brought to our societies was the closure of hospitals and other health services to visitors. Preventing the spread of infection was the main reason for these decisions in the early days of the pandemic when there was no clarity about the means of transmission and the origin of the virus. However, in view of the persistence of the restrictions to date and the numerous negative consequences they have had on the professional and (...) personal quality of life of doctors, nurses, patients and carers, the aim of this article is to analyse in depth the reasons why these decisions have been and, above all, are still being applied, also considering the hypothesis that the choices made so far in the training of health professionals should be questioned. The persistence of restrictions, the constant reduction of human and economic resources in the face of an increase in the demand for care have exacerbated the distance between health professionals and users, to the point of escalating into actual acts of violence and aggression. According to the Critical Pedagogy approach, educators can play a central role in activating formative and collaborative strategies, such as maieutic groups, to rebuild an alliance between those who today find themselves on opposite sides: health professionals on the one hand, and patients and families on the other. (shrink)

In this article, I explore the ethical dimensions of same-sex reproduction achieved through epigenome editing—an innovative and transformative technique. For the first time, I analyse the potential normativity of this disruptive approach for reproductive purposes, focusing on its implications for lesbian couples seeking genetically related offspring. Epigenome editing offers a compelling solution to the complex ethical challenges posed by traditional gene editing, as it sidesteps genome modifications and potential long-term genetic consequences. The focus of this article is to systematically analyse (...) the bioethical issues related to the use of epigenome editing for same-sex reproduction. I critically assess the ethical acceptability of epigenome editing with reproductive purposes from multiple angles, considering harm perspectives, the comparison of ethical issues related to gene and epigenome editing, and feminist theories. This analysis reveals that epigenome editing emerges as an ethically acceptable means for lesbian couples to have genetically related children. Moreover, the experiments of a reproductive use of epigenome editing discussed in this article transcend bioethics, shedding light on the broader societal implications of same-sex reproduction. It challenges established notions of biological reproduction and prompts a reevaluation of how we define the human embryo, while poses some issues in the context of gender self-identification and family structures. In a world that increasingly values inclusivity and diversity, this article aims to reveal a progressive pathway for reproductive medicine and bioethics, as well as underscores the need for further philosophical research in this emerging and fertile domain. (shrink)

Measurement of ability or inability to perform activities of daily living is important to in describing the functional status of a person and then implementing an intervention. Evaluations of ADLs are mainly used in nursing and in rehabilitation of people with disabilities and the elderly. Measuring ability to perform ADLs is crucial for the management of healthcare in aging societies. It is important to understand differences between categories of ADLs and challenges in their evaluation that are connected to the roles (...) of family members. (shrink)

This paper reconstructs the ways in which metaphors are used in the text of “The Wealth of Nations”. Its claims are: a) metaphor statements are basically similar to those in the “Theory of the Moral Sentiments”; b) the metaphors’ ‘primary subjects’ refer to mechanics, hydraulics, blood circulation, agriculture, medicine; c) metaphors may be lumped together into a couple of families, the family of mechanical analogies, and that of iatro-political analogies. Further claims are: a basic physico-moral analogy is the (...) framework for Smith’s psychological theory as well as for his overall social theory and for his theory of market mechanisms; a iatro-mechanical analogy is as pervasive as the physico-moral analogy and provides the framework for his overall evolutionary theory of society; the invisible-hand simile relies on the physico-moral analogy, and elaborates on the role of vis attractiva and vis a tergo in mechanics. (shrink)

Abstract: Retama raetam (RR) is a traditional medicinal plant belongs to fabaceae family which grows in North Africa and East Mediterranean region. Locally, RR is used in several diseases including diabetes mellitus and hypertension. Thus, this study aims to investigate certain behavioral and central effects of methanolic extract of RR seeds in experimental animals (male Albino adult mice of 20 – 35 gm). Three exploratory behavioral models are used in this study, open field, elevated plus maze and light-dark box (...) models, in addition, picrotoxin induced seizure model in mice. In elevated plus-maze test of anxiety, a dose of 25 mg/kg of RR induced a significant increase in number of open arms entries and time spent on open arms of the maze compared to the control. In light-dark model, time spent on light area and number of light-dark transitions are significantly increased after treatment with 25 mg/kg RR extract of seeds. Open field model also revealed a significant increase in general motor activity of the mouse after 25 mg/kg of RR. On the other hand, a dose of 50 mg/kg of RR significantly induced a profound central and peripheral analgesic responses. In summary, this study concludes that RR seeds have a profound anxiolytic-like effect and analgesic response with delay in latency time of seizure induced by picrotoxin in mice. (shrink)

There has been considerable debate over regulated organ markets. Especially current markets, where people sell one of their kidneys while still alive, have received increased attention. Futures markets remain an interesting and under-discussed alternative specification of a market-based solution to the organ shortage. Futures markets pertain to the sale of the right to procure people’s organs after they die. There is a wide range of possible specifications of the futures market. There are, however, some major unaddressed efficiency concerns. This article (...) presents this class of concerns and discusses the implication for organ futures markets. It identifies a number of inefficiency sources pertaining to crowding out, bad organs, costs and missed opportunities, family refusals, moral hazard and strength of the provided incentive. However, a complete assessment of futures market requires better knowledge regarding the potential reaction from donors, families and health professionals. (shrink)

This brief paper summarizes a series of postal investigations on the acceptance of selection for X or Y spermatozoa. These were conducted mainly in Germany but also in the UK, the Netherlands and the US. Selected families were approached with a series of questions about their wish to use sperm selection, and their choice of boys or girls. In general, large majorities opposed this approach for family balancing or sex selection on the basis of cost and inconvenience of the (...) treatment. The view was expressed that its use in medicine was more acceptable. Care was taken to compose a series of open questions to particular sections of the population, e.g.men versus women, differing ages, and families with imbalanced sex ratios. More favourable responses arose, for example in pregnant women. Overall, all four nations had large majorities against the use of sex selection. (shrink)

Activities of daily living are usually defined as skills needed in typical daily self-care. Instrumental activities of daily living are more complex skills beyond basic self-care, and their measurement evaluates how individuals function in their homes, workplaces, and outdoor environments. The skills that pertain to IADLs are exposed to dysfunctions resulting from aging or illness. Reductions in those skills may begin to cause problems with independence but these problems can be solved with the help of others - for example, (...) class='Hi'>family members, social workers, and nurses. (shrink)

Some patients, following brain injury, do not outwardly respond to spoken commands, yet show patterns of brain activity that indicate responsiveness. This is “cognitive-motor dissociation” (CMD). Recent research has used machine learning to diagnose CMD from electroencephalogram (EEG) recordings. These techniques have high false discovery rates, raising a serious problem of inductive risk. It is no solution to communicate the false discovery rates directly to the patient’s family, because this information may confuse, alarm and mislead. Instead, we need a (...) procedure for generating case-specific probabilistic assessments that can be communicated clearly. This article constructs a possible procedure with three key elements: (1) a shift from categorical “responding or not” assessments to degrees of evidence; (2) the use of patient-centred priors to convert degrees of evidence to probabilistic assessments; and (3) the use of standardized probability yardsticks to convey those assessments as clearly as possible. (shrink)

About death, grief, mourning, life after death and immortality. Why should we die like humans to survive as a species. -/- "No one wants to die. Even people who want to go to heaven don't want to die to get there. And yet death is the destination we all share. No one has ever escaped it. And that is as it should be, because Death is very likely the single best invention of Life. It is Life's change agent. It clears (...) out the old to make way for the new." (Steve Jobs) -/- CONTENTS: -/- Death - Philosophy of death - Religions - - Animism - - Atheism - - Buddhism - - Christianity - - Hinduism - - Islam - - Jainism - - Jehovah's Witnesses - - Judaism - - Latter-day Saints - - Spiritism - Symbolism - Personification of Death - - Notable personifications - - In mythologies - - - Hindu mythology - - - In Japan - - - Slavic paganism - - - Lithuanian paganism - - In the three monotheistic religions - - - Judaism - - - Christianity - - - In Mexico - - - Islam - Axiochos - - The characters of dialogue - - Dialogue - - Prologue - - Arguments - - Citations - Paradise - - Greco-Roman mythology - - Mesopotamian mythology and influences - - According to Judaism - - According to Christianity - - - According to Catholicism - - - According to Protestantism - - - According to the Church of Jesus Christ of Latter-day Saints - - According to Islam - - According to Hinduism - - According to modern spiritualities - - - According to the esoteric - Hell - - Mesopotamian origins - - According to Christianity - - - Names appearing in the biblical texts - - - Medieval artistic representations - - - Concepts according to Christian movements - - According to Judaism - - According to Islam - - According to Buddhism - - According to Hinduism - - According to modern esotericism - - - According to Aïvanhov - - - According to Allan Kardec - - Philosophy - - - Jewish Kabbalah - - - Sartre - - - Popular wisdom Funerals - The funeral ritual: a rite of passage - Prehistory - Ancient death customs - - The family bereavement - - Mummification - - Sarcophagi - - Funerals - - Ancient Greece - - Ancient Rome - - Celts, Germans and Scandinavians - Religious funeral rites - - Buddhism - - Judaism - Christianity - - Protestantism - - Islam - Funeral rites by continent - - In Africa - - In Europe - The contemporary era - Mourning (Grief) - - Steps - - - Death of a close - - Loss events without mourning value (white factors) - - Duration and manifestations - - Risks - - Colors - Graveyards (Cemeteries) - - First cemeteries - - Cemeteries today - Funerary art - Dolmens - - Types of dolmens - - Function - - Location - Passage graves - Cenotaphs - - Famous cenotaphs - Lanterns of the Dead Afterlife - History - Questions about death and immortality - Testimonials - - Spiritualistic experiences - - Popular literature on the afterlife - - "Memories" and reminiscences - - Early studies of the science of the 19th century and early 20th century - Types of scenarios - Some religious and philosophical concepts - - Afterlife in Buddhism - - Afterlife in Christianity - - According to Hinduism - - According to Islam - - According to Judaism - - According to Mormonism - - According to the ancient philosophies - - According to Spiritism - - According to Native American traditions - - According to Vedism - - According to Esotericism - In science - Near-death experiences - - Clinical death - - NDE frequency - - Effects of depth of NDE on survival - - Near-death experiences and shared-death experience - - - The first contemporary testimonials - - - Experience according to Moody - - - The concept of "shared death" - - - The NDE scales - - The study of Pim van Lommel - - Spiritual and patient point of view - - - Survivalists studies - - - The religious understanding of the phenomenon - - Scientific views - - - Physiological explanation - - - Psychological explanation - Reincarnation - - Religions - - - In Hinduism - - - In Jainism - - - In Buddhism - - - In Judaism - - - In Christianity - - - In Islam - - In contemporary times - - - Esotericism - - - Works of the psychiatrist Ian Stevenson - - - Radical increase in life expectancy and artificial reincarnation - - Criticism - - - Arthur Schopenhauer - - - Ramana Maharshi - - - Rene Guenon - - - Ananda Kentish Coomaraswamy - Metempsychosis - - Theories - - Ideas - Maschalismos Immortality - Immortality of the soul and religious traditions - - Buddhism - - Christianity - - Islam - - Mormonism - Contemporary perception of the immortality of the body - - Observation in the animal kingdom - - Perspectives for mankind - Immortality in science - - Alexis Carrel - - Jean Rostand - - Hayflick limit - - Étienne-Émile Baulieu and DHEA - - Aubrey de Grey - - Professor Skulachev - - Regenerative medicine - - Professor Christopher Jaeger - Eternal Return - - According to the Mesopotamians - - According to Heraclitus and the Stoics - Fountain of Youth - - History of myth and relatives myths - - - In Roman mythology, Germanic, Celtic and Irish - - - In the Middle-East - - - In Spain - - - In the Bible - - The fountain in art and literature - - Painting - - - Literature and cinema - - Persistent of the myth until today - Senescence - - Why do we age? - - Gene regulation - - Cellular senescence Undead - Ghoul - Lich - Mummy - Skeleton - Vampire - Zombie - Other legendary creatures - Creatures specific to a particular universe - Spiritism - - Point out - - Origins of spiritism - - - The traditions through the ages - - - Advent of Christianity in Europe - - - The survival of necromancy - - - The precursors - - - Relations of spiritualism to science - Mediumship - - History - - Skeptical point of view - - Favorable doctor's viewpoint - Ghosts - - Appearance - - Belief in ghosts - - Origin - - - Duality and return dead - - - Ancient roots - - Typology - - - Poltergeists - - - Revenants - - - Ghosts - - - Banshees - - - Apparitions of crisis - - - Phantasms of the living - - - Vision of his own double - - - Ghost armies - - - Ghosts of animals - - - Means of transport - - Science perspective - - - Hallucinations - - - Sleep paralysis - - - Induced ghosts - - - Aches and infrasounds - - - Magnetic fields - Vampires - - Characteristics - - - Vampire transformation - - - Identification - - - Faculties - - Protection against the vampires - - - Precautions at death and burial - - - Apotropaic objects and places - - Destruction of vampires - Zombie - - The concept - - Africa and voodoo - - - West Africa - - - South Africa - - - In Haiti (and the Caribbean) - - - Scientific research - - The "revenants" in the Western imaginary Death in art - Memento mori - - History - - - Antiquity - - - Christianity - - - Mexican syncretism - - Performing arts - - - In painting - - - In literature - - - In movies - - - In video games - - - In Japanese animation - - - In music - The iconography of Weighing of souls (Particular judgment) - - Origin - - Written sources - - Weighing in Romanesque art - - Weighing in Gothic art - - Weighing in the late Middle Ages: to a new iconography - - Weighing of souls or actions? - Poems - - Charlotte Brontë, “On the Death of Anne Brontë” - - Edgar Allan Poe, “Annabel Lee” - - Edna St. Vincent Millay, “And you as well must die” - - Emily Dickinson, “Because I could not stop for Death” - - Emily Dickinson, “If I Should Die” - - Lord Byron, “Epitaph to a Dog” - - Pablo Neruda, “Only Death” - - Stephen Crane, “God Lay Dead in Heaven” - - W. B. Yeats, “He Wishes His Beloved Were Dead” - - Rainer Maria Rilke, “Death” - Paintings - - The Three Dead Kings - - The Death of Nelson - - Beata Beatrix - Sculptures - - The Kiss of Death - - Background - - Imagery - - Angel of Grief - - Fallen Astronaut - Quotes References About the author - Nicolae Sfetcu - - By the same author - - Contact Publishing House - MultiMedia Publishing -/- DOI: 10.58679/TW44411. (shrink)

The Mamasapano Incident of January 25, 2015, marked a tragic episode in Philippine history, stemming from an operation aimed at neutralizing the suspected international terrorist, Zulkifli bin Hir, also known as Marwan. This operation, conducted by the Philippine National Police – Special Armed Forces (PNP-SAF), led to clashes resulting in casualties from both the SAF and MILF/BIFF members, as well as civilians, and the displacement of local residents. While the incident garnered national attention and spurred investigations primarily focused on the (...) casualties and political ramifications, the plight of the displaced civilians received inadequate scrutiny. Motivated by the impact on families associated with MSU – Maguindanao, situated near the conflict zone, this research delves into the conditions faced by Internally Displaced Persons (IDPs) in the aftermath of the Mamasapano Incident. By exploring the experiences of these respondents, the study contributes to the broader understanding of IDPs and the detrimental effects of armed conflict on society. Moreover, it aims to identify opportunities for mitigating such conflicts. The research objectives encompass examining the evacuation experiences, soliciting suggestions for supporting affected communities during times of conflict, and understanding the challenges faced by IDPs and coping mechanisms. Through an exploratory approach, the study investigates firsthand accounts of evacuation and post-return experiences in Mamasapano, Mindanao, Philippines. Findings reveal that during evacuation, respondents received basic assistance such as food, water, medicine, and clothing from various agencies, yet essential facilities like proper sanitation were lacking. Challenges encountered include food scarcity, inadequate water supply, overcrowding, and health issues. Upon return, observations of increased security presence and dwindling assistance highlighted the enduring impact of the incident on social, economic, educational, and health aspects of the community. In summary, this research sheds light on the overlooked plight of IDPs affected by the Mamasapano Incident, emphasizing the urgent need for comprehensive support and interventions to address their multifaceted challenges and facilitate sustainable recovery. (shrink)

The public health crisis is started with emergence of new coronavirus on 11 February 2020 which triggered as coronavirus disease-2019 (COVID-19) pandemics. The causative agent in COVID-19 is made up of positively wrapped single-stranded RNA viruses ~ 30 kb in size. The epidemiology, clinical features, pathophysiology, and mode of transmission have been documented well in many studies, with additional clinical trials are running for several antiviral agents. The spreading potential of COVID-19 is faster than its two previous families, the severe (...) acute respiratory syndrome coronavirus (SARS-CoV) and the Middle East respiratory syndrome coronavirus (MERS-CoV). Apart from clinical manifestation, comorbid status is playing key role for prevalence of COVID-19 infection and mortalities. The comorbid effects associated with COVID-19 are diabetes, cardiovascular, digestive, hepatitis-B, cerebrovascular, hypertension, liver injury, coronary heart disease, cancer, rheumatoid arthritis, and neurological impairment. Antimalarial drugs (chloroquine and hydroxychloroquine), remdesivir, Tocilizumab, clopinavir/ritonavir, convalescent plasma therapy, spike protein-angiotensin-converting enzyme 2 (ACE2) inhibitors, human monoclonal antibodies, mRNA-1273, mesenchymal stem cells, Indian and Chinese traditional medicine, small molecules antioxidant, natural products and dietary supplements, high doses of vitamin-E, -C, -D, minerals, flavonoids,and IFN-beta are therapeutic intervention running to develop treatment against COVID-19. Although clinical usage of these therapeutic agents against COVID-19 is well documented, cytokine storms, absence of appropriate animal model have limited its therapeutic use. This review explores the clinical information currently available on COVID-19 on the mechanisms of infection, prevention, management, comorbid status, and current drug treatment options. (shrink)

Cattle farming is a traditional agricultural system that contributes to the rural economic, social, and cultural values of the communities. Cattle as common with other livestock, are affected by many diseases that cause mortality and economic losses. In many rural households, the use of plants and associated knowledge are popular for managing cattle diseases, especially in areas experiencing challenges with conventional veterinary medicine. Evidence on the documentation of indigenous knowledge and biological evaluation of plants used against cattle diseases remain (...) understudied and fragmented. The aim of the review is to collate and analyze the ethnoveterinary knowledge and biological evaluation of plants used against cattle diseases in South Africa. Different scientific databases were systematically explored to extract data from 37 eligible studies. A total of 310 medicinal plants from 81 families were used to treat 10 categories of cattle diseases across seven (7) provinces in South Africa. Leguminosae (Fabaceae), Compositae (Asteraceae), Asparagaceae, and Xanthorrhoeaceae were the most frequently used plant families. Common plant parts used were leaves and roots. Twenty-seven (27) combination remedies involving 2–6 plants were identified as treatment regimes against cattle diseases. Common preparation methods were infusion and decoction while the administration mode was predominantly unspecified (52%) while oral and topical contributed 26 and 22%, respectively. In terms of diseases, the most treated ones were general systems infection, reproduction disorders, and gastrointestinal problems. Currently, an estimated 21% of the 310 plants have been evaluated for diverse biological activities using relevant bioassays related to cattle diseases. Antibacterial activity remained the most studied biological activity. Evidence from the review revealed the significance of ethnoveterinary medicine against cattle diseases especially in rural areas of South Africa. Nevertheless, the use of plants for cattle diseases among other ethnic groups, particularly in the Northern Cape and Western Cape, remains understudied. (shrink)

Health institutions recommend that young infants be exclusively breastfed on demand, and it is widely held that parents who can breastfeed have an obligation to do so. This has been challenged in recent philosophical work, especially by Fiona Woollard. Woollard’s work critically engages with two distinct views of parental obligation that might ground such an obligation—based on maximal benefit and avoidance of significant harm—to reject an obligation to breastfeed. While agreeing with Woollard’s substantive conclusion, this paper (drawing on philosophical discussion (...) of the ‘right to rear’) argues that there are several more moderate views of parental obligation which might also be thought to ground parental obligation. We first show that an obligation to breastfeed might result not from a general obligation to maximally benefit one’s child, but from what we call ‘choice-specific’ obligations to maximise benefit within particular activities. We then develop this idea through two views of parental obligation—the Dual Interest view, and the Best Custodian view—to ground an obligation to exclusively breastfeed on demand, before showing how both these more moderate views fail. Finally, we argue that not only is there no general obligation to breastfeed children, but that it is often morally right not to do so. Since much advice from health institutions on this issue implies that exclusive breastfeeding on demand is the best option for all families, our argument drives the feeding debate forward by showing that this advice often misrepresents parents’ moral obligations in potentially harmful ways. (shrink)

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

Abstract: Lung cancer is the top reason of cancer-associated deaths globally. Surgery is the typical treatment for early-stage non-small cell lung cancer (NSCLC). Advancement in the knowledge of the biology of non-small cell lung cancer has shown molecular evidence used for systemic cancer therapy aiming metastatic disease, with a significant impact on patients’ overall survival (OS) and eminence of life. Though, a biopsy of overt metastases is an invasive technique restricted to assured positions and not effortlessly satisfactory in the clinic. (...) The examination of peripheral blood samples of cancer patients embodies a new basis of cancer-derived material, recognized as liquid biopsy, and its constituents (circulating tumour cells (CTCS), circulating free DNA (cfDNA), exosomes, and tumour-educated platelets (TEP)) may be gotten from nearly any body liquids. These constituents have shown to imitate features of the status of both the primary and metastatic diseases, aiding the clinicians to go towards a tailored medicine. In this paper, the reasons of lung cancer will be recognized and the risk elements that initiated the increase of infection, for instance Smoking, Disclosure to secondhand smoke, Disclosure to radon gas, Disclosure to asbestos and other compounds, Family past history of lung cancer, and decrease of the spread of disease and approaches of handling and prevention of lung cancer. (shrink)

Recent bioethical issues that have emerged in the field of medicine include, but are not limited to, eugenics (artificial insemination), palliative care (end of life care), euthanasia (medical resuscitation), abortion, and the development of enhanced human body parts. These bioethical issues have raised ethical questions related to the use of modern technology and how it may affect the future of society. These questions consider issues such as: what is the identity of future children? Have human beings become a commodity (...) exchanged by those who have the ability to own them? What is the meaning of justice in medical treatment? How can physicians and nurses perform humanitarian work? -/- Discussions of these questions should begin by determining their relationships with typical social and cultural values in society, such as life and death, marriage, family, fatherhood, motherhood, relatives, and next-of-kin. -/- This paper presents a review of the important Arabic literature that has been written on these bioethical issues to show the contributions of Arab scholars in this field. Arabic studies in bioethics can be classified into three types: original Arabic writings, translated studies, and congresses held in the Arab region. (shrink)

- First book to describe what pain means in vulnerable or special groups of people - Clinical applications described in each chapter - Provides insight into the nature of pain experience across the lifespan -/- This book, the third and final volume in the Meaning of Pain series, describes what pain means to people with pain in “vulnerable” groups, and how meaning changes pain – and them – over time. -/- Immediate pain warns of harm or injury to the person (...) with pain. If pain persists over time, more complex meanings can become interwoven with this primitive meaning of threat. These cognitive meanings include thoughts and anxiety about the adverse consequences of pain. Such meanings can nourish existential sufferings, which are more about the person than the pain, such as loss, loneliness, or despair. -/- Although chronic pain can affect anyone, there are some groups of people for whom particular clinical support and understanding is urgently needed. This applies to “vulnerable” or “special” groups of people, and to the question of what pain means to them. These groups include children, women, older adults, veterans, addicts, people with mental health problems, homeless people, or people in rural or indigenous communities. Several chapters in the book focus on the lived experience of pain in vulnerable adults, including black older adults in the US, rural Nigerians, US veterans, and adults with acquired brain injury. The question of what pain experience could mean in the defenceless fetus, neonate, pre-term baby, and child, is examined in depth across three contributions. -/- This book series aspires to create a vocabulary on the “meanings of pain” and a clinical framework with which to use it. It is hoped that the series stimulates self-reflection about the role of meaning in optimal pain management. -/- Meanings of Pain is intended for people with pain, family members or caregivers of people with pain, clinicians, researchers, advocates, and policy makers. Volume I was published in 2016; Volume II in 2019. (shrink)

We argue that contemporary conceptualizations of “persons” have failed to achieve the moral goals of “person-centred care” (PCC, a model of dementia care developed by Tom Kitwood) and that they are detrimental to those receiving care, their families, and practitioners of care. We draw a distinction between personhood and selfhood, pointing out that continuity or maintenance of the latter is what is really at stake in dementia care. We then demonstrate how our conceptualization, which is one that privileges the lived (...) experiences of people with dementia, and understands selfhood as formed relationally in connection with carers and the care environment, best captures Kitwood’s original idea. This conceptualization is also flexible enough to be applicable to the practice of caring for people at different stages of their dementia. Application of this conceptualization into PCC will best promote the well-being of people with dementia, while also encouraging respect and dignity in the care environment. (shrink)

This descriptive study explores the views of resident physicians working in intensive care units (ICUs) concerning deceased organ donation and examines the various ethical issues surrounding organ donation encountered by residents. This was a qualitative, descriptive study utilizing solo interviews with participants together with focus group discussions. The participants' experiences and views were elicited via interviews and focus group discussions covering the following topics: ethical thoughts about deceased organ donation, barriers that impede or prevent organ donation, its effect on the (...) next of kin, and its relationship with futile treatment. The discussions were reviewed using qualitative content analysis. The residents commented that deceased organ donation is a complex and stressful process for the family of the potential donor as well as the transplant team, and still lacks wide acceptance in Turkish society. The opt-in system requires informed consent, thus creating a major barrier for both the patient’s family and the ICU team to overcome. The participants stated that new legal, ethical, and medical arrangements are needed to increase organ donation rates in Turkey. In order to increase rates of deceased organ donation and reduce cases of futile treatment, improved communication between the ICU, transplant team, and patient relatives is critical to ensure that ethical issues are properly managed. On a societal level, the subject of deceased organ donation needs to receive greater attention from public health authorities to increase public awareness. Residents can make valuable contributions to the deceased organ donation process as physicians and as psychosocial support for patients and their families. (shrink)

This chapter argues that adequately facing and responding to medical error requires making space for blame. In vindicating blame as a response to medical error, this essay does not advocate a return to a “bad apple” blame culture in which unlucky practitioners are unfairly scapegoated. It does, however, defend the targeted feeling and expression of angry, and even resentful, blaming attitudes toward health-care providers who make at least certain kinds of mistakes. The chapter makes the case that the angry and (...) resentful feelings associated with blame reflect a conception of oneself as a person worthy of consideration, and that expressing these feelings allows victims and families to fight for their dignity and self-respect. Along the way, it distinguishes between shaming and blaming, explaining that blaming, unlike shaming, characteristically aims to draw offenders into a moral dialogue. As a result, a good blaming practice can provide a logic within which providers who make costly errors may seek forgiveness, reconciliation, and healing. (shrink)

One of the most salient contemporary concerns in academic debates and pop culture alike is the extent to which new technologies may re-cast Homo sapiens. Species members may find themselves encased in a type of existence they deem to be wanting in comparison with their present form, even if the promised form was assured to be better. Plausibly, the concern is not merely fear of change or of the unknown, but rather it arises out of individuals’ general identification with what (...) they are and what their friends and family are. In altering that identity beyond a point, they lose it and thus lose themselves in a kind of living death. The three volumes analysed in this essay offer widely differing perspectives on the relations between humans and new technology. As the three works reviewed here together make clear, a whole, fully coherent, definitive work on the composite redesign of human nature (CROHN) still has yet to materialize. (shrink)

In Paris in August 1839, the French government revealed a gift free of charge that would change the world forever. This gift was the daguerreotype process which had been invented by artist Louis Daguerre who used an iodine-sensitised silvered plate and mercury vapour to create some of the world’s earliest photographs and soon afterwards commercial photography was born. The trend of taking photographs spread quickly across the English Channel, but competition was fierce over the next several decades to develop new (...) methods of creating clearer images for less expense and with reduced exposure times. Victorian society embraced the technology of photography and much of the work conducted by family historians today revolves around identifying relatives in nineteenth and early twentieth century photographs. This article explores the history of portrait photography followed by an analysis of the ambrotype, tintype, cartes de visite and cartes postale found in the collection of the Moon/Prescott family from Lancashire which will provide a practical guide to dating and interpreting antique photographs. (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.

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)

Abstract -/- Rationale, aims and objectives: Irregularity limits human ability to know, understand and predict. A better understanding of irregularity may improve the reliability of knowledge. -/- Method: Irregularity and its consequences for knowledge are considered. -/- Results: Reliable predictive empirical knowledge of the physical world has always been obtained by observation of regularities, without needing science or theory. Prediction from observational knowledge can remain reliable despite some theories based on it proving false. A naïve theory of irregularity is outlined. (...) Reducing irregularity and/or increasing regularity can increase the reliability of knowledge. Beyond long experience and specialization, improvements include implementing supporting knowledge systems of libraries of appropriately classified prior cases and clinical histories and education about expertise, intuition and professional judgement. -/- Conclusions: A consequence of irregularity and complexity is that classical reductionist science cannot provide reliable predictions of the behaviour of complex systems found in nature, including of the human body. Expertise, expert judgement and their exercise appear overarching. Diagnosis involves predicting the past will recur in the current patient applying expertise and intuition from knowledge and experience of previous cases and probabilistic medical theory. Treatment decisions are an educated guess about the future (prognosis). Benefits of the improvements suggested here are likely in fields where paucity of feedback for practitioners limits development of reliable expert diagnostic intuition. Further analysis, definition and classification of irregularity is appropriate. Observing and recording irregularities are initial steps in developing irregularity theory to improve the reliability and extent of knowledge, albeit some forms of irregularity present inherent difficulties. (shrink)

The Confucian family, not only in its historical manifestations but also in the imagination of the Confucian founders, was the locus of misogynist norms and practices that have subjugated women in varying degrees. Therefore, advancing women’s well-being and equality in East Asia may seem to require radically transforming the Confucian family to approximate alternative ideal conceptions of the family in the West. This article opposes such a stance by arguing that (1) Western conceptions of the family (...) may be neither plausible nor feasible in traditionally Confucian societies and (2) the Confucian family, once reconstructed in line with Confucianism’s core ideas and values, can be conducive to a feminist future in East Asia that is uniquely Confucian. In order to support my position, not only influential contemporary Western ideal conceptions of the family from the justice perspective and care ethics, but also different interpretations of the Confucian family will be carefully examined. (shrink)

The family poses problems for liberal understandings of social justice, because of the ways in which it bestows unearned privileges. This is particularly stark when we consider inter-generational inequality, or ‘class fate’ – the ways in which inequality is transmitted from one generation to the next, with the family unit ostensibly a key conduit. There is a recognized tension between the assumption that families should as far as possible be autonomous spheres of decision-making, and the assumption that we (...) should as far as possible equalize the life chances of all children, regardless of background. In this article I address this tension by way of recent liberal egalitarian literature, and consideration of the different dimensions of class fate. I argue, firstly, that the tension may not be of the a priori nature which liberals have tended to identify – and secondly, that as well as distributive and recognition-based aspects, the notion of contributive justice provides a particularly illuminating way of analyzing what is wrong about class fate, and the role of the family in promoting it. (shrink)

Families play an essential role in deceased organ procurement. As the person cannot directly communicate his or her wishes regarding donation, the family is often the only source of information regarding consent or refusal. We provide a systematic description and analysis of the different roles the family can play, and actions the family can take, in the organ procurement process across different jurisdictions and consent systems. First, families can inform or update healthcare professionals about a person’s donation (...) wishes. Second, families can authorize organ procurement in the absence of deceased’s preferences and the default is not to remove organs, and oppose donation where there is no evidence of preference but the default is to presume consent; in both cases, the decision could be based on their own wishes or what they think the deceased would have wanted. Finally, families can overrule the known wishes of the deceased, which can mean preventing donation, or permitting donation when the deceased refused it. We propose a schema of 4 levels on which to map these possible family roles: no role, witness, surrogate, and full decisional authority. We conclude by mapping different jurisdictions onto this schema to provide a more comprehensive understanding of the consent system for organ donation and some important nuances about the role of families. This classificatory model aims to account for the majority of the world’s consent systems. It provides conceptual and methodological guidance that can be useful to researchers, professionals, and policymakers involved in organ procurement. (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)

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)

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)