We review the recently proposed universal concept of dynamic complexity and its new mathematics based on the unreduced interaction problem solution. We then consider its progress-bringing applications at various levels of complex world dynamics, including complex-dynamical nanometal physics and living condensed matter, unreduced nanobiosystem dynamics and the integral medicine concept, causally complete management of complex economical and social dynamics, and the ensuing concept of truly sustainable world governance.

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)

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

This study presented the policy of functional integration of the product planning team as a strategy for the development of the pharmaceutical industry in Palestine. The study population consists of all the workers in companies operating in the field of medicine in Palestine, which are (5) companies producing in the West Bank only for pharmaceuticals used by these companies, which are (296) employees, and was used a simple random sample to choose the sample and size (87) employees of the (...) study population, and to achieve the objectives of the study (87) questionnaires were distributed. The descriptive analytical method was used, and SPSS was used to answer and discuss the study's questions. The results showed that there is a significant relationship between the effectiveness of the policy of product development and the competitiveness of pharmaceutical companies in Palestine (West Bank), where the policy of product development efficiency accounts for 56.6% of the total change in the competitiveness of companies. The product quality component was most influential at all levels of product development effectiveness policy, followed by product identification, product cost reduction, packaging and product deletion. The weakest areas of strategic direction in pharmaceutical companies in Palestine (West Bank) are 67%. The weakest aspects of job integration are: non-regular meetings of representatives of different positions to participate in any project related to product development, to achieve spatial convergence of members of the product planning policy team in offices, laboratories and workplaces. (shrink)

Evidence-based medicine (EBM) calls for medical practitioners to “integrate” our best available evidence into clinical practice. A significant amount of the literature on EBM takes this integration to be unproblematic, focusing on questions like how to interpret evidence and engage with patient values, rather than critically looking at how these features of EBM can be implemented together. Other authors have also commented on this gap in the literature, for example, identifying the lack of clarity about how patient preferences and (...) evidence from trials is supposed to be integrated in practice. In this paper, I look at this issue from an epistemological perspective, (looking at how different types of knowledge in EBM can be used to make sounds judgements). In particular, I introduce an epistemological issue for this integration problem, which I call the epistemic integration problem. This is essentially the problem of how we can use information that is both general (eg, about a population sample) and descriptive (eg, about what expected outcomes are) to reach clinical judgements that are individualized (applying to a particular patient) and normative (about what is best for their health). (shrink)

This paper argues that it is morally irresponsible for modern medical providers or health care institutions to support and advocate the integration of CAM practices (i.e. homeopathy, acupuncture, energy healing, etc.) with conventional modern medicine. The results of such practices are not reliable beyond that of placebo. As a corollary, it is argued that prescribing placebos perceived to stand outside the norm of modern medicine is morally inappropriate. Even when such treatments do no direct physical harm, they create (...) unnecessary barriers to patients' informed understanding of their health. (shrink)

Since its introduction just over two decades ago, evidence-based medicine (EBM) has come to dominate medical practice, teaching, and policy. There are a growing number of textbooks, journals, and websites dedicated to EBM research, teaching, and evidence dissemination. EBM was most recently defined as a method that integrates best research evidence with clinical expertise and patient values and circumstances in the treatment of patients. There have been debates throughout the early 21st century about what counts as good research evidence (...) between EBM proponents and philosophical critics and even within the EBM community itself. Similar controversy arises about the relative worth of patient values and clinical expertise (and how these can be integrated). EBM has also evolved in ways that have come under scrutiny. Specifically, policymakers have used EBM research methodology to increase the relative importance of clinical guidelines that some clinicians have argued are tyrannical. Philosophers have addressed all of these controversies, and with very few exceptions have been critical of EBM. In addition most philosophical attention has been on the epistemic role of Randomization and evidence hierarchies, with relatively little attention being paid to the role of Diagnosis, expertise, patient values, and Systematic Reviews within EBM. (shrink)

Precision medicine and molecular systems medicine (MSM) are highly utilized and successful approaches to improve understanding, diagnosis, and treatment of many diseases from bench-to-bedside. Especially in the COVID-19 pandemic, molecular techniques and biotechnological innovation have proven to be of utmost importance for rapid developments in disease diagnostics and treatment, including DNA and RNA sequencing technology, treatment with drugs and natural products and vaccine development. The COVID-19 crisis, however, has also demonstrated the need for systemic thinking and transdisciplinarity and (...) the limits of MSM: the neglect of the bio-psycho-social systemic nature of humans and their context as the object of individual therapeutic and population-oriented interventions. COVID-19 illustrates how a medical problem requires a transdisciplinary approach in epidemiology, pathology, internal medicine, public health, environmental medicine, and socio-economic modeling. Regarding the need for conceptual integration of these different kinds of knowledge we suggest the application of general system theory (GST). This approach endorses an organism-centered view on health and disease, which according to Ludwig von Bertalanffy who was the founder of GST, we call Organismal Systems Medicine (OSM). We argue that systems science offers wider applications in the field of pathology and can contribute to an integrative systems medicine by (i) integration of evidence across functional and structural differentially scaled subsystems, (ii) conceptualization of complex multilevel systems, and (iii) suggesting mechanisms and non-linear relationships underlying the observed phenomena. We underline these points with a proposal on multi-level systems pathology including neurophysiology, endocrinology, immune system, genetics, and general metabolism. An integration of these areas is necessary to understand excess mortality rates and polypharmacological treatments. In the pandemic era this multi-level systems pathology is most important to assess potential vaccines, their effectiveness, short-, and long-time adverse effects. We further argue that these conceptual frameworks are not only valid in the COVID-19 era but also important to be integrated in a medicinal curriculum. (shrink)

Research misconduct remains an important problem in health research despite decades of local, national, regional, and international efforts to eliminate it. The ultimate goal of every health research project, irrespective of setting, is to produce trustworthy findings to address local as well as global health issues. To be able to lead or participate meaningfully in international research collaborations, individual and institutional capacities for research integrity are paramount. Accordingly, this paper concerns itself not only with individuals’ research skills but also with (...) institutional and national policies and governance. Such policies and governance provide an ethical scaffold for the production of knowledge and structure incentives. This paper’s operational definition of research therefore draws from Institute of Medicine’s articulation of health research as an inquiry that aims to produce knowledge about the structure, processes, or effects of personal health services; and from an existing health systems framework. The paper reviews the research regulatory environment and the ethics apparatus in Ghana, and describes a project jointly undertaken by Ghanaian researchers in collaboration with New York University to assess the perceived adequacy of current institutional practices, opportunities, and incentives for promoting RI. (shrink)

Research in infection biology aims to understand the complex nature of host–pathogen interactions. While this knowledge facilitates strategies for preventing and treating diseases, it can also be intentionally misused to cause harm. Such dual-use risk is potentially high for highly pathogenic microbes such as Risk Group-3 (RG3) bacteria and RG4 viruses, which could be used in bioterrorism attacks. However, other pathogens such as influenza virus (IV) and enterohemorrhagic Escherichia coli (EHEC), usually classified as RG2 pathogens, also demonstrate high dual-use risk. (...) As the currently approved therapeutics against these pathogens are not satisfactorily effective, previous outbreaks of these pathogens caused enormous public fear, media attention and economic burden. In this interdisciplinary review, we summarize the current perspectives of dual-use research on IV and EHEC, and further highlight the dual-use risk associated with evolutionary experiments with these infectious pathogens. We support the need to carry out experiments pertaining to pathogen evolution, including to gain predictive insights on their evolutionary trajectories, which cannot be otherwise achieved with stand-alone theoretical models and epidemiological data. However, we also advocate for increased awareness and assessment strategies to better quantify the risks-versus-benefits associated with such evolutionary experiments. In addition to building public trust in dual-use research, we propose that these approaches can be extended to other pathogens currently classified as low risk, but bearing high dual-use potential, given the particular pressing nature of their rapid evolutionary potential. (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)

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)

Mismatch is a prominent concept in evolutionary medicine and a number of philosophers have published analyses of this concept. The word ‘mismatch’ has been used in a diversity of ways across a range of sciences, leading these authors to regard it as a vague concept in need of philosophical clarification. Here, in contrast, we concentrate on the use of mismatch in modelling and experimentation in evolutionary medicine. This reveals a rigorous theory of mismatch within which the term ‘mismatch’ (...) is indeed used in several ways, not because it is ill-defined but because different forms of mismatch are.distinguished within the theory. Contemporary evolutionary medicine has unified the idea of ‘evolutionary mismatch’, derived from the older idea of ‘adaptive lag’ in evolution, with ideas about mismatch in development and physiology derived from the Developmental Origins of Health and Disease (DOHaD) paradigm. A number of publications in evolutionary medicine have tried to make this theoretical framework explicit. We build on these to present the theory in as simple and general a form as possible. We introduce terminology, largely drawn from the existing literature, to distinguish the different forms of mismatch. This integrative theory of mismatch captures how organisms track environments across space and time on multiple scales in order to maintain an adaptive match to the environment, and how failures of adaptive tracking lead to disease. Mismatch is a productive organising concept within this theory which helps researchers articulate how physiology, development and evolution interact with one another and with environmental change to explain health outcomes. (shrink)

Answers to the questions of what justifies conscientious objection in medicine in general and which specific objections should be respected have proven to be elusive. In this paper, I develop a new framework for conscientious objection in medicine that is based on the idea that conscience can express true moral claims. I draw on one of the historical roots, found in Adam Smith’s impartial spectator account, of the idea that an agent’s conscience can determine the correct moral norms, (...) even if the agent’s society has endorsed different norms. In particular, I argue that when a medical professional is reasoning from the standpoint of an impartial spectator, his or her claims of conscience are true, or at least approximate moral truth to the greatest degree possible for creatures like us, and should thus be respected. In addition to providing a justification for conscientious objection in medicine by appealing to the potential truth of the objection, the account advances the debate regarding the integrity and toleration justifications for conscientious objection, since the standard of the impartial spectator specifies the boundaries of legitimate appeals to moral integrity and toleration. The impartial spectator also provides a standpoint of shared deliberation and public reasons, from which a conscientious objector can make their case in terms that other people who adopt this standpoint can and should accept, thus offering a standard fitting to liberal democracies. (shrink)

Defenders of evolutionary medicine claim that medical professionals and public health officials would do well to consider the role of evolutionary biology with respect to the teaching, research, and judgments pertaining to medical theory and practice. An integral part of their argument is that the human body should be understood as a bundle of evolutionary compromises. Such an appreciation, which includes a proper understanding of biological function and physiological homeostasis, would provide a crucial perspective regarding the understanding and securing (...) of human health needs currently lacking in the medical arena. (shrink)

Conscientious objection in health care is a form of compromise whereby health care practitioners can refuse to take part in safe, legal, and beneficial medical procedures to which they have a moral opposition (for instance abortion). Arguments in defense of conscientious objection in medicine are usually based on the value of respect for the moral integrity of practitioners. I will show that philosophical arguments in defense of conscientious objection based on respect for such moral integrity are extremely weak and, (...) if taken seriously, lead to consequences that we would not (and should not) accept. I then propose that the best philosophical argument that defenders of conscientious objection in medicine can consistently deploy is one that appeals to (some form of) either moral relativism or subjectivism. I suggest that, unless either moral relativism or subjectivism is a valid theory—which is exactly what many defenders of conscientious objection (as well as many others) do not think—the role of moral integrity and conscientious objection in health care should be significantly downplayed and left out of the range of ethically relevant considerations. (shrink)

The once animated efforts in medical phenomenology to integrate the art and science of medicine (or to humanize scientific medicine) have fallen out of philosophical fashion. Yet the current competing medical discourses of evidencebased medicine and patient-centered care suggest that this theoretical endeavor requires renewed attention. In this paper, I attempt to enliven the debate by discussing theoretical weaknesses in the way the “lived body” has operated in the medical phenomenology literature—the problem of the absent body—and highlight (...) how evidence-based medicine has refigured medical phenomenology’s historical nemesis, “biomedicine.” What we now need is a phenomenology of the embodied subject in the age of evidence-based medicine. (shrink)

Body Integrity Identity Disorder (BIID) is a very rare condition describing those with an intense desire or need to move from a state of ability to relative impairment, typically through the amputation of one or more limbs. In this paper, I draw upon research in critical disability studies and philosophy of disability to critique arguments based upon the principle of nonmaleficence against such surgery. I demonstrate how the action-relative concept of harm in such arguments relies upon suspect notions of biological (...) and statistical normality, and I contend that each fail to provide normative guidance. I then propose a critical theory of harm, one marked by substantive engagement with both empirical and reflective inquiry across the sciences, social sciences, and humanities. I conclude by discussing the implications of this theory and how it might enrich ongoing debates in bioethics, philosophy of disability, and the health humanities. (shrink)

This paper considers the view that medicine is both “science” and “art.” It is argued that on this view certain clinical knowledge – of patients’ histories, values, and preferences, and how to integrate them in decision-making – cannot be scientific knowledge. However, by drawing on recent work in philosophy of science it is argued that progress in gaining such knowledge has been achieved by the accumulation of what should be understood as “scientific” knowledge. I claim there are varying degrees (...) of objectivity pertaining to various aspects of clinical medicine. Hence, what is often understood as constituting the “art” of medicine is amenable to objective methods of inquiry, and so, may be understood as “science”. As a result, I conclude that rather than endorse the popular philosophical distinction between the art and science of medicine, in the future a unified, multifaceted epistemology of medicine should be developed to replace it. (shrink)

Evidence-based medicine is a clinical decision-making framework which makes claims about what physicians ought to do. Though heralded as the cutting edge of medical science, evidence-based medicine is a value-laden normative theory which implicitly depends on substantive views regarding what is morally good or right. In this paper, I provide an ethical analysis of evidence-based medicine. I consider its normative underpinnings in three ethical theories: utilitarianism, Kantian deontology, and virtue ethics. In the face of uncertainty, evidence-based (...) class='Hi'>medicine endorses expected utility theory using the best available evidence in order to avoid doing more harm than good. In accordance with the Kantian respect for individuals as ends in themselves, evidence-based medicine calls for integrating the values and preferences of the patient. De-emphasizing intuition, clinical expertise, and pathophysiologic rationale emphasizes the need for the intellectual virtues of curiosity, critical thinking, and courage. Evidence-based medicine is a successful clinical practice that can be morally justified by all three major ethical theories. Although its focus on maximizing good health outcomes and integrating respect for individual patients has been emphasized, the role of the intellectual virtues in evidence-based medicine remains highly under-explored. (shrink)

Evidence-based medicine is a clinical decision making framework which makes claims about what physicians ought to do. Though heralded as the cutting edge of medical science evidence-based medicine is a value laden normative theory which implicitly depends on substantive views regarding what is morally good or right. In this paper, I provide an ethical analysis of evidence-based medicine. I consider its normative underpinnings in three ethical theories: utilitarianism, Kantian deontology, and virtue ethics. In the face of uncertainty, (...) evidence-based medicine endorses expected utility theory using the best available evidence in order to avoid doing more harm than good. In accordance with the Kantian respect for individuals as ends in themselves, evidence-based medicine calls for integrating the values and preferences of the patient. De-emphasizing intuition, clinical expertise, and pathophysiologic rationale emphasizes the need for the intellectual virtues of curiosity, critical thinking, and courage. Evidence-based medicine is a successful clinical practice that can be morally justified by all three major ethical theories. Although its focus on maximizing good health outcomes and integrating respect for individual patients has been emphasized, the role of the intellectual virtues in evidence- based medicine remains highly under-explored. (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)

African Traditional Religion and medicine are integral parts of life and culture of the Africans and have greatly influenced their conceptions about human health and wholeness. Their many realities that Africans have not been able to abandon, in spite of the allurements of western civilization, Christianity, Islam and the advances in the biomedical sciences. The aim of this paper is to highlight the meaning of health and wholeness as central issues of concern in African Traditional Religion and Medicine. (...) The misconception, abuse and derogatory attitudes even from some notable Africans towards alternative medicine, as well as the all need of integrating both the alternative and orthodox medicine to bring about total wholeness, serves as the research problem. This paper argued that the biopsycho-socio-ecological model of health and wholeness is fundamental to the African Traditional Religion and Medicine. This model brings together the different aspects of human life and treats the human person as an integral and harmonious whole in perpetual relationship with the sacred, the human community and the environment. This paper therefore recommends that first, Africa has to open to modern medical discoveries and practices and secondly, African Traditional Religion and Medicine concern should be mainstreamed into the medical practice in health care services in contemporary Nigeria. It finally conclude that the alternative medicine despite the arrays of it inadequacies, objections and misconceptions, the practice has come to stay. (shrink)

The Millennium Development Goals (MDG) set time-bound targets that are powerful shapers of how and for whom health is pursued. In this paper we examine some ramifications of both the temporal limitation, and maternal-child health targeting of MDG 4 and 5. The 2015 end date may encourage increasing the number of mass campaigns to meet the specific MDG objectives, potentially to the detriment of a more comprehensive approach to health. We discuss some ethical, political, and pragmatic ramifications of this tendency, (...) and show that these are not unique to the MDGs but rather have a long history in health policy debates. We also examine attempts to counter a narrow focus on vertical interventions in campaigns through integrated health system delivery platforms. We argue that the way forward is not to assume that evidence is value free, but rather to make explicit the political and ethical decisions in the design of metrics and evaluation research. We propose an index of five factors that should be included in research designed to inform decision making about providing interventions as part of routine services or periodic campaigns, toward serving more members of the population, and long-term strengthening of the health system via integrated health interventions. (shrink)

The reality is that soul and death are the integral part of human life. The soul is the essence of life as fuel is the energy that runs the automobile or the light that makes the eye see. We all see the human body when the soul leaves and the human body is left senseless and ultimately dissolves into the earth. Why we do not have knowledge about soul where this element is the integral part of our human life. Most (...) of us are not aware about this and do not like to research on it even do not discuss in life time. There is hardly any study on soul. Western bioethics totally omits discussion on the soul, though they discussed on “good death”. Only religion discussed soul elaborately specially Islam. No literature is available from Bangladesh. Therefore, the present study has been done to expand the body of knowledge on soul in the light of current theory with a view to aware people for further research for understanding and comparing with concept of philosophical, religious and medical variation. (shrink)

Seminal work intended to found a new field of integrative Noetic Science is summarized. Until now the philosophy of Biological Mechanism has ruled medicine and psychology. Penrose claims, AA scientific world-view which does not profoundly come to terms with the problem of conscious mind can have no serious pretensions of completeness@. A noetic action principle synonymous with the historic concept of élan vital is introduced as the basis of a Continuous State Conscious Universe (CSCU). The least unit of (...) CSCU superspace defines Awareness as a fundamental physical quantity like charge in electrodynamics. This cosmological context reveals the origin of complexity in self-organized living-systems wherein the physical basis of qualia is formalized. The dynamics of this teleological action principle, mediated by a unitary noetic field pervading all biochemical species, optimizes the state of well-being through homeostasis and provides the fundamental basis for developing a Moral Psychology. (shrink)

In spite of a considerable progress in comorbidity research and huge literature on it, this phenomenon is one of the greatest epistemological, research and clinical challenges to contemporary psychiatry and medicine. Mental disorders are very often comorbidly expressed, both among themselves and with various sorts of somatic diseases and illnesses. Therefore, comorbidity studies have been expected to be an impetus to research on the validity of current diagnostic systems as well as on establishing more effective and effi cient treatment (...) within the frame of person centered transdisciplinary psychiatry and integrative medicine. This review focuses fi rst on conceptual chaos and different connotations, then on transdisciplinary perspectives of comorbidity and multimorbidity. The authors compiled an extensive set of various views and perspectives, dilemmas and controversies, in order to evaluate what we know and what we don’t about comorbidity, what comorbidity is and what comorbidity is not, what are facts and what are non-facts on comorbidity and multimorbidity. (shrink)

Initially the problems of data integration, for example in the field of medicine, were resolved in case by case fashion. Pairs of databases were cross-calibrated by hand, rather as if one were translating from French into Hebrew. As the numbers and complexity of database systems increased, the idea arose of streamlining these efforts by constructing one single benchmark taxonomy, as it were a central switchboard, into which all of the various classification systems would need to be translated only once. (...) By serving as a lingua franca for database integration this benchmark taxonomy would ensure that all databases calibrated in its terms would be automatically compatible with each other. We describe one strategy for creating such a lingua franca, in which philosophical ontology plays a central role. (shrink)

Despite their shared origins, medicine and dentistry are not always two sides of the same coin. There is a long history in medical philosophy of defining disease and various medical models have come into existence. Hitherto, little philosophical and phenomenological work has been done considering dental caries and periodontitis as examples of disease and illness. A philosophical methodology is employed to explore how we might define dental caries and periodontitis using classical medical models of disease – the naturalistic and (...) normativist. We identify shared threads and highlight how the features of these highly prevalent dental diseases prevent them fitting in either definition. The article describes phenomenology and the current thought around the phenomenology of illness, exploring how and why these dental illnesses might integrate into a phenomenological model. We discover that there are some features particular to dental caries and periodontitis: ubiquity, preventability and hyper-monitorablility. Understanding the differences that these dental diseases have compared to many other classically studied diseases leads us to ethical questions concerning how we might manage those who have symptoms and seek treatment. As dental caries and periodontitis are common, preventable and hyper-monitorable, it is suggested that these features affect the phenomenology of these illnesses. For example, if we experience dental illness when we have consciously made decisions that have led to it, do we experience them differently to those rarer illnesses that we cannot expect? Other diseases share these features are discussed. This paper highlights the central differences between the classical philosophical notion of disease in medicine and the dental examples of caries and periodontitis. It suggests that a philosophical method of conceptualising medical illness - phenomenology - should not be applied to these dental illnesses without thought. A phenomenological analysis of any dental illness is yet to be done and this paper highlights why a separate strand of phenomenology should be explored, instead of employing those that are extant. The article concludes with suggestions for further research into the nascent field of the phenomenology of dental illness and aims to act as a springboard to expose the dental sphere to this philosophical method of analysis. (shrink)

Olfactory Virtual Reality (OVR) for Wellbeing and Reduction of Stress, Anxiety and Pain - Journal of Medical Research and Health Sciences.

BACKGROUND: Little is known about how hospitalized patients share decisions with physicians. METHODS: We conducted an observational study of patient-doctor communication on an inpatient medicine service among 18 hospitalized patients and 9 physicians. A research assistant (RA) approached newly hospitalized patients and their physicians before morning rounds and obtained consent. The RA audio recorded morning rounds, and then separately interviewed both patient and physician. Coding was done using integrated analysis. RESULTS: Most patients were white (61%) and half were female. (...) Most physicians were male (66%) and of Southeast Asian descent (66%). All physicians explained the plan of care to the patients; most believed that their patient understood. However, many patients did not. Physicians rarely asked the patient for their opinion. In all those cases, the decision had been made previously by the doctors. No decisions were made with the patient. Patients sometimes disagreed. CONCLUSIONS: Shared decision-making may not be the norm in hospital care. Although physicians do explain treatment plans, many hospitalized patients do not understand enough to share in decisions. When patients do assert their opinion, it can result in conflict. PRACTICE IMPLICATIONS: Some hospitalized patients are interested in discussing treatment. Improving hospital communication can foster patient autonomy. (shrink)

Empathy is often described as a virtue which that could help in making medicine more humanistic. This paper argues that there are two limits to this thesis. First, it is unclear whether a lack of empathy can be attributed to the biomedical education. Second, empathy itself is not without issues, and another concept, compassion, can be put forward instead. Humanism based on compassion is more minimalist, but integrated with an approach focused on health systems, it makes humanism more tangible (...) and radical. -/- . (shrink)

Integrating medical imaging with computing technologies, such as Artificial Intelligence (AI) and its subsets: Machine learning (ML) and Deep Learning (DL) has advanced into an essential facet of present-day medicine, signaling a pivotal role in diagnostic decision-making and treatment plans (Huang et al., 2023). The significance of medical imaging is escalated by its sustained growth within the realm of modern healthcare (Varoquaux and Cheplygina, 2022). Nevertheless, the ever-increasing volume of medical images compared to the availability of imaging experts. Biomedical (...) experts and radiologists have resulted in a widening disparity, causing an excess and overwhelming workload on these healthcare professionals (Chen et al., 2021). Several studies indicate that the present-day biomedical radiologist is now saddled with the daunting task of interpreting an image almost every 10 seconds to keep pace with the burgeoning clinical demands (McDonald et al., 2015; Hosny et al., 2018; Lantsman et al., 2022). This cognitive drain has invariably led to inevitable consequences such as delays in diagnosis and an amplified risk of diagnostic errors – thus, the biomedical imaging aspect is in dire need of methods that would aid accurate diagnostics and analytics for improved decision making. In this review, the importance of AI-related technologies such as ML and/or DL methods are reviewed in relation to the processing of medical or biomedical images along with their potentials, challenges, and possible suggestions for future studies in the health landscape. The focus will be on machine learning methods associated with the medical field of image classification. (shrink)

In a recent paper, Levy, Gadd, Kerridge, and Komesaroff attempt to defend the ethicality of homeopathy by attacking the utilitarian ethical framework as a basis for medical ethics and by introducing a distinction between evidence-based medicine and modern science. This paper demonstrates that their argumentation is not only insufficient to achieve that goal but also incorrect. Utilitarianism is not required to show that homeopathic practice is unethical; indeed, any normative basis of medical ethics will make it unethical, as a (...) defence of homeopathic practice requires the rejection of modern natural sciences, which are an integral part of medical ethics systems. This paper also points out that evidence-based medicine lies at the very core of modern science. Particular arguments made by Levy et al. within the principlist medical ethics normative system are also shown to be wrong. (shrink)

Although I agree with Sabine Muller’s conclusion that we should first seek to find alternatives to amputation for patients suffering from Body Integrity Identity Disorder (BIID), I disagree with one of the major premises that she uses to argue for her claim. Muller argues that patients with BIID are likely not autonomous when they request that the limb be amputated. Muller’s argument that BIID suffers are not autonomous is flawed because she conflates philosophical conceptions of autonomy with the conception of (...) autonomy that is operative in the context of medicine. (shrink)

This chapter discusses several kinds of reduction that are often found in the biomedical sciences, in contrast to reduction in fields such as physics. This includes reduction as a methodological assumption for how to investigate phenomena like complex diseases, and reduction as a conceptual tool for relating distinct models of the same phenomenon. The case of Parkinson’s disease illustrates a wide variety of ways in which reductionism is an important tool in medicine.

In Brazil, the social demand for veterinary expertise is growing. However, there is still a shortage of professionals trained in this area to apply specific knowledge to each case. Studies and research into forensic veterinary medicine are necessary for veterinary experts to assist in investigations and legal proceedings. Veterinary medicine has subjects on its curriculum that cover the knowledge needed to apply in the fields of animal health, public health and the environment. The interaction between human and veterinary (...) medicine, as well as other areas of health, is of great importance in the prevention and control of various diseases, both in animals and humans. Some cases of infectious bovine abortion have a major impact not only on cattle farming and animal health, but also on public and environmental health. The concept of "One Health" integrates human medicine and health professionals. In this context, knowledge of infectious abortive diseases that affect animal, human and environmental health is fundamental. Cattle are affected by specific infectious abortive diseases, caused by pathogens with different forms of presentation and transmission mechanisms. These include brucellosis, leptospirosis and listeriosis, which are potentially zoonotic diseases. Controlling these diseases can contribute to effective public health actions and reduce global health risks. In order to establish the diagnosis of these diseases, it is essential to properly collect specimens from live or dead animals under biosafety and biosecurity conditions, following the chain of custody for each case. These procedures allow for greater success in diagnosing the suspected agent and facilitate the investigation of other causes. Animal health standards for the prophylaxis and control of these diseases are established by specific legislation, including those of the Ministry of Agriculture, Livestock and Supply (MALS). This literature review was based on current knowledge on the Pubmed platform, Google Scholar, articles and textbooks. The aim of this article is to identify, understand and discuss the main infectious abortive diseases of cattle in the legal and forensic context, which have an impact on cattle farming, animal health, food safety, public and environmental health. -/- Referências bibliográficas Abdullah, N. M., Mohammad, W. M. Z. W., Shafei, M. N., Sukeri, S., Idris, Z., Arifin, W. N., Nozmi, N., Saudi, S. N. S., Samsudin, S., & Zainudin, A.-W. (2019). Leptospirosis and its prevention: knowledge, attitude and practice of urban community in Selangor, Malaysia. BMC Public Health, 19(1), 1–8. Agrimani, D. S. R., Rui, B. R., Cruz, I. V, Romano, R. M., & Lopes, H. C. (2011). 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I., Krug, F. D. M., Cereser, N. D., & Pinto, F. R. (2017). Brucelose: uma questão de saúde pública. REDVET. Revista Electrónica de Veterinária, 18(9), 1–17. Silva, H. R., Gianoglou, F. M., Campos, M. F., Graciano, E. M. A., & Toledo, R. C. C. (2016). Listeriose: Uma doença de origem alimentar pouco conhecida no Brasil. Higiene Alimentar, 30, 17– 20. Simões, L. S., Sasahara, T. H. C., Favaron, P. O., & Miglino, M. A. (2016). Leptospirose–Revisão. PUBVET, 10, 111–189. Slowinski, K., Tremori, T. M., Massad, M. R. R., Tasaka, A. C., & Rocha, N. S. (2016). Responsabilidade ética e civil do médico-veterinário no ambiente hospitalar. Revista de Educação Continuada em Medicina Veterinária e Zootecnia Do CRMV-SP, 14(2), 30–37. Snak, A., & Osaki, S. C. (2019). Uma revisão sobre três importantes agentes causadores de aborto em bovinos: Neospora caninum, Leptospira sp. e Trypanosoma vivax. Revista de Ciência Veterinária e Saúde Pública, 6(1), 160–195. Sobrinho, O. P. L., Véras, G. M. C., Silva, L. F. B., Oliveira, L. S., Xavier, R. S., Alvim, J. F., Costa, D. A. S., Pereira, Á. I. S., Carlos, M. A. S., Cantanhede, E. K. P., & Santos, M. L. C. (2018). Brucelose bovina: Situação epidemiológica em rebanhos no município de Codó-MA. PUBVET, 12(12), 1–4. Souza, A. O. (2010). Listeriose na gravidez. Revista Médica de Minas Gerais, 20, 433–434. Suárez, Á. C. A., & Parra, C. A. B. (2017). Actualización de la leptospirosis bovina en Colombia. Conexión Agropecuaria JDC, 7(1), 57–77. Tonin, A. A., Azevedo, M. I., Escobar, T. P., Casassola, I., Santos, L. G., Cocco, M., Martins, J. L. R., Schaefe, P. C., & Badke, M. R. T. (2010). Leptospirose bovina: aumento na incidência da Leptospira interrogans sorovar butembo no rebanho do Estado de Santa Catarina, Brasil. Acta Veterinaria Brasilica, 4(4), 294–297. Topazio, J., Tonin, A. A., Machado, G., Noll, J. C. G., Ribeiro, A., Moura, A. B., Carmo, G. M., Grosskopf, H. M., Martins, J. L. R., & Badke, M. R. T. (2015). 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The automatic integration of rapidly expanding information resources in the life sciences is one of the most challenging goals facing biomedical research today. Controlled vocabularies, terminologies, and coding systems play an important role in realizing this goal, by making it possible to draw together information from heterogeneous sources – for example pertaining to genes and proteins, drugs and diseases – secure in the knowledge that the same terms will also represent the same entities on all occasions of use. In the (...) naming of genes, proteins, and other molecular structures, considerable efforts are under way to reduce the effects of the different naming conventions which have been spawned by different groups of researchers. Electronic patient records, too, increasingly involve the use of standardized terminologies, and tremendous efforts are currently being devoted to the creation of terminology resources that can meet the needs of a future era of personalized medicine, in which genomic and clinical data can be aligned in such a way that the corresponding information systems become interoperable. (shrink)

The standard of care in the United States favors stabilizing any adult who arrives in an emergency department after a failed suicide attempt, even if he appears decisionally capacitated and refuses life-sustaining treatment. I challenge this ubiquitous practice. Emergency clinicians generally have a moral obligation to err on the side of stabilizing even suicide attempters who refuse such interventions. This obligation reflects the fact that it is typically infeasible to determine these patients’ level of decisional capacitation—among other relevant information—in this (...) unique setting. Nevertheless, I argue, stabilizing suicide attempters over their objection sometimes violates a basic yet insufficiently appreciated right of theirs—the right against bodily invasion. In such cases, it is at least prima facie wrong to stabilize a patient who wants to die even if they lack a contrary advance directive or medical order and suffer from no terminal physical illness. (shrink)

Background: Systematized Nomenclature of Medicine—Clinical Terms (SNOMED CT, hereafter abbreviated SCT) is acomprehensive medical terminology used for standardizing the storage, retrieval, and exchange of electronic healthdata. Some efforts have been made to capture the contents of SCT as Web Ontology Language (OWL), but theseefforts have been hampered by the size and complexity of SCT. Method: Our proposal here is to develop an upper-level ontology and to use it as the basis for defining the termsin SCT in a way that (...) will support quality assurance of SCT, for example, by allowing consistency checks ofdefinitions and the identification and elimination of redundancies in the SCT vocabulary. Our proposed upper-levelSCT ontology (SCTO) is based on the Ontology for General Medical Science (OGMS). Results: The SCTO is implemented in OWL 2, to support automatic inference and consistency checking. Theapproach will allow integration of SCT data with data annotated using Open Biomedical Ontologies (OBO) Foundryontologies, since the use of OGMS will ensure consistency with the Basic Formal Ontology, which is the top-levelontology of the OBO Foundry. Currently, the SCTO contains 304 classes, 28 properties, 2400 axioms, and 1555annotations. It is publicly available through the bioportal athttp://bioportal.bioontology.org/ontologies/SCTO/. Conclusion: The resulting ontology can enhance the semantics of clinical decision support systems and semanticinteroperability among distributed electronic health records. In addition, the populated ontology can be used forthe automation of mobile health applications. (shrink)

Background: The complexity of diagnostic presentations of an inpatient psychiatry population requires an integrative approach to health and well-being. In this sense, the primary need of this research aims at developing clinical strategies and healthier coping skills for anger, anxiety, and depression; promoting self-esteem, healthier sleep, and anxiety reduction; as well as enhancing mood and emotional–behavioral regulation via exercise and nutrition education. Objectives: The primary objective is to promote exercise, fitness, and physical health in inpatient psychiatry patients. The secondary (...) objective includes therapeutic management of depressive symptoms and patient-centered approach to mania, angry outbursts, and generalized disruptive behavior. The tertiary objective is promoting research in the psychophysiological effectors of exercise and nutrition education in combination with psychotherapy. Method: Monitoring self-reported changes in mood and general well-being via administration of surveys and questionnaires pre- and postexercise sessions. Results: The research yielded positive outcomes in all areas investigated, suggesting the positive effects of exercise and mind–body strategies in the context of psychotherapy in inpatient psychiatry. Conclusion: Physical exercise may be a helpful way to reduce mental health disorders in the context of inpatient psychiatry by targeting anxiety, depression, anger, psychomotor agitation, and muscle tension and addressing stressors and triggers and to develop a more balanced and integrated sense of self. (shrink)

The integration of standardized biomedical terminologies into a single, unified knowledge representation system has formed a key area of applied informatics research in recent years. The Unified Medical Language System (UMLS) is the most advanced and most prominent effort in this direction, bringing together within its Metathesaurus a large number of distinct source-terminologies. The UMLS Semantic Network, which is designed to support the integration of these source-terminologies, has proved to be a highly successful combination of formal coherence and broad scope. (...) We argue here, however, that its organization manifests certain structural problems, and we describe revisions which we believe are needed if the network is to be maximally successful in realizing its goals of supporting terminology integration. (shrink)

Evidence-based medicine relies on the execution of clinical practice guidelines and protocols. A great deal of of effort has been invested in the development of various tools which automate the representation and execution of the recommendations contained within such guidelines and protocols by creating Computer Interpretable Guideline Models (CIGMs). Context-based task ontologies (CTOs), based on standard terminology systems like UMLS, form one of the core components of such a model. We have created DAML+OIL-based CTOs for the tasks mentioned in (...) the WHO guideline for hypertension management, drawing comparisons also with other related guidelines. The advantages of CTOs include: contextualization of ontologies, providing ontologies tailored to specific aspects of the phenomena of interest, dividing the complexity involved in creating ontologies into different levels, providing a methodology by means of which the task recommendations contained within guidelines can be integrated into the clinical practices of a health care set-up. (shrink)

Aujourd’hui délaissées, parfois devenues gênantes, les collections médicales furent pourtant à l’avant-garde du renouveau de la médecine au début du XIXe siècle, avant que celle-ci ne devienne la médecine telle que nous la connaissons aujourd’hui. Selon une vision courante de l’histoire de la médecine, les collections médicales auraient perdu de leur utilité lorsque la médecine a accédé au statut de science expérimentale, les musées d’anatomie faisant alors place aux laboratoires. Les collections d’anatomie-pathologie comme le musée Dupuytren ne seraient que le (...) reliquat de cette histoire, le témoignage d’un échec méthodologique à opposer aux succès de la physiologie expérimentale. Cette narration de l’histoire de la médecine est-elle cependant correcte ? Dans quels buts épistémologiques les médecins ont-ils créé ces collections ? Quelles connaissances cherchaient-ils à obtenir par ce biais ? Plus généralement, pourquoi collecter en médecine – et en science – et pourquoi collectionner ? Pour répondre à ces questions, je m’intéressai principalement dans cette contribution aux pratiques de collecte et de collection chez les médecins de la Société Anatomique de Paris au XIXe siècle et au rôle joué par ces pratiques dans la construction de la collection Dupuytren. (shrink)

[186 pages] Just as the six branches of a snow crystal converge in regular proportions toward their common center, the six contributions to this book point toward a future philosophy of cosmic life. In this sense, this edited volume represents a multidisciplinary and transcultural polylogue of distinguished authors from three continents, which aims to establish highly innovative perspectives and open new frontiers of developing philosophical reflections and scientific foundations for the emergence of a common cosmic consciousness, for an integral ecology, (...) and for a cooperative planetary civilization of humanity. John B. Cobb, Jr. uses a process-philosophical foundation to describe life as living events expressing novelty and the cosmos as a process of self-enriching and self-evolving “Life Itself.” Chandra Wickramasinghe unfolds his scientific and philosophical perspective on cosmic life in twelve successive steps, offering a wide range of arguments and insights that support an up-to-date theory of panspermia. Attila Grandpierre presents the "Cosmic Life Principle" and the comprehensive science based upon it that is inextricably linked to the healthy and cooperative civilization, to the biological laws of nature, to the laws of logic, to the uplifting of the well-being of people and ecological communities. Chunyou Yan introduces the approach of his holographic philosophy, according to which the universe must be understood as a vast living entity, every aspect of which represents life. Bei Peng shows that the proportions of energy meridians in traditional Chinese medicine correspond to musical intervals, and on this basis she demonstrates the analogy of the human body to macrocosmic phenomena. David Bartosch offers an examination of three important systematic foundations for a poly-contextural, transcultural philosophy of cosmic life with roots in Greek, Chinese, South and West Asian, and European traditions of thought. (shrink)

In this book I show that science suffers from a damaging but rarely noticed methodological disease, which I call rationalistic neurosis. It is not just the natural sciences which suffer from this condition. The contagion has spread to the social sciences, to philosophy, to the humanities more generally, and to education. The whole academic enterprise, indeed, suffers from versions of the disease. It has extraordinarily damaging long-term consequences. For it has the effect of preventing us from developing traditions and institutions (...) of learning rationally devoted to helping us learn how to make progress towards a wiser, more civilized world. On our fragile earth, overcrowded, fraught with injustice, inequality and conflict, menaced by unprecedented and terrifying technological and industrial means for change and destruction, we urgently need to acquire a little more wisdom and civilization if we are to avoid repeating horrors of the kind suffered by so many during the 20th century (and already suffered by many in the first few years of the 21st century). We can ill afford to have in our hands instruments of learning botched and bungled from the standpoint of helping us learn how to live more wisely. It may seem scarcely credible that something as important as our institutions of learning can suffer from wholesale, structural defects. Why has this not been noticed before? Why have not armies of scientists and scholars appreciated the point and, long ago, put the matter right? The answer will emerge as my argument unfolds. I will show that one of the most damaging features of rationalistic neurosis is that it has built-in methodological and institutional mechanisms which effectively conceal that anything is wrong. But there is also an immediately obvious reason: specialization, and the resulting fragmentation of academia, has resulted in a situation in which hardly anyone takes responsibility for the overall ideals, the overall aims and methods, of academic inquiry. Academics, these days, are specialists, furiously trying to keep abreast of developments in their own specialist fields. They have no time, and no inducement, to lift their eyes from their particular disciplines, and look at the whole endeavour. Science has long been under attack, at least since the Romantic movement. Blake objected to “Single vision & Newton’s sleep” and declared that “Art is the Tree of Life... Science is the Tree of Death”. Keats lamented that science will “clip an Angel’s wings” and “unweave a rainbow”. Whereas the Enlightenment had valued science and reason as tools for the liberation of humanity, Romanticism found science and reason oppressive and destructive, and instead valued art, imagination, inspiration, individual genius, emotional and motivational honesty rather than careful attention to objective fact. Much subsequent opposition to science stems from, or echoes, the Romantic opposition of Blake, Wordsworth, Keats and many others. There is the movement Isaiah Berlin has described as the “Counter-Enlightenment” (Berlin, 1979, ch. 1). There is existentialism, with its denunciation of the tyranny of reason, its passionate affirmation of the value and centrality of irrationality in human life, from Dostoevsky, Kierkegaard and Nietzsche to Heidegger and Sartre (see, for example, Barrett, 1962). There is the attack on Enlightenment ideals concerning science and reason undertaken by the Frankfurt school, by postmodernists and others, from Horkheimer and Adorno to Lyotard, Foucault, Habermas, Derrida, MacIntyre and Rorty (see Gascardi, 1999). The soul-destroying consequences of valuing science and reason too highly is a persistent theme in literature: it is to be found in the works of writers such as D.H. Lawrence, Doris Lessing, Max Frisch, Y. Zamyatin. There is persistent opposition to modern science and technology, and to scientific rationality, often associated with the Romantic wing of the green movement, and given expression in such popular books as Marcuse’s One Dimensional Man, Roszak’s Where the Wasteland Ends, Berman’s The Reenchantment of the World and Appleyard’s Understanding the Present. There is the feminist critique of science and conceptions of science: see, for example, Fox Keller (1984) and Harding (1986). And there are the corrosive implications of the so-called “strong programme” in the sociology of knowledge, and of the work of social constructivist historians of science, which depict scientific knowledge as a belief system alongside many other such conflicting systems, having no more right to claim to constitute knowledge of the truth than these rivals, the scientific view of the world being no more than an elaborate myth, a social construct (see Barnes and Bloor, 1981; Bloor, 1991; Barnes, Bloor and Henry, 1996; Shapin and Schaffer, 1985; Shapin, 1994; Pickering, 1984; Latour, 1987). This latter literature has provoked a counter-attack by scientists, historians and philosophers of science seeking to defend science and traditional conceptions of scientific rationality: see Gross and Levitt (1994), Gross, Levitt and Lewis (1996), and Koertge (1998). This debate between critics and defenders of science came abruptly to public attention with the publication of Alan Sokal’s brilliant hoax article ‘Transgressing the boundaries’ in a special issue of the cultural studies journal Social Text in 1996 entitled Science Wars: see Sokal and Bricmont (1998). What does this book have to contribute, given the above avalanche of criticism of science? The criticisms of science developed in this book are diametrically opposed to the above, in so far as the above criticisms oppose scientific rationality, seek to diminish or restrict its influence, or hold that it is unattainable. My central point is that we suffer, not from too much scientific rationality, but from not enough. What is generally taken to constitute scientific rationality is actually nothing of the kind. It is rationalistic neurosis, a characteristic, influential and damaging kind of irrationality masquerading as rationality. Science is damaged by being trapped within a widely upheld but severely defective philosophy of science; free science from this defective philosophy, provide it with a more intellectually rigorous philosophy, and it will flourish in both intellectual and humanitarian terms. And more generally, as we shall see, academic inquiry as a whole is damaged by being trapped within an intellectually defective philosophy of inquiry; free it from this defective philosophy, from its rationalistic neurosis, and it will flourish in intellectual and human terms. It is not reason that is damaging, but defective pretensions to reason — rationalistic neurosis —masquerading as reason. Thus what I seek to do here is the exact opposite of what all those who oppose science and scientific rationality do. I shall argue that Reason, the authentic article, arrived at by generalizing the progress-achieving methods of science, can have profoundly liberating and enriching consequences for all worthwhile, problematic aspects of life, and thus deserves to enter into every aspect of life. The bare bones of the argument of this book can be stated quite simply like this. Science cannot proceed without making the substantial metaphysical assumption that the universe is physically comprehensible (to some extent at least). But this conflicts with the orthodox view that in science everything is assessed impartially with respect to evidence, nothing being permanently assumed independently of evidence. So the metaphysical assumption of comprehensibility is repressed. Science pretends that no such assumption is made. But this damages science. For the assumption is substantial, influential and highly problematic. It needs to be made explicit within science so that it can be critically scrutinized, so that alternatives can be developed and considered. Pretending the assumption is not being made undermines the intellectual rigour of science, its intellectual value and success. And it does not stop there. For science also makes value assumptions. Quite properly, science is concerned to discover that which is of value. New factual knowledge devoid of all value (whether intellectual or practical) does not contribute to science. But the orthodox view of science holds that values have no place within science. As in the case of metaphysics, here too, science pretends that values have no role to play within the intellectual domain of science. And this damages science. For values are, if anything, even more influential and problematic than metaphysics (in influencing the direction of research). Here too, values need to be made explicit within science so that they can be scrutinized, so that alternatives can be developed and assessed. Pretending that values play no role within the intellectual domain damages science; both the intellectual and the practical aspects of science are adversely affected. Science fails to pursue those avenues of research that lie in the best interests of humanity. And it goes further. Science is pursued in a social, cultural, economic and political context. It is a part of various social, economic and political projects which seek to achieve diverse human objectives. But the idea that science is an integral part of humanitarian or political enterprises with political ends clashes, once again, with the official view of science that the aim of science is to improve factual knowledge. The political objectives of science are repressed. And, once again, this damages science. For, of course, the political objectives of science, like all our political objectives, are profoundly problematic. These need to be made explicit so that they can be scrutinized, so that alternatives can be developed and considered. The pretence that science does not have this political dimension once again undermines the intellectual rigour of science, and its human value. It lays science open to becoming a part of economic, corporate and political enterprises that are not in the best interests of humanity. The upshot of the line of argument just indicated is that we need to bring about a revolution in the aims and methods of science, and of academic inquiry more generally. Natural science needs to change; its relationship with the rest of academic inquiry, with social inquiry and the humanities, needs to change; and most importantly and dramatically, academic inquiry as a whole needs to change. The basic task of the academic enterprise needs to become to help humanity learn how to tackle its problems of living in more cooperatively rational ways than at present. We need to put the intellectual tasks of articulating our problems of living, and proposing and critically assessing possible solutions, possible and actual actions, at the heart of academic inquiry. The basic task needs to be to help humanity learn a bit more wisdom – wisdom being the capacity to realize what is of value in life, for oneself and others, wisdom including knowledge and technological know-how, but much else besides. Natural science, despite its flaws, has massively increased our knowledge and technological know-how. This in turn has led to a massive and sometimes terrifying increase in our power to act. Often this unprecedented power to act is used for human good, as in medicine or agriculture. But it is also used to cause harm, whether unintentionally (initially at least) as when industrialization and modern agriculture lead to global warming, destruction of natural habitats and rapid extinction of species, or intentionally, as when the technology of war is used by governments and terrorists to maim and kill. Before the advent of modern science, when we lacked the means to do too much damage to ourselves and the planet, lack of wisdom did not matter too much. Now, with our unprecedented powers to act, bequeathed to us by science, lack of wisdom has become a menace. This is the crisis behind all the other current global crises: science without wisdom. In these circumstances, to continue to pursue knowledge and technological know-how dissociated from a more fundamental quest for wisdom can only deepen the crisis. As a matter of urgency, we need to free science and academia of their neuroses; we need to bring about a revolution in the academic enterprise so that the basic aim becomes to promote wisdom by intellectual and educational means. At present science and the humanities betray both reason and humanity. The argument of this book, which I have just summarized, begins with a discussion of the philosophical and methodological problems that beset theoretical physics. At once, many of those who are concerned about moral, political and environmental issues that plague our world today, will feel impatient. What have the methodological problems of theoretical physics to do with third world poverty, war and the threat of war, pollution, extinction of species, the menace of conventional, chemical, biological and nuclear armaments? I can only plead with such a reader: patience. The root cause of the sickness of our times does indeed lie, I claim, with a methodological sickness of natural science or, even more specifically, of physical science. What makes the modern world so utterly different from all previous ages is our possession of modern science and technology. This is the instrument that has changed the conditions of human life almost beyond all recognition, and put unprecedented, and sometimes terrifying, powers into our hands. One should not dismiss out of hand the suggestion that a part of our problem may lie with this instrument, this engine, of rapid change. We see, here, too, the way in which intellectual specialization, referred to above, has effectively concealed from view the nature and extent of the problem that confronts us. The argument that I shall develop in what follows begins with physics, with problems concerning the aims and methods of physics. But it then leaps to social science, to philosophy, to the humanities, to education, to psychotherapy, and to politics: in the end there is scarcely an aspect of modern life that is not touched and, potentially, affected by the argument. How many academic experts are prepared to follow, to take seriously, an argument that ranges so recklessly across such a wide range of academic disciplines? How many non-academic non-experts? But just this is what the argument and message of this book requires. I hope that the reader will endure with patience the somewhat esoteric discussion concerning the aims and methods of physics pursued in chapter one. This may not seem to have anything much to do with the urgent problems of our times, but it does. This is in part how the intellectual disaster I seek to expose in this book conceals itself from view: it buries itself in the obscure, recondite field of the philosophy of physics. Those who devote their lives to the philosophy of physics are, by and large, too myopic to see how their specialized field of study has anything to do with the great and dreadful humanitarian problems and disasters of our age; and those who are above all concerned with these humanitarian disasters have no time at all for abstruse issues concerning the aims and methods of physics. And so the connection is never made. As it happens, the methodological neurosis of physics, with which we begin in chapter one, is actually a quite simple matter to grasp. It does not require any real knowledge of physics to understand. Indeed, physicists and philosophers of physics are much more likely to find the argument difficult to follow than are non-experts. We non-scientists can stand back and see the whole wood; scientists, trained to think in terms of the current orthodox conception of science, trapped in the thickets of research, will find this much harder to do. In an attempt to take this peculiar circumstance into account, I have arranged the exposition as follows. In chapter one I give a simple exposition of the case for declaring natural science to suffer from what I call "rationalistic neurosis"; this avoids all technicalities, and goes straight to the heart of the matter. In the appendix I tackle a host of more technical objections that may be made to the elementary argument of chapter one. So, those experts in the fields of the philosophy of physics and philosophy of science who find the argument of chapter one naïve and unconvincing, should consult the appendix before tossing the book away in disgust. I write in the hope that there will be a few who will not dismiss out of hand the suggestion that the question of how we are to go about learning how to live in wiser and more civilized ways might have something to learn from scientific learning, and will take the trouble to pursue the line of argument traced out in this book. I write in the hope that these few will grasp just how desperate our situation is, how urgent the need to change the status quo, and will do everything in their power to alert others to the need to heal the methodological sickness from which our institutions and traditions of learning at present suffer. To begin with, we need a campaigning organization, modelled perhaps on "Friends of the Earth", which might be called something like "Friends of Wisdom". (shrink)

Bad philosophy is responsible for the climate and nature crises, and other global problems too that threaten our future. That sounds mad, but it is true. A philosophy of science, or of theatre or life is a view about what are, or ought to be, the aims and methods of science, theatre or life. It is in this entirely legitimate sense of “philosophy” that bad philosophy is responsible for the crises we face. First, and in a blatantly obvious way, those (...) institutions, organizations, corporations, businesses, endeavours, and activities of humanity that cause the crises and global problems we face, do so because of the aims they pursue (profit perhaps, or power, or heat and light for homes), and the methods adopted in pursuit of those aims – the philosophy in other words, built into the institution, organization, business, human activities, or whatever it may be. It is the philosophy of these institutions, organizations and activities that we need to change to put a stop to, or at least lessen the severity of, the crises we face, the global problems that confront us, above all the climate and nature crises. One institution has an especially crucial role in this respect: our universities. They are dominated in a multitude of ways by a particularly disastrous philosophy, a philosophy of inquiry which may be called knowledge-inquiry. This holds that the basic aim of the university is to acquire and apply knowledge. First, knowledge is to be acquired; once acquired, it can be applied to help solve social problems. But this philosophy of knowledge-inquiry is an intellectual disaster. As a result, universities are, in devastating and almost entirely unrecognized ways, humanitarian disasters too. Judged from the standpoint of helping to promote human welfare, the university shaped by the philosophy of knowledge-inquiry violates THREE of the four most elementary rules of rational problem solving conceivable in a wholesale, structural fashion, and it is this gross, wholesale, structural irrationality of the university, unnoticed by all but a few scientists and scholars, that is in part responsible for the creation of our grave global problems, and our current incapacity to learn how to solve them. The pursuit of knowledge, conducted in universities, within the framework of knowledge-inquiry over the decades and centuries, has produced much of great benefit to humanity. It has made the modern world possible. It has led to modern power production, modern industry and armaments, modern agriculture, modern hygiene and medicine, modern travel and communications, and the internet. But these very successes have also created many of our most serious current global problems: the climate crisis; the destruction of natural habitats, the catastrophic loss of wild life, and impending mass extinction of species (the nature crisis); the lethal character of modern war; the impact on the natural world of the rapid growth of the human population; the menace posed by nuclear weapons; pollution of earth, sea and air; threats to democracy caused in part by the internet and social media. All these grave global problems have been made possible by modern science and technology, pursued largely in universities within the framework of knowledge-inquiry. Nevertheless, it is not science and technology as such that are the problem, but science pursued in a way that is dissociated from a more fundamental task of the university to help humanity resolve conflicts and problems of living in increasingly cooperatively rational ways, so that progress may be made to a better world. Science and technology, pursued within the framework of knowledge-inquiry, create for some of us the power to act, but not the power to act wisely – not the power to learn how to resolve conflicts and problems of living in increasingly cooperatively rational ways. For that, we need our institutions of learning, above all our universities, to take as their primary task to help humanity learn how to do it. In order to do that, the philosophy of inquiry put into practice by universities needs to be dramatically transformed. We urgently need to bring about a revolution in the overall aims and methods of academic inquiry – a revolution in the philosophy of the university, all around the world, wherever possible, so that the basic aim becomes to seek and promote wisdom, construed to be the capacity, active endeavour, and perhaps desire, to realize what is of value in life, for oneself and others, wisdom in this sense including knowledge, understanding and technological know-how, but much else besides, methods being dramatically modified too so as to help achieve the new academic aim. The basic task of the university would be, not to solve problems of knowledge, but rather to help people in the social world beyond the university to resolve conflicts and problems of living so that what is of value in life may be realized by everyone, insofar as that is possible. The pursuit of knowledge would be vital, but not intellectually fundamental. The intellectual and institutional revolution we so urgently need in our universities would affect every discipline and aspect of the university; it would dramatically affect both research and education, and the whole way the university is related to the rest of the social world. The revolution, from knowledge-inquiry to wisdom-inquiry would dramatically enhance the intellectual integrity and rationality of natural science, social inquiry, the humanities and technology, the character of these disciplines and the relationships they have with one another. University education throughout the university would be dramatically improved. And academic inquiry as a whole would do what, on the whole, it fails to do at present: it would help humanity resolve conflicts and problems of living in increasingly cooperatively rational and, as a result, increasingly successful ways, progress at last being made to a genuinely good, civilized world – a world in which there is peace, justice, liberal democracy, individual freedom, education, reasonable equality, sustainable prosperity and worthwhile opportunities in life, all of these for everyone, insofar as this is possible. Why, it may be asked, has academic philosophy not noticed that we urgently need to transform the current bad philosophy of inquiry of knowledge-inquiry into the far more intellectually rigorous and humanly valuable philosophy of wisdom-inquiry, so that we can begin to do what so far we have failed to do so lamentably: learn how to avoid impending disasters, and even make progress to a better world, something that seems at present almost unthinkable given the horrors of war, poverty, political enslavement of the 20th century, and the horrors of this century so far too? The answer is that academic philosophy is in a particularly pitiful state, as philosophers themselves, are just beginning to realize and lament. That is why academic philosophers are blind to the intellectual and humanitarian disaster of the bad philosophy that dominates universities today, and inconceivable to them to them that they might have, as a disciplinary task, to ensure academic inquiry implements a good philosophy of inquiry, and advocate and argue for change if it does not. Once upon a time, in Europe at least, philosophy was an intellectual power in the world. In the 17th century it created modern science which massively increased and improved our knowledge and understanding of the world, which in turn led to the Enlightenment, the industrial revolution, and the modern world. Philosophy was once so intellectually powerful and influential that it changed the course of history. But philosophy also made in the past three disastrous intellectual blunders: the post-Cartesian blunder, the post-Newtonian blunder, and the Enlightenment blunder. Never acknowledged and corrected by subsequent philosophy right down to the present, these unrecognized intellectual blunders rendered academic philosophy the esoteric, pathetic, and powerless discipline it is today, so that throughout the last century and, so far, throughout this one, academic philosophy has remained blind to the intellectual disaster of knowledge-inquiry, and thus failed entirely to take up its proper disciplinary task of warning fellow academics of the structural irrationality of the philosophy that prevails in the university, and of proposing what steps need to be taken to put things right. Instead of performing such an urgently needed philosophical task, so-called analytic philosophy was reduced to analysing the meaning of words. Since then, there has been hardly any discernible improvement, even if analysis of concepts no longer dominates the scene. Bad academic philosophy is indeed responsible for intellectual and humanitarian failures of the university. What the three past intellectual blunders of philosophy are, why their persistence so dramatically reduces academic philosophy to a triviality, and why, furthermore, this results in the failure of scientists and scholars to see what is so blatantly bad about the philosophy prevailing in universities around the world – the failure to see what so urgently needs to be done to put right what has been wrong for so long: all this is made clear in this book. A new kind of philosophy emerges during the course of the argument, critical fundamentalism, which has as its task to keep alive imaginative and critical – that is rational – thinking about our fundamental problem: How can our human world, the world we experience and live in – the world of living things, people, consciousness, free will, meaning and value – how can all of this exist and best flourish embedded as it is in the physical universe? That problem encompasses all others of life, science and thought. Critical fundamentalism tries to improve answers to aspects of this problem; but it also seeks to encourage everyone to think about the problem, from time to time, and think about how it interacts, in both directions, with more urgent particular and specialized problems of life and thought. Critical fundamentalism sets out to help improve bad philosophy wherever it is to be found: in social, political, commercial, legal, financial, and international life; and especially in academia, in institutions of learning, so that they become devoted to enhancing the capacity of people to learn how to achieve what is of genuine value in this brief life of a few decades if we are fortunate. Critical fundamentalism does everything it can to bring about the revolution in our universities we so urgently need. If taken up by mainstream philosophy, it might really have an impact, and begin to transform universities for the better, in both intellectual and humanitarian terms, and thus, enable humanity to learn how, after the grim failures and horrors of the last century and this one, to make progress to a better world. -/- . (shrink)

Basic Formal Ontology (BFO) is a top-level ontology consisting of thirty-six classes, designed to support information integration, retrieval, and analysis across all domains of scientific investigation, presently employed in over 350 ontology projects around the world. BFO is a genuine top-level ontology, containing no terms particular to material domains, such as physics, medicine, or psychology. In this paper, we demonstrate how a series of cases illustrating common types of change may be represented by universals, defined classes, and relations employing (...) the BFO framework. We provide discussion of these cases to provide a template for other ontologists using BFO, as well as to facilitate comparison with the strategies proposed by ontologists using different top-level ontologies. (shrink)

The notion of function is indispensable to our understanding of distinctions such as that between being broken and being in working order (for artifacts) and between being diseased and being healthy (for organisms). A clear account of the ontology of functions and functioning is thus an important desideratum for any top-level ontology intended for application to domains such as engineering or medicine. The benefit of using top-level ontologies in applied ontology can only be realized when each of the categories (...) identified and defined by a top-level ontology is integrated with the others in a coherent fashion. Basic Formal Ontology (BFO) has from the beginning included function as one of its categories, exploiting a version of the etiological account of function that is framed at a level of generality sufficient to accommodate both biological and artifactual functions. This account has been subjected to a series of criticisms and refinements. We here articulate BFO’s account of function, provide some reasons for favoring it over competing views, and defend it against objections. (shrink)