Ong, Caroline Whilst the reason and purpose of suffering may never be fully understood, there are ways of enduring, transcending and growing resilience to how it affects us. Our experience of suffering lies in the web of perceptions that involve our physical, spiritual and cosmological beliefs. Referencing Pain Seeking Understanding: Suffering, Medicine and Faith, edited by Margaret E. Mohrmann and Mark J. Hanson, this article gives a brief exploration of some propositions as to why an all-powerful, good God would (...) allow suffering to exist. From these various perspectives and using examples cited in the book, the article proposes that the healing art of medicine, honed through years of experience, knowledge and wisdom, can help individual patients endure and transcend suffering, and be whole once again. (shrink)

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

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

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

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

This paper addresses the recent rise of the use of alternative medicine in Western countries. It offers a novel explanation of that phenomenon in terms of cognitive and economic factors related to the free-market and patient-centric approach to medicine that is currently in place in those countries, in contrast to some alternative explanations of this phenomenon. Moreover, the paper addresses this troubling trend in terms of the serious harms associated with the use of alternative medical modalities. The explanatory (...) theory defended here is then predicated on the idea that an extreme patient-centric model of medical practice that treats largely ignorant patients as consumers of medical products and services endowed with an essentially unrestricted power of freedom to choose treatments predictably leads serious and avoidable harms. Some important moral and epistemological consequences of this model are then articulated and corrective measures are suggested. (shrink)

For many philosophers, the relation of medicine to health is exemplary for understanding the relation of human power to nature in general. Drawing on Heidegger and Aquinas, this paper examines the relation of art to nature as it emerges in the second book of Aristotle’s Physics, and it does so by articulating the duality of efficient causality. The art of medicine operates as a dispositive cause rather than as a perfective cause; it removes obstacles to the achievement (...) of health, but it does not impose health. Medicine, on this conception, aids the efficient causality of the natural body rather than substituting for it. The loss of dispositive causality makes efficient causality an imposition of force that bypasses the natural power to achieve natural goods. The paper concludes, with Plato, by arguing that dispositive causality offers a way to understand not only medicine but also governing, teaching, and parenting. (shrink)

Kant’s conception of mental illness is unlikely to satisfy contemporary readers. His classifications of mental illness are often fluid and ambiguous, and he seems to attribute to human beings at least some responsibility for preventing mental illness. In spite of these apparent disadvantages, I argue that Kant’s account of mental illness can be illuminating to his views about the normative dimensions of human cognition. In contrast to current understandings of mental illness, Kant’s account is what I refer to as “non-pathological.” (...) That is, most mental illnesses are for Kant continuous with normally functioning cognition. Someone with a healthy reason can easily fall into mental illness and someone with mental illness can (perhaps not as easily) re-establish healthy reason. By accepting a non-pathological definition of mental illness, it follows for Kant that humans have more agency and responsibility regarding their mental health than current views allow, which explains why several of his writings aim to prescribe a “diet of the mind” (2:271). Contrary to popular readings of Kant as a champion of reason’s power, Kant’s conception of mental illness shows that he recognizes how fragile human reason can be. (shrink)

The history, critique and philosophy of the medical profession. What is real?

Since its inception in the early 1990s, evidence-based medicine (EBM) has become the dominant epistemic framework for Western medical practice. However, in light of powerful criticisms against EBM, alternatives such as casuistic medicine have been gaining support in both the medical and philosophical community. In the absence of empirical evidence in support of the claim that EBM improves patient outcomes, and in light of considerations that it is unlikely that such evidence will be forthcoming, another standard is needed (...) to assess EBM against its alternatives. In this paper, I propose a set of criteria for this purpose based on Helen Longino's criteria for assessing the objectivity of a knowledge productive community. I then apply these criteria to assess EBM against a casuistic framework for medical knowledge. I argue that EBM's strict adherence to a hierarchical organization of knowledge can reasonably be expected to block it from fulfilling a high level of objectivity. A casuistic framework, on the other hand, because it emphasizes critical evaluation in conjunction with the flexibility of a case-based approach, could be expected to better facilitate a more optimal epistemic community. (shrink)

Nature, according to Cavendish, has “an Infinite Natural power, that is, a power to produce infinite effects in her own self, by infinite changes of Motions.” While Cavendish mentions powers with respect to human beings, medicines, occasional causes, and other entities, these powers are really just the power of self-moving matter to cause changes in the world. This chapter examines why Cavendish attributes the power of self-motion to matter, what this power is, how it arose, (...) how it is enacted, and its limitations. In doing so, it discusses her views on causation, perception, and motion, and argues that motion is not reducible to change in mereological facts. (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)

There is widespread recognition at universities that a proper understanding of science is needed for all undergraduates. Good jobs are increasingly found in fields related to Science, Technology, Engineering, and Medicine, and science now enters almost all aspects of our daily lives. For these reasons, scientific literacy and an understanding of scientific methodology are a foundational part of any undergraduate education. Recipes for Science provides an accessible introduction to the main concepts and methods of scientific reasoning. With the help (...) of an array of contemporary and historical examples, definitions, visual aids, and exercises for active learning, the textbook helps to increase students’ scientific literacy. The first part of the book covers the definitive features of science: naturalism, experimentation, modeling, and the merits and shortcomings of both activities. The second part covers the main forms of inference in science: deductive, inductive, abductive, probabilistic, statistical, and causal. The book concludes with a discussion of explanation, theorizing and theory-change, and the relationship between science and society. The textbook is designed to be adaptable to a wide variety of different kinds of courses. In any of these different uses, the book helps students better navigate our scientific, 21st-century world, and it lays the foundation for more advanced undergraduate coursework in a wide variety of liberal arts and science courses. Selling Points Helps students develop scientific literacy—an essential aspect of _any_ undergraduate education in the 21 st century, including a broad understanding of scientific reasoning, methods, and concepts Written for all beginning college students: preparing science majors for more focused work in particular science; introducing the humanities’ investigations of science; and helping non-science majors become more sophisticated consumers of scientific information Provides an abundance of both contemporary and historical examples Covers reasoning strategies and norms applicable in all fields of physical, life, and social sciences, _as well as_ strategies and norms distinctive of specific sciences Includes visual aids to clarify and illustrate ideas Provides text boxes with related topics and helpful definitions of key terms, and includes a final Glossary with all key terms Includes Exercises for Active Learning at the end of each chapter, which will ensure full student engagement and mastery of the information include earlier in the chapter Provides annotated ‘For Further Reading’ sections at the end of each chapter, guiding students to the best primary and secondary sources available Offers a Companion Website, with: For Students: direct links to many of the primary sources discussed in the text, student self-check assessments, a bank of exam questions, and ideas for extended out-of-class projects For Instructors: a password-protected Teacher’s Manual, which provides student exam questions with answers, extensive lecture notes, classroom-ready Power Point presentations, and sample syllabi Extensive Curricular Development materials, helping any instructor who needs to create a Scientific Reasoning Course, ex nihilo. (shrink)

This paper analyzes the underlying tendencies and attitudes toward reproductive medicine borrowing the Nietzschean concepts of nihilism: “death of God” with secularization; “will to power” with reproductive liberty and technological power; and the race of “supermen” with transhumanism. Medical science has advanced in leaps and bounds. In some way, technical innovations have given us unprecedented power to manipulate the way we reproduce. The indiscriminant use of medical technology is backed by a warped notion of human freedom. (...) With secularization in the West, freedom has taken on greater significance in society, but with a heavy emphasis on individual choices and rights. As technology joins forces with sexual liberty, it is not difficult to understand why the public accepts the latest novelty from the reproductive industry. As a result, many find Catholic teaching behind the times and incomprehensible, if not downright anti-scientific. In fact, this coupling of reproductive liberty (will) with reproductive technology (power) echoes the famous dictum “will to power” Nietzsche predicted would characterize post-modern societies. When liberty becomes absolute and technology unchecked, transhumanism is the logical outcome. As a response to these nihilistic tendencies, the paper will end with a critique drawing from theological insights. (shrink)

In this paper, I will briefly summarize the history and current accounts of Evolutionary Medicine (EM). I will show that EM, in its current forms, is using an evolutionary understanding that carries the explanatory framework, as well as explanatory limits, of the Modern Synthesis (MS). I will then point out some essential elements that need to be seen as limiting factors within EM and analyze the limitations that are brought about by the MS understanding of it. On this basis, (...) I will argue that if the latest developments in evolutionary theory are considered – in particular, those pertaining to the inheritance mechanisms highlighted by the Extended Evolutionary Synthesis (EES), and the newly introduced evolutionary entities – EM will have a much broader explanatory scope and increased explanatory power in addition to greater relevance, which will enable its application in medical explanations. (shrink)

The paper aims at reconstructing the fundamentals of the sophistic anthropology. Contrary to the recognized view of the humanistic shift which took place in the sophistic thought, there is evidence that the sophists were continuously concerned with the problems of philosophy of nature. The difference between the sophists and their Presocratic predecessors was that their criticism of the philosophical tradition and the transformative answers given to the old questions were the basis and the starting point of the " ethical " (...) and " rhetorical " part of their intellectual activity. This natu-ralistic perspective is reflected in their research in the field of medicine and biology, in the discussion about " the human nature " , and in their interest in the individual physiological and mental conditions, which determine the state of the human body and the behaviour of a man. The sophists pioneered in linguistic, rhetorical, and philological studies. To enhance the power of persuasion, they investigated how various mental conditions influenced cognitive processes and physiological reactions. Thus they started a thorough examination of the human psyche, initiating the field of psychology. (shrink)

Among the many potential benefits arising from the rapidly advancing field of nanomedicine is the possibility of a whole new range of nanovaccines in which novel delivery mechanisms utilizing nanoparticles could make obsolete the use of needles for administering any vaccine. However, as the massive resources of the worldwide pharmaceutical industry are deployed to develop nanovaccines, urgent questions arise as to which diseases should be targeted and which populations will benefit most. -/- This paper explores how such targeting of nanovaccines (...) might be decided in an ethically optimal way and considers some of the practical considerations and potential problems of implementing such a global nanovaccine policy. There seems little doubt that nanomedical research could develop vaccines against most major global infectious diseases. Throughout the history of medicine, however, it is well recognized that insufficient attention and resources have been given to public health and preventive medicine and the environmental causes of ill-health remain under-researched. We urge that national governments and regional authorities of wealthier countries incentivise their powerful pharmaceutical corporations to develop nanovaccines within a global and long term perspective and not just to focus on the diseases of the developed world. (shrink)

Since Circular 34 from the Ministry of Science and Technology of Vietnam required the head of the national project to have project results published in ISI/Scopus journals in 2014, the field of economics has been dominating the number of nationally-funded projects in social sciences and humanities. However, there has been no scientometric study that focuses on the difference in productivity among fields in Vietnam. Thus, harnessing the power of the SSHPA database, a comprehensive dataset of 1,564 Vietnamese authors (854 (...) males, 705 females) with 2,410 publications in the 2008 – 2018 period was extracted and analyzed. Various factors were considered including age, gender, new authors, leading authors, co-authorship, and Impact Factor. The findings suggest a high level of contribution from authors at the age of 40 – 44 in economics (858 publications) in a 12-years period, which is equivalent to the social medicine total output, and two times more than the total output of the education. Moreover, the presence and reinforcement of male researchers are still dominating in Economics and other fields, with the only exception of education. Despite the rapid rise in the number of Vietnamese lead authors, gender disparity among disciplines is an issue. Contrary to the strong international collaboration-oriented tendency in social medicine, economics, and other fields, educational authors are not open to international collaborating. Finally, most of the publications in economics belong to the group with JIF from 0 to 2, in contrast with the high number of social medicine publications with JIF from 2 to 5, which suggesting the field of economics is fulfilling the quantity, but still, need more quality publications. (shrink)

The world is in a state of crisis. Global problems that threaten our future include: the climate crisis; the destruction of natural habitats, catastrophic loss of wild life, and mass extinction of species; lethal modern war; the spread of modern armaments; the menace of nuclear weapons; pollution of earth, sea and air; rapid rise in the human population; increasing antibiotic resistance; the degradation of democratic politics, brought about in part by the internet. It is not just that universities around the (...) world have failed to help humanity solve these global problems; even worse, they have made the genesis of these problems possible. Modern science and technology, developed in universities, have made possible modern industry and agriculture, modern hygiene and medicine, modern power production and travel, modern armaments, which in turn make possible much that is good, all the great benefits of the modern world, but also all the global crises that now threaten our future. What has gone wrong? The fault lies with the whole conception of inquiry built into universities around the world. The basic idea is to help promote human welfare by, in the first instance, acquiring scientific knowledge and technological know-how. First, knowledge is to be acquired; once acquired, it can be applied to help solve social problems, and promote human welfare. But this basic idea is an intellectual disaster. Judged from the standpoint of promoting human welfare, it is profoundly and damagingly irrational, in a structural way. As a result of being restricted to the tasks of acquiring and applying knowledge, universities are prevented from doing what they most need to do to help humanity solve global problems, namely, engage actively with the public to promote action designed to solve global problems. We need urgently to bring about a revolution in universities around the world, wherever possible, so that their central task becomes to help humanity learn how to solve the climate crisis and other problems of living, local and global, so that we may make progress towards a good, civilized world. Almost every branch and aspect of the university needs to change. (shrink)

Foucault’s argument that a major break occurred in the nature of power in the European Eighteenth century—an unprecedented socialization of medicine and concern for the health of bodies and populations, the birth of biopolitics—has become since the 1990s a dominant narrative among sociologists but is rarely if ever scrutinized in its premises. This article problematizes Foucault’s periodization about the politics of health and the way its story has been solidified into an uncritical account. Building on novel historiographic work, (...) it challenges the modernist bias of histories of biopolitics and public health and considers an earlier and more plural history of collective practices of health of which the story told by Foucault is just one important episode. Finally, it discusses the implications of this revised model for wider sociological debates on the link between modernity, health and the body. (shrink)

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

Without doctors being able to explain medical decisions to patients, I argue their use of black box AIs would erode the effective and respectful care they provide patients. In addition, I argue that physicians should use AI black boxes only for patients in dire straits, or when physicians use AI as a “co-pilot” (analogous to a spellchecker) but can independently confirm its accuracy. I respond to A.J. London’s objection that physicians already prescribe some drugs without knowing why they work.

Alison Bailey’s The Weight of Whiteness: A Feminist Engagement with Privilege, Race, and Ignorance examines how whiteness misshapes our humanity, measuring the weight of whiteness in terms of its costs and losses to collective humanity. People of color feel the weight of whiteness daily. The resistant habits of whiteness and its attendant privileges, however, make it difficult for white people to feel the damage. White people are more comfortable thinking about white supremacy in terms of what privilege does for them, (...) rather than feeling what it does to them. The first half of the book focuses on the overexposed side of white privilege, the side that works to make the invisible and intangible structures of power more visible and tangible. Bailey discusses the importance of understanding privileges intersectionally, the ignorance-preserving habits of “white talk,” and how privilege and ignorance circulate in educational settings. The second part invites white readers to explore the underexposed side of white dominance, the weightless side that they would rather not feel. The final chapters are powerfully autobiographical. Bailey engages readers with a deeply personal account of what it means to hold space with the painful weight of whiteness in her own life. She also offers a moving account of medicinal genealogies, which helps to engage the weight she inherits from her settler colonial ancestors. The book illustrates how the gravitational pull of white ignorance and comfort are stronger than the clean pain required for collective liberation. The stakes are high: Failure to hold the weight of whiteness ensures that white people will continue to blow the weight of historical trauma through communities of color. -/- All rights reserved. No portion of this publication may be reproduced, stored in a retrieval system, or transmitted in any form by any means, electronic, mechanical, photocopying, recording or otherwise without the prior written permission of the publisher. -/- -/- . (shrink)

It is well-known that racism is encoded into the social practices and institutions of medicine. Less well-known is that racism is encoded into the material artifacts of medicine. We argue that many medical devices are not merely biased, but materialize oppression. An oppressive device exhibits a harmful bias that reflects and perpetuates unjust power relations. Using pulse oximeters and spirometers as case studies, we show how medical devices can materialize oppression along various axes of social difference, including (...) race, gender, class, and ability. Our account uses political philosophy and cognitive science to give a theoretical basis for understanding materialized oppression, explaining how artifacts encode and carry oppressive ideas from the past to the present and future. Oppressive medical devices present a moral aggregation problem. To remedy this problem, we suggest redundantly layered solutions that are coordinated to disrupt reciprocal causal connections between the attitudes, practices, and artifacts of oppressive systems. (shrink)

The case for an unprecedented penetration of life mechanisms into the politics of Western modernity has been a cornerstone of 20th-century social theory. Working with and beyond Foucault, this article challenges established views about the history of biopower by focusing on ancient medical writings and practices of corporeal permeability. Through an analysis of three Roman institutions: a) bathing; b) urban architecture; and c) the military, it shows that technologies aimed at fostering and regulating life did exist in classical antiquity at (...) the population scale. The article highlights zones of indistinction between natural and political processes, zoē and bíos, that are not captured by a view of destructive incorporation of or over life by sovereign power. In conclusion, the article discusses the theoretical potential of this historical evidence for contemporary debates on ‘affirmative biopolitics’ and ‘environmental biopower’. (shrink)

Jeremy R. Garrett claims that the nature and scope of our rescue duties cannot be properly understood and addressed without reference to social context or institutional background conditions. In my comment I focus not on social or institutional but on psychological background conditions that are also necessary for the conceptualization of rescue cases. These additional conditions are of crucial importance since an entire paradigm of “rescue medicine” is founded, as Garret notices, on the powerful and immediate “impulse to rescue” (...) (Garrett 2015). I understand this “impulse” as the preference toward identified victims, and I argue that it may sometimes distort genuine moral judgments in rescue cases. (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)

Our understanding of body–world relations is caught in a curious contradiction. On one side, it is well established that many concepts that describe interaction with the outer world – ‘plasticity’ or ‘metabolism’- or external influences on the body - ‘environment’ or ‘milieu’ – appeared with the rise of modern science. On the other side, although premodern science lacked a unifying term for it, an anxious attentiveness to the power of ‘environmental factors’ in shaping physical and moral traits held sway (...) in nearly all medical systems before and alongside modern Europe. In this article, I build on a new historiography on the policing of bodies and environments in medieval times and at the urban scale to problematize Foucault’s claim about biopolitics as a modern phenomenon born in the European eighteenth-century. I look in particular at the collective usage of ancient medicine and manipulation of the milieu based on humoralist notions of corporeal permeability (Hippocrates, Galen, Ibn Sīnā) in the Islamicate and Latin Christendom between the 12th and the 15th century. This longer history has implications also for a richer genealogy of contemporary tropes of plasticity, permeability and environmental determinism beyond usual genealogies that take as a starting point the making of the modern body and EuroAmerican biomedicine. (shrink)

Background: Despite the at least decades long record of philosophical recognition and interest, the intricacy of the deceptively familiar appearing concepts of ‘disease’, ‘disorder’, ‘disability’, etc., has only recently begun showing itself with clarity in the popular discourse wherein its newly emerging prominence stems from the liberties and restrictions contingent upon it. Whether a person is deemed to be afflicted by a disease or a disorder governs their ability to access health care, be it free at the point of use (...) or provided by an insurer; it also influences the treatment of individuals by the judicial system and employers; it even affects one’s own perception of self. -/- Aims: All existing philosophical definitions of disease struggle with coherency, causing much confusion and strife, and leading to inconsistencies in real-world practice. Hence, there is a real need for an alternative. -/- Materials & Methods: In the present article I analyse the variety of contemporary views of disease, showing them all to be inadequate and lacking in firm philosophical foundations, and failing to meet the desideratum of patient driven care. -/- Results: Illuminated by the insights emanating from the said analysis, I introduce a novel approach with firm ethical foundations, which foundations are rooted in sentience, that is the subjective experience of sentient beings. -/- Discussion: I argue that the notion of disease is at best superfluous, and likely even harmful in the provision of compassionate and patient-centred care. -/- Conclusion: Using a series of presently contentious cases illustrate the power of the proposed framework which is capable of providing actionable and humane solutions to problems that leave the current theories confounded. (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)

For children, the collateral damage of the COVID-19 pandemic response has been considerable. In this paper, we use the framework of evidence-based medicine to argue that child abuse is another negative side effect of COVID-19 lockdowns. While it was certain that school closures would have profound social and economic costs, it remains uncertain whether they have any effect on COVID-19 transmission. There is emerging evidence that lockdowns significantly worsened child abuse on a global scale. Low-income and middle-income countries are (...) particularly vulnerable to increases in child abuse. The best available external evidence from systematic research during the pandemic demonstrates an increase in the risk of child maltreatment, an increase in child maltreatment hospitalisations and a concerning decrease in official child maltreatment referrals. The paradoxical phenomenon of increased hospitalisations and decreased reports is unlikely to be explained by a genuine decrease in child abuse. We conclude that lockdowns have an unacceptably high risk of negative side effects for children, as evidenced by child abuse, the true extent of which appears to be masked by lockdown-related disruptions to schools and other surveillance systems. The desire for a sense of security may be a tempting bias towards emphasising the resilience of children, but it is ethically problematic to push children towards abuse in the name of public health. It is our view that the collateral damage of prolonged school closures for society’s most vulnerable members is a powerful ethical consideration against any pandemic response which involves their use. (shrink)

The idea that technologies can change moral beliefs and practices is an old one. But how, exactly, does this happen? This paper builds on an emerging field of inquiry by developing a synoptic taxonomy of the mechanisms of techno-moral change. It argues that technology affects moral beliefs and practices in three main domains: decisional (how we make morally loaded decisions), relational (how we relate to others) and perceptual (how we perceive situations). It argues that across these three domains there are (...) six primary mechanisms of techno-moral change: (i) adding options; (ii) changing decision-making costs; (iii) enabling new relationships; (iv) changing the burdens and expectations within relationships; (v) changing the balance of power in relationships; and (vi) changing perception (information, mental models and metaphors). The paper also discusses the layered, interactive and second-order effects of these mechanisms. (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)

At present universities are devoted to the acquisition of specialized knowledge and technological know-how. They fail to do what they most need to do: help the public acquire a good understanding of what our problems are, what needs to be done to solve them. Universities do not even conceive of their task in that way. The result is that the public, by and large, fails to appreciate just how serious the problems that face us are, and so fails to put (...) pressure on governments to act in the ways that are required. -/- Modern science and technology make possible modern industry and agriculture, modern power production and travel, modern hygiene and medicine, modern armaments: these in turn have led to much that is of great benefit, but also to the global problems that threaten our future. Science divorced from the capacity to solve problems of living wisely is a disaster. It is that disaster that academia, as at present constituted, is designed to produce – and has produced: the modern world. We have to learn how to solve the grave global problems that confront us. That in turn requires that our institutions of learning – our schools and universities – are designed and devoted to the job. At present they are not. In giving priority to the pursuit of knowledge, they fail to do what most needs to be done and, even worse, are the source of our problems. It is absolutely vital, for the future of humanity, that universities are transformed radically so that they give absolute priority to the all-important task of helping the public come to understand what our problems are, and what we need to do about them. And as a result get governments to act. -/- The book demonstrates that universities as at present constituted violate reason and, as a result, betray humanity. Cure universities of their structural irrationality, and they would come actively to promote actions required to solve global problems, and help humanity make progress toward a better world. The book spells out in detail the changes that need to be made to academic inquiry, why they need to be made, and how they would enable universities to empower humanity to solve current global problems. (shrink)

Two great problems of learning confront humanity: learning about the universe, and about ourselves and other living things as a part of the universe; and learning how to create a good, civilized, enlightened, wise world. We have solved the first great problem of learning – we did that when we created modern science and technology in the 17th century. But we have not yet solved the second one. That combination of solving the first problem, failing to solve the second one, (...) is very, very, dangerous. Almost all our current global problems have arisen as a result. Modern science and technology immensely increase our powers to act (for some of us), but not our power to act wisely. Modern science and technology lead to modern industry, modern agriculture, travel, medicine, hygiene and armaments, and these in turn lead to much that is of benefit, but also to all our current global problems: population growth, habitat destruction, loss of wild life, mass extinction of species, lethal modern war, the menace of nuclear weapons, pollution of earth, sea and air, antibiotic resistance, degradation of democracy facilitated by the internet and, most serious of all, the climate crisis. Now that we have modern science and technology, wisdom has become, not a private luxury, but a public necessity. But how is it to be achieved? Here is the solution. We can learn from the solution to the first great problem of learning how to solve the second one. That was the basic idea of the 18th century Enlightenment, but in implementing it, the philosophes of the Enlightenment blundered. They got the progress-achieving methods of science wrong; they failed to generalize them properly; and they applied them, not to social life but to creating social science. Their mistakes are still built into academia today. In order to learn how to create a civilized, enlightened world, the key thing we need to do is to cure academia of the structural blunders we have inherited from the Enlightenment. We need to bring about a revolution in science, and in academia more broadly so that the basic aim becomes wisdom, and not just knowledge – wisdom being the capacity, active endeavour and desire to realize what is of value in life for oneself and others, wisdom thus including knowledge and technological know-how, but much else besides. The outcome of the revolution we need would be universities radically transformed, so that they become rationally and actively devoted to helping people solve problems of living, including global problems, thus making progress to as good, civilized, enlightened a world as possible. (shrink)

In recent decades, the intertwining ideas of self-determination and well-being have received tremendous support in bioethics. Discussions regarding self-determination, or autonomy, often focus on two dimensions—the capacity of the patient and the freedom from external coercion. The practice of obtaining informed consent, for example, has become a standard procedure in therapeutic and research medicine. On the surface, it appears that patients now have more opportunities to exercise their self-determination than ever. Nonetheless, discussions of patient autonomy in the bioethics literature, (...) which focus on individual patients making particular decisions, neglect the social structure within which health-care decisions are made. Looking through the lens of disability and informed by the feminist conception of relational autonomy, this essay argues that the issue of autonomy is much more complex than the individualist model suggests. The social system and the ableist ideology impose various forms of pressure or oppressive power that can affect people’s ability to choose according to their value system. Even if such powers are not directly coercive, they influence potential parents’ decisions indirectly—they structure their alternatives in such a way that certain options are never considered as viable and other decisions must be made. This paper argues that, instead of only focusing on the individual act of decision-making, we need to pay attention to the social structure that frames people’s decision. (shrink)

Ethics committees like Institutional Review Boards and Research Ethics Committees are typically empowered to approve or reject proposed studies, typically conditional on certain conditions or revisions being met. While some have argued this power should be primarily a function of applying clear, codified requirements, most institutions and legal regimes allow discretion for IRBs to ethically evaluate studies, such as to ensure a favourable risk-benefit ratio, fair subject selection, adequate informed consent, and so forth. As a result, ethics committees typically (...) make moral demands on researchers: require them to act in a way the committee considers ethically right or appropriate. This paper argues that moral demands are legitimate only if publicly justifiable; and as a result, committee decisions are subject to a public justification requirement. Ethics committees can permissibly request for more information, changes to the research protocol or that the research is delayed or even stopped only if these demands are publicly justifiable. This latter claim is in turn justified on the basis that moral demands to φ are permissible only if we are in a position to know that the addressee ought to φ and that we are in a position to know a proposition only if it is publicly justifiable. This argument suggests that ethics committees must consciously and explicitly appeal to public reasons in their decision-making. In cases where public reasons cannot be offered, committees would not be permitted to reject a given study or make approval conditional on an amendment. (shrink)

Philosophers of science and medicine now aspire to provide useful, socially relevant accounts of mechanism. Existing accounts have forged the path by attending to mechanisms in historical context, scientific practice, the special sciences, and policy. Yet, their primary focus has been on more proximate issues related to therapeutic effectiveness. To take the next step toward social relevance, we must investigate the challenges facing researchers, clinicians, and policy makers involving values and social context. Accordingly, we learn valuable lessons about the (...) connections between mechanistic processes and more fundamental reasons for medical interventions, particularly moral, ethical, religious, and political concerns about health, agency, and power. This paper uses debates over the controversial morning-after pill to gain insight into the deeper reasons for the production and use of mechanistic knowledge throughout biomedical research, clinical practice, and governmental regulation. To practice socially relevant philosophy of science, I argue that we need to account for mechanistic knowledge beyond immediate effectiveness, such as how it can also provide moral guidance, aid ethical categorization in the clinic, and function as a political instrument. Such insights have implications for medical epistemology, including the value-laden dimensions of mechanistic reasoning and the “epistemic friction” of values. Furthermore, there are broader impacts for teaching research ethics and understanding the role of science advisors as political advocates. (shrink)

Many people report that reading first-person narratives of the experience of illness can be morally instructive or educative. But although they are ubiquitous and typically sincere, the precise nature of such educative experiences is puzzling—for those narratives typically lack the features that modern philosophers regard as constitutive of moral reason. I argue that such puzzlement should disappear, and the morally educative power of illness narratives explained, if one distinguishes two different styles of moral reason: an inferentialist style that generates (...) the puzzlement and an alternative exemplarist style that offers a compelling explanation of the morally educative power of pathographic literature. (shrink)

To clarify the proper role of values in science, focusing on controversial expert responses to Covid-19, this article examines the status of (in)convenient hypotheses. Polarizing cases like health experts downplaying mask efficacy to save resources for healthcare workers, or scientists dismissing “accidental lab leak” hypotheses in view of potential xenophobia, plausibly involve modifying evidential standards for (in)convenient claims. Societies could accept that scientists handle (in)convenient claims just like nonscientists, and give experts less political power. Or societies could hold scientists (...) to a higher bar, by expecting them not to modify evidential standards to avoid costs only incidentally tied to error. (shrink)

Gongronema latifolium is primarily used as spice and vegetable as well as a herb in traditional medicine in the treatment of malaria, diabetes and hypertension. This study is aimed at providing in vitro laboratory knowledge on Gongronema latifolium leaves.Methods Minerals were analyzed using Atomic Absorption Spectrophotometer while phyto nutrients were screened using standard laboratory procedures. 2,2 diphenyl 1 picrylhydrazyl DPPH radical scavenging and reducing power activities were determined spectrophotometrically. Usunobun Usunomena | Igwe V. Chinwe "Analysis of phytochemicals, minerals (...) and in vitro antioxidant activities of Gongronema latifolium leaves" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-1 | Issue-4 , June 2017 . (shrink)

The paper offers the concept of reversing the medical humanities. In agreement with the call from Kristeva et al. to recognise the bidirectionality of the medical humanities, I propose moving beyond debates of attitude and aptitude in the application and engagement (either friendly or critical) of humanities to/in medicine, by considering a reversal of the directions of epistemic movement (a reversal of the flow of knowledge). I situate my proposal within existing articulations of the field found in the medical (...) humanities meta-literature, pointing to a gap in the current terrain. I then develop the proposal by unfolding three reasons why we might gain something from exploring a reversed knowledge flow. First, a reversed knowledge flow seems to be an inherent—but still to be articulated—possibility in medical humanities and thus provides an opportunity for more knowledge. Second, the current unidirectionality of the field is founded on an inconsistency in the depiction of the connection between medicine and humanities, which risks creating the very divide that medical humanities set out to bridge. Practising a reversal may help avoid this divide. And third, a reversal might help rebalance the internal epistemic power, so as to motivate less external scepticism and in turn displace more external epistemic power towards medical humanities. I end the paper with a remark on precursors for a reversal, and ideas for where to go from here. (shrink)

The importance of unconscious cognition is seeping into popular consciousness. A number of recent books bridging the academic world and the reading public stress that at least a portion of decision-making depends not on conscious reasoning, but instead on cognition that occurs below awareness. However, these books provide a limited perspective on how the unconscious mind works and the potential power of intuition. This essay is an effort to expand the picture. It is structured around the book that has (...) garnered the most attention, Malcolm Gladwell’s Blink , but it also considers Gut Feelings by Gerd Gigerenzer and How Doctors Think by Jerome Groopman . These books help deepen the . (shrink)

Feminists have indicated the inadequacies of bioethical debates about human embryonic stem cell research, which have for the most part revolved around concerns about the moral status of the human embryo. Feminists have argued, for instance, that inquiry concerning the ethics and politics of human embryonic stem cell research should consider the relations of social power in which the research is embedded. My argument is that this feminist work on stem cells is itself inadequate, however, insofar as it has (...) not incorporated an analysis of disability into its considerations of the ethical and political issues that surround the phenomena. Thus, I consider claims that disability theorists and anti-disability activists have made about the research. I conclude by indicating that stem cell research must be situated within a cultural matrix that operates in the service of normalisation. (shrink)

Rudolf Steiner, who draws attention with his multi-faceted works, is known for his important works in the fields of medicine, education, art and agriculture, as well as esotericism and occultism in particular. In this article, it is explicated to the intellectual infrastructure, the effect of the anthroposophy founded by Steiner and deals with the Spiritual Science, which Steiner created in a unique way. Rudolf Steiner has established an eclectic system by dissolving different schools such as Goethe's doctrine of nature, (...) Rosicrucianism, Kabbalah, Hinduism, Gnostic and Mystic Christianity in his system. The universality is dominant in Steiner's work. His inclusive ideas for all humanity suffered the reaction of the Nazis in his time. Steiner drew attention to the potential of discovering the senses of people by making a distinction between the sensory and the sensual world. The drive and power of discovering the spiritual world in humans has a significant share in his work. Steiner, who says he has seen and experienced the supernatural world personally, is intended to have more knowledge of other people about the supernatural world. The literature review was chosen as a method. Information gathered from different sources may provide a better understanding of Steiner's work. (shrink)

Lilly was one of the greatest scientists and pioneers on the limits of human possibility but after his death a collective amnesia has descended and he is now almost forgotten. His Wiki is good but inevitably incomplete so here are a few missing details and viewpoints. Lilly was a generation (or more) ahead of his time. He is almost single-handedly responsible for the great interest in dolphins (which led to the Marine Mammal Protection Act in the USA and helped to (...) found the animal rights movement). In 1958 he noted that the brains of elephants and cetaceans were larger than ours, that we should not abuse them and that it was one our most important projects to communicate with them. He invented sensory isolation tanks (at NIMH in 1954) and used them extensively with and without powerful psychoactive drugs at a time when it was thought that either the brain would shut down or one would go insane if external stimuli were eliminated. He created methods for implanting electrodes in mammal brains and was planning to do it to himself. He was one of the first to make serious use of computers in bioscience research and created the hardware and software to make the first attempts to communicate with dolphins. He self experimented with dangerous physiological investigations in high altitude medicine for the military during WW2, took LSD with dolphins and movie stars, submitted himself to the rigors of various forms of yoga and of Arica training, and taught classes at Esalen. He was a computer pioneer who forsaw the rapid advances in A.I. and it's inevitable clash with humans. He was the first one to investigate the bizarre psychedelic ketamine (" vitamin K "), and his results (published in the two last chapters of his book `The Scientist`) are still the best data on the dose/effect relation of any psychedelic on one person. It cured his lifelong daily migraine headaches (see http://www.conspiracyarchive.com/UFOs/Gorightly.htm). And all this happened before most of us were born! He had courage, honesty and integrity that is rare anywhere and almost nonexistent in science. His goal was to find the ultimate truth about everything and he went about as far as anyone ever has. He had little patience with the stupid and hypocritical games one has to play to fit into monkey society. Of course the reaction of the establishment was predictable. He left the NIMH and was never given any government or academic support for the last 35 years of his life. His paper and comments at a conference on sensory deprivation were removed from the published version. He was not invited to government sponsored symposia on dolphins (he had refused to help develop them as weapons), though he clearly knew more about them than anyone in the world. He liked to live and work on the edge and few could keep up with him, as his books make clear. If you have read some of his other books it will be much easier going. He was a pioneer in consciousness research and pushed the boundaries of our understanding of who we are and what we might become. Among other things he catalogs the various states reached by drugs, meditation, and isolation, tries to determine their significance, and suggests how to use them. I very briefly review and comment on his life and work. -/- Those interested in all my writings in their most recent versions may download from this site my e-book ‘Philosophy, Human Nature and the Collapse of Civilization Michael Starks (2016)- Articles and Reviews 2006-2016’ by Michael Starks First Ed. 662p (2016). -/- All of my papers and books have now been published in revised versions both in ebooks and in printed books. -/- Talking Monkeys: Philosophy, Psychology, Science, Religion and Politics on a Doomed Planet - Articles and Reviews 2006-2017 (2017) https://www.amazon.com/dp/B071HVC7YP. -/- The Logical Structure of Philosophy, Psychology, Mind and Language in Ludwig Wittgenstein and John Searle--Articles and Reviews 2006-2016 (2017) https://www.amazon.com/dp/B071P1RP1B. -/- Suicidal Utopian Delusions in the 21st century: Philosophy, Human Nature and the Collapse of Civilization - Articles and Reviews 2006-2017 (2017) https://www.amazon.com/dp/B0711R5LGX -/- . (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)

Grau and Pury (Review of Philosophy and Psychology, 5, 155–168, 2014) reported that people’s views about love are related to their views about reference. This surprising effect was however not replicated in Cova et al.’s (in press) replication study. In this article, we show that the replication failure is probably due to the replication’s low power and that a metaanalytic reanalysis of the result in Cova et al. suggests that the effect reported in Grau and Pury is real. We (...) then report a large, highly powered replication that successfully replicates Grau and Pury 2014. This successful replication is a case study in the challenges involved in replicating scientific work, and our article contributes to the discussion of these challenges. (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)