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Pat Daly, MD, has written a series of articles which uphold Bernard Lonergan's method explored in his famous book Insight as a model that could be followed or applied in practicing medicine or promoting healthcare. Daly calls his effort a GEM Model for medicine. Daly, however, has not explored in-depth Lonergan's second major work, Method in Theology, which develops an eight-step method that complements Insight. This book focuses on these eight steps, or Functional Specialties so as to better promote Lonergan's views on "Healing and Creating in History."
In this book the author explores the shifting philosophical boundaries of modern medical knowledge and practice occasioned by the crisis of quality-of-care, especially in terms of the various humanistic adjustments to the biomedical model. To that end he examines the metaphysical, epistemological, and ethical boundaries of these medical models. He begins with their metaphysics, analyzing the metaphysical positions and presuppositions and ontological commitments upon which medical knowledge and practice is founded. Next, he considers the epistemological issues that face these medical models, particularly those driven by methodological procedures undertaken by epistemic agents to constitute medical knowledge and practice. Finally, he examines the axiological boundaries and the ethical implications of each model, especially in terms of the physician-patient relationship. In a concluding Epilogue, he discusses how the philosophical analysis of the humanization of modern medicine helps to address the crisis-of-care, as well as the question of “What is medicine?” The book’s unique features include a comprehensive coverage of the various topics in the philosophy of medicine that have emerged over the past several decades and a philosophical context for embedding bioethical discussions. The book’s target audiences include both undergraduate and graduate students, as well as healthcare professionals and professional philosophers. “This book is the 99th issue of the Series Philosophy and Medicine...and it can be considered a crown of thirty years of intensive and dynamic discussion in the field. We are completely convinced that after its publication, it can be finally said that undoubtedly the philosophy of medicine exists as a special field of inquiry.”
Understanding the social process of diagnosis is critical to improving doctor-patient relationships and health outcomes. Diagnosis, the classification tool of medicine, serves an important social role. It confers social status on those who diagnose, and it impacts the social status of those diagnosed. Studying diagnosis from a sociological perspective offers clinicians and students a rich and sometimes provocative view of medicine and the cultures in which it is practiced. Social Issues in Diagnosis describes how diagnostic labels and the process of diagnosis are anchored in groups and structures as much as they are in the interactions between patient and doctor. The sociological perspective is informative, detailed, and different from what medical, nursing, social work, and psychology students—and other professionals who diagnose or work with diagnoses—learn in a pathophysiology or clinical assessment course. It is precisely this difference that should be integral to student and clinician education, enriching the professional experience with improved doctor-patient relationships and potentially better health outcomes. Chapters are written by both researchers and educators and reviewed by medical advisors. Just as medicine divides disease into diagnostic categories, so have the editors classified the social aspects of diagnosis into discrete areas of reflection, including • Classification of illness • Process of diagnosis • Phenomenon of uncertainty • Diagnostic labels • Discrimination • Challenges to medical authority • Medicalization • Technological influences • Self-diagnosis Additional chapters by clinicians, including New York Times columnist Lisa Sanders, M.D., provide a view from the front line of diagnosis to round out the discussion. Sociology and pre-med students, especially those prepping for the new MCAT section on social and behavioral sciences, will appreciate the discussion questions, glossary of key terms, and CLASSIFY mnemonic.
Social change has placed new demands on the practice of medicine, altering almost every aspect of patient care relationships. Just as medicine was encouraged to embrace the biological sciences some 100 years ago, recent directives indicate the importance of the social sciences in understanding biomedical practice. Humanistic challenges call for changes in curative and technological imperatives. In this book, social scientists contribute to such challenges by using social evidence to indicate appropriate new goals for health care in a changing environment. This book was designed to stimulate and challenge all those concerned with the human interactions that constitute medical practice. To encompass a wide range of topics, the authors include researchers; practicing physicians from the specialties of family, general, geriatric, pediatric, and oncological medicine; social and behavioral scientists; and public health representatives. Cutting across disciplinary boundaries, they explore the ethical, economic, and social aspects of patient care. These essays draw on past studies of the patient-doctor relationship and generate new and important questions. They address social behavior in patient care as a way to approach theoretical issues pertinent to the social and medical sciences. The authors also use social variables to study patient care and suggest new areas of sociomedical inquiry and new approaches to medical practice, education, and research. Its cross-disciplinary approach and jargon-free writing make this book an important and accessible tool for physician, scholar, and student.
In a series of papers published in the 1970s, Christopher Boorse proposed a naturalist theory of health, mainly based on a value-free concept of ‘biological function’, a concept of ‘reference class’ and the notion of ‘statistical normality’. His theory has profoundly shaped the philosophical debates on the concepts of health and disease. It could even be said that the numerous criticisms of his 'biostatistical theory' are at the centre of what is usually referred to as the debate between ‘normativists’ and ‘naturalists’. Today, the predominant naturalist theory of health is still Boorse’s biostatistical theory. This volume offers the first comprehensive review and critical assessment of the nature and status of naturalism in the philosophy of health. It explores the notion of biological normativity and its relevance for the philosophy of health, and it analyses the implications of the philosophical theories of health for healthcare and the debate on health enhancement. In the first section, several contributions identify the kind of ‘naturalism’ the biostatistical theory belongs to and offer further criticisms or possible modifications, such as the concept of function that is required by this theory, and whether a comparativist approach to health is more relevant than a non-comparativist one. The second section explores natural or biological ‘normativity’ and some possible accounts of health that could be based on this concept. The third and final section focuses on the implications of naturalism in healthcare. 'Goals of Medicine’ is the first paper in which Christopher Boorse ventured toward analysing the implication of his biostatistical theory of health on the practice of medicine, the difficult issue of the goals of medicine and the boundary between treating and enhancing. Other papers in this section critically evaluate Boorse’s account and analyse the importance of a positive concept of health.
CATHOLIC PERSPECTIVES AND CONTEMPORARY MEDICAL MORALS A Catholic perspective on medical morals antedates the current world wide interest in medical and biomedical ethics by many centuries[5]. Discussions about the moral status of the fetus, abortion, contraception, and sterilization can be found in the writings of the Fathers and Doctors of the Church. Teachings on various aspects of medical morals were scattered throughout the penitential books of the early medieval church and later in more formal treatises when moral theology became recog nized as a distinct discipline. Still later, medical morality was incorpor ated into the many pastoral works on medicine. Finally, in the contemporary period, works that strictly focus on medical ethics are produced by Catholic moral theologians who have special interests in matters medical. Moreover, this long tradition of teaching has been put into practice in the medical moral directives governing the operation of hospitals under Catholic sponsorship. Catholic hospitals were monitored by Ethics Committees long before such committees were recommended by the New Jersey Court in the Karen Ann Quinlan case or by the President's Commission in 1983 ([8, 9]). Underlying the Catholic moral tradition was the use of the casuistic method, which since the 17th and 18th centuries was employed by Catholic moralists to study and resolve concrete clinical ethical dilem mas. The history of casuistry is of renewed interest today when the case method has become so widely used in the current revival of interest in medical ethics[ll].
This book introduces the idea that ethics are an intrinsic dimension of any water policy, program, or practice, and that understanding what ethics are being acted out in water policies is fundamental to an understanding of water resource management. Thus in controversies or conflicts over water resource allocation and use, an examination of ethics can help clarify the positions of conflicting parties as preparation for constructive negotiations. The author shows the benefits of exposing tacit values and motivations and subjecting these to explicit public scrutiny where the values themselves can be debated. The aim of such a process is to create the proverbial 'level playing field', where values favoring environmental sustainability are considered in relation to values favoring short-term exploitation for quick economic stimulus (the current problem) or quick protection from water disasters (through infrastructure which science suggests is not sustainable). The book shows how new technologies, such as drip irrigation, or governance structures, such as river basin organizations are neither "good" nor "bad" in their own right, but can serve a range of interests which are guided by ethics. A new ethic of coexistence and synergies with nature is possible, but ultimately depends not on science, law, or finances but on the values we choose to adopt. The book includes a wide range of case studies from countries including Australia, India, Philippines, South Africa and USA. These cover various contexts including water for agriculture, urban, domestic and industrial use, the rights of indigenous people and river, watershed and ecosystem management.