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This is the first book that analyzes and systematizes all the general ideas of medicine, in particular the philosophical ones, which are usually tacit. Instead of focusing on one or two points — typically disease and clinical trial — this book examines all the salient aspects of biomedical research and practice: the nature of disease; the logic of diagnosis; the discovery and design of drugs; the design of lab and clinical trials; the crafting of therapies and design of protocols; the moral duties and rights of physicians and patients; the distinctive features of scientific medicine and of medical quackery; the unique combination of basic and translational research; the place of physicians and nurses in society; the task of medical sociology; and the need for universal medical coverage. Health care workers, medicine buffs, and philosophers will find this thought-provoking book highly useful in their line of work and research.
This is the first wide-ranging, multi-authored handbook in the field of philosophy of medicine, covering the underlying conceptual issues of many important social, political and ethical issues in health care. It introduces and develops over 70 topics, concepts, and issues in the field. It is written by distinguished specialists from multiple disciplines, including philosophy, health sciences, nursing, sociology, political theory, and medicine. Many difficult social and ethical issues in health care are based on conceptual problems, most prominently on the definitions of health and disease, or on epistemological issues regarding causality or diagnosis. Philosophy is the discipline that deals with such conceptual, metaphysical, epistemological, methodological, and axiological matters. This handbook covers all the central concepts in medicine, such as ageing, death, disease, mental disorder, and well-being. It is an invaluable source for laypeople, academics with an interest in medicine, and health care specialists who want be informed and up to date with the relevant discussions. The text also advances these debates and will set the agenda for years to come.
This volume covers a wide range of conceptual, epistemological and methodological issues in the philosophy of science raised by reflection upon medical science and practice. Several chapters examine such general meta-scientific concepts as discovery, reduction, theories and models, causal inference and scientific realism as they apply to medicine or medical science in particular. Some discuss important concepts specific to medicine (diagnosis, health, disease, brain death). A topic such as evidence, for instance, is examined at a variety of levels, from social mechanisms for guiding evidence-based reasoning such as evidence-based medicine, consensus conferences, and clinical trials, to the more abstract analysis of experimentation, inference and uncertainty. Some chapters reflect on particular domains of medicine, including psychiatry, public health, and nursing. The contributions span a broad range of detailed cases from the science and practice of medicine, as well as a broad range of intellectual approaches, from conceptual analysis to detailed examinations of particular scientific papers or historical episodes. Chapters view philosophy of medicine from quite different angles Considers substantive cases from both medical science and practice Chapters from a distinguished array of contributors
This book sheds light on important philosophical assumptions made by professionals working in clinical and research medicine. In doing so, it aims to make explicit how active philosophy is in medicine and shows how this awareness can result in better and more informed medical research and practice. It examines: what features make something a scientific discipline; the inherent tensions between understanding medicine as a research science and as a healing practice; how the “replication crisis” in medical research asks us to rethink the structure of knowledge production in our modern world; whether explanations have any real scientific values; the uncertainties about probabilistic claims; and whether it is possible for evidence-based medicine to truly be value free. The final chapter argues that the most important question we can ask is not, “How can we separate values from science?” but, “In a democratic society, how can we decide in a politically and morally acceptable way what values should drive science?” Key features: introduces complex philosophical issues in a manner accessible to non-professional academics; critically examines philosophical assumptions made in medicine, providing a better understanding of medicine that can lead to better healthcare; integrates medical examples and historic contexts so as to frame the rationale of philosophical views and provide lively illustrations of how philosophy can impact science and our lives; uses inter-connected chapters to demonstrate that disparate philosophical concepts are deeply related (e.g., it shows how the aims of medicine inform how we should understand theoretical reasoning).
Philosophy of Medicine asks two central questions about medicine: what is it, and what should we think of it? Philosophy of medicine itself has evolved in response to developments in the philosophy of science, especially with regard to epistemology, positioning it to make contributions that are medically useful. This book locates these developments within a larger framework, suggesting that much philosophical thinking about medicine contributes to answering one or both of these two guiding questions. Taking stock of philosophy of medicine's present place in the landscape and its potential to illuminate a wide range of areas, from public health to policy, Alex Broadbent introduces various key topics in the philosophy of medicine. The first part of the book argues for a novel view of the nature of medicine, arguing that medicine should be understood as an inquiry into the nature and causes of health and disease. Medicine excels at achieving understanding, but not at translating this understanding into cure, a frustration that has dogged the history of medicine and continues to the present day. The second part of the book explores how we ought to consider medicine. Contemporary responses, such as evidence-based medicine and medical nihilism, tend to respond by fixing high standards of evidence. Broadbent rejects these approaches in favor of Medical Cosmopolitanism, or a rejection of epistemic relativism and pluralism about medicine that encourages conversations between medical traditions. From this standpoint, Broadbent opens the way to embracing alternative medicine. An accessible and user-friendly guide, Philosophy of Medicine puts these different debates into perspective and identifies areas that demand further exploration.
It is estimated that up to thirteen percent of hospital admissions result from the adverse effects of diagnosis or treatment, and that almost seventy percent of iatrogenic complications are preventable. The obligation to 'do no harm' has been central to medical conduct since ancient times, yet iatrogenic illness has now come to be recognized as a significant risk factor in health care delivery. This book integrates history, philosophy, medical ethics and empirical data to examine the concept and phenomenon of medical harm. Issues covered include appropriateness of care, acceptable risk and practitioner accountability, and the book concludes with recommendations for limiting iatrogenic harm. Essential reading for medical ethicists, physicians and those involved in health care policy and administration, this stimulating and highly readable book will be of interest to all providers of health care, and many of their patients.
Debates over health care have focused for so long on economics that the proper goals for medicine seem to be taken for granted; yet problems in health care stem as much from a lack of agreement about the goals and priorities of medicine as from the way systems function. This book asks basic questions about the purposes and ends of medicine and shows that the answers have practical implications for future health care delivery, medical research, and the education of medical students. The Hastings Center coordinated teams of physicians, nurses, public health experts, philosophers, theologians, politicians, health care administrators, social workers, and lawyers in fourteen countries to explore these issues. In this volume, they articulate four basic goals of medicine — prevention of disease, relief of suffering, care of the ill, and avoidance of premature death — and examine them in light of the cultural, political, and economic pressures under which medicine functions. In reporting these findings, the contributors touch on a wide range of diverse issues such as genetic technology, Chinese medicine, care of the elderly, and prevention and public health. The Goals of Medicine clearly demonstrates the importance of clarifying the purposes of medicine before attempting to change the economic and organizational systems. It warns that without such examination, any reform efforts may be fruitless.
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.”
This book probes the ethical structure of contemporary medicine in an argument accessible to lay readers, healthcare professionals, and ethicists alike.