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What kind of knowledge is medical knowledge? Can medicine be explained scientifically? Is disease a scientific concept, or do explanations of disease depend on values? What is "evidence-based" medicine? Are advances in neuroscience bringing us closer to a scientific understanding of the mind? The nature of medicine raises fundamental questions about explanation, causation, knowledge and ontology – questions that are central to philosophy as well as medicine. This book introduces the fundamental issues in philosophy of medicine for those coming to the subject for the first time, including: • understanding the physician–patient relationship: the phenomenology of the medical encounter. • Models and theories in biology and medicine: what role do theories play in medicine? Are they similar to scientific theories? • Randomised controlled trials: can scientific experiments be replicated in clinical medicine? What are the philosophical criticisms levelled at RCTs? • The concept of evidence in medical research: what do we mean by "evidence-based medicine"? Should all medicine be based on evidence? • Causation in medicine. • What do advances in neuroscience reveal about the relationship between mind and body? • Defining health and disease: are explanations of disease objective or do they depend on values? • Evolutionary medicine: what is the role of evolutionary biology in understanding medicine? Is it relevant? Extensive use of empirical examples and case studies are included throughout, including debates about smoking and cancer, the use of placebos in randomised controlled trials, controversies about PSA testing and research into the causes of HIV. This is an indispensable introduction to those teaching philosophy of medicine and philosophy of science.
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.
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 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 innovative book clarifies the distinction between philosophy of medicine and medical philosophy, expanding the focus from the ‘knowing that’ of the first to the ‘knowing how’ of the latter. The idea of patient and provider self-discovery becomes the method and strategy at the basis of therapeutic treatment. It develops the concept of ‘Central Medicine’, aimed at overcoming the dichotomies of Western–Eastern medicine and Traditional–Integrative approaches. Evidence-based and patient-centered medicine are analyzed in the context of the debate on placebo and non-specific effects alongside clinical research on the patient-doctor relationship, and the interactive nature of human relationships in general, including factors such as environment, personal beliefs, and perspectives on life’s meaning and purpose. Tomasi’s research incorporates neuroscience, psychology, philosophy, and medicine in a clear, readable, and detailed way, satisfying the needs of professionals, students, and anyone who enjoys the exploration of the complexity of human mind, brain, and heart.
Medical practice is practiced morality, and clinical research belongs to normative ethics. The present book elucidates and advances this thesis by: 1. analyzing the structure of medical language, knowledge, and theories; 2. inquiring into the foundations of the clinical encounter; 3. introducing the logic and methodology of clinical decision-making, including artificial intelligence in medicine; 4. suggesting comprehensive theories of organism, life, and psyche; of health, illness, and disease; of etiology, diagnosis, prognosis, prevention, and therapy; and 5. investigating the moral and metaphysical issues central to medical practice and research. Many systems of (classical, modal, non-classical, probability, and fuzzy) logic are introduced and applied. Fuzzy medical deontics, fuzzy medical ontology, fuzzy medical concept formation, fuzzy medical decision-making and biomedicine and many other techniques of fuzzification in medicine are introduced for the first time.
Edmund D. Pellegrino has played a central role in shaping the fields of bioethics and the philosophy of medicine. His writings encompass original explorations of the healing relationship, the need to place humanism in the medical curriculum, the nature of the patient’s good, and the importance of a virtue-based normative ethics for health care. In this anthology, H. Tristram Engelhardt, Jr., and Fabrice Jotterand have created a rich presentation of Pellegrino’s thought and its development. Pellegrino’s work has been dedicated to showing that bioethics must be understood in the context of medical humanities, and that medical humanities, in turn, must be understood in the context of the philosophy of medicine. Arguing that bioethics should not be restricted to topics such as abortion, third-party-assisted reproduction, physician-assisted suicide, or cloning, Pellegrino has instead stressed that such issues are shaped by foundational views regarding the nature of the physician-patient relationship and the goals of medicine, which are the proper focus of the philosophy of medicine. This volume includes a preface (“Apologia”) by Dr. Pellegrino and a comprehensive Introduction by the editors. Of interest to medical ethicists as well as students, scholars, and physicians, The Philosophy of Medicine Reborn offers fascinating insights into the emergence of a field and the work of one of its pioneers.
Evidence-based medicine (EBM) has become a required element of clinical practice, but it is critical for the healthcare community to understand the ongoing controversy surrounding EBM. Seeking to address questions raised by critics, The Philosophy of Evidence-based Medicine challenges the over dependency of EBM on randomized controlled trials. This book also explores EBM methodology and its relationship with other approaches used in medicine.
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.
The philosophy of medicine has become a vibrant and complex intellectual landscape, and Care and Cure is the first extended attempt to map it. In pursuing the interdependent aims of caring and curing, medicine relies on concepts, theories, inferences, and policies that are often complicated and controversial. Bringing much-needed clarity to the interplay of these diverse problems, Jacob Stegenga describes the core philosophical controversies underlying medicine in this unrivaled introduction to the field. The fourteen chapters in Care and Cure present and discuss conceptual, metaphysical, epistemological, and political questions that arise in medicine, buttressed with lively illustrative examples ranging from debates over the true nature of disease to the effectiveness of medical interventions and homeopathy. Poised to be the standard sourcebook for anyone seeking a comprehensive overview of the canonical concepts, current state, and cutting edge of this vital field, this concise introduction will be an indispensable resource for students and scholars of medicine and philosophy.