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Philosophy, Ethics, and Humanities in Medicine: PEHM

Gernot Rüter, Thomas Fröhlich
In an everyday private practice setting, regularly also existential topics will emerge from doctor-patient encounters. These are often questions of coping with life and lifestyle. To enable a thorough discussion of such topics, an implicit, and sometimes also explicit reference to a philosophical background is needed. Philosophical concepts to be used in this realm are discussed. An individual patient-doctor interaction is used as an example to demonstrate the doctor's choice of hermeneutical and phenomenological philosophical concepts...
January 29, 2019: Philosophy, Ethics, and Humanities in Medicine: PEHM
Mary E Kollmer Horton
Use of humanities content in American medical education has been debated for well over 60 years. While many respected scholars and medical educators have purported the value of humanities content in medical training, its inclusion remains unstandardized, and the undergraduate medical curriculum continues to be focused on scientific and technical content. Cited barriers to the integration of humanities include time and space in an already overburdened curriculum, and a lack of consensus on the exact content, pedagogy and instruction...
January 4, 2019: Philosophy, Ethics, and Humanities in Medicine: PEHM
Richard Fenton
This extended essay seeks to unpack some of the key aspects of philosophy which are applicable to medical thought and practice. It proceeds via an analytical discussion of the contemporary debate in three key areas of medical ethics: euthanasia, concepts of health & disease and psychiatry.The main claims are as follows: 1. The case for legalising euthanasia is strong on philosophical grounds but there are numerous practical obstacles. 2. Elements from the normative and naturalistic definitions of disease are necessary for a thorough definition that dodges common objections to either...
November 9, 2018: Philosophy, Ethics, and Humanities in Medicine: PEHM
Christian Michael Armstrong Holland, Edward Harry Arbe-Barnes, Euan Joseph McGivern, Ruairidh Mungo Connor Forgan
In an increasingly data-driven age of medicine, do companies that offer genetic testing directly to patients represent an important part of personalising care, or a dangerous threat to privacy? Should we celebrate this new mechanism of patient involvement, or fear its implications?The Universities of Oxford and Cambridge addressed these issues in the 10th annual Medical Ethics Varsity Debate, through the motion: "This House Regrets the Rise of Direct-to-Consumer Genetic Testing". This article summarises and extends key arguments made in the debate, exploring the impacts of such genetic testing on both the individual patient and broader society, with special consideration as to whether companies can ever truly guarantee anonymity of genetic data...
October 29, 2018: Philosophy, Ethics, and Humanities in Medicine: PEHM
Edward J Calabrese
BACKGROUND: This paper assesses possible reasons why Hermann J. Muller avoided peer-review of data that became the basis of his Nobel Prize award for producing gene mutations in male Drosophila by X-rays. METHODS: Extensive correspondence between Muller and close associates and other materials were obtained from preserved papers to compliment extensive publications by and about Muller in the open literature. These were evaluated for potential historical insights that clarify why he avoided peer-review of his Nobel Prize findings...
October 19, 2018: Philosophy, Ethics, and Humanities in Medicine: PEHM
Harald Walach, Michael Loughlin
BACKGROUND: The success of medicine in the treatment of patients brings with it new challenges. More people live on to suffer from functional, chronic or multifactorial diseases, and this has led to calls for more complex analyses of the causal determinants of health and illness. METHODS: Philosophical analysis of background assumptions of the current paradigmatic model. RESULTS: While these factors do not require a radical paradigm shift, they do give us cause to develop a new narrative, to add to existing narratives that frame our thinking about medical care...
October 14, 2018: Philosophy, Ethics, and Humanities in Medicine: PEHM
Chris Gilmartin, Edward H Arbe-Barnes, Michael Diamond, Sasha Fretwell, Euan McGivern, Myrto Vlazaki, Limeng Zhu
The 2018 Varsity Medical Ethics debate convened upon the motion: "This house believes that the constant monitoring of our health does more harm than good". This annual debate between students from the Universities of Oxford and Cambridge is now in its tenth year. This year's debate was hosted at the Oxford Union on 8th of February 2018, with Oxford winning for the Opposition, and was the catalyst for the collation and expansion of ideas in this paper.New technological devices have the potential to enhance patient autonomy, improve patient safety, simplify the management of chronic diseases, increase connectivity between patients and healthcare professionals and assist individuals to make lifestyle changes to improve their health...
September 3, 2018: Philosophy, Ethics, and Humanities in Medicine: PEHM
Chiedozie G Ike, Nancy Anderson
Teaching bioethics with visual education tools, such as movies and comics, is a unique way of explaining the history and progress of human research and the art and science of medicine to high school students. For more than a decade, bioethical concepts have appeared in movies, and these films are useful for teaching medical and research ethics in high schools. Using visual tools to teach bioethics can have both interpretational and transformational effects on learners that will enhance their overall understanding of complex moral and legal issues in medicine and research...
July 20, 2018: Philosophy, Ethics, and Humanities in Medicine: PEHM
Zaev D Suskin, James J Giordano
Neurosurgeon Sergio Canavero proposed the HEAVEN procedure - i.e. head anastomosis venture - several years ago, and has recently received approval from the relevant regulatory bodies to perform this body-head transplant (BHT) in China. The BHT procedure involves attaching the donor body (D) to the head of the recipient (R), and discarding the body of R and head of D. Canavero's proposed procedure will be incredibly difficult from a medical standpoint. Aside from medical doubt, the BHT has been met with great resistance from many, if not most bio- and neuroethicists...
July 13, 2018: Philosophy, Ethics, and Humanities in Medicine: PEHM
Helena M Olivieri
Acting for the good of the patient is the most fundamental and universally acknowledged principle of medical ethics. However, given the complexity of modern medicine as well as the moral fragmentation of contemporary society, determining the good is far from simple. In his philosophy of medicine, Edmund Pellegrino develops a conception of the good that is derived from the internal morality of medicine via the physician-patient relationship. It is through this healing relationship that rights, duties, and privileges are defined for both physicians and patients...
July 6, 2018: Philosophy, Ethics, and Humanities in Medicine: PEHM
Joel Michael Reynolds
BACKGROUND: Edmund Pellegrino lamented that the cultural climate of the industrialized West had called the fundamental means and ends of medicine into question, leading him to propose a renewed reflection on medicine's basic concepts, including health, disease, and illness. My aim in this paper is take up Pellegrino's call. I argue that in order to usher in this renewal, the concept of ambiguity should take on a guiding role in medical practice, both scientific and clinical. After laying out Pellegrino's vision, I focus on the concept of normality, arguing that it undergirds modern medicine's other basic concepts...
July 4, 2018: Philosophy, Ethics, and Humanities in Medicine: PEHM
Johanna Shapiro
We are more used to thinking of medicine in relation to the ways that it alleviates the effects of violence. Yet an important thread in the academic literature acknowledges that medicine can also be responsible for perpetuating violence, albeit unintentionally, against the very individuals it intends to help. In this essay, I discuss definitions of violence, emphasizing the importance of understanding the term not only as a physical perpetration but as an act of power of one person over another. I next explore the paradox of a healing profession that is permeated with violence sometimes necessary, often unintentional, and almost always unrecognized...
June 11, 2018: Philosophy, Ethics, and Humanities in Medicine: PEHM
Edward J Calabrese
This historical analysis indicates that it is highly unlikely that the Nobel Prize winning research of Hermann J. Muller was peer-reviewed. The published paper of Muller lacked a research methods section, cited no references, and failed to acknowledge and discuss the work of Gager and Blakeslee (PNAS 13:75-79, 1927) that claimed to have induced gene mutation via ionizing radiation six months prior to Muller's non-data Science paper (Muller, Science 66(1699):84-87, 1927a). Despite being well acclimated into the scientific world of peer-review, Muller choose to avoid the peer-review process on his most significant publication...
June 6, 2018: Philosophy, Ethics, and Humanities in Medicine: PEHM
Berkeley Franz, John W Murphy
BACKGROUND: Despite an expansive literature on communication in medicine, the role of language is dealt with mostly indirectly. Recently, narrative medicine has emerged as a strategy to improve doctor-patient communication and integrate patient perspectives. However, even in this field which is predicated on language use, scholars have not specifically reflected on how language functions in medicine. METHODS: In this theoretical paper, the authors consider how different models of language use, which have been proposed in the philosophical literature, might be applied to communication in medicine...
June 5, 2018: Philosophy, Ethics, and Humanities in Medicine: PEHM
Luchuo Engelbert Bain
Edmund Pellegrino considered medicine as a skill, art, and perhaps most importantly, a moral enterprise. In this essay, I attempt to exemplify how the legacy and contributions of Edmund Pellegrino, as a teacher and a physician, could allow for a renaissance of medical practice in which physicians engage intellectual and moral virtue to both effect sound care, and do so in a humanitarian way, rather than in simple accordance with a business model of medicine. The virtues are viewed in a renewed light as being key characteristics of physicians, and important to patient centered care...
April 10, 2018: Philosophy, Ethics, and Humanities in Medicine: PEHM
Alessandra Gasparetto, Ralf J Jox, Mario Picozzi
Clinical ethics consultation (CEC), as an activity that may be provided by clinical ethics committees and consultants, is nowadays a well-established practice in North America. Although it has been increasingly implemented in Europe and elsewhere, no agreement can be found among scholars and practitioners on the appropriate role or approach the consultant should play when ethically problematic cases involving conflicts and uncertainties come up. In particular, there is no consensus on the acceptability of consultants making recommendations, offering moral advice upon request, and expressing personal opinions...
February 27, 2018: Philosophy, Ethics, and Humanities in Medicine: PEHM
Sarah Wieten
BACKGROUND: Expertise has been a contentious concept in Evidence-Based Medicine (EBM). Especially in the early days of the movement, expertise was taken to be exactly what EBM was rebelling against-the authoritarian pronouncements about "best" interventions dutifully learned in medical schools, sometimes with dire consequences. Since then, some proponents of EBM have tried various ways of reincorporating the idea of expertise into EBM, with mixed results. However, questions remain...
February 2, 2018: Philosophy, Ethics, and Humanities in Medicine: PEHM
Agnès Condat, Nicolas Mendes, Véronique Drouineaud, Nouria Gründler, Chrystelle Lagrange, Colette Chiland, Jean-Philippe Wolf, François Ansermet, David Cohen
Today, thanks to biomedical technologies advances, some persons with fertility issues can conceive. Transgender persons benefit also from these advances and can not only actualize their self-identified sexual identities but also experience parenthood. Based on clinical multidisciplinary seminars that gathered child psychiatrists and psychoanalysts interested in the fields of assisted reproduction technology (ART) and gender dysphoria, philosophers interested in bioethics, biologists interested in ART, and endocrinologists interested in pubertal suppression, we explore how new biotechnical advances, whether in gender transition or procreation, could create new ways to conceive a child possible...
January 17, 2018: Philosophy, Ethics, and Humanities in Medicine: PEHM
Michele Farisco, Kathinka Evers
BACKGROUND: Ethical analyses of disorders of consciousness traditionally focus on residual awareness. Going one step further, this paper explores the potential ethical relevance of the unawareness retained by patients with disorders of consciousness, focusing specifically on the ethical implications of the description of the unconscious provided by recent scientific research. METHODS: A conceptual methodology is used, based on the review and analysis of relevant scientific literature on the unconscious and the logical argumentation in favour of the ethical conclusions...
December 29, 2017: Philosophy, Ethics, and Humanities in Medicine: PEHM
Charles E Dean
BACKGROUND: Despite five decades of increasingly elegant studies aimed at advancing the pathophysiology and treatment of mental illness, the results have not met expectations. Diagnoses are still based on observation, the clinical history, and an outmoded diagnostic system that stresses the historic goal of disease specificity. Psychotropic drugs are still based on molecular targets developed decades ago, with no increase in efficacy. Numerous biomarkers have been proposed, but none have the requisite degree of sensitivity and specificity, and therefore have no usefulness in the clinic...
December 19, 2017: Philosophy, Ethics, and Humanities in Medicine: PEHM
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