http://www.peh-med.com The most accessed research articles published by Philosophy, Ethics, and Humanities in Medicine 2010-02-25T00:00:00Z This is an RSS newsfeed from BioMed Central It is intended to be used with an RSS reader. For more information about RSS newsfeeds from BioMed Central, visit http://www.biomedcentral.com/info/about/rss/ Basing ourselves on the writings of Hans Jonas, we offer to psychosomatic medicine a philosophy of life that surmounts the mind-body dualism which has plagued Western thought since the origins of modern science in seventeenth century Europe. Any present-day account of reality must draw upon everything we know about the living and the non-living. Since we are living beings ourselves, we know what it means to be alive from our own first-hand experience. Therefore, our philosophy of life, in addition to starting with what empirical science tells us about inorganic and organic reality, must also begin from our own direct experience of life in ourselves and in others; it can then show how the two meet in the living being. Since life is ultimately one reality, our theory must reintegrate psyche with soma such that no component of the whole is short-changed, neither the objective nor the subjective. In this essay, we lay out the foundational components of such a theory by clarifying the defining features of living beings as polarities. We describe three such polarities:1) Being vs. non-being: Always threatened by non-being, the organism must constantly re-assert its being through its own activity.2) World-relatedness vs. self-enclosure: Living beings are both enclosed with themselves, defined by the boundaries that separate them from their environment, while they are also ceaselessly reaching out to their environment and engaging in transactions with it.3) Dependence vs. independence: Living beings are both dependent on the material components that constitute them at any given moment and independent of any particular groupings of these components over time.We then discuss important features of the polarities of life: Metabolism; organic structure; enclosure by a semi-permeable membrane; distinction between "self" and "other"; autonomy; neediness; teleology; sensitivity; values. Moral needs and values already arise at the most basic levels of life, even if only human beings can recognize such values as moral requirements and develop responses to them. http://www.peh-med.com/content/5/1/2 Michael Schwartz Osborne Wiggins Philosophy, Ethics, and Humanities in Medicine 2010, 5:2 2010-01-21T00:00:00Z doi:10.1186/1747-5341-5-2 Philosophy, Ethics, and Humanities in Medicine 1747-5341 5 2 2010-01-21T00:00:00Z XML Background: Delusion is one of the most intriguing psychopathological phenomena and its conceptualization remains the subject of genuine debate. Claims that it is ill-defined, however, are typically grounded on essentialist expectations that a given definition should capture the core of every instance acknowledged as delusion in the clinical setting. Objective: In this paper, we attempt to show the major limitations of the definition of delusion from a non-essentialist point of view. Method: The problem is analyzed within the framework of constructs and their translation into definitions. Different linguistic and epistemological perspectives that do concur when one deals with psychopathological phenomena are also considered. Results: The 'construct of delusion', rather than its clinical instances, is the reference in which its definition appears inept. Here we claim that the broad contextual and pragmatic bases that underpin the construct of delusion tend to be either overlooked or downplayed in the quest for a satisfactory definition of this phenomenon. http://www.peh-med.com/content/5/1/5 Adriano Rodrigues Claudio Banzato Philosophy, Ethics, and Humanities in Medicine 2010, 5:5 2010-02-25T00:00:00Z doi:10.1186/1747-5341-5-5 Philosophy, Ethics, and Humanities in Medicine 1747-5341 5 5 2010-02-25T00:00:00Z PDF Over 45 million Americans are uninsured or underinsured. Those living in poverty exhibit the worst health status. Employment, education, income, and race are important factors in a person's ability to acquire healthcare access. Having established that there are people lacking healthcare access due to multi-factorial etiologies, the question arises as to whether the intervention necessary to assist them in obtaining such access should be considered a privilege, or a right. The right to healthcare access is examined from the perspective of Western thought. Specifically through the works of Aristotle, Immanuel Kant, Thomas Hobbes, Thomas Paine, Hannah Arendt, James Rawls, and Norman Daniels, which are accompanied by a contemporary example of intervention on behalf of the medically needy by the The Johns Hopkins Urban Health Institute.As human beings we are all valuable social entities whereby, through the force of morality, through implicitly forged covenants among us as individuals and between us and our governments, and through the natural rights we maintain as individuals and those we collectively surrender to the common good, it has been determined by nature, natural laws, and natural rights that human beings have the right, not the privilege, to healthcare access. http://www.peh-med.com/content/2/1/2 Thomas Papadimos Philosophy, Ethics, and Humanities in Medicine 2007, 2:2 2007-03-28T00:00:00Z doi:10.1186/1747-5341-2-2 Philosophy, Ethics, and Humanities in Medicine 1747-5341 2 2 2007-03-28T00:00:00Z XML A common theme in the contemporary medical model of psychiatry is that pathophysiological processes are centrally involved in the explanation, evaluation, and treatment of mental illnesses. Implied in this perspective is that clinical descriptors of these pathophysiological processes are sufficient to distinguish underlying etiologies. Psychiatric classification requires differentiation between what counts as normality (i.e.- order), and what counts as abnormality (i.e.- disorder). The distinction(s) between normality and pathology entail assumptions that are often deeply presupposed, manifesting themselves in statements about what mental disorders are.In this paper, we explicate that realism, naturalism, reductionism, and essentialism are core ontological assumptions of the medical model of psychiatry. We argue that while naturalism, realism, and reductionism can be reconciled with advances in contemporary neuroscience, essentialism - as defined to date - may be conceptually problematic, and we pose an eidetic construct of bio-psychosocial order and disorder based upon complex systems' dynamics. However we also caution against the overuse of any theory, and claim that practical distinctions are important to the establishment of clinical thresholds. We opine that as we move ahead toward both a new edition of the Diagnostic and Statistical Manual, and a proposed Decade of the Mind, the task at hand is to re-visit nosologic and ontologic assumptions pursuant to a re-formulation of diagnostic criteria and practice. http://www.peh-med.com/content/5/1/3 Tejas Patil James Giordano Philosophy, Ethics, and Humanities in Medicine 2010, 5:3 2010-01-28T00:00:00Z doi:10.1186/1747-5341-5-3 Philosophy, Ethics, and Humanities in Medicine 1747-5341 5 3 2010-01-28T00:00:00Z XML Through its adoption of the biomedical model of disease which promotes medical individualism and its reliance on the individual-based anthropology, mainstream bioethics has predominantly focused on respect for autonomy in the clinical setting and respect for person in the research site, emphasizing self-determination and freedom of choice. However, the emphasis on the individual has often led to moral vacuum, exaggeration of human agency, and a thin (liberal?) conception of justice. Applied to resource-poor countries and communities within developed countries, autonomy-based bioethics fails to address the root causes of diseases and public health crises with which individuals or communities are confronted. A sociological explanation of disease causation is needed to broaden principles of biomedical ethics and provides a renewed understanding of disease, freedom, medical practice, patient-physician relationship, risk and benefit of research and treatment, research priorities, and health policy. http://www.peh-med.com/content/5/1/1 Jacquineau Azetsop Stuart Rennie Philosophy, Ethics, and Humanities in Medicine 2010, 5:1 2010-01-18T00:00:00Z doi:10.1186/1747-5341-5-1 Philosophy, Ethics, and Humanities in Medicine 1747-5341 5 1 2010-01-18T00:00:00Z XML This paper examines the philosophical substructure to the theoretical conflicts that permeate contemporary mental health care in the UK. Theoretical conflicts are treated here as those that arise among practitioners holding divergent theoretical orientations towards the phenomena being treated. Such conflicts, although steeped in history, have become revitalized by recent attempts at integrating mental health services that have forced diversely trained practitioners to work collaboratively together, often under one roof. Part I of this paper examines how the history of these conflicts can be understood as a tension between, on the one hand, the medical model and its use by the dominant profession of psychiatry, and on the other, those alternative models and practitioners in some way differentiated from the medical model camp. Examples will be given from recent policy and research to highlight the prevalence of this tension in contemporary practice. Part II of this paper explores the deeper commonalities that lay beneath the theoretical conflict outlined in Part I. These commonalities will be shown to be apart of a captivating framework that has continued to grip the conflict since its inception. By exposing this underlying framework--and the motivations inherent therein--the topic of integration appears in wholly different light, allowing a renewed philosophical basis for integration to emerge. http://www.peh-med.com/content/5/1/4 Nathan Gerard Philosophy, Ethics, and Humanities in Medicine 2010, 5:4 2010-02-04T00:00:00Z doi:10.1186/1747-5341-5-4 Philosophy, Ethics, and Humanities in Medicine 1747-5341 5 4 2010-02-04T00:00:00Z XML It is one of the central aims of the philosophy of science to elucidate the meanings of scientific terms and also to think critically about their application. The focus of this essay is the scientific term predict and whether there is credible evidence that animal models, especially in toxicology and pathophysiology, can be used to predict human outcomes. Whether animals can be used to predict human response to drugs and other chemicals is apparently a contentious issue. However, when one empirically analyzes animal models using scientific tools they fall far short of being able to predict human responses. This is not surprising considering what we have learned from fields such evolutionary and developmental biology, gene regulation and expression, epigenetics, complexity theory, and comparative genomics. http://www.peh-med.com/content/4/1/2 Niall Shanks Ray Greek Jean Greek Philosophy, Ethics, and Humanities in Medicine 2009, 4:2 2009-01-15T00:00:00Z doi:10.1186/1747-5341-4-2 Philosophy, Ethics, and Humanities in Medicine 1747-5341 4 2 2009-01-15T00:00:00Z XML In Voltaire's work, Candide, a young, naïve man, who has been taught that humans live in the best of all possible worlds, is thrust into the world only to find that this may not be so. He learns over time to balance his optimism with the skepticism he acquires through experience. While today's medical students are not naïve like the character Candide, they, nonetheless, carry an impression of the ideal medical practice, along with the expectation of a successful medical practice. Good mentors and role models are important to students in order to temper their optimism, control their skepticism, and to help them to be realistic, not only about their expectations of medical practice, but what society expects of them. http://www.peh-med.com/content/2/1/13 Thomas Papadimos Philosophy, Ethics, and Humanities in Medicine 2007, 2:13 2007-07-03T00:00:00Z doi:10.1186/1747-5341-2-13 Philosophy, Ethics, and Humanities in Medicine 1747-5341 2 13 2007-07-03T00:00:00Z XML One argument used by detractors of human embryonic stem cell research (hESCR) invokes Kant's formula of humanity, which proscribes treating persons solely as a means to an end, rather than as ends in themselves. According to Fuat S. Oduncu, for example, adhering to this imperative entails that human embryos should not be disaggregated to obtain pluripotent stem cells for hESCR. Given that human embryos are Kantian persons from the time of their conception, killing them to obtain their cells for research fails to treat them as ends in themselves.This argument assumes two points that are rather contentious given a Kantian framework. First, the argument assumes that when Kant maintains that humanity must be treated as an end in itself, he means to argue that all members of the species Homo sapiens must be treated as ends in themselves; that is, that Kant regards personhood as co-extensive with belonging to the species Homo sapiens. Second, the argument assumes that the event of conception is causally responsible for the genesis of a Kantian person and that, therefore, an embryo is a Kantian person from the time of its conception.In this paper, I will present challenges against these two assumptions by engaging in an exegetical study of some of Kant's works. First, I will illustrate that Kant did not use the term "humanity" to denote a biological species, but rather the capacity to set ends according to reason. Second, I will illustrate that it is difficult given a Kantian framework to denote conception (indeed any biological event) as causally responsible for the creation of a person. Kant ascribed to a dualistic view of human agency, and personhood, according to him, was derived from the supersensible capacity for reason. To argue that a Kantian person is generated due to the event of conception ignores Kant's insistence in various aspects of his work that it is not possible to understand the generation of a person qua a physical operation. Finally, I will end the paper by drawing from Allen Wood's work in Kantian philosophy in order to generate an argument in favor of hESCR. http://www.peh-med.com/content/3/1/4 Bertha Alvarez Manninen Philosophy, Ethics, and Humanities in Medicine 2008, 3:4 2008-01-31T00:00:00Z doi:10.1186/1747-5341-3-4 Philosophy, Ethics, and Humanities in Medicine 1747-5341 3 4 2008-01-31T00:00:00Z XML Critical care is in an emerging crisis of conflict between what individuals expect and the economic burden society and government are prepared to provide. The goal of critical care support is to prevent suffering and premature death by intensive therapy of reversible illnesses within a reasonable timeframe. Recently, it has become apparent that early support in an intensive care environment can improve patient outcomes. However, life support technology has advanced, allowing physicians to prolong life (and postpone death) in circumstances that were not possible in the recent past. This has been recognized by not only the medical community, but also by society at large. One corollary may be that expectations for recovery from critical illness have also become extremely high. In addition, greater numbers of patients are dying in intensive care units after having receiving prolonged durations of life-sustaining therapy. Herein lies the emerging crisis – critical care therapy must be available in a timely fashion for those who require it urgently, yet its provision is largely dependent on a finite availability of both capital and human resources. Physicians are often placed in a troubling conflict of interest by pressures to use health resources prudently while also promoting the equitable and timely access to critical care therapy. In this commentary, these issues are broadly discussed from the perspective of the individual clinician as well as that of society as a whole. The intent is to generate dialogue on the dynamic between individual clinicians navigating the complexities of how and when to use critical care support in the context of end-of-life issues, the increasing demands placed on finite critical care capacity, and the reasonable expectations of society. http://www.peh-med.com/content/4/1/3 Robert McDermid Sean Bagshaw Philosophy, Ethics, and Humanities in Medicine 2009, 4:3 2009-02-12T00:00:00Z doi:10.1186/1747-5341-4-3 Philosophy, Ethics, and Humanities in Medicine 1747-5341 4 3 2009-02-12T00:00:00Z XML