Health and Illness

Phenomenology has been adapted for use in qualitative health research, where it’s often used as a method for conducting interviews and analyzing interview data. But how can phenomenologists study subjects who cannot accurately reflect upon or report their own experiences, for instance, because of a psychiatric or neurological disorder? For conditions like these, qualitative researchers may gain more insight by conducting observational studies in lieu of, or in conjunction with, interviews. In this article, we introduce a phenomenological approach to conducting (...) this kind of observational research. The approach relies on conceptual grounding to focus a study on specific aspects of the participants’ experiences. Moreover, the approach maintains the openness to novel discoveries that qualitative research requires while also providing a structured framework for data collection and analysis. To illustrate its practical application, we use examples of hemispatial neglect—a neurologic disorder in which patients characteristically lack awareness of their own illness and bodily capacities. However, the approach that we describe can be applied more broadly to the study of complex illness experiences and other experiential alterations. (shrink)

What position on dualism does medicine require? Our understanding of that ques- tion has been dictated by holism, as defined by the biopsychosocial model, since the late twentieth century. Unfortunately, holism was characterized at the start with con- fused definitions of ‘dualism’ and ‘reductionism’, and that problem has led to a deep, unrecognized conceptual split in the medical professions. Some insist that holism is a nonreductionist approach that aligns with some form of dualism, while others insist it’s a reductionist view (...) that sets out to eradicate dualism. It’s important to consider each version. Nonreductive holism is philosophically consistent and clinically unprob- lematic. Reductive holism, however, is conceptually incoherent—yet it is the basis for the common idea that the boundary between medical and mental health disorders must be vague. When we trace that idea through to its implementation in medical practice, we find evidence that it compromises the safety of patient care in the large portion of cases where clinicians grapple with diagnosis at the boundary between psychiatry and medicine. Having established that medicine must embrace some form of nonreduc- tionism, I argue that Chalmers’ naturalistic dualism is a stronger prima facie candidate than the nonreductive alternatives. Regardless of which form of nonreductionism we prefer, some philosophical corrections are needed to give medicine a safe and coherent foundation. (shrink)

It is often taken for granted that notions of health and disease are generally applicable across the biological world, in that they are not restricted to contemporary human beings, and can be unproblematically applied to a variety of organisms both past and present (taking relevant differences between species into account). In the historical sciences it is also common to normatively contrast health states of individuals and populations from different times and places: e.g., to say that due to nutrition or pathogen (...) load, some lived healthier lives than others. However, health concepts in contemporary philosophy of medicine have not been developed with such cross-lineage, non-human, or diachronic uses in mind, and this generates what I call the ‘new normal’ problem. I argue that the new normal problem shows that current naturalistic approaches to health (when based on biological reference classes) are worryingly incomplete. Using examples drawn from evolutionary archaeology and the human fossil record, I outline an alternative, function-based strategy for naturalizing health that might help address the new normal problem. Interestingly, this might also reconstruct a certain uniqueness for humans in the philosophy and science of health, due to the deep history of obligate enculturation and cultural adaptation that archaeology demonstrates. (shrink)

Major Depressive Disorder (MDD) is a serious condition with a large disease burden. It is often claimed that MDD is a “brain disease.” What would it mean for MDD to be a brain disease? I argue that the best interpretation of this claim is as offering a substantive empirical hypothesis about the causes of the syndrome of depression. This syndrome-causal conception of disease, combined with the idea that MDD is a disease of the brain, commits the brain disease conception of (...) MDD to the claim that brain dysfunction causes the symptoms of MDD. I argue that this consequence of the brain disease conception of MDD is false. It incorrectly rules out genuine instances of content-sensitive causation between adverse conditions in the world and the characteristic symptoms of MDD. Empirical evidence shows that the major causes of depression are genuinely psychological causes of the symptoms of MDD. This rules out, in many cases, the “brute” causation required by the brain disease conception. The existence of cases of MDD with non-brute causes supports the reinstatement of the old nosological distinction between endogenous and exogenous depression. (shrink)

Phenomenology has contributed to healthcare by providing resources for understanding the lived experience of the patient and their situation. But within a burgeoning literature on the characteristic features of illness, there has not yet been an account appropriate to describe congenital illnesses: conditions which are present from birth and cause suffering or medical threat to their bearers. Congenital illness sits uncomfortably with standard accounts in phenomenology of illness, in which concepts such as loss, doubt, alienation and unhomelikeness presuppose prior health. (...) These accounts reflect, in different ways, Maurice Merleau-Ponty’s assumption that the ways of living of the ill contain allusions to fundamental, healthy functions. The originality of congenital illness complicates this assumption and demands its own original phenomenology. In this paper, I sketch my personal experience living with a single-ventricle heart condition. While some of this story may reflect my own idiosyncratic experience, I hope that much of it will resonate with the congenital illness experience. I argue that the phenomenological literature on illness, grounded in the notion of loss, does not describe the congenital illness experience. I show how a number of other patient-centred theories of health and illness which have been influential on phenomenology can and cannot elucidate congenital illness. In particular, I consider Georges Canguilhem’s account of the normal and the pathological; debates in disability; and the notion of illness as biographical disruption. I show that congenital illness results in the preadmission of its patients to a paradoxical logic of medical palliation, one product of which is existential maturity. (shrink)

A large part of contemporary phenomenology of medicine has been devoted to accounts of health and illness, arguing that they contribute to the improvement of healthcare. Less focus has been paid to the issue of prevention of disease and the associated difficulty of adhering to health-promoting behaviours, which is arguably of equal importance. This article offers a phenomenological account of this disease prevention, focusing on how we – as embodied beings – engage with health-promoting behaviours. It specifically considers how we (...) engage with oral hygiene regimes to prevent periodontitis and why we are not good at it. The article suggests that poor adherence to health-promoting behaviours can be explained with reference to the concept of the absent body, as prevention of disease is generally concerned with pre-symptomatic illness experience. The final section contains a discussion of some strategies for the improvement of disease prevention based on this viewpoint. (shrink)

Jonathan Y. Tsou examines and defends positions on central issues in philosophy of psychiatry. The positions defended assume a naturalistic and realist perspective and are framed against skeptical perspectives on biological psychiatry. Issues addressed include the reality of mental disorders; mechanistic and disease explanations of abnormal behavior; definitions of mental disorder; natural and artificial kinds in psychiatry; biological essentialism and the projectability of psychiatric categories; looping effects and the stability of mental disorders; psychiatric classification; and the validity of the DSM's (...) diagnostic categories. The main argument defended by Tsou is that genuine mental disorders are biological kinds with harmful effects. This argument opposes the dogma that mental disorders are necessarily diseases that result from biological dysfunction. Tsou contends that the broader ideal of biological kinds offers a more promising and empirically ascertainable naturalistic standard for assessing the reality of mental disorders and the validity of psychiatric categories. (shrink)

Selon l’une des thèses les plus répétées de la médecine narrative, la théorie littéraire, ou plus largement, la narration, permettrait aux membres du personnel médical d’appréhender les récits des patients et par là, de prendre en considération leurs expériences dans leur singularité absolue. Dans ma contribution, je soulignerai quelques limites de cette thèse. J’appuierai mon analyse sur un exemple de récit dominant de maladie, les récits portant sur le cancer du sein aux États-Unis au XXe siècle, à partir des analyses (...) féministes qui en ont été faites. Ainsi je montrerai d’une part qu’il est peu plausible que les récits des patients soient absolument singuliers et uniques, en un sens pertinent, et d’autre part que certains récits peuvent devenir dominants et marginaliser des récits qui voudraient s’en démarquer. (shrink)

Background: Physical exercises can affect executive function both acutely and chronically, with different mechanisms for each moment. Currently, only a few reviews have elaborated on the premise that different types of exercises have different mechanisms for improving executive function. Therefore, the primary purpose of our systematic review was to analyze the effects of acute and chronic exercises on executive function in children and adolescents.Objective: We identified acute and chronic exercise studies and randomized controlled trials of executive function in children and (...) adolescents that reported overall effect, heterogeneity, and publication bias of acute and chronic exercises on executive function.Methods: We searched for RCTs of exercise interventions in children and adolescents from databases including PubMed, Web of Science, Scopus, The Cochrane Library, CNKI, and Wanfang, from January 1 2009 to December 31 2019. We performed methodological quality evaluations on the included literature using the Physiotherapy Evidence Database Scale and graded evidence with a meta-analysis using Stata 12.0 software.Results: In total, 36 RCTs were included ; the overall results of the meta-analysis indicated that acute exercises significantly improved working memory = −0.72; 95% confidence interval −0.89 to −0.56; p < 0.001), inhibitory control, and cognitive flexibility, whereas chronic exercises significantly improved working memory, inhibitory control, and cognitive flexibility.Conclusion: Acute and chronic exercises can effectively improve the executive function of children and adolescents. The effects on inhibitory control and cognitive flexibility are considered as small effect sizes, while the effects on working memory are considered as moderate effect size. Limited by the quantity and quality of the included studies, the above conclusions need to be verified with more high-quality studies. (shrink)

This book offers a philosophically-based, yet clinically-oriented perspective on current medical reasoning aiming at 1) identifying important forms of uncertainty permeating current clinical reasoning and practice 2) promoting the application of an abductive methodology in the health context in order to deal with those clinical uncertainties 3) bridging the gap between biomedical knowledge, clinical practice, and research and values in both clinical and philosophical literature. With a clear philosophical emphasis, the book investigates themes lying at the border between several disciplines, (...) such as medicine, nursing, logic, epistemology, and philosophy of science; but also ethics, epidemiology, and statistics. At the same time, it critically discusses and compares several professional approaches to clinical practice such as the one of medical doctors, nurses and other clinical practitioners, showing the need for developing a unified framework of reasoning, which merges methods and resources from many different clinical but also non-clinical disciplines. In particular, this book shows how to leverage nursing knowledge and practice, which has been considerably neglected so far, to further shape the interdisciplinary nature of clinical reasoning. Furthermore, a thorough philosophical investigation on the values involved in health care is provided, based on both the clinical and philosophical literature. The book concludes by proposing an integrative approach to health and disease going beyond the so-called “classical biomedical model of care”. (shrink)

Is it possible to train empathy? We suggest a new way, based on insights from phenomenology.

En este artículo abordamos los conceptos de «salud» y «enfermedad» tal y como han sido entendidos en el seno de la Logoterapia del psiquiatravienés Viktor Frankl, uno de los métodos psicoterapéuticos más importantes del siglo XX. Esta psicoterapia existencial otorga preeminencia a la dimensión noética o espiritual de la salud, que ha sido, sin embargo, totalmente obviada en el debate naturalismo/normativismo propio de la filosofía de la medicina. Por ello, en este escrito tratamos de mostrar de qué modo las aportaciones (...) teóricas de Viktor Frankl pueden contribuir a la discusión filosófica acerca del estatuto ontológico de la enfermedad, especialmente en el ámbito polémico dela psiquiatría. (shrink)

Aims and Objectives. This article uses the concept of embodiment to demonstrate a conceptual approach to applied phenomenology. -/- Background. Traditionally, qualitative researchers and healthcare professionals have been taught phenomenological methods, such as the epoché, reduction, or bracketing. These methods are typically construed as a way of avoiding biases so that one may attend to the phenomena in an open and unprejudiced way. However, it has also been argued that qualitative researchers and healthcare professionals can benefit from phenomenology’s well-articulated theoretical (...) framework, which consists of core concepts, such as selfhood, empathy, temporality, spatiality, affectivity, and embodiment. -/- Design. This is a discursive article that demonstrates a conceptual approach to applied phenomenology. -/- Method. To outline and explain this approach to applied phenomenology, the Discussion section walks the reader through four stages of phenomenology, which progress incrementally from the most theoretical to the most practical. -/- Discussion. Part one introduces the philosophical concept of embodiment, which can be applied broadly to any human subject. Part two shows how philosophically trained phenomenologists use the concept of embodiment to describe general features of illness and disability. Part three illustrates how the phenomenological concept of embodiment can inform empirical qualitative studies and reflects on the challenges of integrating philosophy and qualitative research. Part four turns to phenomenology’s application in clinical practice and outlines a workshop model that guides clinicians through the process of using phenomenological concepts to better understand patient experience. -/- Conclusion and Relevance to Clinical Practice. A conceptual approach to applied phenomenology provides a valuable alternative to traditional methodological approaches. Phenomenological concepts provide a foundation for better understanding patient experience in both qualitative health research and clinical practice, and therefore provide resources for enhancing patient care. (shrink)

A very basic form of experience consists in feeling energetic, vital, alive, tired, dispirited, vigorous and so on. These feelings – which I call feelings of vitality or vital feelings – constitute the main concern of this paper. My aim is to argue that these feelings exhibit a distinctive form of affectivity which cannot be explained in terms of emotions, moods, background feelings or existential feelings and to explore different paths for their conceptualization. The paper proceeds as follows. After introducing (...) the topic (sect. 1), I show that these feelings cannot be subsumed under any of the current categories of the affective mind (sect. 2). Against this backdrop, I present and critically assess Scheler’s notion of vital feelings as an alternative model for capturing their distinctive nature (sect. 3). Next, I explore varieties of vital feelings by focusing on different levels of the bodily-felt experience (sect. 4) and analyze their specific form of self-involvement (sect. 5). Finally, I conclude by showing how the study of vital feelings might contribute to phenomenological bioethics (sect. 6). (shrink)

In this article I aim to make progress towards the philosophical goal of ascertaining what, if anything, all mental illnesses have in common, attempting to unify a large sub-set of them that have a relational or interpersonal dimension. One major claim is that, if we want a promising theory of mental illness, we must go beyond the dominant western accounts of mental illness/health, which focus on traits intrinsic to a person such as pain/pleasure, lethargy/liveliness, fragmentation/integration, and falsehood/authenticity. A second major (...) claim is that the relational facets of mental illness are plausibly understood theoretically in terms of a person’s inability to identify with others or to exhibit solidarity with them, relational values that are salient in the African philosophical tradition. I show that these two extrinsic properties well explain several intuitive instances of mental illness, including, amongst several others, being abusive, psychopathic, narcissistic, histrionic, paranoid, and phobic. (shrink)

The Global Burden of Disease Study is one of the largest-scale research collaborations in global health, producing critical data for researchers, policy-makers, and health workers about more than 350 diseases, injuries, and risk factors. Such an undertaking is, of course, extremely complex from an empirical perspective. But it also raises complex ethical and philosophical questions. In this volume, a group of leading philosophers, economists, epidemiologists, and policy scholars identify and discuss these philosophical questions. Better appreciating the philosophical dimensions of a (...) study like the GBD can make possible a more sophisticated interpretation of its results, and it can improve epidemiological studies in the future, so that they are better suited to produce results that help us to improve global health. (shrink)

The modern concept of ideology was established by the liberal politician and philosopher Destutt de Tracy, with the objective of creating an all-embracing and general science of ideas, which followed the sensualist and empiricist trend initiated by Locke that culminated in the positivism of Comte. Natural selection and immunity are two key concepts in the history of biology that were strongly based on the Malthusian concept of struggle for existence. This concept wrongly assumed that population grew faster than the means (...) of existence. This “natural” law contained implicitly the idea that the poor and least gifted would not survive. This idea led to the progressive development of the concept of natural selection, whose definitive version was given by Darwin. Mechnikov took the concepts of struggle for existence and natural selection and conceived infectious diseases as a struggle between a host and its invader, the so-called phagocytosis theory. This theory created the necessity to possess mechanisms to discriminate between the own and the foreign, and led to the conception of the immune self. These concepts were not developed from ideas coming from perceptions or sensations, but from ideas coming from their values: individual interest, inevitable inequality, property, utility and profit. Values are ideals that constitute an ideological matrix which exerts a numinous activity and influence the development of our future actions. In consequence, science and its practice cannot avoid and ignore the values that drive them and impulse them towards certain directions. (shrink)

This philosophical dialogue explores some of the barriers to an adequate definition of general health, encompassing physical, social, and mental/emotional well-being. Many of the putative obstacles to such a definition—concerns about subjectivity, cultural difference, marginal cases, etc.—prove to be chimerical once the characters take seriously the Peircean insight that truth-claims methodologically grounded in people’s lives, experiences, and conversations need not be apodictic to be useful. Drawing on Canguilhem and others, the characters critically discuss a proposed definition of health: a dynamic (...) equilibrium by which a human being thrives in relation to its situation. Although they do not manage to resolve all of this definition’s difficulties, or all of their differences, their interaction in some ways models the ongoing task of inquiry. (shrink)

Thanks to how Girolamo Fracastoro defines the different types of contagion in his book De contagione, et contagiosis morbis et eorum curatione, libri tres (1546), and his defense of the “seeds of contagion” (seedbed) as the cause of contagious diseases, he is considered today one parent of the modern epidemiology and microbiology. One of the crucial problems in this book is to explain the remote transmission of the contagious diseases refuting the etiologic use of the occult qualities. The aim of (...) this study is to investigate the philosophical background of the problem and draw the conclusions that his solution had for medicine and for science in general. (shrink)

What is the appropriate relation of human reason to the human psyche--indeed, to human life--taken as a whole? The essays in this volume range over literature and ethics, psychoanalysis, social theory, and ancient Greek philosophy. But, from different angles, they all address this question. Wisdom Won from Illness probes deep into the heart of psychoanalysis to understand how it illuminates the human condition. At the same time it goes back to the origins of psychological thinking in ancient Greece--and the effort (...) to understand the ethical life of human beings. It examines the continuing travails of the Crow Nation in its efforts to find ways to live after cultural catastrophe. It probes the deep meaning of Kierkegaard's irony. It also considers two of the great writers of our time--John Coetzee and Marilynne Robinson--and their use of literature to change the human mind. Socrates thought reason should rule over the whole psyche; but much hangs on what we might mean by this claim. We humans have inflicted unimaginable suffering on each other, justified by arrogant conceptions of reason, and of ruling. The same is true of our treatment of other animals. False images of reason regularly blind us to the claims and reality of others. One way to react to all this pain and destruction is to denounce the very idea of reason as nothing more than an ideological tool of power. This book argues that is the wrong way to go. We should not be too quick to dismiss our real human capacities just because they have so often been put to such poor uses. The essays in this book aim to offer a philosophical anthropology and psychology that is adequate to who we are--and who we might legitimately hope to become.--. (shrink)

In some quarters within philosophy of medicine, more particularly in the phenomenological approaches, naturalism is looked upon with suspicion. This paper argues, first, that it is necessary to distinguish between two expressions of this attitude towards naturalism: phenomenological approaches to illness disagree with naturalism regarding various theoretical claims and they disapprove of naturalism on an ethical level. Second, this paper argues that both the disagreement with and the disapproval of naturalism are to a large extent confused. It then offers some (...) proposals to set up an agenda for future collaboration. (shrink)

According to recent approaches in the philosophy of medicine, biomedicine should be replaced or complemented by a humanistic medical model. Two humanistic approaches, narrative medicine and the phenomenology of medicine, have grown particularly popular in recent decades. This paper first suggests that these humanistic criticisms of biomedicine are insufficient. A central problem is that both approaches seem to offer a straw man definition of biomedicine. It then argues that the subsequent definition of humanism found in these approaches is problematically reduced (...) to a compassionate or psychological understanding. My main claims are that humanism cannot be sought in the patient–physician relationship alone and that a broad definition of medicine should help to revisit humanism. With this end in view, I defend what I call an outcomes-oriented approach to humanistic medicine, where humanism is set upon the capacity for a health system to produce good health outcomes. (shrink)

Obesity is the focus of multiple lines of inquiry that have -- together and separately -- produced many deep insights into the physiology of weight gain and maintenance. We examine three such streams of research and show how they are oriented to obesity intervention through multilevel integrated approaches. The first research programme is concerned with the genetics and biochemistry of fat production, and it links metabolism, physiology, endocrinology and neurochemistry. The second account of obesity is developmental and draws together epigenetic (...) and environmental explanations that can be embedded in an evolutionary framework. The third line of research focuses on the role of gut microbes in the production of obesity, and how microbial activities interact with host genetics, development and metabolism. These interwoven explanatory strategies are driven by an orientation to intervention, both for experimental and therapeutic outcomes. We connect the integrative and intervention-oriented aspects of obesity research through a discussion of translation, broadening the concept to capture the dynamic, iterative processes of scientific practice and therapy development. This system-oriented analysis of obesity research expands the philosophical scrutiny of contemporary developments in the biosciences and biomedicine, and has the potential to enrich philosophy of science and medicine. (shrink)

Public health policies typically assume that there are characteristics and constraints over health that an individual cannot control and that there are choices that an individual could change if he is nudged or provided with incentives. We consider that health is determined by a range of personal, social, economic and environmental factors and we discuss to what extent an individual can control these factors. In particular, we assume that the observed health status of an individual is a result of factors (...) within the individual’s control and constraints the individual faces. We suggest three different constraints: budget, time and psychological constraints and position various determinants of health according to increasing levels of constraint and increasing degrees of individual control. We finally discuss public health policies such as nudging, intervening and rewarding within this new framework and show that the level of constraints and the degree of individual control on health status are essential dimensions to consider when designing and implementing public health policies. (shrink)

Despite the conceptual problems in identifying the placebo effect, an increasing number of multidisciplinary inquiries rest on the assumption that there is a distinct class of effects, placebo effects. In this chapter, I argue against this assumption. I present cases and characterizations of the placebo effect as offered in the literature, and argue that the latter are subject to insurmountable problems. Moreover, I argue that identification of placebo effects as such is not useful for the three main purposes offered in (...) the literature. I then offer suggestions for why it may remain intuitive that some effects are placebo effects and close by noting the potential benefits of ultimately explaining away these intuitions. (shrink)

Discussions of patient-centred care and patient autonomy in bioethics have tended to focus on the decision-making context and the process of obtaining informed consent, leaving open the question of how patients ought to be counselled in the daily maintenance of their health and management of chronic disease. Patient activation is an increasingly prominent counselling approach and measurement tool that aims to improve patients’ confidence and skills in managing their own health conditions. The strategy, which has received little conceptual or ethical (...) analysis, raises important questions about how clinicians ought to foster confidence and a sense of control in their patients without exposing them to blame, stigma and other harms. In this paper, we describe patient activation, discuss its relationship to personal responsibility, autonomy and health disparities, and make recommendations regarding its use and measurement. (shrink)

The Foucaultian sociologist Nikolas Rose has influentially argued that psychosocial technologies have offered means through which the ideals of democracy can be made congruent with the management of social life and the government of citizens in modern western liberal democracies. This interpretation is contested here through an examination of the 1948 International Congress on Mental Health held in London and the mental hygiene movement that organized it. It is argued that, in Britain, this movement’s theory and practice represents an uneasy (...) and ambiguous attempt to reconcile visions of ‘the modern’ with ‘the traditional’. The mental hygienist emphasis on the family is central. Here it appears as a forcing-house of the modern self-sustaining individual. Mental hygienists cast the social organization of ‘traditional’ communities as static, with rigid authority frustrating both social progress and the full emergence of individual personality. Yet mental hygienists were also concerned about threats to social cohesion and secure personhood under modernity. If the social organization of ‘traditional’ communities was patterned by the archetype of the family, with its personal relations of authority, mental hygienists compressed these relations into the ‘private’ family. Situated here they became part of a developmental process of mental adjustment through which ‘mature’, responsible citizens emerged. This reformulation of the family’s centrality for the social order informed mental hygienist critiques of the growth of state power under existing forms of democracy, as well as suspicion of popular political participation or protest, and of movements towards greater egalitarianism. (shrink)

This article reflects upon the debate, initiated by Bernard Williams in 1973, concerning the desirability of immortality, where the latter expression is taken to mean endless bodily life as a human or humanoid being. Williams contends that it cannot be desirable; others have disputed this contention. I discuss a recent response from Timothy Chappell and attempt to pinpoint the central disagreement between Chappell and Williams. I propose that neither side in the debate has firm grounds for its claims, and then (...) proceed to consider four reasons for suspecting that the whole debate has yet to be placed on a conceptually coherent footing. (shrink)

The crisis of our day is epitomized by Paul Kurtz in two propositions: -"Theistic religions... are in retreat." "Most traditional moral and philosophical guideposts seem to be crumbling." On the basis of these findings, Kurtz asks incisively what new directions need to be taken in order that we may sight more promising guideposts. He develops, in the final pages of his book, a series of proposed answers to that question. In the section in which he depicts the crumbling of traditional (...) guideposts, he elaborates on, first, "the death of theism," marshaling what he considers the most persuasive objections to the standard arguments for theism; secondly, the "perversion of Marxism" as seen in "man’s spiritual death and a new kind of suffering" in Marxist countries; and, thirdly, excesses of the New Left, the mindlessness of certain viewpoints of the counter-culture, and continuing hypocrisy in the political establishment. Among the upbeat principles which Kurtz offers at the end as more humane guideposts are promotion of the idea that life can be meaningful, worthwhile, and full; application of rationality and the ideal of moderation to problems of sexual and other forms of libertarianism; recognition of tolerance as a major value; respect for equality of opportunity for individuals; strengthening of "the democratic ethic;" and redirecting of "the promise of technology." On the prospects for widespread adoption of these guideposts, Kurtz declares: "Whether we will be able to realize these potentialities cannot be determined beforehand. Our future is contingent and precarious..." Our future can be one of "human greatness," he concludes, "if we will but give full vent to the highest within us-our intelligence, our capacity for compassion, our audacious spirit."—W.G. (shrink)

In this article I will bring phenomenological analysis to medicine, but differently from many "humane" approaches to various medical issues, I will explore from the standpoint of Husserlian phenomenological philosophy one "empirical" method of medical diagnostics, i.e. medical imaging, which in turn belongs to the celebrated tradition of scientific imaging. Hence I will relate three major Husserlian projects, that is Categorial intuition. Image Consciousness and Constitution of the Other to radiological diagnostics, based on various modes of medical imaging, for example, (...) stages of radiological diagnosis and the structure of Image Consciousness. This perspective opens up the way to distil transcendental conditions of the "radiologist at work", to see the importance of mediating intentionalities, discovered by Husserl, for any theoretical enterprise and to speculate about the possible improvement of diagnostics performed by human being and/or computer. (shrink)

This article first appeared in Life and Learning XIV: Proceedings of the Fourteenth University Faculty for Life Conference, and is reprinted here with the kind permission of the editor, Joseph W. Koterski, S.J..Despite the enormous attention it received, the Terri Schindler-Schiavo litigation is not legally significant. The litigation involved the application of a fairly well-settled legal framework. This framework permitted, however, an unjust result. The controversy over Terri’s fatehas, though, helped to focus attention on a consensus that is in need (...) of re-examination. This paper explores the lessons that ought to be learned from the Terri Schindler-Schiavo litigation. After briefly discussing the basic facts and the complex litigation history, the paper considers the relevant federal constitutional and Florida law. The paper then critiques Florida law and explains the legal and moral considerations that ought to inform the re-examination that is so sorely needed. The most important effort needed is to restore the sanctity of life ethic. (shrink)

Gupta effectively probes the methodological and ethical presuppostions of Evidence Based Medicine, and its more contestable application to psychiatry. She concludes with an endorsement of a very modest reformulation of it as one guide to practice among many.

Defenders of evolutionary medicine claim that medical professionals and public health officials would do well to consider the role of evolutionary biology with respect to the teaching, research, and judgments pertaining to medical theory and practice. An integral part of their argument is that the human body should be understood as a bundle of evolutionary compromises. Such an appreciation, which includes a proper understanding of biological function and physiological homeostasis, would provide a crucial perspective regarding the understanding and securing of (...) human health needs currently lacking in the medical arena. (shrink)

In Ecological Thinking, Lorraine Code argues that advocacy “often makes knowledge possible” and without it “certain kinds of knowing are impossible.” By acknowledging the value of subjectivity and testimony in knowledge creation, I argue that ecological thinking serves as an appropriate framework for engagement with individuals who are living with mental illnesses. Contrasted with the dominant Anglo-American epistemologies that involve excessive degrees of mastery and control (with the tendency to silence the voices of Others), I argue that ecological thinking facilitates (...) healthy advocacy practices precisely because of its inclusivity and receptivity towards different perspectives in knowledge creation. (shrink)