The move to patient-centered medical practice is important for providing relevant and sustainable health care. Narrative medicine, for example, suggests that patients should be involved significantly in diagnosis and treatment. In order to understand the meaning of symptoms and interventions, therefore, physicians must enter the life worlds of patients. But physicians face high patient loads and limited time for extended consultations. In current medical practice, then, is narrative medicine possible? We argue that engaging patient perspectives in the medical visit does (...) not necessarily require a lengthy interview. Instead, a new orientation to this process that emphasizes dialogue between practitioners and patients should be considered. In this new model, the purpose of the visit is to communicate successfully and develop a mutual understanding of illness and care. (shrink)

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. 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. In particular, the authors contrast the traditional, indexical thesis of language with new models that focus on interpretation instead of standardization. The authors demonstrate how paying close attention to the role of language in medicine provides a philosophical foundation for supporting recent changes in doctor-patient communication. In particular, interpretive models are at the foundation of new approaches such as narrative medicine, that emphasize listening to patient stories, rather than merely collecting information. Ultimately, debates regarding the role of language which have largely resided in non-medical literatures, have important implications for describing communication in medicine. In particular, interpretive models of language use provide an important rationale for facilitating a more robust dialogue between doctors and patients. (shrink)

Critics are calling for the decolonization of AI (artificial intelligence). The problem is that this technology is marginalizing other modes of knowledge with dehumanizing applications. What is needed to remedy this situation is the development of human-centric AI. However, there is a serious blind spot in this strategy that is addressed in this paper. The corrective that is usually proposed—participatory design—lacks the philosophical rigor to undercut the autonomy of AI, and thus the colonization spawned by this technology. A more radical (...) or substantial proposal is advanced in this discussion that is known as community-based design. This alternative makes a theoretical maneuver that allows AI design to be directed by human agency, thereby introducing a safeguard that may help to prevent colonization by this technology. (shrink)

Choi and Murphy seek to analyze the key facets of the debate over PC. Until now, PC has tended to be treated in news stories, magazines articles, and reports where the examination of PC has been short and under developed--rarely have the writers looked beyond single issues. Choi and Murphy provide a comprehensive examination of PC, from its philosophical underpinnings and historical background, through the significance of post-structural philosophy and postmodern literary criticism.

Murphy's study is the first to bring a broad interdisciplinary perspective to the subject and to present postmodernism as a coherent social theory.

Six articles discuss the benefits and disadvantages of postmodern philosophy as a foundation for social work and human service practice. Simultaneously co-published as Social Thought, v.18, no.3 1998. Annotation copyrighted by Book News, Inc., Portland, OR.

Professors Murphy and Choi use postmodern philosophy to expose an important source of racism and cultural domination. They examine foundationalism, which they see at the core of the Western intellectual tradition and which is shown to foster a metaphysics of domination. By contrast, postmodernism undermines this root of racism. They demonstrate that foundationalism is not needed to support identity, institutions, or political order. Indeed, they assert that true pluralism is possible once foundationalist approaches to knowledge and order are set aside. (...) Special attention is directed to two current modes of discrimination: institutional racism and symbolic violence. Murphy and Choi provide an intriguing look at ways to undercut the justification for racism and other threats to cultural difference. This volume will be of particular interest to scholars and other researchers in the areas of race relations, cultural studies, and political theory. (shrink)

Though many social service practitioners believe that computerization dehumanizes clients and should be avoided, this work demonstrates how, through a holistic approach to computer use, these problems can be solved. By providing an introduction to both theoretical and practical issues, Murphy and Pardeck promote a rational understanding of the possible uses and limitations of computers in social service agencies. They focus on the philosophical justification of computer use and the conceptual or symbolic nature of computerization, as well as illustrating how (...) to create the organizational conditions necessary for computers to improve social service delivery. (shrink)

Reason and Rationality in Health and Human Services Delivery is the first book to discuss the topic of decisionmaking and services from a multidisciplinary approach. It uses theory and social considerations, not just technology, as a basis for improved services. Health and human service students and professionals will learn how to form rational and reasonable decisions that take their clients'cultural backgrounds into consideration when identifying an illness or appropriating any kind of intervention. With a particular emphasis on theories, models, organizational (...) settings, technologies, and practitioner training methods that lead to culturally sensitive decisions, Reason and Rationality will help you deliver efficient and improved medical and social services to clients from all ethnic backgrounds. Recognizing reason as the centerpiece of most of Western philosophy, this text reveals how our idea of truth, fact, and order are wrongly thought to be universal; yet, Western principles are continually used in the decision-making process for health and social services. Focusing on the policy implications of decisionmaking in medical and social service settings, this text works to incorporate a broad range of factors into the reasoning process, such as cultural traditions and beliefs, that will result in better treatment for patients. Giving you suggestions and strategies for upgrading reasoning and decision-making processes and applying them to every area of service, Reason and Rationality discusses different themes that will help you improve services to patients, such as: the rationale currently used to justify decision-making strategies concerning medical and human services using computer technology to make clinical assessments revising administrative structure, management theories, and organizational strategies so that decision-making processes enhance the overall quality of service delivery how the practitioner/patient relationship is important in choosing the proper treatment soliciting community-based input to assess the public's health and human service needs in order to lessen political involvement in decision-making stages In addition, Reason and Rationality provides information and examples that show why you should consider the "life-world"--the values, beliefs, and commitments of a culture's history-- as the key to understanding the powers of reasoning that specify parameters of health and illness. (shrink)

Most workers report that they are alienated from their jobs and find their workplaces to be stifling and uninviting. Given this condition, the introduction of computer technology, including AI, will only make matters worse, unless a more humane organizational culture is created. The key point in this article is the need to produce a responsible technology, so that employees are not further overworked and manipulated. To achieve this end, phenomenology is invoked, particularly the life world, to provide technology with a (...) human foundation. In practice, this shift in philosophy means that when AI is introduced into an organization, workers have a central role in the design, implementation, and evaluation of this technology. Computer technology can thus promote human flourishing instead of control and alienation in workplaces. (shrink)

Social planners have begun to recognize that communities are an important resource for solving many problems. Understanding local norms and values is thought to provide insight into how issues are defined and what interventions might be considered practical. Communities in this framework are not just the physical locations at which programs are targeted, but are actively constructed spaces that must be properly understood. In many ways, the field of public health has been sensitive to this understanding and has elevated the (...) community in importance, thus emphasizing that significant features are variable and locally defined. Even in the new public health, however, empirical indicators are still often relied on, thereby leading to the increasing standardization of communities, rather than to openness to neighborhood particularities. For this reason, a community-based focus should guide future public health endeavors. Most important, this strategy underscores the importance of getting to know the communities in which symptoms, illness and care are defined, and allows for full participation by community members that make interventions both relevant and sustainable. (shrink)

The purpose of this article is to introduce the sociological reader to the thought of merleau-ponty, specifically how that author can be applied to the work a sociologist purports to accomplish. also, this article also attempts to provide the sociologically trained reader with an introduction to phenomenological philosophy, and how that philosophy handles many of the traditional problems discussed by the sociologist. this article outlines such common sociological themes as methodology, individualism, social institutions, and culture from a phenomenological perspective, which (...) will hopefully make the sociologist more sensitive to the meaning of the social world. (shrink)