In Sahan et al ’s article,1 they present the ethical challenges faced by clinical laboratory scientists in genetic medicine, including labour allocation and responsibility, interpretation and accuracy of results with new technologies, and the need for better standardisation and ethical consistency. At the same time, they also propose a potential solution to the aforementioned challenges: ethical preparedness(EP). Along with their vivid case discussions and insightful analysis, I would like to propose two more points that are worth further examination and (...) discussion to aid stakeholders in better comprehending the ethical issues that clinical laboratory scientists face in the practice of genetic medicine. The case 1 reported by Sahan et al raises concerns about who should be responsible for tracking families or individuals with genetic results, particularly in the absence of mainstream services to track future risks. However, this should not be a factor influencing the decision to inform gene carriers. If there is a clear division of responsibilities in current practice, clinical laboratory scientists can report detected gene carriers without psychological burden. However, the decision to report gene carriers should be based on who is being served when clinical laboratory scientists face genetic problems in clinical practice and who is being considered when …. (shrink)

As disenchantment began to be recognized as a recurring, never-ending process in recent scholarship, “When Jupiter Meets Saturn” argues that Aby Warburg and Karl Sudhoff’s debate on Reformation astrological medicine provided a new theory of the emergence of modern science and rationality. Drawing on their encounter and divergence in interwar Germany, especially their curatorial collaboration for the 1911 Internationale Hygiene-Ausstellung, the article shows that Warburg and Sudhoff generated completely opposite historical evaluations of astrological medicine using the very same (...) materials. Approaching history as healers, they developed different ways of seeing from medical epistemologies and brought out entangled temporalities from images. (shrink)

This book offers cutting edge research on the modifications and disruptions of bodily experience in the context of anxiety, depression, trauma, chronic illness, pain, and aging. It presents original contributions in applied phenomenology, biomedical ethics, and the use of medical technologies.

Recent years have seen a rise in the number of sociological, anthropological, and ethnological works on the gift metaphor in organ donation contexts, as well as in the number of philosophical and theological analyses of giving and generosity, which has been mirrored in the ethical debate on organ donation. In order to capture the breadth of this field, four frameworks for thinking about bodily exchanges in medicine have been distinguished: property rights, heroic gift-giving, sacrifice, and gift-giving as aporia. Unfortunately, (...) they all run into difficulties in terms of both making sense of the relational dimensions of postmortem and live organ donations and being normatively adequate in the sense of shedding light and providing guidance on ethical concerns when body parts are donated. For this reason, this article presents a phenomenological framework of giving-through-sharing, based on Maurice Merleau-Ponty’s philosophy. This framework makes sense of relational dimensions of postmortem and live organ donation. It also sheds light on three highly debated concerns in organ donation ethics: indebtedness on the part of recipients, the fact that some live donors do not experience donation as a matter of choice, and the potentially painful experience of donors’ relatives, who need to make decisions about postmortem organ donation at a time of bereavement. It can indirectly support what may be called a normalization of bodily exchanges in medicine. (shrink)

‘四象醫學’으로 象徵되는 동무 이제마(1837~1900)의 四象說은 이제 학적체계를 구축한 하나의 학문으로서 정립되어, 그 학문적 위상은 매우 높다고 할 수 있다. 하지만 그의 사상설에는 기초적인 이론적 토대에 관한 논의에 있어서조차 아직 해결하지 못한 뜨거운 쟁점 또한 존재한다.BR 크게 보면 두 가지 정도인데, 그중 하나가 ‘사상의학은 한의학의 기초 이론인 오행론을 수용하는가?’의 與否문제이며, 또 다른 하나는 “동무 자신의 醫論에 (본래 ‘四象’이라는 용어의 출처인) 『주역』의 ‘易理’를 적용했을까?”라는 문제이다.BR 이에 대한 견해는 현재 학자에 따라 긍정 혹은 부정으로 크게 갈린다. 동무의 주요 저작으로는 철학서인 『格致藁』(1880~1893)와 의학적 내용을 (...) 담고 있는 『東醫壽世保元』(1894)이 있고, 이외에도 易理로 『東醫壽世保元』을 풀이한 『東武遺稿』(시기 미상), 五行에 관한 서술이 들어 있는 『東醫壽世保元草本卷』(1882~1883?) 등이 있으나, 후자의 문헌들은 典據로서의 신뢰를 얻지 못하고 있다. ‘四象’의 주역설을 옹호하는 이들은 주로 『東武遺稿』를 전거로 제시하지만, 반론을 제기하는 이들은 필사본 초고 형태로 발견된 이미상의 문집이 동무의 직접적인 저작물이 아닐 수 있다는 의구심을 품는다.BR 본고에서는 『東醫壽世保元』을 역리로 해석한 斗庵韓東錫(1911~1968)의 『東醫壽世保元註釋』(1967)을 통해 『東醫壽世保元』 ｢性命論｣서두에 나오는 개념들의 敍述方式을 분석하였다. 이 서술 방식을 相異한 방식으로 서술한 다른 문장들과 비교해 보면, ‘四象’의 導出이 易理에 근거하고 있음을 추론해 보는 것이 가능하다. 즉 『동의수세보원』 ｢性命論｣과 『東武遺稿』에 나타난 四象에 관한 서술 순서[방식]는 易理[天機]의 관점과 인간주체적[四象人] 관점을 병행했을 때라야 비로소 이해 가능하다. 다시 말해 본고에서는 ‘四象’의 도출 과정에 관한 중요한 단서를 동무가 직접 저술한 문헌들을 통해 얻고자 하였다. (shrink)

A definitive and authoritative guide to a vibrant and growing discipline in current philosophy, The Bloomsbury Companion to Contemporary Philosophy of Medicine presents an overview of the issues facing contemporary philosophy of medicine, the research methods required to understand them and a trajectory for the discipline's future. -/- Written by world leaders in the discipline, this companion addresses the ontological, epistemic, and methodological challenges facing philosophers of medicine today, from the debate between evidence-based and person-centered medicine, (...) medical humanism, and gender medicine, to traditional issues such as disease, health, and clinical reasoning and decision-making. Practical and forward-looking, it also includes a detailed guide to research sources, a glossary of key terms, and an annotated bibliography, as well as an introductory survey of research methods and discussion of new research directions emerging in response to the rapid changes in modern medicine. -/- “Philosophy needs medicine', Hillel Braude argues, 'to become more relevant'. By showing how modern medicine provides philosophers with a rich source of material for investigating issues facing contemporary society, The Bloomsbury Companion to Contemporary Philosophy of Medicine introduces the opportunities medicine offers philosophers together with the resources and skills required to contribute to contemporary debates and discussions. (shrink)

Society has historically not taken a benign view of genetic disease. The laws permitting sterilization of the mentally re tarded~ and those proscribing consanguineous marriages are but two examples. Indeed as far back as the 5th-10th centuries, B.C.E., consanguineous unions were outlawed (Leviticus XVIII, 6). Case law has traditionally tended toward the conservative. It is reactive rather than directive, exerting its influence only after an individual or group has sustained injury and brought suit. In contrast, state legislatures have not been (...) inhibited in enacting statutes. Many of their products can be characterized as hasty, unnecessary, ill-conceived, and based on the heart rather than the head. Moreover the lack of expert consultation sought has also been remarkable. One state legislature, for example, has advocated immunization for sickle cell anemia! Many others have enacted laws for the screening of inborn errors of metabolism, e.g., phenylketon uria, but have poorly defined the lines of responsibility to secure compliance. A spate of specific disease-related bills has emerged in the u.S. Congress, each seeking recognition and appropriations. Sickle cell anemia, hemophilia, Cooley's anemia and Tay-Sachs disease have been among the front-runners for support. Finally, in 1975, Congress has begun to examine an omnibus bill concerning all forms of genetic disease. The bill, termed the National Genetic Diseases Act is, however, still far from being enacted. (shrink)

Galasso (2024) reiterates the problem of medical research being grounded on data from people with European ancestry and subsequently describes efforts made by the All of Us Research Program in the...

Ulysses contracts are a method by which one person binds himself by agreeing to be bound by others. In medicine such contracts have primarily been discussed as ways of treating people with episodic mental illnesses, where the features of the illness are such that they now judge that they will refuse treatment at the time it is needed. Enforcing Ulysses contracts in these circumstances would require medical professionals to override the express refusal of the patient at the time treatment (...) is required, something that is generally problematic both ethically and legally. In this paper I will argue that despite appearances Ulysses contracts can make it the case that treating a patient in such circumstances is an instance of treating him with his consent, although safeguards are needed to ensure that this is the case. Given the potential benefits to patients I further argue that modified Ulysses contracts should be made legally enforceable. (shrink)

Regina R. is a 12-year-old girl with recently diagnosed insulin-dependent diabetes. Before discharging her from the hospital, her family physician and consulting diabetes specialist try to instruct the girl and her parents in the appropriate program of treatment, including diet, insulin, and regular self-monitoring. However, the parents become upset when they learn what is involved in insulin treatment and inform the family physician they plan to employ the services of an alternative healing clinic that promises to cure their daughter with (...) a combination of herbal potions, macrobiotics, aroma therapy, therapeutic touch, Ayurveda, homeopathy, and guided imagery. (shrink)

In reference to the different approaches in philosophy(of medicine) of the nature of (medical) technology,this article introduces the topic of this specialissue of Theoretical Medicine and Bioethics, that is,the way the different forms of medical technologyfunction in everyday medical practice. The authorselaborate on the active role technology plays inshaping our views on disease, illness, and the body,whence in shaping our world.

Despite its vagueness Personalized, Precision, P4, P5, individualized, stratified medicine—or p-medicine in short—has become an increasingly popular term in biomedical literature. Philosophers have attempted to analyze what these various terms involve and have discussed consequences for medical practices. In this article, I argue that an important question remains unaddressed: what has made this project of p-medicine convincing to so many? My argument is that without real achievements, it would never have been. I also make the case that (...) these achievements stem from the domain of monoclonal antibodies, a new type of drug that justifies talks of personalized, precise, stratified, etc., medicine. In conclusion, while it may be possible to label any projection in the future of medicine as ‘p-medicine’, it is impossible to overlook mab-medicine as the spearhead. (shrink)

This is a major work by Ian Maclean exploring the foundations of learning in the Renaissance. Logic, Signs and Nature offers a profoundly learned, compelling and original account of the range of what was thinkable and knowable by learned medics of the period c.1530-1630. This is a study of great significance to the history of medicine, as well as the history of European ideas in general.

The philosophical aspects of Greek medicine are now more widely appreciated, not only by historians of science and medicine but also by students of philosophy in a more narrow sense. There has also been a greater appreciation of the fact that Greek medical writers not only reflect a derivative awareness of developments in philosophy but that they also actively contributed to the formation of philosophical thought more strictly defined, for instance by developing concepts and methodologies for the acquisition (...) of knowledge and understanding. Yet the consequences of this for a renewed study of the formation of Greek philosophy have yet to be drawn; and disciplinary boundaries between historians of medicine on the one hand and philosophers and historians of philosophy on the other still pose obstacles to an integrated account of Greek thought that takes on board the contributions by the medical writers. Some preliminary remarks may therefore be in order. (shrink)

Over the past decades, public trust in medical professionals has steadily declined. This decline of trust and its replacement by ever tighter regulations is increasingly frustrating physicians. However, most discussions of trust are either abstract philosophical discussions or social science investigations not easily accessible to clinicians. The authors, one a surgeon-turned-philosopher, the other an analytical philosopher working in medical ethics, joined their expertise to write a book which straddles the gap between the practical and theoretical. Using an approach grounded in (...) the methods of conceptual analysis found in analytical philosophy which also draws from approaches to medical diagnosis, the authors have conceived an internally coherent and comprehensive definition of trust to help elucidate the concept and explain its decline in the medical context. This book should appeal to all interested in the ongoing debate about the decline of trust - be it as medical professionals, medical ethicists, medical lawyers, or philosophers. (shrink)

The failure of Western medicine to deal with many of the problems it is currently facing has led to an awareness of the need for a fundamental reappraisal. The way in which medical concepts derived from the nineteenth century have brought technical medical advances in this century and the alliances that medicine has made with statistics and more recently the social sciences, have prevented a questioning of medicine's underlying assumptions. Thus, despite a number of critical initiatives from (...) both within and outside medicine, there has been no coherent development to seriously confront the question 'what is medicine?'. It is suggested that the basis for such a development depends on the return to a philosophical questioning of our conceptual understanding of disease, a subject which has largely been ignored during the past hundred years. (shrink)

Is Translational Science and Medicine new? Its dramatic expansion has spelled a dizzying array of new disciplines, departments, buildings, and terminology. Yet, without novel theories or concepts, Translational Science and Medicine may appear to be nothing more than an old concept with a new brand. Yet, is this view true? As is illustrated herein, histories of TSM which treat it as merely an old product under a new name misunderstand its essential architecture. As an expressly economic transformation, modern (...) translational approaches are differentiated precisely by a set of semi-permanent architectures which render it an altogether different kind of object when compared to previous attempts by institutions to turn science into medicine. Powered by new software, embedded within campuses that now house companies, and with legal agreements that outline agreed-upon scientific activity, TSM is now powered by a set of robust and durable structures that differentiate it from previous approaches. Based on ethnographic research about translational neuroscience in North America, this paper suggests that the sense of TSM as not being new is a consequence of analytic modes that tend to see scientific enterprises in epistemic terms alone. Analyzing TSM as primarily a scientific object misses the fact that it is a principally a financial one. (shrink)

The traditional paradigm of medicine assumes that health is a natural given depending on a body's intrinsic teleology, and that medicine aims at restoring or preserving health, making a physician only an "assistant to nature." I argue that nowadays this paradigm is becoming obsolete, because the concept of health is no longer a "natural given" and interventions on the human body attempt not only to help nature's teleology, but also to change it whenever doing so can satisfy human (...) needs and wants. We should abandon the term "medicine" and adopt the term "health care" to mark such an epoch-making transition, analogous to that marking the passage from "alchemy" to "chemistry.". (shrink)

Caplan has argued that the philosophy of medicine does not exist. Although I will not deny the points he makes, I will argue that the philosophy of medicine has characteristics of a developing field with the potential to meet all of Caplan's criteria. The argument is based on Dewey's established views on logical development for a field of inquiry, as well as pointing out how other criteria Caplan imposes can be fulfilled.

In lieu of an abstract, here is a brief excerpt of the content:Modern Vs. Contemporary Medicine: The Patient-Provider Relation in the Twenty-First CenturyRobert M. Veatch (bio)The revolution in medical ethics of the past quarter century has begun reshaping the patient-provider relation in such a way that it will never be the same. 1 Dramatic changes have occurred at the level of specific decisions such as consent, forgoing treatment, and birth technologies, but the most significant impact will be on the (...) way the relation is conceptualized and the kinds of authority each party in the relation will be assumed to possess. The change is so fundamental that it deserves to be called a change from modern to contemporary medicine.Contrasting Modern and Contemporary MedicineModern MedicineMedicine of the modern period can be said to have had its origins in the sixteenth century with the emergence of the scientific mentality in such figures as Francis Bacon, but it really took off in the enlightenment of the eighteenth century. While intellectuals in medicine up to that time tended to be in conversation with those of philosophy, theology, and the arts, the emergence of medicine as a science changed that communication.The effect of the scientizing of medicine was that physicians tended to lose contact with the humanists. It was as if a physician, if he mastered the medical science, could, without any intervening value judgments, know how to treat the patient. In fact, for some conditions, there was (and still is) so much consensus [End Page 366] on the values that it is as if they were not present at all. If a patient has pneumonia, the most important element in a clinical decision seems to be pharmacological knowledge of whether a drug can produce a cure. The clinician knowledgeable of penicillin seems all that is needed.Upon reflection a suppressed premise becomes obvious: if it is better to live with the penicillin than to die without it, then one ought to take the penicillin. Since almost no one doubts the wisdom of that value judgment, all that seems to be needed is pharmacological knowledge. This view of medicine implies that certain treatments are “medically indicated,” as if the knowledge of the science could demonstrate that certain treatments were appropriate, in fact, were “treatments of choice.”Of course, on rare occasions, someone would question the value presumption. We discovered that certain patients with metastatic cancer who developed pneumonia might not automatically agree that it is better to live with the penicillin. Also Christian Scientists might deny that use of the drug led to the best possible consequences. These were set aside as unusual cases, ethically exotic problems, to be addressed outside the normal bounds of medical science. We still believed that medical science together with competent diagnostic skills were the critical factors in deciding what the appropriate treatment was.Some clinicians spoke as if these decisions could be made with no value judgments at all (except in cases in which outside “religious” or “cultural” influences contravened). Many more sophisticated clinicians, however, understood all along that an implicit value system was built into the medical profession. Some have even claimed that the very concept of medicine contains within it a set of norms or goals or values that are “intrinsic to the practice” (Pellegrino and Thomasma 1988, p. 116). For many those values are encapsulated in the Hippocratic tradition, particularly the core Hippocratic principle that the physician should act always for the benefit of the patient according to his ability and judgment.When physicians began spending their time learning medical science, the richness of their conversation with the philosophical and religious traditions of the day was lost. Clinicians, without a rich knowledge of those traditions, hit upon the Hippocratic ethic, embracing it as the epitome of their goals without real understanding of its implications and potential conflicts with other ethical traditions (cf. Veatch and Mason 1987).Contemporary MedicineThe most critical contribution of the medical ethics of the current generation has been the calling into question of the Hippocratic ethic, especially the presumption that science by itself (or aided by a single, core ethic intrinsic to all practice of medicine) is sufficient to practice medicine. This generation’s medical ethics... (shrink)

Benito Feijoo (1676-1764) fue uno de los divulgadores de las ideas científicas y filosóficas más importantes del siglo XVIII español. Lúcido crítico de todo tipo de ideas y miembro de la República de las Letras, se tenía a sí mismo por escéptico. En un primer momento, se alineó con el médico Martín Martínez, famoso por su crítica al aristotelismo médico, que tambíen se autodenominó escéptico. Tras defender contra sus adversarios la medicina escéptica de Martínez, Feijoo abandona el término, tal vez (...) porque intuyó que podría ser entendido en algunos ámbitos como una defensa del materialismo ateo y una forma de socavar las ideas de la Iglesia católica. Asimismo, investigó con detalle qué podía querer significar ser escéptico en medicina, aunque evitó usar el término en asuntos filosóficos y teológicos. (shrink)

Professionalism and Ethics in Medicine: A Study Guide for Physicians and Physicians-in-Training is a unique self-study guide for practitioners and trainees covering the core competency areas of professionalism, ethics, and cultural sensitivity. This novel title presents real-world dilemmas encountered across the specialties of medicine, offering guidance and relevant information to assist physicians, residents, and medical students in their decision-making. The text is divided into two parts: Foundations and Questions with Answers. The first part provides a substantive foundation of (...) knowledge in the principles, scholarship, policy guidelines, and decision-making strategies of the modern health professions. The second part assists practitioners and trainees in preparing for the complex issues that arise each day in the settings where health professionals work and train – clinics, research centers, educational contexts, and communities. Developed by renowned leaders in a broad range of clinical fields, Professionalism and Ethics in Medicine: A Study Guide for Physicians and Physicians-in-Training is a major, invaluable contribution to the literature and an indispensable reference for clinicians at all levels. (shrink)

There is a need to bring ethics and medical practice closer together, despite the risk and problems this may involve. Deontological ethics may promote sanctity of life considerations against the quality of life considerations favoured by consequentialists or utilitarians; while talk of respect for life and the value of life may point to more qualified ethical positions. This paper argues for a respect-for-life position, dismissing a utilitarian cost-benefit outlook as too simplistic; but an unqualified fixed principles approach is also ruled (...) out, both because of its unacceptable consequences in individual cases and also because of its reliance on the slippery slope argument which, it is argued, is logically and psychologically deficient. The case of genetic engineering provides an example in which the notion of respect may operate, but in which broad general principles also apply. A cautious conservatism towards accepted principles is recommended in the development of medical technologies. (shrink)

Definition of the problemIn medicine and bioethics, the term “suffering” is not clearly defined from a normative point of view. Nevertheless, suffering due to infertility is the starting point for medical interventions in assisted reproductive medicine. This implies that the unfulfilled desire to have children is a form of suffering, but the validity of this statement has not yet been clarified.ArgumentsBased on descriptions of some common concepts, certain characteristics of suffering are identified. We discuss the significance of suffering (...) as an anthropological condition in connection with the mission of medicine to alleviate human suffering. Furthermore, the risks of reproductive treatment and their significance for health are addressed.ConclusionWe conclude that the unfulfilled desire to have children is a form of suffering, and therefore has a normative value. The legitimacy of appropriate somatic intervention can only be established by taking the psycho-existential dimension of suffering into account. (shrink)

Cytogenetic research has had a major impact on the field of reproductive medicine, providing an insight into the frequency of chromosomal abnormalities that occur during gametogenesis, embryonic development and pregnancy. In humans, aneuploidy has been found to be relatively common during fetal life, necessitating prenatal screening of high‐risk pregnancies. Aneuploidy rates are higher still during the preimplantation stage of development. An increasing number of IVF laboratories have attempted to improve pregnancy rates by using preimplantation genetic diagnosis (PGD) to ensure (...) that the embryos transferred to the mother are chromosomally normal. This paper reviews some of the techniques that are key to the detection of aneuploidy in reproductive samples including comparative genomic hybridization (CGH). CGH has provided an unparalleled insight into the nature of chromosome imbalance in human embryos and polar bodies. The clinical application of CGH for the purposes of PGD and the future extensions of the methodology, including DNA microarrays, are discussed. BioEssays 25:289–300, 2003. © 2003 Wiley Periodicals, Inc. (shrink)

To what extent can postmodern developments be observed in modern medicine and which theories of postmodern philosophy can we draw on with regard to medicine's theoretical problem? This article explores these questions with special emphasis on the epistemological status of medicine, the concept of disease, and the anthropological model. It is examined whether medicine's inherent duty to act can be questioned in the light of the plurality that characterizes postmodernity. It is concluded that, according to postmodern (...) philosophy, medicine should be characterized by a justified variety of paradigms. Cooperation within the variety must continue to be guaranteed, always in favor of the constitutive moral duty of medicine. (shrink)

In reference to historical developments, this article introduces the topic of this special issue of Theoretical Medicine and Bioethics, that is, the relationship(s) between theory and practice. The authors emphasize the need for scientific research in this neglected area for the sake of both clinical practice and medical education.