Short overview of the From Small Beginnings Project and its relevance for resisting eugenics in contemporary society.

George Will, the well-known pundit, once observed: “A society's recreation is charged with moral significance. Sport—and a society that takes it seriously—would be debased if it did not strictly forbid things that blur the distinction between the triumph of character and the triumph of chemistry.” In opposition, Dan Duchaine, the highly publicized “steroid guru” and counter-culture columnist, declared: “There comes a time for many in competitive athletics where winning is more important than those initial goals of health, recreation, and relaxation.” (...) The parallels of these two philosophies to life in general are patent simply by substituting “sports” and “winning” for “career” and “success,” respectively.This paper will review the basis for banning anabolic steroids in athletics, and consider especially the recent medical findings that support this prohibition. This survey leads into a discussion of the available deterrents, and the secondary, but essential, role of random drug testing as a final safeguard. (shrink)

George Will, the well-known pundit, once observed: “A society's recreation is charged with moral significance. Sport—and a society that takes it seriously—would be debased if it did not strictly forbid things that blur the distinction between the triumph of character and the triumph of chemistry.” In opposition, Dan Duchaine, the highly publicized “steroid guru” and counter-culture columnist, declared: “There comes a time for many in competitive athletics where winning is more important than those initial goals of health, recreation, and relaxation.” (...) The parallels of these two philosophies to life in general are patent simply by substituting “sports” and “winning” for “career” and “success,” respectively.This paper will review the basis for banning anabolic steroids in athletics, and consider especially the recent medical findings that support this prohibition. This survey leads into a discussion of the available deterrents, and the secondary, but essential, role of random drug testing as a final safeguard. (shrink)

For many philosophers, the relation of medicine to health is exemplary for understanding the relation of human power to nature in general. Drawing on Heidegger and Aquinas, this paper examines the relation of art to nature as it emerges in the second book of Aristotle’s Physics, and it does so by articulating the duality of efficient causality. The art of medicine operates as a dispositive cause rather than as a perfective cause; it removes obstacles to the achievement of (...) health, but it does not impose health. Medicine, on this conception, aids the efficient causality of the natural body rather than substituting for it. The loss of dispositive causality makes efficient causality an imposition of force that bypasses the natural power to achieve natural goods. The paper concludes, with Plato, by arguing that dispositive causality offers a way to understand not only medicine but also governing, teaching, and parenting. (shrink)

The ancient Greeks used the term _catharsis_ for the cleansing of both the body by medicine and the soul by art. In this inspiring book, internationally renowned cardiologist Andrzej Szczeklik draws deeply on our humanistic heritage to describe the artistry and the mystery of being a doctor. Moving between examples ancient and contemporary, mythological and scientific, _Catharsis_ explores how medicine and art share common roots and pose common challenges. The process of diagnosis, for instance, belongs to a world (...) of magic and metaphor; the physician must embrace it like a poem or painting, with particular alertness and keen receptivity. Speculation on ways to slow aging through genetics, meanwhile, draws directly on the dream of immortality that artists and poets have nourished through the ages. And the concept of _catharsis_ itself has made its way from the writings of Aristotle to today's growing interest in the benefits of music to health, especially in newborns. As Szczeklik explores such subjects as the mysteries of the heart rhythm, the secret history of pain relief, the enigmatic logic of epidemics, near-death or out-of-body experiences, and many more, he skillfully weaves together classical literature, the history of medicine, and moving anecdotes from his own clinical experiences. The result is a life-affirming book that will enrich the healing work of patients and doctors alike and make an invaluable contribution to our still-expanding vision of the art of medicine. (shrink)

The ancient Greeks used the term catharsis for the cleansing of both the body by medicine and the soul by art. In this inspiring book, internationally renowned cardiologist Andrzej Szczeklik draws deeply on our humanistic heritage to describe the artistry and the mystery of being a doctor. Moving between examples ancient and contemporary, mythological and scientific, Catharsis explores how medicine and art share common roots and pose common challenges. The process of diagnosis, for instance, belongs to a world (...) of magic and metaphor; the physician must embrace it like a poem or painting, with particular alertness and keen receptivity. Speculation on ways to slow aging through genetics, meanwhile, draws directly on the dream of immortality that artists and poets have nourished through the ages. And the concept of catharsis itself has made its way from the writings of Aristotle to today's growing interest in the benefits of music to health, especially in newborns. As Szczeklik explores such subjects as the mysteries of the heart rhythm, the secret history of pain relief, the enigmatic logic of epidemics, near-death or out-of-body experiences, and many more, he skillfully weaves together classical literature, the history of medicine, and moving anecdotes from his own clinical experiences. The result is a life-affirming book that will enrich the healing work of patients and doctors alike and make an invaluable contribution to our still-expanding vision of the art of medicine. (shrink)

Ong, Caroline Whilst the reason and purpose of suffering may never be fully understood, there are ways of enduring, transcending and growing resilience to how it affects us. Our experience of suffering lies in the web of perceptions that involve our physical, spiritual and cosmological beliefs. Referencing Pain Seeking Understanding: Suffering, Medicine and Faith, edited by Margaret E. Mohrmann and Mark J. Hanson, this article gives a brief exploration of some propositions as to why an all-powerful, good God would (...) allow suffering to exist. From these various perspectives and using examples cited in the book, the article proposes that the healing art of medicine, honed through years of experience, knowledge and wisdom, can help individual patients endure and transcend suffering, and be whole once again. (shrink)

The ancient Greeks used the term _catharsis_ for the cleansing of both the body by medicine and the soul by art. In this inspiring book, internationally renowned cardiologist Andrzej Szczeklik draws deeply on our humanistic heritage to describe the artistry and the mystery of being a doctor. Moving between examples ancient and contemporary, mythological and scientific, _Catharsis_ explores how medicine and art share common roots and pose common challenge. As Szczeklik explores such subjects as the mysteries of the (...) heart rhythm, the secret history of pain relief, the enigmatic logic of epidemics, near-death or out-of-body experiences, and many more, he skillfully weaves together classical literature, the history of medicine, and moving anecdotes from his own clinical experiences. The result is a life-affirming book that will enrich the healing work of patients and doctors alike and make an invaluable contribution to our still-expanding vision of the art of medicine. “Drawing on mathematical ideas, physics, music, mythology, clinical science and clinical practice, Szczeklik never forces the issues or compels.... He approaches the questions of pain, suffering and death that confront the doctor daily and that the world regards as ‘terrible, futile, and destructive.’ Here he stresses the immense value of the experienced doctor in helping patients in the loneliness of pain.”—Niall O'Higgins, _Times Higher Education Supplement_. (shrink)

For many philosophers, the relation of medicine to health is exemplary for understanding the relation of human power to nature in general. Drawing on Heidegger and Aquinas, this paper examines the relation of art to nature as it emerges in the second book of Aristotle’s Physics, and it does so by articulating the duality of efficient causality. The art of medicine operates as a dispositive cause rather than as a perfective cause; it removes obstacles to the achievement of (...) health, but it does not impose health. Medicine, on this conception, aids the efficient causality of the natural body rather than substituting for it. The loss of dispositive causality makes efficient causality an imposition of force that bypasses the natural power to achieve natural goods. The paper concludes, with Plato, by arguing that dispositive causality offers a way to understand not only medicine but also governing, teaching, and parenting. (shrink)

Herophilus, a contemporary of Euclid, practiced medicine in Alexandria in the third century B.C., and seems to have been the first Western scientist to dissect the human body. He made especially impressive contributions to many branches of anatomy and also developed influential views on many other aspects of medicine. Von Staden assembles the fragmentary evidence concerning one of the more important scientists of ancient Greece. Part 1 of the book presents the Greek and Latin texts accompanied by English (...) translation and interpretative commentary. Significant background information is given in the introductory essay preceding each chapter. Part 2 briefly sketches the major developments within the Herophilean school after Herophilus, and discusses the individual members within it. Anyone interested in the history of science, the history of medicine, or intellectual history will find this book a rich source of information about an unusual and important aspect of Greek culture. (shrink)

There has been increased interest in what the philosophical subdiscipline of phenomenology can contribute to medical humanities due to its dual emphases on practicality and its attempt to understand the experience of others, thus positioning it as a potentially helpful conceptual toolkit to guide clinical care. Using various figures from the phenomenological tradition, most prominently Martin Heidegger and Martin Buber, the authors illuminate relevant philosophical concepts, employ them in various examples, and provide three principles revolving around empathy, communication, and listening (...) to patients’ individual values to guide medical professionals who practice the art of medicine in cancer care settings. (shrink)

The traditional medical epistemology, resting on a biomedical paradigmatic monopoly, fails to display an adequate representation of medical knowledge. Clinical knowledge, including the complexities of human interaction, is not available for inquiry by means of biomedical approaches, and consequently is denied legitimacy within a scientific context. A gap results between medical research and clinical practice. Theories of knowledge, especially the concept of tacit knowing, seem suitable for description and discussion of clinical knowledge, commonly denoted the art of medicine. A (...) metaposition allows for inquiry of clinical knowledge, inviting an expansion of the traditional medical epistemology, provided that relevant criteria for scientific knowledge within this field are developed and applied. The consequences of such approaches are discussed. (shrink)

In December of 1899, Sir John Scott Burdon-Sanderson delivered an address to the Middlesex Hospital Medical Society in London on the relation between science and medicine. Commenting specifically on the future of medicine in the upcoming century, he criticized the gap between scientific research in academic settings and the practice of medicine in the clinical setting. He ends by stating that “all depends on whether you accept the proposition I have submitted to you—namely, that the science of (...) medicine, even more than the art, holds the promise of the future” (Burdon-Sanderson 1900, 255). Burdon-Sanderson’s proposition was actualized in the United States through the Flexner Report of 1910, which helped to universalize what medical education would come to look like in the country: the emphasis was placed squarely on science, rather than art (Flexner 1910). While there are still gaps between clinical practice and scientific research, there is no doubt that modern medicine is scientific medicine. There is also no doubt that scientific medicine leads to better health outcomes (Duffin 2010).However, some have argued that the emphasis of medicine as a science has left the art of medicine behind, to the detriment of modern medicine. Thomas Duffy, for instance, an internist at the Yale School of Medicine, states that the aftermath of the Flexner Report “created an excellence in science that was not balanced by a comparable excellence in clinical caring” (2011,276). Indeed, at the onset of our current century, many called for a reinvestment in the art of medicine so as to balance the emphasis on science (The Commonwealth Fund 2002; Committee on the Roles of Academic Health Centers in the 21 st Century 2003; Association of American Medical Colleges 2004). The burgeoning field of medical humanities—that is, the interdisciplinary field dedicated to demonstrating “how the arts and humanities inform and 2elevate the work of healing” (Campo 2005)—is evidence that such calls have been heard. While we surely want to celebrate scientific medicine, there are certain areas of medical practice where the art of medicine is as important, if not more important , as the science of medicine. We argue that one of those areas is the sphere of cancer care in which health professionals are asked not only to treat patients with cancer, but also to help them navigate through what is oftentimes one of the scariest, most vulnerable, and suffering-ridden times of their lives. Using concepts from the phenomenological tradition, we aim to provide philosophical clarity to situations in the medical setting in which health professionals must treat the whole person, rather than simply the person’s body, in order to provide proper patient care, thus highlighting an element of the art of medicine. We end by providing three principles that we think can help guide phenomenologically-informed cancer care. (shrink)

Physical environmental factors – or ‘artifacts’ – are linked to healthcare outcomes in the field of social psychology. However, the role of artifacts remains rarely examined in the burgeoning discipline of placebo studies. In this paper, we argue that a careful consideration of artifacts – such as provider clothing and office décor – may carry significant potential in eliciting placebo effects in clinical settings. We discuss three potential mechanisms by which artifacts may enhance or diminish placebo (or nocebo) effects: classical (...) conditioning, response expectancy, and mindsets. We propose testable hypotheses and conclude by providing innovative research designs that might help to better advance this novel research agendum. (shrink)

1. At least since W.F. Edwards’ pioneering articles on medieval and renaissance interpretations of the prologue to Galen's Art of Medicine,1 it has often been maintained that Latin scholastics inte...

The Swiss psychologist Jean Piaget devoted his life to following, step by step and lovingly, the development in children of the art of reasoning. In the course of the successive stages of this development, the child's view of the world changes in nature. Similarly, from its earliest infancy, medicine has viewed living things in successively different manners. For medicine, it is true, the stages overlap; one may still be using an ancient discourse from which another has daringly freed (...) itself. Nevertheless, for the sake of clarity in this analysis, I will try to define successive epistemological attitudes as if they had represented a regular progression of medical thinking. (shrink)

This essay discusses the ethics of traditional Chinese medicine. After a brief remark on the history of traditional Chinese medical ethics, the author outlines the Confucian ethics which formed the cultural context in which traditional Chinese medicine was evolving and constituted the core of its ethics. Then he argued that how Chinese physicians applied the principles of Confucian ethics in medicine and prescribed the attitude a physician should take to himself, to patients and to his colleagues. In (...) the last part of the essay he discusses the characteristics of traditional Chinese medical ethics. Keywords: Confucian, China, humaneness, compassion, virtues CiteULike Connotea Del.icio.us What's this? (shrink)

A number of art projects are currently tackling the medical domain. This activity stems from a perceived need to increase the transparency and democracy of the medical domain, and it often questions the power relations and the one-dimensionality in current medical practices. This article sheds light on how artists process medical themes, elaborates on research elements embedded in art making processes, and considers the relevance of artists' projects for researchers from other disciplines. It deliberates on the author's media and performance (...) art practice in exploring the doctor-patient relationship and discusses the artistic methods and techniques employed. The article promotes the personal, imaginative, and figurative characteristics in the discussion and signification of the body in medicine. (shrink)

Drawing on his extensive experience as both a medical practitioner and a patient, acclaimed author, award-winning physician, and ethicist Philip Hébert creates a brave and intimate portrait of the complex ethical questions raised by revolutionary advances in medical diagnosis and treatment. Philip Hébert addresses the complex ethical questions raised by revolutionary advances in medical treatment. This work expands upon Hébert's previous book, "Doing Right," and extends his knowledge of the field beyond medical professionals to reach the patients they treat.

In this introduction to a special subsection of Theoretical Medicine and Bioethics comprising separate reviews of the Springer Handbook of the Philosophy of Medicine, The Routledge Companion to Philosophy of Medicine, and The Bloomsbury Companion to Contemporary Philosophy of Medicine, I compare the three texts with respect to their overall organization and their approach to the relation between the science and the art of medicine. I then indicate two areas that merit more explicit attention in (...) developing a comprehensive philosophy of medicine going forward: health economics and systematic relations within the field as a whole. The reviews that follow speak for themselves. (shrink)

The article offers an approach to inquiry about, the foundation of medical ethics by addressing three areas of conceptual presupposition basic to medical ethical theory. First, medical ethics must presuppose a view about the nature of medicine. it is argued that the view required by a cogent medical morality entails that medicine be seen both as a healing relationship and as a practical art. Three ways in which medicine inherently involves values and valuation are presented as important, (...) i.e., in being aimed at the good of health, in being a cognitive art evaluating towards that good, and as a manifestation of a virtuous disposition concerning that good. Finally, a value ontology drawn from these considerations is seen as necessarily underlying medical ethics. A set of three such basic values are promoted as crucial: the value of health; the value of the individual patient; and the value of altruism that mediates the class of potential patients. (shrink)

Perceptions are often merely regarded as the basic elements of knowledge. They have, however, a complex structure of their own and are far from being elementary. My paper will analyze two basic patterns of perception and some of the resulting medical implications. Most basically, all object perception is characterized by a mixture of knowledge and ignorance (Husserl). Perception essentially perceives with inner and outer horizons, brought about by the kinesthetic activity of the perceiving subject (Sartre). This first layer of perceptual (...) reality, the world of open perceptions, is the inescapable background for every rationality, every value, every existence (Merleau-Ponty). On an epistemological level a characteristic change of perceptual patterns in medicine was introduced by pathological anatomy (Foucault). The reference of medical perception to the dead body created the new possibility of absolute perception, allowing for more precise medical interventions, but at the same time coming into conflict with the open structures of ordinary, non-scientific perception patterns in everyday life. On the basis of these distinctions, an analysis of the different perceptual patterns in medicine becomes possible. Such an analysis would be the task of a sub-field in medical philosophy that could be called medical aesthetics having as its goal an art of perception understood as a technique of adequately applying different perceptual patterns in medical practice. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:An Encounter with the Art and Science of MedicineAnonymous Five“Let Nothing Upset YouLet Nothing Frighten YouEverything is ChangingOnly God is Changeless”—St. Theresa of AvilaSt. Teresa’s prayer is on the front cover of each of four binders dedicated to storing insurance authorizations, studies, references, and reports about our daughter’s brain tumor treatment. They represent our experience, what we learned, the information we were given, and the information we sought out. (...) I kept them in case our daughter ever wanted to understand how my husband and I arrived at a decision for her treatment that was in direct opposition to the strong recommendation of her primary treatment team of physicians.On December 10, 2003, I received an urgent call from our daughter’s neurologist requesting that we meet with the doctor late that afternoon. For six months prior to that appointment, our daughter had been telling us about odd sensations with breathing, nausea, and balance. Sometimes she would seem extremely distressed for a short period of time or report that her friends told her about doing or saying things that didn’t make sense and that she didn’t remember. We consulted a series of physicians as her symptoms became steadily more intense and more prevalent. Our family practice physician referred us to an allergy specialist and a pulmonologist. There were a number of tests for allergies and lung problems. As the tests and treatments did not help, our daughter became increasingly unwilling to go to doctor’s appointments. My husband and I were confused and deeply concerned about the lack of progress. The next series of referrals included a gastroenterologist and a neurologist. The gastroenterologist suggested our daughter had partial–complex epilepsy, concurred with our plan to see a neurologist, and mentioned she should have an MRI.I remember the neurologist putting the MRI scans up, pointing to the large dark spot which he called a “large mass” (5 cm), that could be either a cluster of blood vessels or a neoplasm. He said his office had arranged for us to meet a neurosurgeon the following day. We all remember the same thing about that visit—the image of the large dark mass on the scan—and the neurologists flat, brisk tone. We met with the neuro-surgeon the next day. Her team was kind and sympathetic—she was positive, up beat and direct. She did not think this mass was blood vessels. She thought it was a large tumor that needed to be removed right away. Our daughters surgery was scheduled for the following Friday—December 19, 2003. She had turned 15 on November 5.Four and a half hours after our daughter was wheeled into the operating room, her surgeon told us they had removed 98% of the tumor. She said there was no cure, but there was a good prognosis based on the surgical outcome. Several days later, she called us and said she had more data, and it looked like the resection was closer to 90%. The first pathology report, a “first impression” directly after surgery, described our daughter’s tumor as an astrocytoma, probably high grade. Three weeks after surgery, we met with a panel of doctors—two oncologists and radiologist—who explained that based on the final pathology report, our daughter’s tumor was classified as an ependymoma, grade 2. We were dismayed. First, there had been the change in the estimated success of the resection and now a complete shift in both grade and tumor type.The team recommended radiation to follow her surgery, which they said was standard treatment. We began to try to inform ourselves about her tumor. Her father, an agronomist, did an extensive search in PubMed to evaluate and sort through the literature on low–grade gliomas and radiation. What he could find was inconclusive and grim. Most reports in the literature suggested at best delayed mortality at five years after radiation. [End Page E7] Meanwhile, our daughter went through a spinal MRI and the preparatory “fitting” of the mask to immobilize her head during radiation.E7I consulted with a friend who had worked as an EKG tech. She urged... (shrink)

Background The American Association of Medical Colleges has called for incorporation of the health humanities into medical education, and many medical schools now offer formal programs or content in this field. However, there is growing recognition among educators that we must expand beyond empathy and wellness and apply the health humanities to questions of social justice – that is, critical health humanities. In this paper we demonstrate how this burgeoning field offers us tools for integrating social justice into medical education, (...) utilizing the frameworks of critical consciousness and structural competency. Practice of health humanities Critical health humanities can be applied at multiple levels of learners, and in a variety of contexts. We are two physician-writers who have developed several educational programs that demonstrate this. We taught a seminar that introduced first-year and second-year undergraduates to concepts such as social determinants of health, intergenerational trauma, intersectionality, resilience, and cross-cultural care through works of fiction, poetry, film, podcasts, stand-up comedy, and more. Through creative projects and empathic reflection, students engaged with the complexities of structural forces that create and maintain health disparities. Medical students in their clinical years can engage in critical health humanities learning experiences as well. We teach several multidisciplinary electives that address social (in)justice in medicine, as well as mentor fourth-year students engaged in independent electives that foster critical awareness around health equity and ethics. Beyond the classroom, we have actively engaged in critical health humanities practices through story slams, literary journal clubs, conference presentations, and Grand Rounds. Through these activities we have included learners at GME and CME levels. These examples also demonstrate how community engagement and multidisciplinary partnerships can contribute to the practice of critical health humanities. Conclusion In this paper, we explore the growing field of critical health humanities and its potential for teaching health equity through narrative practices. We provide concrete examples of educational activities that incorporate critical consciousness and structural competency – frameworks we have found useful for conceptualizing critical health humanities as a pedagogical practice. We also discuss the strengths and challenges of this work and suggest future directions. (shrink)

This paper considers the view that medicine is both “science” and “art.” It is argued that on this view certain clinical knowledge – of patients’ histories, values, and preferences, and how to integrate them in decision-making – cannot be scientific knowledge. However, by drawing on recent work in philosophy of science it is argued that progress in gaining such knowledge has been achieved by the accumulation of what should be understood as “scientific” knowledge. I claim there are varying degrees (...) of objectivity pertaining to various aspects of clinical medicine. Hence, what is often understood as constituting the “art” of medicine is amenable to objective methods of inquiry, and so, may be understood as “science”. As a result, I conclude that rather than endorse the popular philosophical distinction between the art and science of medicine, in the future a unified, multifaceted epistemology of medicine should be developed to replace it. (shrink)