Through close analysis of texts, cultural and civic communities, and intellectual history, the papers in this collection for the first time, propose a dynamic relationship between rhetoric and medicine as discourses and disciplines of cure in early modern Europe. Although the range of theoretical approaches and methodologies represented here is diverse, the essays explore various ways in which the interventionist disciplines and practices of medicine, moral philosophy and rhetoric were thought consanguine in early modernity.

In lieu of an abstract, here is a brief excerpt of the content:Journal of the History of Ideas 65.2 (2004) 191-211 [Access article in PDF] Oratory and Rhetoric in Renaissance Medicine Nancy G. Siraisi Hunter College In Renaissance medical practice rhetoric had an ambiguous reputation. Many authors warned physicians against use of persuasion or repeated some version of the truism that patients are cured not by eloquence but by medicines. On the other hand, physicians were also reminded (...) that by speaking well they helped patients to have confidence in their advice and to understand directions, which in turn facilitated cure.1 Yet some aspects of medical culture of the period between 1450 and 1600 seem profoundly attentive to rhetoric, at least as regards the use of language, performative elements, and the influence of these features in ancient models (most notably Galen himself).2 One area in which rhetoric had an unambiguous, acknowledged, and essential place was in the medical orations pronounced at university ceremonies. A sample follows: Pursuit of all these different things by study, investigation of obscurities with ingenuity, conquest of difficulties with industry, and—after penetrating into the very fibers of the earth and searching everywhere into the arcana of the whole of nature and from all herbs, fruits, trees, animals, gems, and even poisons—inquiry after remedies and the proper way to use them for all the ills of human life from so many authors, so many disciplines, and even from the very stars: these things, I say, [End Page 191] have uncovered so many hidden cures, been attained with such arduous powers of the mind, completed with so much effort of memory, offer so many things necessary for the health of the entire human race in common, that does not indeed [the entire enterprise of medicine] seem to have been superhuman and really in a certain way divine?3This nicely exuberant example of Renaissance medical rhetoric exemplifies the genre in several respects. The oration to which it belongs was originally delivered to an academic faculty of medicine by a physician; it shows the impact in medical settings of the revival of epideictic rhetoric, and its author drew on learned sources and commonplaces about medicine that belonged to a store of broadly humanistic erudition, shared both in and outside the medical profession. In fact the only truly distinctive feature of this passage is its author. It comes from Erasmus's Encomium medicinae, which he wrote in 1499 for a friend—a physician named Gysbertus—to deliver to the medical faculty of the University of Paris.4If Gysbertus was exceptionally fortunate in his ghost, many other surviving medical orations are internal products of medical faculties, the work of university masters or students of medicine. But whoever their authors, orations delivered in or written for an academic medical setting offer some telling illustrations both of the way in which certain kinds of humanistic interests and requirements came to penetrate medical learning and of the reaction of humanistic rhetoric to medicine. "Medical humanism" is usually understood to encompass both the core enterprise of intensive philological study, editing, and translation of Greek medical texts—never the occupation of more than a handful of hellenist scholars—and also the reception and scientific influence of the fruits of their labors among a wider medical audience. But Renaissance medicine was also a humanistic discipline in a much broader and more inclusive sense; that is, it both fostered and provided ample scope for the development among learned physicians of interests characteristic of humanistic culture in general: rhetoric, history, biography, fascination with remote peoples and places, and antiquarianism. At the same time, as the passage from Erasmus quoted [End Page 192] above demonstrates, humanists outside the medical profession interested themselves in medicine and controlled a stock of rhetorical commonplaces on the subject. To be sure, the penetration of terminology and concepts from medicine into the general culture long antedated the Renaissance.5 But the revival of rhetoric together with attention to ancient sources and commonplaces provided humanist observers with new tools for commenting, sometimes in quite specific and detailed terms, on the contemporary medical scene, a phenomenon... (shrink)

In a recent issue of the Journal of Medical Ethics, Svoboda and Van Howe commented on the 2012 change in the American Academy of Pediatrics policy on newborn male circumcision, in which the AAP stated that benefits of the procedure outweigh the risks. Svoboda and Van Howe disagree with the AAP conclusions. We show here that their arguments against male circumcision are based on a poor understanding of epidemiology, erroneous interpretation of the evidence, selective citation of the literature, statistical manipulation (...) of data, and circular reasoning. In reality, the scientific evidence indicates that male circumcision, especially when performed in the newborn period, is an ethically and medically sound low-risk preventive health procedure conferring a lifetime of benefits to health and well-being. Policies in support of parent-approved elective newborn circumcision should be embraced by the medical, scientific and wider communities. (shrink)

This essay examines several of Plato’s philosophical texts to show how in the process of trying to differentiate rhetoric and medicine—to prove that medicine is an art or science like philosophy, and that rhetoric, in comparison, is just a knack or skill—Plato indirectly and unwittingly reveals just how similar the two practices may be. As such, this essay seeks a fuller interpretation of Plato’s attitude toward rhetoric, supplementing the work of scholars who claim the only (...) evidence Plato gives us about an ideal rhetoric is through its relationship to philosophy. This essay shows instead that Plato captures the potential of rhetoric as a true art precisely through its intricate relationship to medicine. (shrink)

In this paper, I intend to focus on some rhetorical strategies of argumentation which play crucial role in the therapeutic discourse of Roman Stoicism, namely in Musonius Rufus, Epictetus, Seneca, and Marcus Aurelius. Reference is made to Chaim Perelman’s view of ancient rhetoric as an art of inventing arguments. Moreover, it is pointed out that in rhetorical education as well as in therapeutic discourse the concept of “exercise” and constant practice play a crucial role.

As an example of Aristotle's genre of epideictic, or ceremonial rhetoric, the Hippocratic Oath has the capacity to persuade its self-addressing audience to appreciate the value of the medical profession by lending an element of stability to the shifting ethos of health care. However, the values it celebrates do not accurately capture communally shared norms about contemporary medical practice. Its multiple and sometimes conflicting versions, anachronistic references, and injunctions that resist translation into specific conduct diminish its longer-term persuasive force. (...) Only when expunged of these elements and reconstructed using values over which there is widespread agreement can the Oath succeed in moving its audience from core values located in past discussions to principled action in the future. (shrink)

This book offers an interdisciplinary approach to concepts of the self associated with the development of humanism in England, and to strategies for both inclusion and exclusion in structuring the early modern nation state. It addresses writings about rhetoric and behavior from 1495–1660, beginning with Erasmus’ work on sermo or the conversational rhetoric between friends, which considers the reader as an ‘absent audience’, and following the transference of this stance to a politics whose broadening democratic constituency needed a (...) legitimate structure for governance-at-a-distance. Unusually, the book brings together the impact on behavior of these new concepts about rhetoric, with the growth of the publishing industry, and the emergence of capitalism and of modern medicine. It explores the effects on the formation of the ‘subject’ and political legitimation of the early liberal nation state. It also lays new ground for scholarship concerned with what is left out of both selfhood and politics by that state, studying examples of a parallel development of the ‘self’ defined by friendship not only from educated male writers, but also from women writers and writers concerned with socially ‘middling’ and laboring people and the poor. (shrink)

Bug chasing, the practice of pursuing HIV positive sexual partners in order to acquire HIV, presents multiple dilemmas for health affiliates in terms of how to address discourses and practices that challenge widely held beliefs about health and medicine. In order to examine how researchers respond to controversial counterpublic rhetorics, this essay chronicles the construction of “bug chasing” in published social science literature. Guided by a theory of containment rhetoric, I analyze how bug chasers are configured in the (...) language of social science used to describe and explain them. I find that social scientific coverage of bug chasing often addresses the behavior using a recipe of rhetorical containment: first, authors gaze upon bug chasers via distanced descriptions of the community; second, authors characterize the behavior as exhibiting an idealistic naiveté; and, third, authors stress the inconceivable, and therefore reproachable, sacrifice that bug chasing ultimately demands of its onlookers and participants. In closing, I evaluate the consequences of this containment rhetoric and offer three rhetorical maneuvers to aid future scholarship that examines the discourses and communities that counter dominant health ideologies. (shrink)

Does a τέχνη, qua τέχνη, need to be good-directed? On the basis of the Gorgias, many scholars have thought the answer is yes; I argue here to the contrary. There are, of course, many beneficial τέχναι, such as medicine and weaving; and there are even unconditionally good τέχναι, like the πολιτικὴ τέχνη; but Plato also happily construes piracy as a τέχνη in the Sophist, and, more normally, all sorts of neutral practices as τέχναι. In order to make this argument, (...) I provide a taxonomy of the different kinds of τέχναι and demonstrate that, across the corpus, there does not seem to be a good-directedness requirement. I then address the evidence of the Gorgias, where most commentators find a connection between τέχνη and good-directedness. I argue that this interpretation is incorrect, and that rhetoric in fact fails to be a τέχνη in the Gorgias solely because it is unable to give a rational account. A close reading of the Gorgias shows that this is a plausible interpretation, and comparison with the Phaedrus reinforces the point: in both dialogues, whether rhetoric will be a τέχνη or not hinges only on the question of rationality, not a good-directedness condition. (shrink)

The language of “participant-driven research,” “crowdsourcing” and “citizen science” is increasingly being used to encourage the public to become involved in research ventures as both subjects and scientists. Originally, these labels were invoked by volunteer research efforts propelled by amateurs outside of traditional research institutions and aimed at appealing to those looking for more “democratic,” “patient-centric,” or “lay” alternatives to the professional science establishment. As mainstream translational biomedical research requires increasingly larger participant pools, however, corporate, academic and governmental research programs (...) are embracing this populist rhetoric to encourage wider public participation. We examine the ethical and social implications of this recruitment strategy. We begin by surveying examples of “citizen science” outside of biomedicine, as paradigmatic of the aspirations this democratizing rhetoric was originally meant to embody. Next, we discuss the ways these aspirations become articulated in the biomedical context, with a view to drawing out the multiple and potentially conflicting meanings of “public engagement” when citizens are also the subjects of the science. We then illustrate two uses of public engagement rhetoric to gain public support for national biomedical research efforts: its post-hoc use in the “care.data” project of the National Health Service in England, and its proactive uses in the “Precision Medicine Initiative” of the United States White House. These examples will serve as the basis for a normative analysis, discussing the potential ethical and social ramifications of this rhetoric. We pay particular attention to the implications of government strategies that cultivate the idea that members of the public have a civic duty to participate in government-sponsored research initiatives. We argue that such initiatives should draw from policy frameworks that support normative analysis of the role of citizenry. And, we conclude it is imperative to make visible and clear the full spectrum of meanings of “citizen science,” the contexts in which it is used, and its demands with respect to participation, engagement, and governance. (shrink)

This essay examines Harriet Jacobs’s Incidents in the Life of a Slave Girl (1861) in light of new archival findings on the medical practices of Dr. James Norcom (Dr. Flint in the narrative). While critics have sharply defined the feminist politics of Jacobs’s sexual victimization and resistance, they have overlooked her medical experience in slavery and her participation in reform after escape. I argue that Jacobs uses the rhetoric of a woman-led health reform movement underway during the 1850s to (...) persuade her readers to end slavery. This essay reconstructs both contexts, revealing that Jacobs links enslaved women’s physical and sexual vulnerability with her female readers’ fears of male doctors’ threats to modesty and of their standard bleed-and-purge treatments. Jacobs illustrates that slavery damages women’s health as much as heroic medicine, and thus merits the political activism of her readers. Specifically, Jacobs dramatizes her conflicts with the rapacious physician-master at moments that are crucial to women’s health: marriage, pregnancy, childbirth, and motherhood. Ultimately, this essay advances a new understanding of the role of health reform in social change: it galvanized other movements such as women’s rights and abolition, particularly around issues of bodily autonomy for women and African Americans. (shrink)

Since the late 1980s, the human genetics and genomics research community has been promising to usher in a “new paradigm for health care”—one that uses molecular profiling to identify human genetic variants implicated in multifactorial health risks. After the completion of the Human Genome Project in 2003, a wide range of stakeholders became committed to this “paradigm shift,” creating a confluence of investment, advocacy, and enthusiasm that bears all the marks of a “scientific/intellectual social movement” within biomedicine. Proponents of this (...) movement usually offer four ways in which their approach to medical diagnosis and health care improves upon current practices, arguing that it is more “personalized,” “predictive,” “preventive,” and “participatory” than the medical status quo. Initially, it was personalization that seemed to best sum up the movement's appeal. By 2012, however, powerful opinion leaders were abandoning “personalized medicine” in favor of a new label: “precision medicine.” The new label received a decisive seal of approval when, in January 2015, President Obama unveiled plans for a national “precision medicine initiative” to promote the development and use of genomic tools in health care. (shrink)

How did physicians come to dominate the medical profession? Lyn Bennett challenges the seemingly self-evident belief that scientific competence accounts for physicians' dominance. Instead, she argues that the whole enterprise of learned medicine was, in large measure, facilitated by an intensely classical education that included extensive training in rhetoric, and that this rhetorical training is ultimately responsible for the achievement of professional dominance. Bennett examines previously unexplored connections among writers and genres as well as competing livelihoods and classes. (...) Engaging the histories of rhetoric, medicine, literature, and culture throughout, she goes on to focus specifically on the work of women who professed as well as practiced medicine. Pointing to some of the ways women's writing shapes realities of body, mind, and spirit as it negotiates social, cultural, and professional ideologies of gender, this book offers an important corrective to some long-held beliefs about women's role in early modern discourse. (shrink)

Throughout the COVID-19 pandemic the use of the term “hero” has been widespread. This is especially common in the context of healthcare workers and it is now unremarkable to see large banners on hospital exteriors that say “heroes work here”. There is more to be gleaned from the rhetoric of heroism than just awareness of public appreciation, however. Calling physicians and nurses heroes for treating sick people indicates something about the concept of medicine and medical professionals. In this (...) essay, I will examine three aspects of the social role of medicine exposed by the language of heroism. One, if a hero is someone who goes above and the call of duty, then does that mean exposing oneself to risk of infection is no longer a duty of physicians? If so, does that mean the “profession” of medicine is much like any other business? Two, physicians and nurses are not the only “heroes” this go-around. Anyone deemed essential to the US “infrastructure” is designated by the US government as having “special responsibilities” to remain at their posts for the public good, which explicitly puts physicians in the same category as sewage workers and grocery store cashiers. Three, what does it mean to belong to a profession that does have self-sacrifice and risk-taking as part of its mission—especially a profession that rarely gets called upon to practice these obligations? (shrink)

Inspired by Pierre-Jean-Georges Cabanis' claim in 1798 that physicians might learn forms of medical reasoning from les anciens rhéteurs, in this paper I explore intimate associations between medicine and rhetoric over the longue durée. Gravely susceptible to error, medical reasoning relies on signs and examples, both gleaned from experience and both the subject of rhetorical inquiry; like rhetoric, medicine reaches plausible conclusions from probable premises. Here, ranging from Hippocrates and Plato through Aristotle to early modern England, (...) I argue that forms of inference developed and refined in the history of rhetoric offer ancient and early modern philosophers and physicians models and metaphors for their own forays into the probable. (shrink)

This paper explores some of the important parallels between recent reforms to legal rules for the admissibility of scientific and expert evidence, exemplified by the US Supreme Court's decision in Daubert v Merrell Dow Pharmaceuticals, Inc. in 1993, and similar calls for reforms to medical practice, that emerged around the same time as part of the Evidence-Based Medicine (EBM) movement. Similarities between the “movements” can be observed in that both emerged from a historical context where the quality of (...) class='Hi'>medicine and legal approaches to science were being subjected to growing criticism, and in the ways that proponents of both movements have used appeals to “folk epistemologies” of science to help legitimate their reform aspirations. The term folk epistemology is used to describe the weaving together of formal and informal images of scientific method with normative and pragmatic concerns such as eradicating “junk science”, and promoting medical best practice. Perhaps unsurprisingly, given the unfocused breadth of these aspirations the implications of these “reforms” for medical and legal practice have not been straightforward, although they do represent an important new set of rhetorical resources to critique and or legitimate expertise in medical and legal domains. Discussion closes, by noting the growth of calls for these movements to reciprocate in areas where law and medicine intersect, such as medical negligence litigation. (shrink)

There is no cure or vaccine for HIV/AIDS. The only life-prolonging treatment available is antiretroviral (ARV) therapy. WHO estimates, however, that less than 5 percent of those who require treatment in developing countries currently enjoy access to these medicines. In Africa fewer than 50,000 people–less than 2 percent of the people in need–currently receive ARV therapy. These facts have elicited strongly divergent reactions, and views about the appropriate response to this crisis have varied widely.The intensity of the debate concerning access (...) to life-prolonging medicines for the treatment of HIV/AIDS, and the heated rhetoric with which they are often conducted, suggest that these disagreements may be rooted in deeper disagreements of value. It is not obvious, however, what disagreements of value are at stake in this debate. By analyzing the statements of scholars, public officials, activist organizations, and private sector representatives, each of whom may endorse very different policy recommendations on access to HIV/AIDS drugs, we have identified and created a typology of the different sources of disagreement in the debate. We conclude that the central disagreements concerning access to medicines arise from competing understandings of how responsibilities for bringing remedy to hardships should be allocated to different agents and institutions. A central lesson that emerges from our analysis is that thinking about “health equity” must extend beyond the explanation and justification of goals, values, and ideals, and engage more honestly with the difficult question of how responsibilities for bringing remedy to health crises should be allocated in complex social contexts. (shrink)

In silico medicine is still forging a road for itself in the current biomedical landscape. Discursively and rhetorically, it is using a three-way positioning, first, deploying discourses of personalised medicine, second, extending the 3Rs from animal to clinical research, and third, aligning its methods with experimental methods. The discursive and rhetorical positioning in promotions and statements of the programme gives us insight into the sociability of the scientific labour of advancing the programme. Its progress depends on complex social, (...) institutional and technological conditions which are not external to its epistemology, but intricately interwoven with it. This article sets out to show that this is the case through an analysis of the process of computational modelling that is at the core of its epistemology. In this paper I show that the very notion of ‘model’ needs to be re-thought for in silico medicine, and propose a replacement, in the form of the ‘Model-Simulation-Experiment-System’ or MSE-system, which is simultaneously an epistemological, social and technological system. I argue that the MSE-system is radically mediated by social relations, technologies and symbolic systems. We need now to understand how such mediations operate effectively in the construction of robust MSE-systems. (shrink)

Statistics is the science of collection, summarizing, presentation and interpretation of data. Moreover, it yields methods used in the verification of research hypotheses. The presence of a statistician in a research group remarkably improves both the quality of design and research and the optimization of financial resources. Moreover, the involvement of a statistician in a research team helps the physician to effectively utilize the time and energy spent on diagnosing, which is an important aspect in view of limited healthcare resources. (...) Precise, properly designed and implemented Computerized Clinical Decision Support Systems certainly lead to the improvement of healthcare and the quality of medical services, which increases patient satisfaction and reduces financial burdens on healthcare systems. (shrink)

A decade after the completion of the Human Genome Project, the widespread appeal of personalized genomic medicine's vision and potential virtues for health care remains compelling. Advocates argue that our current medical regime “is in crisis as it is expensive, reactive, inefficient, and focused largely on one size fits all treatments for events of late stage disease.” What is revolutionary about this kind of medicine, its advocates maintain, is that it promises to resolve that crisis by simultaneously increasing (...) the ability to be “personalized,” “predictive,” “preventive,” and “participatory.” Some call personalized genomic medicine “P4 Medicine,” inscribing these cardinal virtues into the movement's name. All of these putative virtues have interesting implications for the future of health care. In this essay, we are especially interested in the claims that personalized medicine will lead to a more “participatory” or “patient‐centered” approach to health care, in which patients are “empowered” to take more personal control over their care. The rhetoric of patient empowerment is nothing new in health care, but personalized medicine is an interesting case study because it portrays empowerment as one of its key virtues and as a mechanism for fixing the health care “crisis.”. (shrink)

The introduction of respiratory machines in the 1950s may have saved the lives of many, but it also challenged the notion of death itself. This development endowed “machines” with the power to form a unique ontological creature: a live body with a “dead” brain. While technology may be blamed for complicating things in the first place, it is also called on to solve the resulting quandaries. Indeed, it is not the birth of the “brain-dead” that concerns us most, but rather (...) its association with a web of epistemological and ethical considerations, where technology plays a central role. The brain death debate in Israel introduces highly sophisticated religious thought and authoritative medical expertise. At focus are the religious acceptance and rejection of brain death by a technologically savvy group of rabbis whose religious doctrine––along with a particular form of religious reasoning––is used to support the truth claims made from the scientific community but challenge the ways in which they are made credible. In our case, brain death as “true” death is made religiously viable with the very use of technological apparatus and scientific rhetoric that stand at the heart of the scientific ethos. (shrink)

The contemporary moment in rhetoric studies is complex, marked by a number of powerful currents pulling scholarship in new directions. One of those currents is the deepening engagement with science and technology studies through rhetorical investigations of medicine, environmental policy, and science. Another is the increasing experimentation with qualitative methodologies, often called “rhetorical ethnography.” A third is the rapidly developing encounter with interwoven philosophies of speculative realism, object-oriented ontology, and new materialism. If you are interested in any of (...) these, you should absolutely read Scott Graham’s The Politics of Pain Medicine. The title is overly... (shrink)

_ Source: _Volume 12, Issue 1, pp 13 - 38 This paper assembles evidence from the full scope of Julian’s writings that the emperor had a pronounced interest in medicine and human health, which impacted both his rhetorical and real approach to political, philosophical, and religious problems. His initiatives aimed to promote doctors, medical research, and public health. He emphasized a holistic view of bodily and spiritual health in his version of theurgic Neoplatonism. Medical frames of reference also played (...) an appreciable role in his anti-Christian program. Finally, he himself and others styled him as a physician-king on a divine mission to heal the Empire of the Christian disease. (shrink)

This article explores how older adults negotiate and partially counter normative expectations of “health citizenship” that stress individual responsibility for maintaining health and preventing health problems. Based on interviews with 55 participants in Canada and the U.K. about what healthy living means to them in their everyday lives, we examine how the dominant discourse of personal responsibility in participants’ responses is counterpointed by a more muted, yet significant, alternative critical perspective on the relative roles and responsibilities of government and citizens (...) in making healthy living possible. Drawing on Hauser’s (1999) concept of vernacular rhetoric along with recent theories of environmental citizenship, we analyze how participants exercise their civic-political judgment by using a logic of dissociation to argue that what government says about the importance of healthy living is incompatible with what government does to support citizens’ abilities to eat healthily and live actively. By deploying this technique of argumentation to address structural-political-economic dimensions of healthy living, participants enact, in modest ways, an alternative, critical-collective mode of health citizenship that complicates and, at least partially, disrupts neoliberal constructions of the individually responsible, “good” health citizen. (shrink)

The Patient Protection and Affordable Care Act represents the most significant reform of the United States health care system in decades. ACA also substantially amplifies the federal role in health care regulation. Among other provisions, ACA expands government health care programs, imposes detailed federal standards for commercial health insurance policies, creates national requirements on employers and individuals, and enlists state administrative capacity to implement various federal reforms. In response, a persistent voice in the protracted, contentious debate surrounding ACA was, and (...) continues to be, resistance from states. The rhetoric of federalism — states’ rights, reserved powers, state sovereignty, limited government, and local diversity — resonates deeply even around provisions of ACA that do not specifically implicate state interests. For example, the loudest and most persistent state objections target the new mandate that individuals maintain health insurance, a requirement imposed by ACA and enforced through federal tax penalties. (shrink)

The Patient Protection and Affordable Care Act represents the most significant reform of the United States health care system in decades. ACA also substantially amplifies the federal role in health care regulation. Among other provisions, ACA expands government health care programs, imposes detailed federal standards for commercial health insurance policies, creates national requirements on employers and individuals, and enlists state administrative capacity to implement various federal reforms. In response, a persistent voice in the protracted, contentious debate surrounding ACA was, and (...) continues to be, resistance from states. The rhetoric of federalism — states’ rights, reserved powers, state sovereignty, limited government, and local diversity — resonates deeply even around provisions of ACA that do not specifically implicate state interests. For example, the loudest and most persistent state objections target the new mandate that individuals maintain health insurance, a requirement imposed by ACA and enforced through federal tax penalties. (shrink)

The Rwandan writer, Scholastique Mukasonga chronicles her eye-witness account of Rwandan civil war and genocide; her two novels are part of literary attempts to historicize ethnic collective trauma and memory, but they end up traumatizing national history itself and deconstructing Eurocentric representations. Her works are popularly read as autobiographies and could be mapped under trauma studies. However, this study intends to read these works as autoethnographical texts which this hyphenated writer uses to dismantle conventional boundaries of linguistic morpho-syntax of French, (...) to deconstruct European historical constructions and to contest Eurocentric epistemologies that gave rise to the literary cartography of the Other world. This Eurocentrism produces markers of post/colonial idioms such as “civilized/primitive” and “modern/traditional” as means of justifying the essence of empires. Mukasonga’s account opens our eyes to Rwandan indigenous art, science, medicine and society; therefore, it contests the ontology of European civilization. Although her novels are predominantly written in French, Mukasonga uses her native dialect of Kinyarwanda to unveil age-long Rwandan [African] civilization, thus forcing her European readership to see the “lilies in the mires”. (shrink)

In evidence-based medicine (EBM), methodology has become the central means of determining the quality of the evidence base. The “gold standard” method, the randomised, controlled trial (RCT), imbues medical research with an ethos of disinterestedness; yet, as this essay argues, the RCT is itself a rhetorically interested construct essential to medical-professional boundary work. Using the example of debates about methodology in EBM-oriented research on complementary and alternative medicine (CAM), practices not easily tested by RCTs, I frame the problem (...) of method as a fundamentally rhetorical problem, situated within a boundary drama, and deeply rooted in the discursive practices of science and medicine. The genre of the RCT report, for example, idealises the research process and can tilt the course of arguments about CAM, while the notion of efficacy can function as a rhetorically mobile boundary object that can redefine the very terms of debate. I suggest herein that arguments about method in CAM debates can productively be read, metonymically, as expressions of more general anxieties in medicine about knowledge and evidence, community values, and professional boundaries; as such, these debates can illuminate some of the rhetorical dimensions of EBM. (shrink)

Equity is a foundational concept for the new World Health Organization (WHO) Pandemic Treaty. WHO Member States are currently negotiating to turn this undefined concept into tangible outcomes by borrowing a policy mechanism from international environmental law: “access and benefit-sharing” (ABS).

“Democratization” has recently become a popular trope in Western public discourses on medicine, where it refers to patient participation in the gathering and distribution of health-related data using various digital technologies, in order to improve healthcare technically and socially. We critically analyze the usage of the term from the perspective of the “politics of buzzwords.” Our claim is that the phrase works primarily to publicly justify the dramatic increase in the application of information and data technologies in healthcare and (...) therefore fosters the corresponding industry. As a buzzword, “democratizing healthcare” is characterized by vagueness, which is why it receives meaning only through a word collective—a group of words that provide it with a context and are often used together with it. We examine key terms associated with “democratization” in the healthcare discourse—participation, empowerment, and personalized medicine—and show that the buzzword receives rhetorical power through the ambiguous reference to these concepts. As a consequence, the idea of “democracy” becomes diluted into meaning merely “access to,” and “healthcare” is reduced to the notion of a preventive, nonacute, monitored form of medical care. (shrink)

Development of the cochlear implant, discussed in this article, depended vitally on deaf people being persuaded to undergo implantation. Media "reconstruction" of the device as the "bionic ear" was typically encouraged by implant pioneers. Unexpectedly, however, a "counter-rhetoric" based on a very different understanding of deafness emerged. With it, deaf people are slowly succeeding in gaining influence over the further deployment of the technology. The analysis suggests modifications to existing theoretical models of technological change in medicine.

Drawing inspiration from Susan Sontag’s notion of ‘rhetorical ownership’—applied not only to illness but also to the body more generally—this essay argues that philosophy, like medicine, has privileged a metaphorics of war and violence in its own discourses on embodiment. Drawing inspiration from Barbara Christian’s seminal essay ‘The Race for Theory,’ as well as literary theorist Eve Sedgwick’s account of what she calls ‘paranoid’ forms of inquiry in her book Touching Feeling, this essay explores the status of violence as (...) an especially resonant trope in discourses on materiality. One worry is that the omnipresence of violent metaphors in contemporary philosophy of the body may be narrowing the space for the elaboration of nonviolent understanding of corporeality that would imagine the body otherwise than as a battlefield or a site of violence. (shrink)

Introduction: Clinical practice guidelines (CPGs) are an important source of justification for clinical decisions in modern evidence-based practice. Yet, we have given little attention to how they argue their evidence. In particular, how do CPGs argue for treatment with long-term medications that are increasingly prescribed to older patients? Approach and rationale: I selected six disease-specific guidelines recommending treatment with five of the medication classes most commonly prescribed for seniors in Ontario, Canada. I considered the stated aims of these CPGs and (...) the techniques employed towards those aims. Finally, I reconstructed and logically analysed the arguments supporting recommendations for pharmacotherapy. Analysis: The primary function of CPGs is rhetorical, or persuasive, and their means of persuasion include both a display of their credibility and their argumentation. Arguments supporting pharmacotherapy recommendations for the target population follow a common inductive pattern: statistical generalization from randomized controlled trial (RCT) and meta-analysis evidence. Two of the CPGs also argue their treatment recommendations for older patients in this style, while three fail to justify pharmacotherapy specifically for the older population. Discussion: The arguments analysed lack the auxiliary assumptions that would warrant making a generalization about the clinical effectiveness of medications for the older population. Guidelines reason using simple induction, while ignoring important inferential gaps. Future guidelines should aspire to be well-reasoned rather than simply evidence-based; argue from a plurality of evidence; be wary of hasty inductions; appropriately limit the scope of their recommendations; and avoid making law-like, prescriptive generalizations. (shrink)

The idea that ethics might be fruitfully understood in analogy with, or indeed as a form of, medicine has enjoyed a long and distinguished history. A staple of ancient philosophical thinking, it also achieved wide expression in the Islamic world. This essay explores the role of the medical analogy in the work of the eleventh-century Muslim intellectual Abū Ḥāmid al-Ghazālī. Al-Ghazālī’s use of this analogy offers a unique vantage point for approaching several key features of his ethics of virtue, (...) as notably expressed in the Revival of the Religious Sciences. These include his understanding of the nature of virtue and moral education; the fundamental structure of value; and most importantly, the place of human reasoning in the ethical life. This analogy also illuminates the rhetorical context of the Revival, taken as a book that aims to foster skills of practical reasoning and train its readers to become their own physicians. (shrink)

This article challenges the widespread assumption that Plato’s valuation of medicine remains steady across the corpus. While Plato’s opposition to poetry and sophistry/rhetoric endures, in the Laws he no longer views medicine as a rival concerning phusis and eudaimonia. Why is this dispute laid to rest, even as the others continue? This article argues that the Laws’ developments with a bearing onmedicine stem ultimately from the philosopher-ruler’s disappearance. The deeper appreciation of good medical practice that ensues, combined (...) with an array of sociopolitical mechanisms for detecting injustice, means that the health care setting is no longer—as in the Republic—the crossroads where judgments of the whole person must be made. For the first time, by Plato’s lights, medicine may be a truly self-standing technē. (shrink)

Lorenzo Valla's rhetorical reform of logic resulted in important changes in sixteenth-century mathematical sciences, and not only in mathematical education and in the use of mathematics in other sciences, but also in mathematical theory itself. Logic came to be identified with dialectic, syllogisms with enthymemes and necessary truth with the limit case of probable truth. Two main ancient authorities mediated between logical and mathematical concerns: Cicero and Proclus. Cicero's 'common notions' were identified with Euclid's axioms, so that mathematics could be (...) viewed as core knowledge shared by all humankind. Proclus' interpretation of Euclid's axioms gave rise to the idea of a universal human natural light of reasoning and of a mathesis universalis as a basic mathematics common to both arithmetic and geometry and as an art of thinking interpretable as algebra. (shrink)

Discussion of the worldwide corporate development of biotechnologies is sometimes diverted through the introduction of images of heroic medical intervention, exemplified by the statement, I would do anything to save my daughter. Such heroic images seem to justify virtually any deployment of resources and nearly any health or environmental risk. But it is instructive for future public discussions to examine the use of such images, and to note that those advocating a prominent role for biotechnologies in an expanding global economy (...) welcome such diversionary patterns. Our responsibility to do our own thinking is beset by conditions that may lead us astray. In a time burdened by profound worry—crushing inequalities among the world's peoples, an ecological crisis, and threat of nuclear war—it is tempting to avert our eyes when we are faced with grave new dangers. Moreover, in our increasingly visual culture, images have come to function as a facsimile of and substitute for real thinking. If we are to have significant discussions about the potential of biotechnology, we must not only be wary of promises of economic growth but must also be mindful of sources of diversion and the appeals of image-thinking. We should strive to become more critical of our own ways of thinking, thus opening the discussion to a fuller consideration of what needs to be saved. (shrink)