Scientism in medical education distracts educators from focusing on the content of learning; it focuses attention instead on individual achievement and validity in its measurement. I analyze the specific form that scientism takes in medicine and in medical education. The competencies movement attempts to challenge old “scientistic” views of the role of physicians, but in the end it has invited medical educators to focus on validity in the measurement of individual performance for attitudes and skills that medicine (...) resists conceptualizing as objective. Academic medicine should focus its efforts instead on quality and relevance of care. The social accountability movement proposes to shift the focus of academic medicine to the goal of high quality and relevant care in the context of community service and partnership with the institutions that together with medicine create and cope with health and with health deficits. I make the case for this agenda through a discussion of the linked histories of the opioid prescribing crisis and the professionalism movement. (shrink)

Christian Scientists' refusal of medical care for their children illustrates the kind of conflict over moral and practical authority that can arise between groups in a pluralistic society. While consensus may not be possible, changes in the way both groups socialize members may allow the medical and Christian Science communities to achieve a compromise that is respectful to both.

Emerging medical biotechnology typically exhibits a ‘dual-use’ nature, which, while promoting human well-being, concurrently presents potential risks of misuse or abuse, thereby posing significant threats. Globally, including in China, emerging medical biotechnology is developing rapidly. To understand the views and perspectives of Chinese scientists on dual-use concerns, this empirical study conducted semistructured qualitative interviews with researchers (n=14) from various specialties within the Chinese medical field, analysing their perspectives and ethical considerations regarding dual-use concerns. The findings of (...) this study reveal a spectrum of attitudes among interviewees towards the exploration and application of emerging medical biotechnology, ranging from aggressive to conservative. This tension reflects the complexity and challenges of seeking a balance between promoting scientific innovation and maintaining ethical boundaries. Furthermore, while there is a consensus among scientists that the development and application of biotechnology encompass both risks and benefits, their stances on weighing these factors differ, reflecting how risk perception is influenced by professional limitations. Moreover, although scientists recognise the indispensability of both self-regulation and external oversight in practice, they also exhibit misunderstandings in ethical cognition and misinterpretations of regulatory measures. In light of these findings, it is imperative for us to urgently fortify national regulatory mechanisms and the construction of legal and ethical frameworks while also enhancing the ethical awareness and risk assessment capabilities of researchers. These measures are crucial for minimising the potential risks associated with dual use and fostering the sustainable and responsible development of emerging medical biotechnology. (shrink)

Muslim Medical Ethics draws on the work of historians, health-care professionals, theologians, and social scientists to produce an interdisciplinary view of ...

When anthropologists and other social scientists study health services in medical institutions, tensions sometimes arise as a result of the social scientists and health care professionals having different ideas about the ethics of research. In order to resolve this type of conflict and to facilitate mutual learning, we describe two general categories of research ethics framing: those of anthropology and those of medicine. The latter focuses on protection of the individual through the preservation of autonomy expressed through (...) the requirement of informed consent whereas the former focuses on broader political implications. After providing an example of a conflict, we outline four issues that characterize the occasional clashes between social scientists and medical staff: (1) a discrepancy in the way anthropologists perceive patients and medical staff; (2) ambiguity concerning the role of medical staff in anthropological research; (3) impediments to informed consent in qualitative research projects; and (4) property rights in data. Enhanced dialogue could serve to invigorate the ethical debate in both traditions. (shrink)

In this essay, I argue that exploring institutional racism also needs to examine interactions and communications between patients and providers. Exchange between bioethicists, social scientists, and life scientists should emphasize the biological effects—made evident through health disparities—of racism. I discuss this through examples of patient–provider communication in fertility clinics in South Africa and the ongoing COVID-19 pandemic to emphasize the issue of mistrust between patients and medical institutions. Health disparities and medical mistrust are interrelated problems of (...) racism in healthcare provision. (shrink)

Winner of the Los Angeles Times Book Prize With a new preface by the author In his most powerful and important book, renowned psychiatrist Robert Jay Lifton presents a brilliant analysis of the crucial role that German doctors played in the Nazi genocide. Now updated with a new preface, The Nazi Doctors remains the definitive work on the Nazi medical atrocities, a chilling exposé of the banality of evil at its epitome, and a sobering reminder of the darkest side (...) of human nature. (shrink)

Ludwik Fleck is known mainly for his pioneering studies of science as a social activity. This text investigates a different aspect of Fleck’s epistemological thought—his engagement with normative aspects of medicine and public health and their political underpinnings. In his sinuous professional trajectory, Fleck navigated between two distinct thought styles: fundamental microbiological research and practice-oriented investigations of infectious diseases. Fleck’s awareness of tensions between these two approaches favored the genesis of his theoretical reflections. At the same time, his close observation (...) of medical and epidemiological practices led him to the conclusion that collectively produced scientific facts are situated and fragile. Thought collectives, Fleck explained, can err or yield to external pressures, with potentially disastrous consequences. While Fleck the reflexive experimental scientist has been creatively translated into the science studies idiom, Fleck the reflexive practical microbiologist and public health expert still awaits inspired translation. (shrink)

Medicalization has been a process articulated primarily by social scientists, historians, and cultural critics. Comparatively little is written about the role of bioethics in appraising medicalization as a social process. The authors consider what medicalization means, its definition, functions, and criteria for assessment. A series of brief case sketches illustrate how bioethics can contribute to the analysis and public policy discussion of medicalization.

As one component of a broader social and normative response to the problem of suicide, scientism served to minimize sociopolitical and religious conflict around the issue. As such, it embodied, and continues to embody, a number of interests and values, as well as serving important social functions. It is thus comparable with other normative frameworks and can be appraised, from an ethical perspective, in light of these values, interests, and functions. This work examines the key values, interests, and functions of (...) scientism in suicidology and argues that although scientism has had some social benefit, it primarily serves to maintain political and professional interests and has damaging implications for suicide research and prevention. (shrink)

Clinician scientists have gained institutional support in the era of translational research, as the key solution to closing the ‘translational gap’ between biomedical research and medical practice. However, clinician scientists remain an ‘endangered species’ in search of a secure niche, while new grants and training programs attempt to counteract their measurable decline in numbers over the past decades. Our study asks how an occupational space for clinician scientists is currently situated between the politics of translation, professional (...) dynamics, and the specialization of academic disciplines. We interviewed clinician scientists, their adjacent professions—clinicians and biomedical researchers—, and contrast their views with expectations from the discourse on clinician scientists in the biomedical and policy literature. We identify professionalizable work and tasks that relate to, first, being able to speak the two languages of both clinic and research, second, translating patients’ needs and clinical experience for further research, and third, counteracting the trends towards specialization by providing an inclusive point of view. We find that clinician scientists are overburdened with fulfilling a hybrid role of simultaneously being clinicians and scientists. Based on these findings, we suggest a path for the future professional development of clinician scientists towards the role of a translator. (shrink)

Every human being has a vast store of knowledge about health and sickness and the ability to draw conclusions on the basis of this knowledge. Yet science research continues to be based largely on `objective studies' conducted by academics and to look down on `subjective' studies. The belief that `pure' objective science is highest and subjective information is lowest, inculcated by the way science is taught in schools, deters doctors from communicating information based on personal experience lest it be decried (...) - as it certainly will be - as scientifically worthless. Alternative medicine with its open, flexible approach to the whole person, has something to teach conventional medicine. And doctors must pay more attention to what their patients can tell them. There is no rational justification for accepting the factual information that people give (in a case history) while disregarding what they have to say about their condition. Old-style science is particularly inept in helping doctors deal with psychosomatic problems. What is needed is a new `science of the subjective' which would be truly appropriate to the subject of study, the whole human being. There is a commentary on this paper by Sir Douglas Black, President of the Royal College of Physicians. (shrink)

Contrasts the monster-creating escapades of mad scientists such as Frankenstein, Moreau, and Jekyll with the methods used by real scientists who try to help, not hurt, the world.

Medical ethicists have assumed a role in justifying public voyeurism of human "curiosities." This role has precedent in how scientists and natural philosophers once legitimized the marketing of museums of "human curiosities." At the beginning of the twentieth century, physicians dissociated themselves from entrepreneurial displays of persons with anomalies, and such commercial exhibits went into decline. Today, news media, principally on television, promote news features about persons that closely resemble the nineteenth century exhibits of human curiosities. Reporters solicit (...) medical ethicists for soundbites to affirm the newsworthiness and propriety of public voyeurism of these medical stories. Ethicists' soundbites are usually ambiguous or self-evident and rarely enable viewers to morally engage the issues. The precedent of early twentieth century physicians disengaging from such exploitive public shows is a useful example for medical ethics. (shrink)

In June 2005, Italy held a referendum on repealing the law on medically assisted fertilization , which limits access to artificial reproduction to infertile couples, and prohibits the donation of gametes, the cryopreservation of embryos, preimplantation genetic diagnosis , and research on human embryos. The referendum was invalidated, and the law remained unchanged. The Italian political e bioethical debate on assisted reproduction was manipulated by the Catholic Church, which distorted scientific data and issues at stake with the help of Catholic (...) politicians and bioethicists. What happened in Italy shows that some perverse socio-cultural e political mechanisms are spreading the absurd and anti-historical view that scientific and technological advancements are threatening democracy and personal freedom. Scientists should not only contrast the political attempts at limiting freedom of scientific research, but also tell politicians, humanists and citizens that the invention of Western science with its view of scientific community as an “open society”, contributed and still contributes, through scientific education, to the construction and maintaining of the moral and political values underlying Western democracies. (shrink)

Summary Benjamin Moore (1867?1922), physiologist and biochemist, was an eminent member of the British scientific and medical community in the early twentieth century. As a founder and president of the State Medical Services Association (SMSA) from its establishment in 1912 until his untimely death in 1922, Moore was a prominent medical services activist and planner in a period of intense debate on health services reform. As a medical scientist, Moore was also a participant in the campaign (...) by laboratory scientists to obtain a larger role in clinical education, research, and medicine in this period. This article examines the medical services activism and ideas of Benjamin Moore. In particular, it seeks to demonstrate how his health services proposals and those he influenced, including SMSA and Labour Party plans, sought to advance the interests of laboratory scientists. (shrink)

In this essay, I argue that bioethicists have a thus-far unfulfilled role to play in helping life scientists, including medical doctors and researchers, think about race. I begin with descriptions of how life scientists tend to think about race and descriptions of typical approaches to bioethics. I then describe three different approaches to race: biological race, race as social construction, and race as cultural driver of history. Taking into account the historical and contemporary interplay of these three (...) approaches, I suggest an alternative framework for thinking about race focused on how the idea of race functions socially. Finally, using assisted reproductive technologies as an example, I discuss how bioethicists and scientists might work together using this framework to improve not only their own but broader perspectives on race. (shrink)

This study seeks to advance the understanding of controversy resolution in science. I take as a case study conceptualization and treatment of ulcer disease. Analysis of causal accounts and effective treatments illustrate the ways in which competing parallel research programs in medicine embody opposing social, political, and economic forces which are bound to the epistemological dimensions of scientific controversy (e.g., standards of evidence, reference, and inference), and which in turn shift perception of the burden of proof. The analysis illustrates the (...) ways in which (1) medical diagnoses create as much as discover useful distinctions and (2) epistemic and non epistemic values divide scientists into competing research programs, as well as (3) the ways in which these structures often effectively prevent scientific controversy closure. (shrink)

We suggest that in the particular context of medical education, ethics can be considered in a similar way to other kinds of knowledge that are categorised and shaped by academics in the context of wider society. Moreover, the study of medical ethics education is translational in a manner loosely analogous to the study of medical education as adjunct to translational medicine. Some have suggested there is merit in the idea that much as translational research attempts to connect (...) the laboratory scientist's work to its implications for patient care, translational ethics focuses on bringing ethics scholarship into the sphere of personal and public action. We distinguish the term ‘translational ethics’ (the study of ethics being translated between academy, classroom and clinic) from other prominent definitions in the bioethics literature. To do this, we build off a notion of knowledge translation that focuses on the nonlinear movement of information that comes to professionals through multiple competing sources. We suggest that this knowledge, and particularly knowledge about ethics, becomes embodied by the individual. It is through a reflective practice that internally embedded ethics knowledge might be modified, and this work might be best carried out with a moral community that maintains a sense of practical wisdom. Applying this translational approach to the study of medical ethics education can be both academically relevant and practically useful. This view of translation can help bridge the evident, multidirectional relationships between research, education and performance. It might also create further opportunities to develop medical ethics education theory. (shrink)

This paper is a survey of the law in the United States which is applicable to consulting scientists and engineers. Based on the body of law which has developed for the construction industry and professional “advice-givers” such as attorneys, medical doctors and accountants, the paper reviews professional responsibilities in the areas of Common Law Torts. Common Law Contracts, certain U.S. Federal and State Statutes and the protection of sensitive information.

If scientists can successfully clone sheep, will humans be next? Today's headlines read like a science fiction novel! Due Consideration takes a poignant look at the rapidly changing field of biomedicine and the consequences it will have on our lives. Arthur Caplan, one of this nation's leading bioethicists, explores these issues and analyzes moral questions including: * Will we retain our essential humanity if we modify our biological blueprint? * Would it be irresponsible to procreate without a thorough genetic (...) examination? * Who will decide if physical traits like short stature and baldness are considered diseases? * Can biomedicine make our lives better? You'll also learn about the most current and controversial topics such as: * Cloning, abortion and assisted suicide. * Genetically engineering a human to be immune from infectious diseases. * The ability to "design" our children from head to toe. * Diagnosing and treating illnesses during fetal development. * Programs to prevent the transmission of HIV. No other book on the market today combines this analytic clarity with the latest from medical journals and media headlines. Now, you can decide for yourself what the future ought to hold in store. (shrink)

The medical profession contains five “spheres of morality”: clinical care, clinical research, scientific knowledge, population health, and the market. These distinct sets of normative commitments require physicians to act in different ways depending on the ends of the activity in question. For example, a physician-scientist emphasizes patients’ well-being in clinic, prioritizes the scientific method in lab, and seeks to maximize shareholder returns as a board member of a pharmaceutical firm. Physicians increasingly occupy multiple roles in healthcare and move between (...) them frequently, creating the possibility of conflict between the ethical obligations of their various roles. This paper examines the entire moral landscape of medicine through the lens of role morality. It develops a novel framework that helps physicians recognize how their moral commitments depend on the nature and context of the situation, clarifies ethical conflicts that physicians face, and concludes with ideas for resolving these conflicts. (shrink)

In this article, we investigate the role of scientific and patient narratives on perceptions of the medical debate around gestational diabetes testing. Among medical scientists, we show that the narrative surrounding GDM testing affirms that future research and data will lead to medical consensus. We call this narrative trajectory the “deferred quest.” For patients, however, diagnosis and their subsequent discovery that biomedicine does not speak in one voice ruptures their trust in medical authority. This new (...) distrust creates space for patients to develop a Frankian quest narrative where they become the protagonist in their story. Additionally, across these different narratives, we observe how character is constructed and employed to negotiate trust. We conclude that healthcare providers should assess the narrative trajectory adopted by patients after diagnosis. Also, we suggest that providers acknowledge the lack of medical consensus to their patients. This veracity would foster women’s sense of trust in their provider as well as allow women to be active interlocutors in a debate that ultimately plays out in their deliberation about their body, pregnancy, and risk. (shrink)

The correlation between medical ethics and medical law, while seemingly far removed from the context of Eastern Orthodoxy, is in fact of deep theological significance and eschatological prominence and has become increasingly a matter of concern in contemporary Russia. The following study examines different modes of this correlation and their moral implications for the wider society.

Non-medical or Social egg freezing (oocyte cryopreservation) is currently a controversial topic in Islam, with contradictory fatwas being issued in different Muslim countries. While Islamic authorities in Egypt permit the procedure, fatwas issued in Malaysia have banned single Muslim women from freezing their unfertilized eggs (vitrified oocytes) to be used later in marriage. The underlying principles of the Malaysian fatwas are that (i) sperm and egg cells produced before marriage, should not be used during marriage to conceive a child; (...) (ii) extraction of mature egg cells from single women being unacceptable; and (iii) fertility preservation in anticipation of late marriage is a conjecture that has not yet occurred. Ovarian tissue freezing can potentially be a more Shariah-compliant alternative to social egg freezing, because once the frozen ovarian cortical tissue sections have been re-transplanted back into the woman, mature egg cells can readily be produced, collected, and fertilized by the husband’s sperm only during the period of marriage contract (′akd al-nikāḥ). Unlike accidental mix-ups with frozen eggs, muddling of lineage (nasab) would be automatically avoided in ovarian tissue freezing due to immunological rejection. However, upon critical analysis based on Qawā’id Fiqhiyyah (Islamic Legal Maxims), Maqāṣid-al-Shariah (Higher Objectives of Islamic Law), and Maslaḥah-Mafsadah (benefits versus harmful effects on society), elective ovarian tissue freezing by healthy single women for social reasons would likely be a highly contentious and controversial issue within Muslim communities that may conflict with conservative social-religious norms. This thus needs further debate among Islamic jurists in dialogue with medical doctors and biomedical scientists. (shrink)

Since the advent of the natural sciences, natural scientists have spread the idea that the pursuit of truth about the facts of the world is the main drive of scientific research. The aim, they say, is to acquire knowledge and to provide explanations and predictions of phenomena and events. Surprisingly, even in our contemporary world in which scientific research is strongly involved in seeking solutions to practical problems pertaining to the pursuit of food, water, energy, health, labor, peace, war, (...) nuclear weapons, money, and the like, the pursuit-of-truth postulate nevertheless enjoys vigorous advocacy, especially in philosophy. In this chapter, the role that truth actually plays in medicine will be examined. Our discussion of this issue divides into the following four sections: 24.1 Truth in Medical Sciences; 24.2 Truth in Clinical Practice; 24.3 Misdiagnoses; 24.4 Truth Made in Medicine. In summary, it is shown that medical knowledge does not contain much truth because it mainly consists of hypotheses, theories, and deontic rules. The truth values of the former are unknown, while theories and deontic rules do not assume truth values. Likewise, in clinical practice true diagnoses and prognoses are not always attainable because (i) medical knowledge is inevitably vague, uncertain, and unreliable and is therefore scarcely truth-conducive; (ii) this also applies to most parts of patient data; (iii) physicians are not trained in viable and efficient methodology of clinical reasoning; and (iv) neither clinical decision support systems nor the automation of clinical decision-making will be able to compensate for the first two shortcomings. So, misdiagnoses will remain inevitable forever, although their frequency may be reduced by improving the techniques of clinical judgment. Since medical theories are artifactual structures and medical languages are artifactual systems, the truth of diagnoses and prognoses, and of any other judgment based thereon is made in medicine. (shrink)

This book addresses the moral, social and political problems emerging from the practice of healing and caring, biomedical research and the provision of health care services. The primary aim of many professional bioethicists is, of late, to solve as efficiently as possible, the problems encountered by health care providers and scientists in clinical, laboratory and administrative settings. Seen from the viewpoint of applied philosophy, however, this is a dangerous tendency if the grounds for the suggested solutions are not properly (...) examined. Even choices which are harmless and seem to involve no immoralities can be indirectly hazardous if those making choices appeal to dubious ethical principles or inaccurate data. This is why this book is dedicated to the examination of the reasons that people can and should have for their health care related decisions as well as to the formulation of good solutions to difficult problems. It covers criterial in life and death decisions, voluntary euthanasia and medical paternalism, wrongful medical authoritarianism, health education, preventive medicine and the welfare of the population, AIDS, discrimination and legal restrictions, and health care policy-making. (shrink)

In late nineteenth- and early twentieth-century Germany, the integration of product-evaluating certificates and reports ( Gutachten) into advertisements triggered repeated condemnations of “advertisement- Gutachten” ( Reklamegutachten), and scientists and science administrators introduced various restrictions to prevent the appearance of such documents. At the same time, the provision of Gutachten to private individuals and firms seemed crucial to the success of many private and public laboratories. Some chemical and other professionals, moreover, argued that the authoring and use of Reklamegutachten could (...) represent a “scientific” and, therefore, ethical practice. By examining the contested history of the advertisement- Gutachten, this article reveals how a previously tolerated knowledge service lost its legitimacy in a particular place and period of time, and highlights the challenges of eliminating this practice or restoring its legitimacy afterward. The article also explores how professional scientists’ approaches to maintaining a reputation for integrity in the face of commercial and competitive pressures related to the better-known efforts of professionals in other fields, particularly the medical. I emphasize that, in determining whether a Gutachten qualified as scientific, the nature and transparency of the underlying research process was only one of the criteria that were considered, and often not the most significant yardstick. At the same time, however, ideas about the personal and professional/institutional integrity of providers of Gutachten were inextricably connected with assessments of the honesty and objectivity of their research. (shrink)

Holocaust literature gives exhaustive attention to direct means of exterminating Jews, by using gas chambers, torture, starvation, disease, and intolerable conditions in ghettos and camps, and by the Einsatzgruppen. In some circles, the term “Holocaust” has become the ultimate description of horror or horrific events. The Nazi medical experiments and practices are an example of these. Nazi medical science played a central and crucial role in creating and implementing practices designed to achieve a “Master Race.” Doctors interfered with (...) the most intimate and previously sacrosanct aspects of life in these medical experiments – reproductive function and behavior – in addition to implementing eugenic sterilizations, euthanasia, and extermination programs. Manipulating reproductive life – as a less direct method of achieving the genocide of Jews – has been less acknowledged. The Nazis prevented those regarded as not meeting idealized Nazi racial standards – and particularly Jewish women – from having sex or bearing children through legal, social, psychological and biological means, as well as by murder. In contrast, they promoted reproductive life to achieve the antithesis of genocide – the mass promotion of life – among those deemed sufficiently “Aryan.” Implementing measures to prevent birth is a core feature of the UN Convention on the Prevention and Punishment of Genocide. As with many other aspects of the Holocaust, science and scientists were inveigled into providing legitimacy for Nazi actions. The medical profession was no exception and was integrally involved in the manipulation of birth to implement the Holocaust. (shrink)

In 1948 Ludwik Fleck published a paper in Polish discussing the use of humans in medical experiments, thereby addressing his peers. Though the paper has so far not been translated or studied, it has been taken to indicate Fleck’s deep commitment to ethical questions, notably the question of informed consent. In being written by a former victim of the Nazi policy and a survivor of the Holocaust also acting as an expert witness in the trial of the IG Farben (...) in Nuremberg, the paper is of interest. A scrutiny of Fleck’s text and related sources discloses, however, not only the complexity of the issue at the centre of the Nuremberg trial, but also Fleck’s unexpected stance in seemingly adducing his arguments from both the German defendants and the prosecution, heavily informed by US scientists. Further, the contentious discussion of the past in Fleck’s paper reveals its links to modern bioethical discussion. Though sometimes oblivious of that past, it still faces the same questions. (shrink)

People with disabilities are underrepresented in STEM fields, and all too often, they face isolation and ableism in academia. Uncharted is a collection of powerful first-person stories by current and former scientists with disabilities or chronic conditions who have faced changes in their careers, including both successes and challenges, because of their health. It gives voice to common experiences that are frequently overlooked or left unspoken. These deeply personal accounts describe not only health challenges but also the joys, sorrows, (...) humor, and wonder of science and scientists. With a breadth of perspectives on being disabled or chronically ill, these stories highlight the intersectionality of minoritized identities with the disability community. Uncharted features essays by contributors who are d/Deaf, blind, neurodivergent, wheelchair users, have experienced traumatic brain injuries, have blood sugar disorders, have rare medical diagnoses, or have received psychiatric diagnoses, among many others. In many cases, the scientific field is not fully accessible to them, and they frankly describe struggling as well as thriving alongside their conditions. This book serves as representation for scientists who have never felt comfortable disclosing their disability or who have never felt fully understood. The stories shared in this book seek to normalize medical conditions and disabilities in scientific culture, offering recommendations for how and why to improve access. Uncharted is vital and compelling reading for current and aspiring scientists who want to make their fields more inclusive and supportive for everyone. (shrink)

Although women have made important inroads in science and engineering since the early 1970s, their progress in these fields has stalled over the past several years. This study looks at women in science and engineering careers in the 1970s and 1980s, documenting differences in career outcomes between men and women and between women of different races and ethnic backgrounds. The panel presents what is known about the following questions and explores their policy implications: In what sectors are female Ph.D.s employed? (...) What salary disparities exist between men and women in these fields? How is marital status associated with career attainment? Does it help a career to have a postdoctoral appointment? How well are female scientists and engineers represented in management? Within the broader context of education and the labor market, the book provides detailed comparisons between men and women Ph.D.s in a number of measures: financial support for education, academic rank achieved, salary, and others. The study covers engineering; the mathematical, physical, life, and social and behavioral sciences; medical school faculty; and recipients of National Institutes of Health grants. Findings and recommendations in this volume will be of interest to practitioners, faculty, and students in science and engineering as well as education administrators, employers, and researchers in these fields. (shrink)

Due to advancements in technology such as data science and artificial intelligence, healthcare research has gained momentum and is generating new findings and predictions on abnormalities leading to the diagnosis of diseases or disorders in human beings. On one hand, the extensive application of data science to healthcare research is progressing faster, while on the other hand, the ethical concerns and adjoining risks and legal hurdles those data scientists may face in the future slow down the progression of healthcare (...) research. Simply put, the application of data science to ethically guided healthcare research appears to be a dream come true. Hence, in this paper, we discuss the current practices, challenges, and limitations of the data collection process during medical image analysis (MIA) conducted as part of healthcare research and propose an ethical data collection framework to guide data scientists to address the possible ethical concerns before commencing data analytics over a medical dataset. (shrink)

Nathaniel Hawthorne’s The Birthmark offers a sharp lens through which to examine power, purity, and personal identity. Scientist and spiritual idealist, Aylmer, is obsessed with “correcting” the only flaw he perceives in his wife Georgina, the imprint of a small red hand on her pale cheek. For Alymer, this one “imperfection” reaches deep into Georgina’s heart, a sign of sin, decay, and mortality. It is the natural that must be overcome with science. Drawing on Hawthorne’s tragic fiction, this paper questions (...) the influence of stigma, power dynamics, and mind-body dualism in constructing disability identity within the framework of medical and spiritual practices of care. Whether in the role of a spiritual leader, chaplain, or medical professional, people providing care must first address ableism and perceptions of normalcy in relation to their own identity and calling before offering professional advice to disabled people seeking guidance or support. It is only as professional fields adopt a posture marked by courageous humility that healing practices will promote the flourishing of all people, including those with disabilities. (shrink)

Three medical ethicists take varied and often opposing stands on the ethical, social, and political issues that arise when religious and medical practices conflict. The interchange focuses on the tensions between the belief systems, institutional practices, and health-related decisions of Christian Scientists and those of a secularized medically oriented, broader society.

What clinicians, biomedical scientists, and other health care professionals know as individuals or as groups and how they come to know and use knowledge are central concerns of medical epistemology. Activities associated with knowledge production and use are called epistemic practices. Such practices are considered in biomedical and clinical literatures, social sciences of medicine, philosophy of science and philosophy of medicine, and also in other nonmedical literatures. A host of different kinds of knowledge claims have been identified, each (...) with different uses and logics of justification. A general framework is needed to situate these diverse contributions in medical epistemology, so we can see how they fit together. But developing such a framework turns out to be quite tricky. In this survey, three possible frameworks are considered along with the difficulties associated with each of them. The essay concludes with a fourth framework, which considers any epistemology as part of a practice that is oriented toward overcoming errors that emerge in antecedently given practices where knowledge is developed and used. As medicine indirectly advances health by directly mitigating disease, so epistemology indirectly advances knowledge by directly mitigating error. (shrink)

The “Universal Declaration of Human Rights” and the “Geneva Declaration” by the World Medical Association, both in 1948, were preceded by the foundation of the United Nations in New York (1945), the World Medical Association in London (1946) and the World Health Organization in Geneva (1948). After the end of World War II the community of nations strove to achieve and sustain their primary goals of peace and security, as well as their basic premise, namely the health of (...) human beings. All these associations were well aware of the crimes by medicine, in particular by the accused Nazi physicians at the Nuremberg Doctors Trial (1946/47, sentence: August 1947). During the first conference of the World Medical Association (September 1947) issues of medical ethics played a major role: and a new document was drafted concerning the values of the medical profession. After the catastrophe of the War and the criminal activities of scientists, the late 1940s saw increased scrutiny paid to fundamental questions of human rights and medical ethics, which are still highly relevant for today’s medicine and morality. The article focuses on the development of medical ethics and human rights reflected in the statement of important persons, codes and institutions in the field. (shrink)

The American term Bioethics has been adopted over the last ten years and the development of Bioethics committees on the American model testifies this influence, even before the official appointment of a National Committee in 1983. This phenomenon acknowledged as the emergence of French bioethics is in fact the final outcome of a long-lasting crisis in the medical profession, in quest for a new style of ethics, breaking with the traditional professional ethics (French Déontologie, through the Ordre des Médecins). (...) Among other factors of conceptual and institutional change, the increase of biomedical research comes first: a major consequence is the sharing of moral responsibilities in decision-making with outsider scientists and finally the involvement of the whole population as potential moral subjects.The designation of these events as the emergence of French bioethics is hardly appropriate for an account of this dramatic shift in ethical norms and roles in medicine. This paper attempts to review the intellectual roots of the recent evolution and to summarize present and prospective trends. (shrink)

In this paper, we outline a framework for understanding the different kinds of knowledge required for medical practice and use this framework to show how scientism undermines aspects of this knowledge. The framework is based on Michael Polanyi’s claim that knowledge is primarily the product of the contemplations and convictions of persons and yet at the same time carries a sense of universality because it grasps at reality. Building on Polanyi’s ideas, we propose that knowledge can be described along (...) two intersecting “dimensions”: the tacit–explicit and the particular–general. These dimensions supersede the familiar “objective−subjective” dichotomy, as they more accurately describe the relationship between medical science and medical practice. Scientism, we argue, excludes tacit and particular knowledge and thereby distorts “clinical reality” and impairs medical practice and medical ethics. (shrink)

Before 1933 commentaries on laws were exclusively juristic texts, written and read only by legal professionals. Beginning in 1934, scholars from different disciplines, especially medical scientists, began writing juristic commentaries. The essay examines the reasons for this development and explores how it changed the genre, using the example of the most important commentary on theBlutschutz-andEhegesundheitsgesetz, which resulted from the collaboration of two medical professionals and a legal professional. The article argues that the recruitment of non-juristic authors and (...) the corresponding methodological changes were caused by a debate on a possible “reform” of juristic commentaries which took place in law journals. From the perspective of the National Socialist regime, the genre in its traditional form was not compatible with the Third Reich’s philosophy of law.In this new genre, commentaries not only referred to legal problems, but also dealt with issues from other disciplines, such as medical questions. The essay modifies Mitchell G. Ash’s theoretical approach regarding the “entanglement” of jurisprudence and other disciplines. Law and other sciences became, according to Ash, “resources for one another”: Legal scholars could claim that legal decisions were based on scientific facts and therefore “unquestionable.” The affected disciplines also gained greater importance as a result of this process in which their findings becoming legally relevant. This transformation also enabled them to acquire resources for new research projects.Moreover, the essay examines the connection between this development and the change of audience within German courts. Not only did the authors of the commentaries change, but also the recipients: Many laws passed after 1933 introduced new courts using lay judges, professionals with a non-law background. These “experts” came from multiple fields connecting them to the new law, such as medical professionals. (shrink)