Volume 24, Issue 11, November 2024, Page 1-3.

Volume 25, Issue 2, February 2025, Page 67-70.

Volume 24, Issue 12, December 2024, Page 6-7.

An instrument to assess 'ethical sensitivity' has been developed. The instrument presents four clinical vignettes and the respondent is asked to list the ethical issues related to each vignette. The responses are classified, post hoc, into the domains of autonomy, beneficence and justice. This instrument was used in 1990 to assess the ethical sensitivity of students in all four medical classes at the University of Toronto. Ethical sensitivity, as measured by this instrument, is not related to age or grade-point (...) average. Sensitivity increases between the 1st and 2nd year and then decreases throughout the rest of undergraduate medical training, such that the 4th-year students identify fewer issues than those entering medical school. Students expressing a career choice of family medicine identify more issues than their peers. Several problems with the use of the instrument and the interpretation of the data were found. Nonetheless, these findings, if reproducible, are important and their meaning needs further discussion. (shrink)

The Pneumatist school of medicine has the distinction of being the only medical school in antiquity named for a belief in a part of a human being. Unlike the Herophileans or the Asclepiadeans, their name does not pick out the founder of the school. Unlike the Dogmatists, Empiricists, or Methodists, their name does not pick out a specific approach to medicine. Instead, the name picks out a belief: the fact that pneuma is of paramount importance, (...) both for explaining health and disease, and for determining treatments for the healthy and sick. In this paper, we re-examine what our sources say about the pneuma of the Pneumatists in order to understand what these physicians thought it was and how it shaped their views on physiology, diagnosis and treatment. (shrink)

In this article, the author explores a model of alternative medical education being pioneered at Loyola University Chicago Stritch School of Medicine. The five-year Global Health Fieldwork Fellowship track allows two students per year to complete an extra year of medical education while living and working in a free rural clinic in the jungle lowlands of Bolivia. This alternative curricular track is unique among other existing models in that it is longitudinally immersive for at least one full additional (...) year of medical education, grounded in clinical and service learning, and heavily focused upon global health and the social components of medicine. Studies have shown that both longitudinal alternative medical curricular tracks and short-term global health electives have long-term benefits upon the professional development of participants, suggesting that the GHFF is likely to do the same. The author also argues that the GHFF is an advantageous model of global health education compared to standard offerings and provides a unique curricular model by which to foster the development of social values—such as professionalism, advocacy, and social justice—that are widely considered lacking in today’s medical education. (shrink)

Introduction: The high degree of religious/spiritual involvement that brings meaning and purpose to a patients’ life, especially when they are weakened by pain, is among the various reasons to consider the spiritual dimension in clinical practice. This involvement may influence medical decisions and, therefore, should be identified in the medical history of a patient.Objective: To verify the opinion of undergraduate medical students of the Paulista School of Medicine – Federal University of São Paulo regarding the use of a (...) patient’s Spirituality/Religiosity as a therapeutic resource in clinical practice.Method: Quantitative approach of the transversal analytical observational type. The sample was composed of academics’ medical program, from the first to the sixth year, regularly enrolled in 2017. Data collection was performed with a standardized questionnaire divided into three sections: sociodemographic profile; Duke University Religious Index; Spirituality/Religiosity in the clinical and academic context.Results: Participated in the survey 72% of the enrolled students, of which 61.4% had religious affiliation, 26.2% declared themselves agnostic and 12.4% atheists. All of them proposed to answer questions about the insertion of Spirituality/Religiosity in the patient care process. Through the Duke Religiosity Index, we evaluated the importance of religiosity in the student’s personal life and the pertinence of religiosity as a therapeutic insertion for medical treatment. Regarding the clinical and academic context, most participants considered relevant the proposition of didactic-pedagogical actions in medical education related to the spiritual dimension of the patient.Conclusion: We conclude, through our research, that the insertion of the Spirituality/Religiosity of the patient as a therapeutic resource in clinical practice is feasible for most undergraduate students in Medicine of the Escola Paulista de Medicina – Universidade Federal de São Paulo. The result of the research, although it shows only the opinion of medical students at a Brazilian university, indicates that Spirituality/Religiosity is already part of the contemporary medical universe. (shrink)

Introduction: We live in a society that encourages self-medication and one reason is the availability of drugs that do not require a prescription and are easily accessible, the abuse of these have important implications for the health of the general population; being the most commonly used drugs: analgesics, antibiotics, antihistamines and others. Objective: Determine the causes that induce self-medication in freshmen and fifth year of the Faculty of Medicine of the Universidad Mayor, Real y Pontificia de San Francisco Xavier (...) de Chuquisaca - Bolivia, 2012. Methodology: Quantitative and descriptive cross-sectional approach. A sample of 284 students which they apply structural survey was obtained. Results.A high percentage of students who are self-medicating themselves without.medical.supervision. Conclusions: We can say that self-medication on freshmen and fifth year of medical school at the University Of San Francisco Xavier De Chuquisaca is induced by influence of social circle (friends and parents), advertising of certain medications, access to internet and lack of time. (shrink)

Medical education at the Colombian School of Medicine has undergone a reconceptualization and reorganization so as to encompasses three fundamental elements of medical practice: 1) development of general abilities and standards necessary for appropriate professional medical practice; 2) technical education which makes it possible to utilize the bases that science and technology have provided for the development and application of knowledge, and in turn, to expand this base through research and development; and 3) humanistic education to guide students (...) into ethical professional practice. (shrink)

In many settings, and perhaps especially in low-middle income countries, training institutions do not adequately prepare their students for the ethical challenges that confront them in professional life. We conducted a survey to assess the training needs in research ethics among the faculty at the University of Zambia, School of Medicine using a structured questionnaire distributed to faculty members in January 2015. The study was approved by the University of Zambia Biomedical Research Ethics Committee. Seventy-five faculty members of (...) various ranks completed the questionnaire. It was found that 31% of the faculty had not received any research ethics training. Of those who had received training, most of them had received it through short workshops of five days or less, while only 27.7% received ethics training as a component of an academic degree and 22.2% obtained it through electronic web-based courses. While most faculty reported being well-prepared to guide their students in developing a research methods section of a research protocol, only 25.3% felt they were well-prepared to guide on ethical considerations. This study has demonstrated gaps in research ethics training among faculty members at UNZASoM. Mandatory instruction in research ethics among faculty and students is recommended. (shrink)

The development of the philosophy of medicine in the Federal Republic of Germany since 1945 is presented in a thematic form. The first two decades were characterized by the evolution of an anthropological school of thought that aimed at relating physician and patient in a more personal and existential form than had hitherto been the case. In the last years, this tendency to demand deeper psychic and broader social involvement with medical problems had increased. Somatic disorders were considered (...) to be fundamentally caused by socially induced mental stress. After a brief period during which the theme of organisms in general and phenomenologically grasped living-body of human beings in particular were discussed, there followed since the mid-seventies an essential preoccupation with the methodology and epistemology of medicine. According to this trend, medicine is to be analyzed in terms of the theory of action, with its conceptual and strategic orientation towards practice and not, as generally believed, towards the standards of scientific truth. The concepts of disease, diagnosis and therapy are therefore relative and their validity is dependent on time, persons and circumstances involved. Thus, the highest criteria of utility for medical actions cannot but be the affected patient and society. (shrink)

The author argues that ancient Skepticism may be most suited to deal with two crises in the Age of COVID-19: both the physical or epidemiological aspects of the pandemic, and the epistemological and ethical crisis of increasing disbelief in the sciences. Following Michel Bitbol, I suggest one way to mitigate this crisis of faith may be for science to become more epistemically modest, renouncing some of its claims to describe reality as it objectively is, and adopting an “intransitive” rather than (...) a “transitive” approach to Nature. This was the attitude adopted by the Greco-Roman medical school of the Empirics, which may also be of assistance in combatting the urgent problem of Fake News. The epistemology of Skepticism and the scientific methodology of the closely related Medical Empiricism shows that an epistemically modest, non-interventionist approach to science is quite compatible with a robust and sophisticated proto-experimental scientific methodology. (shrink)

This study explores ethnic variations in animal companion attachment among 133 students enrolled in a school of veterinary medicine. The 57 White and 76 African American participants completed surveys that included background information, several questions about their animal companions, and a pet attachment questionnaire .White students had significantly higher PAQ scores than did African American students . White students also had significantly more pets and more kinds of pets and were more likely to allow pets to sleep on (...) their beds . Although keeping pets is a universal cultural phenomenon, how that attachment is expressed may vary from culture-to-culture. This study explores possible explanations and implications for these variations. (shrink)

Volume 24, Issue 10, October 2024, Page 80-82.

The best things in my Ufe have come to me by accident and this book results from one such accident: my having the opportunity, out of the blue, to go to work as H. Tristram Engelhardt, Jr. 's, research assistant at the Institute for the Medical Humanities in the University of Texas Medi cal Branch at Galveston, Texas, in 1974, on the recommendation of our teacher at the University of Texas at Austin, Irwin C. Lieb. During that summer Tris "lent" (...) me to Chester Bums, who has done important schol arly work over the years on the history of medical ethics. I was just finding out what bioethics was and Chester sent me to the rare book room of the Medical Branch Library to do some work on something called "medical deontology. " I discovered that this new field of bioethics had a history. This string of accidents continued, in 1975, when Warren Reich (who in 1979 made the excellent decisions to hire me to the faculty in bioethics at the Georgetown University School of Medicine and to persuade Andre Hellegers to appoint me to the Kennedy Institute of Ethics) took Tris Engelhardt's word for it that I could write on the history of modem medical ethics for Warren's major new project, the Encyclopedia of Bioethics. Warren then asked me to write on eighteenth-century British medical ethics. (shrink)

Edmund D. Pellegrino has played a central role in shaping the fields of bioethics and the philosophy of medicine. His writings encompass original explorations of the healing relationship, the need to place humanism in the medical curriculum, the nature of the patient’s good, and the importance of a virtue-based normative ethics for health care. In this anthology, H. Tristram Engelhardt, Jr., and Fabrice Jotterand have created a rich presentation of Pellegrino’s thought and its development. Pellegrino’s work has been dedicated (...) to showing that bioethics must be understood in the context of medical humanities, and that medical humanities, in turn, must be understood in the context of the philosophy of medicine. Arguing that bioethics should not be restricted to topics such as abortion, third-party-assisted reproduction, physician-assisted suicide, or cloning, Pellegrino has instead stressed that such issues are shaped by foundational views regarding the nature of the physician-patient relationship and the goals of medicine, which are the proper focus of the philosophy of medicine. This volume includes a preface by Dr. Pellegrino and a comprehensive Introduction by the editors. Of interest to medical ethicists as well as students, scholars, and physicians, _The Philosophy of Medicine Reborn_ offers fascinating insights into the emergence of a field and the work of one of its pioneers. “After a long period of dormancy, philosophy of medicine has blossomed with new life. The single most important physician-philosopher in that rebirth has been Edmund Pellegrino. His contributions to virtue theory, the concept of beneficence, the dispute over the internal and external sources of a morality for medicine, and the role of the Hippocratic tradition are all critical. The essays collected in this volume have changed the history of the philosophy of medicine. He shows that philosophy of medicine can be done with both passion and compassion.” —_Robert M. Veatch, Kennedy Institute of Ethics, Georgetown University_ “Edmund Pellegrino's words have helped medical students, faculty, scholars and patients address the challenges they encounter in medicine and medical practice. His personal support has also been critical for many of us in developing programs in medical ethics and philosophy of medicine in our universities. Dr. Pellegrino combines the wisdom of a great physician with those of a great philosopher to produce a body of writing that will continue to inspire us all. This volume contains some of his best and most influential work.” —_Loretta Kopelman, The Brody School of Medicine, East Carolina University_ _ _ “Edmund Pellegrino has been a leading light in the philosophy of medicine for a generation. He was instrumental in the birth of bioethics, founded one of the leading journals, and provided able leadership in organizing early activities of the profession. He has served as department chairman, dean, and university president. Most recently, he chairs the President’s Council on Bioethics. In all this, first and foremost, he has been a physician. Those who are ill and suffering make a claim upon him. To respond to this claim, Pellegrino creatively brings together the worlds of science and of the humanities. For him, that is what medicine is about, making it the most scientific of the humanities and the most humane of the sciences. Fortunately for us, Pellegrino brings these worlds together in thought, as well as in practice. In this selection from his writings, Engelhardt and Jotterand have captured the heart of Pellegrino’s project, both in depth and breadth, so we can also hear that claim of the ill and so we can see what worlds must come together if we are to respond in the appropriate way.” —_George Khushf, University of South Carolina_ “Pellegrino’s work is both a treasure and important for understanding bioethics. His work in philosophy of medicine addresses the crucial questions that are so important to understanding the practice of medicine and the ethics of health care.” —_Kevin Wildes, President, Loyola University_ _ _. (shrink)

Introduction Illegal practice of medicine by medical students is a worldwide problem. In Brazil, information about this issue is scarce.Objective To describe the perception of illegal practice of medicine by medical students.Methods A cross-sectional study in a stratified random sample of 130 medical students in the 6th to 12th semesters from a private faculty of medicine in Salvador, State of Bahia, Brazil, from September to October 2011. Students responded to a standardised questionnaire about the illegal practice of (...) medicine by medical students.Results Knowing medical students who practised medical activities without supervision was reported by 86% of the respondents, and 93.8% had heard about someone who performed such practices. Medical specialties most often associated with illegal practice were general medicine and occupational health . Illegal practice of medicine was more common in peripheral cities/towns than in the State capital, Salvador City . Only 10.5% of illegal activities were reported to the authorities. Unsupervised medical practice was more often reported in the 8th–9th semester and 10th–11th semester of medical school.Conclusions Illegal practice of medicine was commonly reported by the medical students questioned. The high frequency of reported illegal practice for financial reasons highlights the need for greater availability of paid internships for medical students. Educational institutions represent the social control responsible for supervising the activities of academics. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Intersection of Medicine and ReligionJohn C. DormoisThe practice of medicine offers a host of rewards to the practitioner. Besides the obvious intellectual satisfaction of solving a difficult diagnostic problem or the ability to make a comfortable living, I have found the greatest personal sense of moral gratification when helping [End Page 196] families negotiate the most challenging event in life: making decisions at end of life. (...) Whether the condition was a ruptured intracranial aneurysm with brain death or a patient with far advanced cancer struggling with the choice between experimental chemotherapy or choosing comfort therapy at home surrounded by family for the remaining days of life, the moral courage required to provide the best guidance was considerable. In my early years of practice I didn’t call my actions in these situations “courageous” nor were there moral “guidelines” providing a blueprint. I knew I responded with empathy and compassion and that this ability had a lot to do with being raised in a religious or spiritual home. At the same time, I suspected that some of the lack of empathy and compassion I witnessed in some of my colleagues was related to the very training programs of physicians. This essay traces the origin of my moral and ethical concerns about medical education and my intention to reinvigorate the spiritual or existential voice in medicine.An early life experience had a great deal to do with shaping my moral development. At age seven my family traveled through the West Indies. My father’s amateur radio hobby meant that at every stop we would be greeted by one of his radio contacts. One stop in particular was life changing.Port au Prince, Haiti was an unknown place to this seven year–old, but to say it was a culture shock to a boy from Kansas would be an understatement of epic proportions. It was during this visit that I experienced true poverty in its most blatant form. In downtown Port au Prince I saw limbless beggars and the deformed from polio and malnutrition. But it was the sight of the garbage dump near the center of town that changed my world forever. There, among piles of detritus, I saw children and families making their home in the dump. They had hollowed out a sort of cavern in the piles of trash that served as a place of refuge from both the rain and the sun.This experience in many ways has served as a framework and background for my life. Although seen through the eyes of a seven year–old, the picture can only be adequately understood within the context of being raised by religiously faithful parents, parents free of hypocrisy whose lives personified the best in Christian virtues and practices. These early experiences planted the seeds that would only fully blossom some 60 years later.Medical school was a demanding but exhilarating experience. Each day was a day of discovery … anatomy, physiology, pathology … all subjects opening up a whole new world to explore. Internal medicine suited me best since it was the specialty that most closely integrated all the basic sciences necessary to arrive at a diagnosis. I loved the elegance of endocrinology in particular where a given hormone mediator could cause widely different effects if present in excess or completely absent. But I was in the end drawn to cardiology since it combined complex physiology with my avocation, the love of running.There was, however, a disturbing aspect of medicine education that I observed affecting many of my classmates. Although I can vividly recall the enthusiasm that all of us shared as we donned our white coats for the first time and envisioned a future of caring for our patients, things gradually and insidiously changed over the next four years. The altruism and empathy that was so evident in the early years gradually lessened as graduation approached. I could not help being struck by this change and wondered at the time why that should happen. I had no insight then that what I had observed was a well recognized consequence of the medical school experience. I’m sure that the passage from professional training to practice in... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Philosophy of George Engel and the Philosophy of MedicineJeffrey P. Spike (bio)KeywordsGeorge Engel, psychosocial medicine, medical education, medical humanities, interviewing skills, philosophy of medicine, scientific methodDoctor Brad Lewis has encouraged us to consider George Engel’s philosophy with his excellent essay on Engel and Pragmatism. As a philosopher teaching full time in a medical school, it is refreshing to have an opportunity to analyze the work (...) of two physicians at this level of reflection and abstraction. It is even more of a pleasure because I knew Dr. Engel personally while I was teaching at the University of Rochester School of Medicine. I will make some observations of the philosophy behind Dr. Engel’s work, both published and practical, that is, as reflected in his writing but also in his influence in the medical curriculum at the institution that he called home for some thirty years (as seems appropriate when considering someone’s bona fides as a pragmatist).Engel’s Philosophy and Medicine’s PhilosophyGeorge Engel’s primary philosophical concern was to fight the powerful belief (or perhaps delusion) that medicine was evolving into a pure physical science, an extension of biochemistry and cell biology, or as we would now call them, proteomics and genomics. There is little evidence that he espoused any one methodology for basic science, so much as he opposed any one methodology for medicine. So to say he was a pragmatist seems underdetermined by his words, if that is taken to mean he advocated for changing the methodological model for scientific research. Rather the question is whether his preferred medical methodology is best characterized as pragmatic, or by some other description. On that score I agree with Lewis wholeheartedly.Of course, it might be that the claim of pragmatism is not meant to suggest a change in method for basic science, but to advocate for retaining an appreciation for the whole range of approaches to knowledge, from experimental science to epidemiology, and from epidemiology to acculturation. By that definition of pragmatism, Engel was indeed a pragmatist. Interpreted this way, he wanted medicine to stop worshipping the scientific method and appreciate that there are many paths to knowledge besides through the wet lab.It might be said that there are different scientific methods for different sciences, and Engel wanted us to appreciate that the reductionist methods [End Page 315] appropriate to the sciences of the small are not necessarily methods that can be applied to all sizes of objects we study, or all levels of reality (like the psychological and social). This is the truth about the world, although I am not sure that this is what Engel meant. As Lewis notes, Engel’s writing does sometimes sound as if he worshipped at the alter of science, as if all subjects of importance can be studied scientifically. But if he believed that, he was not correct. It might be, if all the subjects of the university that Lewis mentions are important, that some will turn out to be able to be studied in academically rigorous methods that are not scientific in any of the usual meanings of the word. Consider philosophy itself, for example.To the degree that it may stretch the evidence to say that Engel would have advocated for a pragmatic scientific method, it is still the case that pragmatism as outlined by Lewis and Engel’s biopsychosocial model can both be used to help medicine understand itself and overcome the temptation to idolize science. Medicine is not a science, or at least it is not just a science; in fact, I would suggest that it never was a science, and it will never be a science. Medicine is about health and illness, and uses whatever science it can to promote health and to treat (ameliorate or cure) illness.None of this should necessarily lead us to idolize pragmatism either. If each subject has its own ideal methodology for study, then it may be that pragmatism is the preferred method for, say, clinical judgment, whereas the scientific method is the best for the ‘hard’ sciences, and logic for philosophy. Or perhaps pragmatism and inductive logic are competing models for clinical... (shrink)

The author argues that ancient Skepticism may be most suited to deal with two crises in the Age of COVID-19: both the physical or epidemiological aspects of the pandemic, and the epistemological and ethical crisis of increasing disbelief in the sciences. Following Michel Bitbol, I suggest one way to mitigate this crisis of faith may be for science to become more epistemically modest, renouncing some of its claims to describe reality as it objectively is, and adopting an “intransitive” rather than (...) a “transitive” approach to Nature. This was the attitude adopted by the Greco-Roman medical school of the Empirics, which may also be of assistance in combatting the urgent problem of Fake News. The epistemology of Skepticism and the scientific methodology of the closely related Medical Empiricism shows that an epistemically modest, non-interventionist approach to science is quite compatible with a robust and sophisticated proto-experimental scientific methodology. (shrink)

This paper explores the academic and psychosocial outcomes of immigrant students from the former Soviet Union in an ethnic school in Toronto. Based on interviews with the principal, teachers, students and parents, together with questionnaire responses, the paper describes school programmes and practices that contribute to FSU immigrant students' high academic achievement, within the categories of curriculum, pedagogy, discipline policy and teacher–student relationships. The creation of this ethnic school suggests that Canada's educational system has not met (...) the needs of the immigrant group. The paper seeks to further understanding of educating FSU immigrant students, and discusses the implications of ethnic schools for educating children in a multicultural society. (shrink)