Some of Michel Foucault’s work focusses on an archeological and genealogical analysis of certain aspects of the medical episteme, such as ‘Madness and Civilization’ (1964/2001), ‘The Birth of the Clinic’ (1973) and ‘The History of Sexuality’ (1978/2020a). These and other Foucauldian works have often been invoked to characterize, but also to normatively interpret mechanisms of the currently existing medical episteme. Writers conclude that processes of patient objectification, power, medicalization, observation and discipline are widespread in various areas where the medical specialty (...) operates and that these aspects have certain normative implications for how our society operates or should operate. The Foucauldian concepts used to describe the medical episteme and the normative statements surrounding these concepts will be critically analyzed in this paper.By using Foucault’s work and several of his interpreters, I will focus on the balance between processes of subjectification and objectification and the normative implications of these processes by relating Foucault’s work and the work of his interpreters to the current medical discipline. Additionally, by focusing on the discussion of death and biopower, the role of physicians in the negation and stigmatization of death is being discussed, mainly through the concept of biopower. Lastly, based on the discussion of panopticism in the medical discipline, this paper treats negative and positive forms power, and a focus will be laid upon forms of resistance against power. The discussed aspects will hopefully shed a different and critical light on the relationship between Foucault’s work and medicine, something that eventually can also be deduced from Foucault’s later work itself. (shrink)

Philosophy and Medicine in the Formative Period of Islam. Edited by Peter Adamson and Peter Pormann. Warburg Institute Colloquia, vol. 31. London: The Warburg Institute, 2017. Pp. vi + 308. $80.

Fredrik Svenaeus' book is a delight to read. Not only does he exhibit keen understanding of a wide range of topics and figures in both medicine and philosophy, but he manages to bring them together in an innovative manner that convincingly demonstrates how deeply these two significant fields can be and, in the end, must be mutually enlightening. Medicine, Svenaeus suggests, reveals deep but rarely explicit themes whose proper comprehension invites a careful phenomenological and hermeneutical explication. Certain philosophical (...) approaches, on the other hand - specifically, Heidegger's phenomenology and Gadamer's hermeneutics - are shown to have a hitherto unrealized potential for making sense of those themes long buried within Western medicine. Richard M. Zaner, Ann Geddes Stahlman Professor of Medical Ethics, Vanderbilt University. (shrink)

In this article, I apply the concept of solidarity to collective knowledge practices in healthcare. Generally, solidarity acknowledges that people are dependent on each other in many respects, and it captures those support practices that people engage in out of concern for others in whom they recognise a relevant similarity. Drawing on the rich literature on solidarity in bioethics and beyond, this article specifically discusses the role that epistemic solidarity can play in healthcare. It thus focuses, in particular, on solidarity’s (...) relationship with justice and injustice. In this regard, it is argued (1) that justice and solidarity are two equally important and complementary values that should both be considered in healthcare practices and institutions and (2) that solidarity often arises in unjust situations and can be a means to bring about justice. I transfer these ‘general’ insights about solidarity to knowledge practices in healthcare and link them to the discussion about epistemic injustices in healthcare and how to overcome them. I argue that epistemic solidarity can play an important role in overcoming epistemic injustices as well as—and independently from its contribution to justice—in knowledge production in medicine more generally. To demonstrate how epistemic solidarity can add to our understanding of collective knowledge practices, I discuss two examples: patients sharing their medical data for research purposes and healthcare professionals’ engagement with patients to better understand their afflictions. (shrink)

It is surely obvious that medicine, like any other rational activity, must be based on evidence. The interest is in the details: how exactly are the general principles of the logic of evidence to be applied in medicine? Focussing on the development, and current claims of the ‘Evidence-Based Medicine’ movement, this article raises a number of difficulties with the rationales that have been supplied in particular for the ‘evidence hierarchy’ and for the very special role within that (...) hierarchy of randomized controlled trials (and meta-analyses of the results of randomized controlled trials). The point is not at all to question the application of a scientific approach to evidence in medicine, but, on the contrary, to indicate a number of areas where philosophers of science can contribute to a proper implementation of exactly that scientific-evidential approach. (shrink)

Buddhism and Medicine: An Anthology of Premodern Sources, edited by C. Pierce Salguero. Columbia University Press, 2017. 728 pp.; Hb $150. ISBN-13: 9780231179942.

During the last three decades there has been a wave of interest in narrative and narrativity in the humanistic and the social sciences. This “narrative turn” has spilled over to medicine, where narrative medicine has gained a considerable influence. However, there have also appeared second thoughts on the role of narratives in our lives, as well as on what narratives may mean in relation to clinical medicine. This article presents some influential voices in this debate and scrutinizes (...) the assumptions of narrative medicine in the light of these. It is concluded that there are sound reasons to tread this path with some caution and avoid the too far reaching ambitions on behalf of narrativity in relation to clinical medicine. However, narrative medicine should still be seen as a promising attempt within the broader scope of medical humanities to emphasize the importance of human subjectivity in clinical medicine. (shrink)

(2008). Humanism and Medicine in Sixteenth‐Century Aberdeen. Intellectual History Review: Vol. 18, Humanism and Medicine in the Early Modern Era, pp. 31-40.

From the 1970s onwards, Feyerabend argues against the freedom of science. This will seem strange to some, as his epistemological anarchism is often taken to suggest that scientists should be free of even the most basic and obvious norms of science. His argument against the freedom of science is heavily influenced by his case study of the interference of Chinese communists in mainland China during the 1950s wherein the government forced local universities to continue researching traditional Chinese medicine rather (...) than Western medicine. Feyerabend claims this move was justifiable and, eventually, vindicated by the resulting research which was beneficial for locals and the West at large. The purpose of this paper is to provide a comprehensive overview and analysis on Feyerabend’s views on the freedom of science and his social commentary on US science funding policy that follows therefrom. This proves to be exceedingly difficult because Feyerabend’s writings on the subject are filled with gaps, unnoticed tensions, and cognitive dissonance. Still, I think Feyerabend’s scattered insights and the contradictions that emerge lead to an interesting microcosm of the issues contained in the freedom of science debate. (shrink)

Assistive systems based on Artificial Intelligence (AI) are bound to reshape decision-making in all areas of society. One of the most intricate challenges arising from their implementation in high-stakes environments such as medicine concerns their frequently unsatisfying levels of explainability, especially in the guise of the so-called black-box problem: highly successful models based on deep learning seem to be inherently opaque, resisting comprehensive explanations. This may explain why some scholars claim that research should focus on rendering AI systems understandable, (...) rather than explainable. Yet, there is a grave lack of agreement concerning these terms in much of the literature on AI. We argue that the seminal distinction made by the philosopher and physician Karl Jaspers between different types of explaining and understanding in psychopathology can be used to promote greater conceptual clarity in the context of Machine Learning (ML). Following Jaspers, we claim that explaining and understanding constitute multi-faceted epistemic approaches that should not be seen as mutually exclusive, but rather as complementary ones as in and of themselves they are necessarily limited. Drawing on the famous example of Watson for Oncology we highlight how Jaspers’ methodology translates to the case of medical AI. Classical considerations from the philosophy of psychiatry can therefore inform a debate at the centre of current AI ethics, which in turn may be crucial for a successful implementation of ethically and legally sound AI in medicine. (shrink)

This edited volume provides a biosemiotic analysis of the ecological relationship between food and medicine. Drawing on the origins of semiotics in medicine, this collection proposes innovative ways of considering aliments and treatments. Considering the ever-evolving character of our understanding of meaning-making in biology, and considering the keen popular interest in issues relating to food and medicines - fueled by an increasing body of interdisciplinary knowledge - the contributions here provide diverse insights and arguments into the larger ecology (...) of organisms’ engagement with and transformation through taking in matter. Bodies interpret molecules, enzymes, and alkaloids they intentionally and unintentionally come in contact with according to their pre-existing receptors. But their receptors are also changed by the experience. Once the body has identified a particular substance, it responds by initiating semiotic sequences and negotiations that fulfill vital functions for the organism at macro-, meso-, and micro-scales. -/- Human abilities to distill and extract the living world into highly refined foods and medicines, however, have created substances far more potent than their counterparts in our historical evolution. Many of these substances also lack certain accompanying proteins, enzymes, and alkaloids that otherwise aid digestion or protect against side-effects in active extracted chemicals. Human biology has yet to catch up with human inventions such as supernormal foods and medicines that may flood receptors, overwhelming the body’s normal satiation mechanisms. This volume discusses how biosemioticians can come to terms with these networks of meaning, providing a valuable and provocative compendium for semioticians, medical researchers and practitioners, sociologists, cultural theorists, bioethicists and scholars investigating the interdisciplinary questions stemming from food and medicine. (shrink)

Why is understanding causation so important in philosophy and the sciences? Should causation be defined in terms of probability? Whilst causation plays a major role in theories and concepts of medicine, little attempt has been made to connect causation and probability with medicine itself. Causality, Probability, and Medicine is one of the first books to apply philosophical reasoning about causality to important topics and debates in medicine. Donald Gillies provides a thorough introduction to and assessment of (...) competing theories of causality in philosophy, including action-related theories, causality and mechanisms, and causality and probability. Throughout the book he applies them to important discoveries and theories within medicine, such as germ theory; tuberculosis and cholera; smoking and heart disease; the first ever randomized controlled trial designed to test the treatment of tuberculosis; the growing area of philosophy of evidence-based medicine; and philosophy of epidemiology. This book will be of great interest to students and researchers in philosophy of science and philosophy of medicine, as well as those working in medicine, nursing and related health disciplines where a working knowledge of causality and probability is required. (shrink)

SECTION I THE PRE-HIPPOCRATICS AND PLATO So far as is known Ionian philosophy was not connected with medicine in any way. It was, in fact, a thing apart, ...

This volume introduces readers to the main philosophical issues of measurement in medicine, illustrating the connections between the natural and social sciences by integrating essays on causation, measuring instruments and issues of measurement and policy.

The field of spirituality and medicine has seen explosive growth in recent years, due in part to significant private support for the development of curricula in more than half of all U.S. medical schools, and for related residency training programs and research centers. While there is no single definition of " spirituality " in use across these initiatives, this article examines the definitions and learning objectives relevant to spirituality that are addressed in a 1999 report of the Medical School (...) Objectives Project, with special attention to their ethical implications. It concludes with several "diagnostic" case studies of religious consciousness from the medical literature and in literary texts, again with attention to ethical concerns. (shrink)

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

Charles Darwin "had medicine in his blood" (Bynum 1983). His father and grandfather were physicians, and he himself studied medicine. Although Darwin left medical school after two years and did not become a physician, he retained a strong interest in medicine and regularly used examples drawn from human biology and medicine in his writings. Clearly, he believed that medicine fell within the purview of his theory of evolution, and he recognized the ways in which the (...) study of evolution and of medicine could be mutually enriching. In The Descent of Man (1871), Darwin argued that humans, like other species, have evolved from earlier, ancestral species. "Descent with modification," Darwin's term for evolution, accounts .. (shrink)

Winston Black, Medicine and Healing in the Premodern West. A History in Documents.

Serious ethical violations in medicine, such as sexual abuse, criminal prescribing of opioids, and unnecessary surgeries, directly harm patients and undermine trust in the profession of medicine. We review the literature on violations in medicine and present an analysis of 280 cases. Nearly all cases involved repeated instances of intentional wrongdoing, by males in nonacademic medical settings, with oversight problems and a selfish motive such as financial gain or sex. More than half of cases involved a wrongdoer (...) with a suspected personality disorder or substance use disorder. Despite clear patterns, no factors provide readily observable red flags, making prevention difficult. Early identification and intervention in cases requires significant policy shifts that prioritize the safety of patients over physician interests in privacy, fair processes, and proportionate disciplinary actions. We explore a series of 10 questions regarding policy, oversight, discipline, and education options. Satisfactory answers to these questions will require input from diverse stakeholders to help society negotiate effective and ethically balanced solutions. (shrink)

Cortisone, initially known as ‘compound E’ was the medical sensation of the late 1940s and early 1950s. As early as April 1949, only a week after Philip Hench and colleagues first described the potential of ‘compound E’ at a Mayo Clinic seminar, the New York Times reported the drug’s promise as a ‘modern miracle’ in the treatment of rheumatoid arthritis. Given its high profile, it is unsurprising that historians of medicine have been attracted to study the innovation of cortisone. (...) It arrived at the end of a decade of ‘therapeutic revolutions’, kicked off by penicillin transforming the treatment of bacterial infections and ending with hopes of a revolution in the treatment of non-infectious, chronic inflammatory diseases. Despite these studies of cortisone’s introduction, few historians have taken the story forward and considered how cortisone was adopted and adapted into clinical practice. This article tells the longer of how the drug and its derivatives were taken from research laboratories and integrated into clinical practice; what has in recent decades become known as translational medicine. In exploring cortisone’s first decade in Britain, we focus specifically on its role in the treatment of RA. Our approach is always to consider cortisone’s use in the context of other treatments available to clinicians, and at local and national institutional settings. We do not discuss the many other therapeutic uses of cortisone, which ranged for topical applications for skin diseases to the management of cancers, especially childhood leukaemia, nor do we discuss its close analogue ACTH—AdenoCorticoTropic Hormone. We think there are lessons in our study for TM policies today. (shrink)

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

Complexity and integration are longstanding widely debated issues in philosophy of science and recent contributions have largely focused on biology and biomedicine. This paper specifically considers some methodological novelties in cancer research, motivated by various features of tumours as complex diseases, and shows how they encourage some rethinking of philosophical discourses on those topics. In particular, we discuss the integrative-cluster approach, and analyse its potential in the epistemology of cancer. We suggest that, far from being the solution to tame cancer (...) complexity, this approach offers a philosophically interesting new manner of considering integration, and show how it can help addressing the apparent contrast between a pluralistic and a unitary account. (shrink)

Truth, Trust and Medicine investigates the notion of trust and honesty in medicine, and questions whether honesty and openness are of equal importance in maintaining the trust necessary in doctor-patient relationships. Jackson begins with the premise that those in the medical profession have a basic duty to be worthy of the trust their patients place in them. Yet questions of the ethics of withholding information and consent and covert surveillance in care units persist. This book boldly addresses these (...) questions which disturb our very modern notions of a patient's autonomy, self-determination and informed consent. (shrink)

In “Communication Breakdown: Probing the Limits of Narrative Medicine and its Discontents” (2019), David J. Leichter engages practical experience teaching medical ethics in the college classroom to explore opportunities—and limits—of narrative engagement within medical ethics and clinical practice. Leichter raises concerns regarding potential epistemic harms, both testimonial and hermeneutical, when individuals, or their pain, cannot be adequately recognized through expressive modes traditionally understood as “narrative.” While I largely agree with Leichter’s worries about narrative authority and limits, I challenge his (...) characterization of “narrative medicine.” In response, I suggest that “narrative medicine” is more than merely narrative engagement in medicine. As theorized by Rita Charon (2001, 2006), “narrative medicine” involves an inclusive approach to what narrative is, and more than mere mastery of “narrative competency.” I argue that at least one way to conceptualize “narrative medicine” is as a technical term, which refers to the process of attention, representation, and affiliation Charon develops as the achievement of narrative medicine. When understood in this technical way, narrative medicine can both resist and respond to the kinds of epistemic harms about which Leichter is rightfully worried. (shrink)

The philosophers of science who viewed causality as a metaphysical headache were right. Yet when they concluded that it is of no scientific import and of less practical import, they were clearly in error. I say clearly because they thereby recommended that we replace cause by mere empirical correlation, which obviously will not do. Here is an obvious example which proves them in error without even touching upon the question of what science is.