이 글은 연명의료결정법이 2년간의 유예기간을 거쳐 2018년 2월부터 시행되고 있다는 점에 착안하여, 그것의 시행 발단이 된 상황을 두 가지로 제시하고(하나는 세브란스 병원 김할머니 사건과, 다른 하나는 죽음의 의료화 현상이다) 그 내용을 살펴보는데서 출발하였다. 그렇다면 연명의료결정법이 시행되는 궁극적 목적은 무엇인가? 그 과정을 필자는 ‘좋은 죽음이란 무엇인가’ 라는 물음을 통하여 고찰하였다. 그 결과 좋은 죽음이란 첫째, 가족이나 주변인과 마지막을 ‘함께’ 함으로써 관계단절 고독사를(필자는 가족과 함께 거주했지만, 치료의 공간에서 연명장치에 의존한 후 의사의 사망선고로 생을 마감함으로써 가족과의 작별인사나 주변과의 정리도 거의 생략되는 상황에서의 죽음, (...) 즉 임종과정에서의 ‘관계의 단절’을 의미) 해결하며, 둘째, 육체적인 집착 치료가 아닌 정신과 영혼의 상처까지 포함된 전인적 치료를 통한 ‘준비하고 맞이하는’ 죽음임을 도출하였다. 그렇다면 연명의료결정법 시행으로 그 가능성을(좋은 죽음의 가능성을) 타진할 수 있는가? 이다. 이에 대항 필자는 우선 무의미한 연명의료로 인한 의료집착적 행위로 인한 가족이나 주변인조차 마지막을 함께 하지 못하고 죽음에 이르는 상황을 ‘관계단절 고독사’로 정의하였다. 그리고 이 관계단절 고독사를 연명의료결정법의 시행으로 해결 될 수 있는가에 대하여 고찰하였다. 그 결과 첫째, 연명의료결정법은 호스피스 완화의료를 통해 암환자에게만 국한되어 있는 호스피스 서비스를 일정한 범위의 말기환자에게 확대 적용시키고 있다. 즉 호스피스에 대한 체계적이고 종합적인 근거 법령이 마련됨으로써 국민 모두가 무의미한 연명의료를 위해 중환자실에 고립될 필요가 없다는 것이다. 그런 한에서 연명의료결정법은 인간적 품위를 지키며 편안하게 삶을 마무리하는데 유의미하다고 평가된다. 둘째, 연명의료결정법은 임종과정에 있는 환자의 연명의료 결정을 사전연명의료의향서와 연명의료계획서를 통해 제도화시키고 있다. 즉 환자의 연명의료에 대한 자기결정이 존중되고 환자의 존엄과 가치를 보장시킴으로써 무의미한 연명의료를 위해 중환자실에 고립될 필요가 없다. 그런 한에서 연명의료결정법은 연명장치로부터 야기되는 관계단절 고독사의 유효한 방안일 수 있다. 다음으로 육체 중심의 집착적 치료에서 벗어나 그 동안 받았던 정신이나 영혼의 상처까지도 치료하기 위한 전제조건으로 단일체로서의 인간관을 제시하고, 이 인간관이 연명의료결정법의 호스피스 완화의료에도 유효함을 고찰하였다. 그 과정에서 필자는 호스피스 완화의료에서 전인적 돌봄을 위한 하나의 패러다임을 제시하였다, 즉 임종자가 죽음을 받아들이는 마지막 단계를 퀴블러-로스에 의한 임종단계에서 ‘수용’임을 통하여 알 수 있듯이, 환자가 자신의 심경을 주변인이나 간호하는 사람이 수용하고 있다고 느낄 때, 환자는 간호제공자와 상호 소통에 놀라운 영향을 줄 수 있다는 것이다. 그 결과 임종환자는 죽음을 어쩔 수 없이 ‘수용’하는 것이 아니라 ‘긍정적으로 수용’하고 내세에 대한 희망 속에서 평온한 죽음을 맞이할 수 있다는 것이다. 결국은 죽음을 앞둔 임종환자와 간호제공자(가족이나 주변인을 포함한 모든 간호제공자) 사이의 소통 내지는 관계가 중요하다는 의미이다. 결국 연명의료결정법에서 제시되는 호스피스 완화의료는 전인적 돌봄을 목표로 하지만 그럼에도 불구하고 임종기 환자의 죽음 수용 단계에 있어서 간호제공자와의 사랑과 공감을 토대로 한 관계가 강조되었을 때 임종기 환자는 ‘좋은 죽음’에 다가설 수 있는 지반을 마련하게 된다. 그리고 바로 이 지점에서 필자는 사랑과 공감을 바탕으로 간호제공자와 환자의 관계의 중요성을 강조함으로써 ‘공감의 생명윤리학’이라는 새로운 패러다임을 제시함으로써, 이것이 호스피스 완화의료에서 어느 정도 유효한지에 대하여 고찰하였다. 즉 이 글은 연명의료결정법 시행으로 좋은 죽음의 실현 가능성(관계적 고독사의 해결과 육체집착적 치료에서 벗어나 전인적 치료를 통한 준비하고 맞이하는 죽음)을 고찰함으로써 ‘공감의 생명윤리학’이라는 패러다임의 중요성을 밝히는 데 그 의미가 있다고 하겠다. (shrink)

This article explains the attempts of nurses to practice humanistic, holistic care in line with their professionalizing strategy. Ideally, the intention of nurses is to broaden their concerns beyond the physiological needs of patients, thereby circumventing biomedical control over their work. However, the author argues that resource constraints, and the coalescing of biomedical and managerial definitions of patients, suggest that holistic notions of care are subjected to a new form of calculus and normalizing technology. Critically, nurses (...) are more preoccupied with the day-to-day struggle to free up resources for healthcare, in particular bed spaces, and to pre-empt the problem of bed blocking. Such work suggests that the ‘emptying of beds’ is not just a symbol of accomplishment for nursing work. From the governmentality theory of Foucault, the administration of ‘beds’ has become part of the managerial power/knowledge discourse and an instrument for making nurses toe the financial bottom-line. (shrink)

Nursing policy and healthcare reform are focusing on two, interconnected areas: person‐centred care and fundamental care. Each initiative emphasises a positive nurse–patient relationship. For these initiatives to work, nurses require guidance for how they can best develop and maintain relationships with their patients in practice. Although empirical evidence on the nurse–patient relationship is increasing, findings derived from this research are not readily or easily transferable to the complexities and diversities of nursing practice. This study describes a novel methodological (...) approach, called holistic interpretive synthesis (HIS), for interpreting empirical research findings to create practice‐relevant recommendations for nurses. Using HIS, umbrella review findings on the nurse–patient relationship are interpreted through the lens of the Fundamentals of Care Framework. The recommendations for the nurse–patient relationship created through this approach can be used by nurses to establish, maintain and evaluate therapeutic relationships with patients to deliver person‐centred fundamental care. Future research should evaluate the validity and impact of these recommendations and test the feasibility of using HIS for other areas of nursing practice and further refine the approach. (shrink)

The topic of this book is a comparison between holism in the philosophy and language and social holism on the one hand and holism about space-time and quantum systems on the other hand. The main claim is that holism in the humanities and holism in fundamental physics come under the same substantial, general conception of holism. That is to say: arguments to the effect that the holism of the mental is unscientific or that the mental is separated from the physical (...) owing to holism are not sound. The holism of the mental fits into a world-view that bases itself on scientific realism. The addressees of this book are all those who care about our view of the world and ourselves in the spirit of an argumentative examination of different positions. No familiarity with physics is presupposed. (shrink)

Christians care for orphans and children without parental care in different forms. However, in the Global South, care is primarily provided in orphanages or large residential settings. Despite good intentions, there are limitations to provide a nurturing family environment for the children in such care environment. With current knowledge of alternative child care and in light of the holistic ministry, this article suggests an approach for the church to care for orphans and children (...) at risk by focusing on the family and the local community. Additionally, simple steps to transition to holistic orphan care are offered. (shrink)

BackgroundRationing of care in nursing is nurses' inability to complete all care activities for patients because of scarcity in time and resource. Literature suggests that rationing of care is closely related to patient safety and quality of care. The phenomena have been defined and studied from varied perspectives and contexts. A systematic review of studies related to the concept was aimed at identifying and synthesizing the finding.MethodsThe review followed Preferred Reporting Items for Systematic Reviews and Meta‐analysis (...) guidelines, and literature searches were conducted in MEDLINE, CINAHL, PsycInfo, Web of Science and EMBASE databases. Fifty‐seven quantitative studies were included in the review.FindingsThe review observed that nursing activities addressing the emotional, educational, mobility and hygiene needs of the patients were commonly rationed. Antecedents of rationing included resource inadequacy and organizational work environment. Rationing influenced patient satisfaction, mortality and a number of adverse events and was associated with decreased job satisfaction, increased intention to leave and high turnover among nurses.DiscussionsThis review concludes that rationing in nursing is ubiquitous, embedded in the work environment and poses a threat to the professional health and philosophical base of nursing in addition to having serious implications on patients' safety. Strategies to reframe and reconsider organizational traits, and open discussion with other healthcare stakeholders can reduce rationing of nursing care. The review suggests future researchers adopt different methodological layout to study rationing. (shrink)

: Holistic health principles, practices, personnel, programs, and problems comprise the ingredients of the movement of holistic health as described in this book. Using medical anthropology as its main perspective, the text is written with health practitioners in mind, to provide a contract of an interrelated physical, mental, spiritual, and emotional view of healing with that of the established scientific view: that humans are composed of reducible parts and that medicine's job is to find causes of malfunctioning in (...) these parts. Public health issues such as quality care, cost, and the role of holistic health, are another focus of the book. Background information and history on holistic health, including philosophy and history, practices, functioning health centers, clientele characteristics, and trends favoring holistic health development are some of the topics discussed. A glossary and extensive bibliography are included as well as self-tests on wellness and social readjustments.. (shrink)

Introduction -- Healing justice and whole self-care -- Oppression, trauma, and healing justice -- Stress and the self-care revolution -- The whole self -- A skillful path of healing justice -- Holistic self-care practices and skills -- Connecting to the body -- Befriending the mind-heart -- Rediscovering spirit -- In the fabric of community -- Cultivating connections between person and planet -- Where the rubber meets the road -- The healing justice organization -- Healing justice on (...) the frontlines -- Widening the circle and coming home -- Notes -- Index. (shrink)

It has sometimes been suggested that quantum phenomena exhibit a characteristic holism or nonseparability, and that this distinguishes quantum from classical physics. One puzzling quantum phenomenon arises when one performs measurements of spin or polarization on certain separated quantum systems. The results of these measurements exhibit patterns of statistical correlation that resist traditional causal explanation. Some have held that it is possible to understand these patterns as instances or consequences of quantum holism or nonseparability. Just what holism and nonseparability are (...) supposed to be has not always been made clear, though, and each of these notions has been understood in different ways. Moreover, while some have taken holism and nonseparability to come to the same thing, others have thought it important to distinguish the two. Any evaluation of the significance of quantum holism and/or nonseparability must rest on a careful analysis of these notions. (shrink)

In the last two decades, studies on the relationship between spirituality and health have grown significantly in the International literature. In Brazil, the debate on this subject has reached greater visibility since 2009, mainly in the health sciences, with the appearance of the term "spiritual care". In theology, studies on spiritual care in the health care context are still scarce. This paper aims to contribute to the broadening of this reflection. Firstly, spiritual care is approached from (...) scientific publications in Portuguese language. Second, the interdisciplinary spiritual care model is presented as a holistic approach to patient care and consequences of applying a spiritual care model are outlined. The newly defined role of the hospital chaplains, pastoral counselors and spiritual caregivers is also discussed. As a conclusion, the paper mentions the main challenges going along with interdisciplinary spiritual care, especially those concerning the training of health care professionals. (shrink)

The health theories of Nordenfelt and Boorse are compared. Critical attention is focused on Nordenfelt's description of his theory as one of holistic welfare, contrasting with Boorse's analytical and statistical approach. Neither theory is found to give an entirely satisfactory account of ‘health’ in scientific medicine or common usage. Because Nordenfelt attenuates the ontological significance of organs and organ parts and simplifies the role of statistics, his theory is regarded as weakly holistic. Boorse underrates the importance of non-statistical (...) evaluation. A mediating position, termed ‘strong holism’ is suggested as a way of integrating normative and statistical elements in a more adequate health concept. (shrink)

One of my main points in this study is that the knowledge of orthodox medical theory is an incomplete guide for practical action when relating to our patients' specifically human problems. By following a holistic perspective on patients' health and on our medical enterprise we will be more efficient as doctors. This standpoint is illuminated by means of two case reports. Instead of focusing on symptoms as such and letting them refer to orthodox medical theory, I explicitly relate to (...) the patients as if they are conveying a personal meaning by means of experienced symptoms. The experience of illness could be a successful strategy on the existential level although destructive on the technical biological level. A holistic theory of health can give doctors a good conceptual base when relating to people whose presented illnesses are to be regarded explicitly as their way of making themselves understood. The doctor's understanding of the patient's illness, of the theory of health, and of how health is regained, is dependent on the doctor's having the courage to reduce the distance to the patient, the courage to participate and be changed. (shrink)

Peregrin and Svoboda propose an inferential and holistic approach to formalization, and a similar approach (to correctness) is considered by Brun. However, while the inferential criteria of adequacy explicitly endorsed by these authors may be holistic "in spirit," they are formulated for single formulas. More importantly, they allow the trivialization of equivalence and face problems when materially correct arguments come into play. Against this background, this paper tries to motivate holistic inferential criteria that compel us to distinguish (...) carefully between non-trivially equivalent formalizations as well as between materially and logically correct arguments on an inferential basis. (shrink)

After nearly fifty years of mea culpas and explanatory additions, the biopsychosocial model is no closer to a life of its own. Bolton and Gillett give it a strong philosophical boost in The Biopsychosocial Model of Health and Disease, but they overlook the model’s deeply inconsistent position on dualism. Moreover, because metaphysical confusion has clinical ramifications in medicine, their solution sidesteps the model’s most pressing clinical faults. But the news is not all bad. We can maintain the merits of holism (...) as we let go of the inchoate bag of platitudes that is the biopsychosocial model. We can accept holism as the metaphysical open door that it is, just a willingness to recognize the reality of human experience, and the sense in which that reality forces medicine to address biological, psychological, and social aspects of health. This allows us to finally characterize Engel’s driving idea in accurate philosophical terms, as acceptance of consciousness in the context of medical science. This will not entirely pin down medicine’s stance on dualism, but it will position it clearly enough to readily improve patient care. (shrink)

Ethically complex and challenging cases confront health care professionals in neonatal‐perinatal medicine more often than in most other subspecialties in medicine. Neonatologists regularly encounter situations where crucial life‐or‐death decisions need to be made in the best interest of an infant and its family. While physicians and their professional societies seem to dictate this best interest standard by weighing the risk of mortality and morbidities, parents may have other perspectives to be considered.Our review of programs for teaching ethics in Canadian (...) neonatal‐perinatal residency programs has revealed that 90 percent of them incorporated formal and informal medical ethics education, meeting the Royal College of Physician and Surgeons of Canada requirements, but that the teaching strategies, topics covered, and time devoted to teaching ethics are not standardized. Lectures and case presentations—the pedagogic strategy used by most programs—are not ideal for teaching communication skills. We propose, therefore, a holistic approach to teaching and training that imparts (1) a traditional understanding of ethical theory and reasoning, (2) advanced skills in communication and counseling, and (3) a disposition to engage in self‐reflection and to be aware of the emotional and spiritual dimensions of neonatal‐perinatal medicine. (shrink)

Existing regulation of end-of-life care is flawed. Problems include poorly-designed laws, policies, ethical codes, training, and funding programs, which often are neither effective nor helpful in guiding decision-making. This leads to adverse outcomes for patients, families, health professionals, and the health system as a whole. A key factor contributing to the harms of current regulation is a siloed approach to regulating end-of-life care. Existing approaches to regulation, and research into how that regulation could be improved, have tended to (...) focus on a single regulatory instrument (e.g., just law or just ethical codes). As a result, there has been a failure to capture holistically the various forces that guide end-of-life care. This article proposes a response to address this, identifying “regulatory space” theory as a candidate to provide the much-needed holistic insight into improving regulation of end-of-life care. The article concludes with practical implications of this approach for regulators and researchers. (shrink)

Moral particularists are united in their opposition to the codification of morality, and their work poses an important challenge to traditional ways of thinking about moral philosophy. Defenders of moral particularism have, with near unanimity, sought support from a doctrine they call “holism in the theory of reasons.” We argue that this is all a mistake. There are two ways in which holism in the theory of reasons can be understood, but neither provides any support for moral particularism. Moral particularists (...) are united in their opposition to the codification of morality in purely descriptive terms, but their opposition takes different forms. Sometimes particularists maintain that codifying the moral landscape is impossible. In other contexts particularists argue that moral principles are in any event unnecessary. In yet other contexts particularists contend that the codification of morality is undesirable, perhaps because it would encourage people to look less carefully at the case at hand.1 These are distinct theses, although particularists often endorse all three. As Jonathan Dancy, citing John McDowell puts it, “Particularism is at its crudest the claim that we neither need nor can see the search for an ‘evaluative outlook which one can endorse as rational as the search for a set of principles.’”2 On any interpretation, particularism poses an important challenge for traditional conceptions of moral philosophy.. (shrink)

Popular visions of holistic health and holistic medicine are not so much reactions to perceived excesses of technological medicine as they are visions of the good life itself and how to attain it. This paper attempts to clarify some of the concepts associated with holistic health and medicine. The particular vision of holistic health presented here is well exemplified in the writings of Plato. First, I examine the scientific concept of holism and argue that, while medicine (...) is inadequately characterized by scientific reductionism, any plausible holistic medicine must make room for a limited scientific reductionism. Next, I analyze the complexity of Plato's usage of health and demonstrate some of the parallels between Plato's thought and popular and scientific visions of holistic health. Finally, I look at what Plato has to say about medical practice and the relation of medicine and philosophy as therapies for the whole person. (shrink)

In this paper it is argued that nurses should be holists whilst at the same time accepting that ‘holism’ is a contentious concept. One of the problems for a supporter of holism is that of which holism -- an attempt to outline the version of holism advocated is made by identifying only two versions of holism: The Strong theory and the Pragmatic theory of holism. By introducing this device it is hoped to avoid, if only by stipulation, some of the (...) more sophisticated nuances of holism drawn by other commentators. However despite a most judicious use of Ockham's Razor some detailed groundwork remains. In the first part of this paper a simple example is used which aims to articulate what are arguably some of the central issues within the holism debate. These issues are then placed within a wider philosophical context. The second part of the paper will offer definitions of Strong and Pragmatic holism. Drawing on specific examples from the nursing context it will be argued that the Pragmatic theory of holism is the theory of holism most compatible with nursing theory and practice. The methods employed in this paper are philosophical. Since the questions considered are conceptual rather than empirical requiring a discursive approach, utilising thought experiments and case implication to explore the issues. (shrink)

Ancient India recognized the supreme value of education in human life. The ancient thinkers felt that a healthy society was not possible without educated individuals. They framed an educational scheme carefully and wisely aiming at the harmonious development of the mind and body of students. What they framed was a very liberal, all-round education of a very high standard, calculated to prepare the students for a useful life in enjoying all aspects of life. This is essentially a universally applicable educational (...) framework highlighting the purpose of human life and interconnectedness at all levels of existence as a basis of human values. Insights from ancient Indian educational system are of great help in facilitating the production of a creative, ethical and a learning mind, which will concern itself not only with greater ‘progress’, but primarily or more importantly with the inner transformation of the human consciousness. (shrink)

With no statutory definition of death, the accepted medical definition relies on brain stem death criteria as a definitive measure of diagnosing death. However, the use of brain stem death criteria in this way is precarious and causes widespread confusion amongst both medical and lay communities. Through critical analysis, this paper considers the insufficiencies of brain stem death. It concludes that brain stem death cannot be successfully equated with either biological death or the loss of integrated bodily function. The overemphasis (...) of the brain-stem and its consequences leaves the criteria open to significant philosophical critique. Further, in some circumstances, the use of brain stem death criteria causes substantial emotional conflict for families and relatives. Accordingly, a more holistic and comprehensive definition of death is required. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Hildegard and HolismSuzanne M. Phillips (bio) and Monique D. Boivin (bio)Keywordsbiopsychosocial, integration, medieval, mental illnessWe appreciate the careful and enriching commentary offered by Kroll and by Radden on our paper about holistic views of mental illness in the writings of the twelfth-century abbess and healer Hildegard of Bingen. Both reviewers are well-established figures in the study of historical perspectives on mental illness, an area that we have just (...) begun to explore. We are glad for the opportunity to respond to their observations and thereby to continue the dialogue.First, we would like to clarify our purpose in preparing this paper. Nowhere do we claim that Hildegard used a biopsychosocial model of mental illness, either in addressing the needs of the particular case of Sigewiza, or more generally in her writings on illness and health. In fact, we agree with Kroll (2007, 370), when he states that Hildegard did not use a biopsychosocial model. We use the term “biopsychosocial” only three times in the paper, always by contrast with what we see in Hildegard’s writings. The present-day biopsychosocial model focuses on getting a range of perspectives on the table, encouraging the consideration of biological, psychological, and social issues when thinking about mental illness. This is a good thing, but we argue that it does not go far enough. Specifically, there has been insufficient attention to ways these perspectives might interact.How, then, might we describe Hildegard’s way of conceptualizing mental illness? In place of the label “biopsychosocial model,” Kroll suggests that Hildegard’s approach could be described as a “religious model” (p. 372). Here we disagree. By our reading, Hildegard’s description of mental illness involves religious components, certainly, but also humoral, astrological, interpersonal, community, and intrapsychic components. Radden correctly notes that we are not so much interested in the particular components as we are in their interactions. We are attracted to Hildegard’s writings because she attends to these interactions. Our students, like Kroll’s (p. 371), are curious about mind–body relationships, which represent one example of the interplay between components. Our concern is that the current biopsychosocial model often fails to satisfy our own, and our students’, interest in the nature of those interactions. Our hope is that Hildegard’s writings might help us to think more richly about the interactions.As Radden (2007, 373) points out, present-day psychiatrists and psychologists do in fact use mul-ticausal accounts of depression. And we agree that such accounts need not be reductionistic (Kroll, 371). But we also recognize that psychology and psychiatry have well-established reductionist (more specifically, materialist) habits. To borrow [End Page 377] Kroll’s phrase, the biological model threatens “to swallow all other models” (p. 371). We must guard against such reductionism, given the habits of our disciplines. As we noted, McHugh and Slavney (1998) respond to that threat by building walls between the perspectives, suggesting that we might use different perspectives when thinking about different sorts of problems. We think that there ought to be more synthetic, holistic ways of responding to that threat, and we are hopeful that Hildegard’s writings can help us to develop those.At a basic level, we see Hildegard asking different questions than people ask today. On the first page of his commentary, for example, Kroll poses the question of “which of these three modalities [bio-, psycho-, social] may be sufficient” (p. 369) in the particular medieval text. We found that the sufficiency of one modality or another does not concern Hildegard. We are not able to speak to the general point that Kroll raises, that one or another element is emphasized depending on the goal of the medieval text; we can report our experience in reading Hildegard, where we found no sense in which one or another component is privileged. Even though Hildegard operated within a thoroughly religious context, we did not find examples of her subsuming other factors under religion. Everything interacts with spiritual concerns, to be sure, but everything also interacts with the biological, and with the interpersonal, and with the astrological. Although it may seem odd to us post-Darwinian thinkers, Hildegard’s model is essentially... (shrink)

The conventional concept of sustainability is commonly limited to the realm of diplomacy, emphasizing the need to protect the environment while also addressing human needs and desires. However, upon closer examination, this definition and practice reveals a deeply ingrained anthropocentric perspective in which human beings occupy the dominant position within the value systems. This perspective raises the crucial question of whether it provides a comprehensive, unbiased and cohesive framework for understanding and practicing sustainability and demanding justice. Following this issue, when (...) we investigate into the predominant anthropocentric viewpoints on sustainability through the holistic lens of ancient Indian philosophical traditions such as Vedanta, Buddhism and Jainism, we encounter challenges in adequately addressing fundamental questions concerning nature, preservation, justice and human well-being. In this article, we focus on Jainism, one of these ancient Indian schools of thought, which offers a distinctive and holistic philosophy for understanding sustainable thinking and practice. To restate, it not only encourages care and reverence for the natural world but also strives to rectify existing injustices, whether humanistic or ecological. With this, we aim to convey that Jainism’s unique philosophy offers a holistic framework for sustainability. (shrink)

Committee composition is a recurrent theme within the literature on Institutional Animal Care and Use Committees (IACUCs). The ability of IACUCs to ensure the ethical treatment of nonhuman research subjects depends upon who makes up these committees. Non-scientists and those not affiliated with the research institution have been deemed indispensable for the democratic, objective review of protocols and, thus, for ethical treatment. IACUCs’ critics and partners alike have persistently offered suggestions for how to further optimize committee composition towards these (...) ends. This paper contributes to the ongoing conversation by advocating for the addition of holistic species experts to IACUCs, arguing that holistic species experts are as indispensable for the political and epistemic viability of protocol reviews as non-scientists and non-affiliates. Holistic species experts are defined here as members of the larger community who have extensive firsthand experience with animals living and dying under relatively ideal conditions. If we accept that non-scientists and non-affiliates are crucial for IACUCs' ethical treatment of animals, then we have every reason to embrace holistic species experts. The values, welfare expertise, and productive epistemic dissonance that these experts bring to the table would prove invaluable. (shrink)

In order to cope with the changing health needs in the community, an holistic approach on AIDS prevention and control with particular reference to essential quality was introduced at an educational seminar at Hebei Medical University in China, 1996. We have identified three major points in the present study through learning and research process: 1. The importance of ‘cultural norm’ for the unification of science and technology is identified for the community approach; 2. ‘community care’ emphasising human quality provides (...) unity in diversity for educational program; and 3. ‘community control’ emphasising quality assurance demonstrates the effectiveness for program analysis from the viewpoint of human centred systems. (shrink)

Introduction: Probationers, offenders with less serious and non-violent offences, and under statutory supervision, have low levels of self-esteem and physical health, and high level of family conflict, and poorer quality of family relationships. This study examined the effectiveness of the existing probation service and the additional use of a positive family holistic health intervention to enhance physical, psychological, and family well-being in probationers and relationships with probation officers.Methods: Probationers under the care of the Hong Kong Social Welfare Department (...) were randomized into a care-as-usual control group, a brief intervention group receiving two 1-h individual sessions [of a brief theory-based positive family holistic health intervention integrating Zero-time Exercise and positive psychology themes of “Praise and Gratitude” in the existing probation service], or a combined intervention group receiving BI and a 1-day group activity with family members. The outcomes were physical activity, fitness performance, self-esteem, happiness, anxiety and depression symptoms, life satisfaction, quality of life, family communication and well-being, and relationships with probation officers. Self-administered questionnaires and simple fitness tests were used at baseline, 1-month and 3-month follow-up. Linear mixed model analysis was used to compare difference in the changes of outcome variables among groups, adjusted of sex, age, and baseline values. Focus group interviews were conducted. Thematic content analysis was used.Results: 318 probationers were randomized into CAU, BI, or CI group. CAU showed enhanced physical activity, fitness performance and psychological health, and family communication with small effect sizes. BI and CI showed further improved physical activity, family communication and family well-being. Additionally, CI reported greater improvements in the relationships with probation officers than CAU with a small effect size. CI also reported greater increases in physical activity and family communication than BI with small to moderate effect sizes. Qualitative feedbacks corroborated the quantitative findings.Conclusion: Our trial provided the first evidence of the effectiveness of probation service and the additional use of an innovative, relatively low-cost, theory-based brief positive family holistic health intervention. This intervention may offer a new model for enhancing probation service.Trial Registration: The research protocol was registered at the National Institutes of Health. (shrink)

The emerging concept of systems medicine (or ‘P4 medicine’—predictive, preventive, personalized and participatory) is at the vanguard of the post-genomic movement towards ‘precision medicine’. It is the medical application of systems biology, the biological study of wholes. Of particular interest, P4 systems medicine is currently promised as a revolutionary new biomedical approach that is holistic rather than reductionist. This article analyzes its concept of holism, both with regard to methods and conceptualization of health and disease. Rather than representing a (...) medical holism associated with basic humanistic ideas, we find a technoscientific holism resulting from altered technological and theoretical circumstances in biology. We argue that this holism, which is aimed at disease prevention and health optimization, points towards an expanded form of medicalization, which we call ‘holistic medicalization’: Each person’s whole life process is defined in biomedical, technoscientific terms as quantifiable and controllable and underlain a regime of medical control that is holistic in that it is all-encompassing. It is directed at all levels of functioning, from the molecular to the social, continual throughout life and aimed at managing the whole continuum from cure of disease to optimization of health. We argue that this medicalization is a very concrete materialization of a broader trend in medicine and society, which we call ‘the medicalization of health and life itself’. We explicate this holistic medicalization, discuss potential harms and conclude by calling for preventive measures aimed at avoiding eventual harmful effects of overmedicalization in systems medicine (quaternary prevention). (shrink)

This article examines parallels between the increasing mental burnout and environmental overshoot in the organisational context. The article argues that there is a particular philosophy of management that connects these two phenomena of overshoot and burnout, namely productivism. As there are boundaries in all ecological processes and systems, the productivist aim of having ever more output and growth is deemed absurd. It is proposed that productivity as a management philosophy not only leads to mental ill-health in organisations but also to (...) overshoot in the environment. The article concludes that productivism, which denies the limits in utilisation of humans and other natural resources, fits poorly with circular economy and sustainability. Hence, ecological management should be complemented with a more holistic and processual view of organizations, as well as have an aim of peaceful coexistence between all earthbound objects. This signifies acknowledging and caring for human and non-human needs both now and in future by applying the idea of moderation to production of goods and services. (shrink)

In recent philosophy of mind a non-holistic view on concept possession, originally developed by Tyler Burge, has emerged as an alternative to holistic analyses of language mastery. The article discusses the implications of this view for analyses of communication in doctor—patient-interaction. The central question Burge's theory gives an answer to is this: to what extent must a doctor and a patient understand a medical term in the same way in order to communicate in the sense that they express (...) the same concept by the term? Many empirical studies have shown that patients do not, typically, understand medical terms in the same way as doctors they encounter. Holistic approaches therefore imply that doctors and patients seldom communicate. Burge's position, on the other hand, implies that it is sufficient that patients have a minimal understanding. In an important range of cases doctors can make sure that patients have a minimal understanding by being explicit about common dictionary definitions of the terms in question. (shrink)

This article explores the meeting of two approaches towards philosophy and education: the philosophy for children approach advocated by Lipman and others, and Schmid’s philosophical concept of Lebenskunst. Schmid explores the concept of the beautiful or good life by asking what is necessary for each individual to be able to develop their own art of living and which aspects of life are significant when shaping a good and beautiful life. One element of Schmid’s theory is the practical application of philosophy (...) through the notions of Bildung, reflection, prudence and practical wisdom, as well as the requirement for each individual to take responsibility for actively shaping their life as an artwork. In this sense, each person is the artist responsible for living their own beautiful life. We argue that there are useful parallels between Schmid’s concept of the art of living and P4C, such as the ideal of a holistic philosophy that is “lived.” The pragmatic approach of P4C focuses on the embodied learner who practices critical, caring and creative thinking. Both P4C and Schmid’s theory are reminiscent of the Aristotelian notion of practical wisdom, which allows for an approach to an education for life that prepares students to develop their own art of living. (shrink)

We argue for the need for a new language for business – one that is capable of changing the current business decision-making frame of wins and losses to a frame of community and social learning. This paper outlines a classroom exercise about Nelson Mandela’s leadership, involving movies, case studies and poetry, and shows how the more holistic approach helps shift student views of the triple bottom line. Since neuroscience literature has shown that poetry can help enhance learning, students carefully (...) study “Invictus,” a poem written by Victorian-era poet Henley and revered by Mandela. As students dig deeper into the case study through classroom discussion, they begin to see Mandela’s leadership through a new frame, and in doing so broaden their own views. This more holistic approach to studying leadership may allow decision makers to adjust both their goals and the focus of their analysis to go beyond monetary outcomes to include socially and environmentally sustainable outcomes. (shrink)

My aim in this chapter is to address what looks like a tension in Fichte’s derivation of ethical content for the moral law in his System of Ethics. In the first place, Fichte seeks to derive the content of our duties from our “natural drive [Naturtrieb],” which he defines in terms of our striving for enjoyment. But later in the book we find a second argument that derives the content of our duties from what Fichte calls the conditions of our (...) “I-hood [Ichheit],” namely, our embodiment, intelligence, and sociality. I argue that a careful rereading of Fichte’s notion of a natural drive is consistent with this second derivation. The key to this reading lies in Fichte’s effort to reframe the natural drive through the category of “reciprocal interaction [Wechselwirkung],” which allows us to view the natural drive as a “formative drive [Bildungstrieb]” that is both active and passive. For Fichte, the formative drive amounts to a striving for self-organization, and this striving, I argue, prefigures what becomes the ethical drive to engage in reciprocal interaction with other members of the rational community. (shrink)

Analyzing the doctrine of methodological individualism and its opposition to methodological holism, I start by briefly reviewing three historical periods in which the discussion around it was very lively (i.e., the turn of the century around 1900, the 1950s, and the 1980s-90s) explicating the variety of characterizations of methodological individualism. To highlight the connection of these philosophical discussions to social scientific practice, intradisciplinary as well as interdisciplinary dynamics, I then look into the debates around microfoundations (in the 1980s) and so-called (...) economics imperialism in the social sciences (and its impact within political science in the 1990s). While both the microfoundations project and economics imperialism are driven by methodological individualists, here too it seems important to pay attention to the variety of understandings of methodological individualism as well as the exact ambition of their undertakings (evaluated along different dimensions, i.e., ontological, epistemological, axiological, and institutional). Overall, I conclude that when looking into the history of the social sciences, the best philosophers can do when discussing methodological individualism and holism is to carefully distinguish the broad variety of positions that can be evaluated along multiple dimensions, to demonstrate the benefits of methodological pluralism as well as expose the downsides of methodological monocultures. (shrink)

In this study, Consistency and Balance Model (CBM) is proposed and introduced. In the context of the model, the importance of consistency is emphasized in morality just like in Philosophy. Therefore, CBM gives the reason prominence in morality to ensure the consistency and according to CBM the emotion, the intuition and the conscience in addition to the reason, are also important. In order to see the principles determined by the reason in human behaviors, two kinds of classification are developed for (...) the virtues that is defined as the middle of excess and defect. The first of them is the triple classification of virtues that draws attention to the false existence of virtues and determines the opposite of virtues as forming dichotomy. The latter is the tetrad classification, which is based on the duality of two means that propose to consider the virtues together. The Contrast is considered as the central concept in the first classification and the integration is considered as the central concept in the second classification. Then it is offered that the virtues may be evaluated consistently in the social, global and theological contexts. However, the ideal morality with objective qualities and the real morality with subjective qualities are produced in order to reach the universal morality that is determined by the reason, then the consistency and the integration are proposed for them. Similarly, consistency and integration are proposed in the dualities of principle-virtue, abstract-concrete, intention-outcome, universality-locality, objectivity-subjectivity throughout the study. Finally, it is pointed out that the reasonableness of applying consistency in morality has exceptions.Summary: Philosophy is the logical, systematic and consistent thinking that focuses on specific questions and topics to reach the reality. When this basic tendency of philosophy is applied to morality, logical, systematic and consistent actions are expected to emerge. Accordingly, a new model called as Consistency and Balance Model (CBM) is proposed and introduced in this article. By this model, the importance of consistency is emphasized in morality just like in philosophy. Therefore, CBM gives the reason prominence in morality to ensure thought, expression and behavior consistency. According to CBM the human emotion, the divine intuition and the solid conscience in addition to reason are required to determine the virtues. CBM, which is a synthesis of the good intention and the reason, aims to constitute the sensible and good actions. According to CBM, which has a holistic structure, if a person can adopt the virtue as a principle and reflect the virtue in all of his behaviors during his whole life, he can be defined as consistently virtuous.CBM defines the good with the concepts of consistency and balance. According to CBM, the good is the mean of excess and defect. In this respect, CBM is based on Aristotle’s mean idea. However, CBM aims to develop it with new content. Two important questions arise during the identification of the evil: 1. Is it bad that nothing happens? 2. Is it bad that something is wrong? The point of defect represents the absence and the point of excess represents the fallacy in the entity. Both of them are bad in morality. The middle of them is the virtue. In order to see the principles determined by the reason in human behaviors, two kinds of classification are developed for the virtues which are defined as the middle of excess and defect. The first is the triple classification of virtues that draws attention to the false existence of virtues and determines the opposite of virtues as forming dichotomy. The triple classification, which forms a dichotomy as an empty pattern that can be applied to all virtues, is determined as over virtue-virtous-virtueless. According to CBM the opposite of the mean is always clearly the point of defect and implicitly the point of excess. Therefore, it is important to determine extremes of virtues. The point of defect can be briefly denoted as virtueless. The point of excess can be denoted as in fact virtueless, pretending as virtuous, masked virtue and over virtue. The latter is the tetrad classification, which is based on the duality of two means. In this classification, it is possible to produce new and better virtues by considering two virtues together. The Contrast is considered as the central concept in the first classification and the integration is considered as the central concept in the second classification.The principle is seen as a guarantee for the consistency in philosophy. CBM points out that a similar situation should be in ethics. According to Kant, the invisible internal principles of the actions are more important than the actions themselves to determine the moral value. The principle does not vary according to the individual and the condition, on the contrary, the individual is shaped by the principle and all individuals benefit equally from the outcome of the principle. Thus, the abuse of the rights of individuals with arbitrary treatments and double standards are prevented. In this democratic environment formed by the principle not only the owner of the power, but all right holders can get their rights. In this respect, the adherence to the principle is the guarantee of the rights and the freedom by establishing a balance between the rule and the freedom.Aristotle’s virtue and Kant’s principle are discussed in a holistic manner in this study. Thus, it is aimed that the principles in the human mind and the virtues in human actions are consistent in themselves and ultimately the union of the principles and the virtues can be ensured. Besides, the concepts of the ideal morality and the real morality are introduced in this article. The ideal morality takes place on the objective basis of the good and the truth, which is absolute, universally and unarguably accepted by everyone. The ideal morality with its objective qualities can be seen as the target that people know and want to achieve. The real morality is the morality that is shaped in the people or society in all its positive and negative aspects, which also includes the subjectivity of them as their own realities. The real morality with subjective qualities is the morality that occurs in life. CBM aims at the integrity and the consistency between the ideal morality and the real morality to reach the universal morality. In this article, the virtues are divided into two parts as material and spiritual. Then it is offered that the virtues may be evaluated consistently in the principal, individual, social, global and theological contexts. In this context, on the one hand it is aimed that the principal, individual, social, global and theological virtues are consistent within themselves and on the other hand they all are consistent within each other. In this classification the principal and theological morality have objective qualities and the individual and social morality have subjective qualities. CBM aims at an objectivity that incorporates subjectivity within the consistency and integrity of the principal, individual, social, global and theological morality. CBM aims to achieve the ultimate morality by integrating the starting point as the principal morality and the end point as the theological morality and to make them clear in the individual and social morality. As a result, CBM confirms the mean found by reason, by the revelation given by God. In other words, the morality that God has already there and always presents and the morality that the human mind finds here and now coincide. The consistency and integration are also proposed in the dualities of principle-virtue, abstract-concrete, intention-outcome, universality-locality, objectivity-subjectivity in the article. However, consistency, which is the central concept of the article, can form the basis for possible criticisms. But, it can be foreseen that the possible criticisms oriented to CBM would come from an extreme consistency perception that detaches the concept of consistency from reality without careful consideration. For this reason it should be kept in mind that it is wrong to expect excessive consistency in human behavior and to accept the ideal morality as absolute by neglecting the real morality. Finally, it is pointed out that the reasonableness of applying the consistency in morality has exceptions. (shrink)

Numerous humans - in my opinion, far too many - continue to live apart from nature, rather than as a part of nature. In this personal essay I discuss various aspects of traditional science and suggest that holistic and heart-driven compassionate science needs to replace reductionist and impersonal science. I argue that creative proactive solutions drenched in deep caring, respect, and love for the universe need to be developed to deal with the broad range of problems with which we (...) are confronted. Simply put, I have had enough. I want the world to be a better place for all of its inhabitants and time is not on our side. I feel a deep sense of urgency and passionate impatience. We are worrying about wildness as it is disappearing right in front of our eyes - as I write and we discuss. Thus, I am willing to open myself to criticism, to be vulnerable for expressing views that are not part of main-stream science. Rather than take a doomsday view that the world will not even exist in 100 years if we fail to accept our unique responsibilities, it is more disturbing to imagine a world in which humans and other life coexist in the absence of any intimacy and interconnectedness. Surely we do not want to be remembered as the generation that killed nature. To illustrate some of my points, I discuss various aspects of translocation studies in which animals are moved about from one place to another in humans' attempts to "redecorate" nature. In these projects interdisciplinary collaboration is necessary and disciplinary boundaries must be trespassed. I also emphasize the importance of teaching children well for their and our futures rest on their developing a deeply-rooted caring ethic. My vision is to create a world-wide community in which humans perceive themselves as a part of nature and not apart from her, in which humans who are overwhelmed and whose spirits and souls have been robbed and squelched by living in and amongst steel, concrete, asphalt, noise, and a multitude of invasions of their private space reconnect with raw nature - with the wind in their faces, the odors of wild flowers, and the sounds, sights, odors, and touch of other animals and inanimate environs. A world in which sensing is feeling. Nature is our unconditional friend and reconnecting with nature can help overcome alienation and loneliness. The power of love must not be underestimated as we forge ahead to reconnect with nature. (shrink)

This paper exposes some examples of continuing murky thinking concerning holism. The exposure is a prelude to noting the importance of proximity in causal explanations of illnesses and wounds. The paper then draws attention to how the proximate should not hold exclusive sway regarding what constitutes best nursing treatment and care. The error of excessive preference for proximity is shown to be an error, using as an example the treatment of leg ulcers. One component of holism that can be (...) clearly expressed amounts therefore simply to the claim: resist the error of excessive proximity preference, resist the error of concentrating solely on nearness. It is left open whether there is any further sense to be gleaned from the holistic babble. (shrink)

Gebserian consciousness structures as expressed in human culture are readily understood as analogous to developmental dynamics in holistic biology, and eastern praxis and philosophy. Probably the most integral and fruitful western paradigm of whole-organism biology is that carefully developed in the Goethean tradition to incorporate an understanding of consciousness. This tradition profoundly understands our early childhood through adult development as a dynamic organic process in time, thus integrating the study of heterochrony and chronobiology with morphology, physiology and consciousness. In (...) addition to revealing compelling convergences with the classic work of Gebser on consciousness structures, this Goethian tradition reveals significant parallels with contemporary studies in the realm of biophysics, the science of complexity and eastern spiritual traditions which regard the body as a coherent field, manifesting dynamic, directed currents of development that can be traced and mapped out. These paradigms recognize the importance of recursive organizing principles that structure the biosphere's spatial dimensions and, in the temporal realm, structure long- and short-term evolutionary cycles. The marriage of Gebserian cultural philosophies with Goethean biology, the science of complexity and eastern praxis traditions leads to a simple, elegant and remarkably broad appreciation of the fundamental role of consciousness as an essential property of dynamic living systems. This synthesis helps address many of the difficult questions faced by students of consciousness in a relatively simple and straightforward manner, beginning with a focus on our own species and close mammalian relatives. Two main conclusions arise from this synthesis. First, although enjoying increased attention recently, the Gebserian and Goethean paradigms were far ahead of their time and so have been overlooked. Second, consciousness must be regarded as a primary biologically-embedded datum of life/existence and not merely an epiphenomenon associated with the function of localized or specific organs. (shrink)

We care for our own future experiences. Most of us, trivially, would rather have them pleasurable than painful. When we care for our own future experiences we do so in a way that is different from the way we care for those of others (which is not to say that we necessarily care more about our own experience). Prereflectively, one would think this is because these experiences will be ours and no one else's. But then, of (...) course, we need to explain what it means to say that a future experience will be mine and how knowledge of this fact renders it rational for me to care for this experience in a special way. Indeed most philosophers take this route. But in doing so, they quickly stumble on insuperable problems. I shall argue that the problem of egocentric care, as it is sometimes called, can be solved by turning things upside down: it is much more fruitful to think that the special kind of care we feel for some future experiences (and not others) is part of what makes them ours should they occur. This requires an explanation of egocentric care for future experiences that does not draw in a theory of personal identity, but rather contributes to one. I will attempt to provide this explanation by making use of the idea of a diachronic mental holism. (shrink)

This article presents the works of great Polish philosopher, Mieczysław Albert Krąpiec, whose creative output can be applied to professional nursing practice. Krąpiec's philosophical heritage is extensive and encompasses many philosophical fields: metaphysics, philosophical anthropology, philosophy of law, philosophy of culture, philosophy of politics and philosophy of language. Krąpiec created an original philosophical synthesis characterized by a realistic approach. In this paper, I present only one of several original philosophical concepts developed by Krąpiec: the theory of the person based on (...) seven essential characteristics, that is the ability for cognition, love, freedom, religion, legal subjectivity, completeness and dignity. I attempt to show how these personal characteristics correspond to various patient needs. I argue that the qualitative deficit of any personal characteristics indicated by Krąpiec corresponds to a patient's real need that must be satisfied. I also stress that the skilful diagnosing of all—not only selected—qualitative deficits of characteristics can be defined as holistic care in the nursing profession. (shrink)

Cartea Karenei Gloy este un produs tipic al tradiţiei universitare germane ce-şi are originile încă de la Wolff: solidă, cuprinzătoare, bine informată, fără excese şi fără părtinire în interpretare. Aceste caracteristici fac din ea un excelent ghid în clarificarea tematicii tratate. Înţelegerea naturii în civilizaţia occidentală, de la greci până în zilele noastre este, desigur, un subiect extrem de vast, şi, aparent, o sarcină imposibilă. Concentrându-se însă doar asupra perspectivei istorice, autoarea reuşeşte foarte bine să evite complicaţiile inerente unor domenii (...) ca antropologia culturală, istoria mentalităţilor, a ideilor sau a ideologiilor, punând în faţa cititorului o lucrare care, în intenţie dar şi în realizare, îşi merită pe deplin numele: o istorie a gândirii naturii, al cărei gen proxim este istoria filosofiei propriu-zise. (shrink)

The practice of pastoral care (cura animarum) over the ages has been informed and influenced by the need to develop creative ways (interventions) to respond to people’s contextual challenges. These approaches have been well documented. However, the history, developments and emerging pastoral care practices in Africa have not been documented. This article, by way of a survey, considers the pastoral care approaches that emerged in Africa from the period when Christianity was introduced to the continent. It addresses (...) three interlinked questions. Firstly, to what extent has pastoral care approaches and practices in Africa been influenced by the African context and developments? Secondly, to what extent has the context and the emerging pastoral care approaches in Africa been discerned from historical developments and documented? Thirdly, what links can be drawn between pastoral care practices in Africa and its historical as well as cultural context? In answering these questions, the article retrieves pastoral care developments in Africa by discerning pastoral care during the periods of Christianity in Africa. The notion of cura animarum as ‘soul care’, referring to care for the whole person (holistic care, i.e., nephesh care) from a Christian spiritual perspective, will be employed as a framework. The assumption guiding the article is that pastoral care practices and approaches in Africa have arisen as responses to the contextual realities being experienced at the interface of Christianity and the African people. These realities arose and persist to this day as a struggle to relate, apply and live out an authentic African Christian life to cope with life in a meaningful way. It concludes by suggesting ways on how pastoral care in Africa should be practiced in the current period and going forward. (shrink)