Locating hygienic medicine within the intellectual history of hygiene: cases of E. W. Lane and T. R. Allinson.

Nineteenth century hygiene might be a confusing concept. On the one hand, the concept of hygiene was gradually becoming an important concept that was focused on cleanliness and used interchangeably with sanitation. On the other hand, the classical notions of hygiene rooted in the Hippocratic teachings remained influential. This study is about two attempts to newly theorise such a confusing concept of hygiene in the second half of the century by Edward. W. Lane and Thomas R. Allinson. Their works, standing on the borders of self-help medical advice and theoretical treatises on medical philosophies, were not exactly scholarly ones, but their medical thoughts - conceptualised as hygienic medicine - show a characteristically holistic medical view of hygiene, a nineteenth-century version of the reinterpretation of the nature cure philosophy and vitalism. However, the aim of this study is to properly locate their conceptualisations of hygienic medicine within the historical context of the second half of the nineteenth century rather than to simply introduce the medical ideas in their books. Their views of hygiene were distinguished not only from the contemporary sanitary approach but also from similar attempts by contemporary orthodox and unorthodox medical doctors. Through a chronological analysis of changes in the concept of hygiene and a comparative analysis of these two authors' and other medical professionals' views of hygiene, this paper aims to help understand the complicated picture of nineteenth-century hygiene, particularly during the second half of the century, from the perspective of medical holism and reductionism.

Modern Medicine: Ideas and Advances.

Considering the limitations of medical science and the risks associated with medical treatments, we need to re-examine the connotation of medical science from the perspective of philosophy. Medical science is the natural expression of human kindness and human nature of rescuing the dying and healing the wounded. It is a combination of the natural sciences, social sciences, and humanities. From the perspectives of medical philosophy and humanistic care, this article expounds the concepts and ideas of evidence-based, translational, and precision medicine in modern medicine and emphasizes the importance of avoiding new technical bureaucracy, paying attention to achieving a holistic view and systematic understanding, and avoiding biases in development because of the loss of the humanistic spirit in modern medical practice.

China, Gender Issues, Medical Philosophy and Measurement Scales.

In this fourth issue of the Journal of Religion and Health for 2022, four key themes are explored: (1) religious and spiritual issues in China, (2) gender-related issues affecting communities, couples, women and men, (3) a multitude of philosophical perspectives regarding medicine, science, health and religion, (4) and an array of new or adapted religion/spirituality measurements and scales. Finally, we also recall and celebrate the life of former JORH Editorial Board member, Professor John S. Peale.

Reductionism, Vitalism, and Holism.

The reductionist strategy, adopted by physics and chemistry, which was based on the effort to reduce the concepts necessary for the statement of scientific explanations to a minimum, was attractive to those who worked in the biomedical field. On the other hand, the vitalistic point of view opposed mechanism, believing that there were processes in living organisms that do not obey the laws of physics and chemistry. Finally, the holistic approach is focused on the evidence that the organized whole is almost always much more than the sum of its parts, and have led to direct attention to emerging qualities in a highly organized system which is a living being.

The implications of complexity, systems thinking and philosophy for pediatricians.

National service systems in child healthcare are characterized by diversity and complexity. Primary, secondary, tertiary and quaternary healthcare services create complex networks covering pediatric subspecialties, psychology, sociology, economics and politics. Can pediatrics exist without philosophy? Does the absence of integrating philosophical perspectives during conceptualization of pediatric care contribute to deficiencies in the service systems structuring child healthcare? Philosophy offers new ways of complex systems thinking in scientific and clinical pediatrics. Philosophy could improve coping strategies on different levels when dealing with ethics of research projects, individual child healthcare and crises of healthcare service systems. Boundary and ultimate situations experienced by severely sick children require help, hope and resilience. Patients and families as well as pediatricians and other caregivers must act in concert. All of them may benefit from consulting with philosophers. The aim of this article is to point out the risks of a strict separation of scientific insight and sensory experience affecting child healthcare in our modern society, which is dominated by technology, competition and lack of equity and time.

The Manchurian candidate: chiropractors as propagators of neoliberalism in health care.

The rise of neoliberalism has influenced the health care sector, including the chiropractic profession. The neoliberal infiltration of market justice behavior is in direct conflict with the fiduciary agreement to serve the public good before self-interests and has compromised the chiropractor, who now may act as an agent of neoliberalism in health care. The purpose of this paper is to present an overview of the impact of neoliberalism on the chiropractic profession and provide recommendations for a professional philosophical shift from a market justice model to a communal and social justice model.

Health and capabilities: a conceptual clarification.

There are great health disparities in the world today, both between countries and within them. This problem might be seen as related to the access to various kinds of capabilities. It is not fully clear, however, what the exact relation is between health and capabilities. Neither Amartya Sen nor Martha Nussbaum has explicitly formulated a theory of health to go with their theories of capabilities. This paper attempts to present a clarification of the conceptual relation between health and capabilities. Health, it is argued, should be seen as a holistic multi-dimensional phenomenon, made up of basic abilities and subjective well-being, and of fundamental states and processes. Using this theory, the paper shows how health is related to Nussbaum's ten capabilities. It is argued that health, in the senses described, is a necessary part of all ten capabilities. Moreover, some of the capabilities on Nussbaum's list, such as thinking and imagining, and practical reasoning, refer to health. Finally, it is shown that even though health is part of all capabilities, health cannot itself primarily be seen as a capability. An acceptable degree of health is required as a functioning for any theory of human flourishing to be reasonable.

Ferments and the AIDS virus: interspecies counter-conduct in the history of AIDS.

In the first three decades after AIDS started infecting people in the USA and Canada, before, during and after the emergence of anti-retroviral therapies, numerous "alternative and holistic treatments" for AIDS were debated, tested, circulated, written about and taught. This paper, taking a narrow focus, examines documents that reveal how some people with AIDS developed a logic of care predicated on intimate interactions with microscopic lifeforms-the AIDS virus and the bacteria involved in fermentation, in particular. Focusing on the writings of Jon Greenberg and Sandor Katz, two former members of ACT UP/NY, I show that the men did not just dissent from management by biomedical authority but found new authority about how to care for themselves as people with AIDS from their interactions with non-human microscopic life. The practices and writings of both men demonstrate that Foucault's theory of counter-conduct exists in the history of AIDS as an interspecies process in which microscopic existents lead humans. From Katz and Greenberg, I argue there is an interspecies dimension to counter-conduct that exists as a frame for understanding people who find in non-human life a guide towards unconventional forms of care, revised forms of human behaviour and philosophies for persisting with illness.

Psychosomatic subjects and the agencies of addiction.

Addiction science and public policy have for some time been articulated in conformity with a broader antinomy in Western thought between biological reductionism and liberal voluntarism. Hence, mainstream debates have concerned whether and how addiction might be understood as a disease in the biomedically orthodox sense of anatomical or physiological pathology or whether and how addiction might be understood as a voluntary choice of some kind. The fact that those who staff these debates have appeared either unable or unwilling to consider alternatives to this antinomy has resulted in a rather unhappy and intransigent set of intellectual anomalies both on the biomedical and the social scientific sides of this divide. Perhaps more importantly, it has also resulted in a striking isolation of scientific debates themselves from the vicissitudes of therapeutically caring for those putatively suffering from addictions both within and outside clinical settings. After briefly demonstrating the conformity of debates in addiction science with the broader antinomy between biological reductionism and liberal voluntarism and the anomalies that thereby result, this article considers the scientific and therapeutic benefits of a psychosomatic framework for the understanding of both self-governing subjects and the experience of a loss of self-control to agencies of addiction.

On illness and value: biopolitics, psychosomatics, participating bodies.

In its heyday, around the mid-twentieth century, psychosomatic medicine was promoted as heralding a new science of body/mind relations that held the promise of transforming medicine as a whole. Sixty years on, the field appears to have achieved no more than a respectable position as a research specialism within the medical status quo. This paper articulates the problematic of psychosomatics through a number of propositions that reconnect its promise of novelty to the present and to contemporary concerns. In contrast to classic approaches to 'psychosomatic problems', which typically set out by denouncing the conceptual inadequacy of mind/body dualism, the focus proposed is on the resilience of dualism as an empirical datum deserving closer analysis. The paper thus asks: what is the character of dualism considered under the aspect of what it achieves, and thus as an expression of value? Drawing on the thought of A N Whitehead, Michel Foucault and Viktor von Weizsäcker, the argument formulates a set of 'psychosomatic problems' informed by the concept of biopolitics and introduces their relevance in relation to the politics of participatory medicine.

Agency, embodiment and enactment in psychosomatic theory and practice.

In this paper, we examine some of the conceptual, pragmatic and moral dilemmas intrinsic to psychosomatic explanation in medicine, psychiatry and psychology. Psychosomatic explanation invokes a social grey zone in which ambiguities and conflicts about agency, causality and moral responsibility abound. This conflict reflects the deep-seated dualism in Western ontology and concepts of personhood that plays out in psychosomatic research, theory and practice. Illnesses that are seen as psychologically mediated tend also to be viewed as less real or legitimate. New forms of this dualism are evident in philosophical attacks on Engel's biopsychosocial approach, which was a mainstay of earlier psychosomatic theory, and in the recent Research Domain Criteria research programme of the US National institute of Mental Health which opts for exclusively biological modes of explanation of illness. We use the example of resignation syndrome among refugee children in Sweden to show how efforts to account for such medically unexplained symptoms raise problems of the ascription of agency. We argue for an integrative multilevel approach that builds on recent work in embodied and enactive cognitive science. On this view, agency can have many fine gradations that emerge through looping effects that link neurophenomenology, narrative practices and cultural affordances in particular social contexts. This multilevel ecosocial view points the way towards a renewed biopsychosocial approach in training and clinical practice that can advance person-centred medicine and psychiatry.

Towards a holistic definition of death: the biological, philosophical and social deficiencies of brain stem death criteria.

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.

Integrating Osteopathic Philosophy in Cancer Care.

Recent breakthroughs in the fields of genomics and biology have resulted in a better understanding of diseases and their underlying biology. New targeted and immune-based therapies take advantage of these new discoveries to treat the patient individually. This scientific revolution toward personalized medicine reflects osteopathic medicine's emphasis on patient-centered care and its tenets, which go against the "one-size-fits-all" approach. The authors discuss the importance of applying osteopathic philosophy to the delivery of patient-directed cancer care revolutionized by scientific advances.

Leaving gift-giving behind: the ethical status of the human body and transplant medicine.

The paper argues that the idea of gift-giving and its associated imagery, which has been founding the ethics of organ transplants since the time of the first successful transplants, should be abandoned because it cannot effectively block arguments for (regulated) markets in human body parts. The imagery suggests that human bodies or their parts are transferable objects which belong to individuals. Such imagery is, however, neither a self-evident nor anthropologically unproblematic construal of the relation between a human being and their body. The paper proposes an alternative conceptualization of that relation, the identity view according to which a human being is identical with their living body. This view, which offers a new ethical perspective on some central concepts of transplant medicine and its ethical and legal standards and institutions, supports widely shared intuitive ethical judgments. On this proposal, an act of selling a human body or one of its parts is an act of trade in human beings, not in owned objects. Transfers of human body parts for treatment purposes are to be seen as sharing in another human being's misfortune rather than as giving owned objects. From the perspective of policy-making, the proposal requires, first, that informed consent for removal of transplant material be obtained from the potential benefactor. Secondly, explicit consent by the prospective benefactor is obligatory in the case of removal of transplant material from a living benefactor. Thirdly, in the case of posthumous retrieval, informed consent by the potential benefactor during their life is not ethically indispensable. Additionally, while refusal of posthumous retrieval expressed by a potential benefactor during their life must be respected, such a refusal needs ethical justification and explanation.

What deserves our respect? Reexamination of respect for autonomy in the context of the management of chronic conditions.

The global increase in patients with chronic conditions has led to increased interest in ethical issues regarding such conditions. A basic biomedical principle-respect for autonomy-is being reexamined more critically in its clinical implications. New accounts of this basic principle are being proposed. While new accounts of respect for autonomy do underpin the design of many public programs and policies worldwide, addressing both chronic disease management and health promotion, the risk of applying such new accounts to clinical setting remain understudied. However, the application of new accounts of respect for autonomy to clinical settings could support disrespectful attitudes toward or undue interference with patients with chronic conditions. Reconsidering autonomy and respect using Kantian accounts, this paper proposes respect for persons as an alternative basic bioethical principle to respect for autonomy. Unlike the principle of respect for persons in the Belmont Report, our principle involves respecting any patient's decisions, behaviors, emotions, or life-style regardless of his or her "autonomous" capabilities. Thus, attitudes toward patients should be no different irrespective of the assessment of their decisional or executive capabilities.