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1.
Rev. med. cine ; 18(4): 377-390, dic. 2022. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-213920

RESUMO

Un problema de la medicina son las incertidumbres epistémicas que le son propias, tanto por sus métodos de elaboración conceptual como por las que toma de las ciencias naturales y sociales en las que se apoya. En consecuencia, la medicina no es una ciencia, aunque sus bases son cada vez más científicas. Dado que en la medicina en general, y en los conceptos de salud y enfermedad, y en la realidad de los enfermos hay componentes biológicos, psicológicos y sociológicos, no tiene nada de particular invocar a la filosofía y a la literatura para la elaboración de las teorías de la medicina. En este artículo planteamos algunos de estos enfoques, se resaltan las limitaciones de la concepción biologicista y reduccionista de la medicina y se estima que adquiere mayor potencia explicativa de los conceptos de salud y enfermedad cuando se consideran los aspectos humanos y sociales de la teoría y la práctica de la medicina. Además, la literatura aporta una imagen social de la medicina y de los enfermos que deberíamos integrar en los conceptos de salud, enfermedad y enfermo. Llamamos, por último, la atención sobre un proceso que parece haber desaparecido de la práctica médica como es la convalecencia y la necesidad de una completa restauración de la salud por el riesgo, como advierte el aforismo hipocrático, de que de los residuos que quedan de las enfermedades, suelen surgir las recidivas. (AU)


A problem of medicine is the epistemic uncertainties that are inherent to it, due to its both conceptual elaboration methods and those it takes from the natural and social sciences on which they are based on. Consequently, medicine is not a science, although its basis are scientifically increasing. Given that there are biological, psychological and sociological aspects in medicine in general, and in the concepts of health and disease, and in the reality of patients, there is nothing special about invoking philosophy and literature for the elaboration of theories of medicine. In the present article we consider some of these approaches, the limitations of the biological and reductionist conception of medicine are highlighted and it is estimated that it acquires greater explanatory power of the concepts of health and disease when the human and social aspects of theory and medicine are considered. In addition, literature provides a social image of medicine and of patients that we should integrate into the concepts of health, disease and patient. Finally, we draw attention to a process that seems to have disappeared from medical practice, such as convalescence and the need for a total restoration of health due to the risk, as the Hippocratic aphorism warns, that the residues that remain from disease, relapse often occurs. (AU)


Assuntos
Humanos , Saúde , Educação Médica , Doença , Sistemas de Saúde , Filosofia Médica , Literatura
2.
Theor Med Bioeth ; 43(5-6): 401-419, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-36376739

RESUMO

Medicine is increasingly subject to various forms of criticism. This paper focuses on dominant forms of criticism and offers a better account of their normative character. It is argued that together, these forms of criticism are comprehensive, raising questions about both medical science and medical practice. Furthermore, it is shown that these forms of criticism mainly rely on standards of evaluation that are assumed to be internal to medicine and converge on a broader question about the aim of medicine. Further work making medicine's internal norms explicit and determining the aim of medicine would not only help to clarify to what extent the criticism is justified, but also assist an informed deliberation about the future of medicine. To illustrate some of the general difficulties associated with such a task, the paper concludes by critically engaging Edmund Pellegrino's account of the aim of medicine as well as the Hastings Center's consensus report.


Assuntos
Medicina , Filosofia Médica , Humanos
3.
Hist Philos Life Sci ; 44(4): 51, 2022 Oct 25.
Artigo em Inglês | MEDLINE | ID: mdl-36282398

RESUMO

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.


Assuntos
Higiene , Medicina , História do Século XIX , História do Século XX , Higiene/história , Vitalismo/história , Filosofia/história , Filosofia Médica
4.
Theor Med Bioeth ; 43(5-6): 375-400, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-36114828

RESUMO

Elselijn Kingma argues that Christopher Boorse's biostatistical theory does not show how the reference classes it uses-namely, age groups of a sex of a species-are objective and naturalistic. Boorse has replied that this objection is of no concern, because there are no examples of clinicians' choosing to use reference classes other than the ones he suggests. Boorse argues that clinicians use the reference classes they do because these reflect the natural classes of organisms to which their patients belong. Drawing on a thorough exploration of how the disease osteoporosis is defined in adults, I argue that clinicians do indeed make choices about which reference classes to use in diagnosis. Clinicians use young adult reference classes to diagnose osteoporosis in elderly patients. They also use young female reference classes to diagnose osteoporosis in elderly males. Clinicians adjust their reference classes so that the diagnosis of osteoporosis reflects a person's risk of sustaining a fragility fracture. The ethical intuition that people with the same risk of fracture should receive the same diagnosis overwhelms the naturalistic intuition that reference classes should reflect natural classes of organisms of uniform functional design. Clinicians construct a variety of reference class types, including pathological reference classes and epidemiological population-specific reference classes, to serve this ethical intuition. I show how clinicians use several reference classes at once so that they can more accurately predict risk of fracture. Ultimately, the reference classes chosen and used in medical practice are quite different from those proposed in naturalistic philosophy of medicine.


Assuntos
Doença , Osteoporose , Humanos , Feminino , Idoso , Filosofia Médica , Saúde , Princípios Morais , Osteoporose/diagnóstico
5.
Med Health Care Philos ; 25(4): 579-586, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-35849217

RESUMO

This paper critically examines the metaphorical use of medical terms in philosophy. Three examples selected from distinct philosophical contexts demonstrate that such terms have been employed as metaphors both to describe the practice of philosophising and historically to diagnose philosophical positions. The selected examples are (i) the title of Avicenna's main philosophical work, The Book of Healing, (ii) the criticism of medical metaphors in Enlightenment philosophy, and (iii) recent historical diagnoses in philosophy. The underlying epistemological assumptions of all three contexts are reconstructed to critically analyse the medical metaphors. Through this tripartite synopsis, I arrive at a normative conclusions medical metaphors, such as the "healing of the soul" or "pathology of reason", do not stand up to the critique of Enlightenment and are obsolete against the theoretical background of my reference texts.


Assuntos
Metáfora , Filosofia , Humanos , Conhecimento , Filosofia Médica
6.
Chin Med Sci J ; 37(2): 91-94, 2022 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-35796333

RESUMO

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.


Assuntos
Medicina , Ciências Humanas , Humanos , Medicina/tendências , Filosofia Médica
7.
J Relig Health ; 61(4): 2637-2642, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35829813

RESUMO

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.


Assuntos
Religião , Espiritualidade , China , Feminino , Humanos , Relações Interpessoais , Masculino , Filosofia Médica
8.
J Med Philos ; 47(3): 482-493, 2022 08 04.
Artigo em Inglês | MEDLINE | ID: mdl-35532319

RESUMO

The paper engages Christopher Boorse's Bio-Statistical Theory (BST). In its current form, BST runs into a significant challenge. For BST to account for its central tenet-that lower-level part-dysfunction is sufficient for higher-level pathology-it must provide criteria for how to decide which lower-level parts are the ones to be analyzed for health or pathology. As BST is a naturalistic theory, such choices must be based solely on naturalistic considerations. An argument is provided to show that, if BST is to be preserved, such parthood choices are based on non-naturalistic considerations. We demonstrate that even when parthood choices are based on the best way to preserve BST, there are counterintuitive results which bring the central tenet of BST into question.


Assuntos
Doença , Filosofia Médica , Dissidências e Disputas , Saúde , Humanos
9.
Camb Q Healthc Ethics ; 31(2): 192-198, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-35243975

RESUMO

This paper considers the relation between medical ethics (ME) and common morality (CM), professional norms, and moral philosophy. It proceeds by analyzing two recent book-length critical analyses of this relationship by Bob Baker in "The Structure of Moral Revolutions-Studies of Changes in the Morality of Abortion, Death, and the Bioethics Revolution" and Rosamond Rhodes in "The Trusted Doctor-Medical Ethics and Professionalism." It argues that despite the strengths of these critical arguments, there is nevertheless a relationship between ME, understood as the professional ethics of the healthcare professions, and both CM and moral philosophy. It also argues that ME cannot and should not be understood purely as the internally developed professional norms of the medical or healthcare professions.


Assuntos
Bioética , Ética Médica , Feminino , Humanos , Princípios Morais , Filosofia , Filosofia Médica , Gravidez
10.
Med Oncol ; 39(5): 75, 2022 Feb 23.
Artigo em Inglês | MEDLINE | ID: mdl-35195776

RESUMO

In scientific context, the first step for scientific theoretical and methodological production is the epistemological analysis. What are assumptions for interaction between oncology and psychology? What are the conditions for psycho-oncological contribution in treating cancer? Furthermore, what are epistemological observations about the current developments in cancer field? And what are implications for sciences treating patients with neoplasms? Due to advances in oncology and in sciences supporting oncology, epistemological questions focus on the object of study of the integration between oncology and psychology. Therefore, the purpose of this study is to describe a proposal of theoretical and methodological frame suitable for current clinical and research needs in cancer patients asking for psychological support. Epistemological analysis lets the health professionals and researchers observe there are sciences using formal languages and sciences using ordinary language. Currently, personalized approach is pursued by oncology, identifying specific patients' characteristics to define the proper treatment process: not only tumor characteristics but also behavioral and psychological features. Cancer patients features can be found in patients' narrations about neoplasms: narration represents the core of clinical and research in psychoncology. Therefore when formalized, language provides the connection between oncology and psychology. Language used by patients and all the roles involved in the care of cancer patients can become a measure of these patients' features. Dialogics science measuring the ordinary language allows the ordinary language formalization, pursuing a personalized medicine.


Assuntos
Neoplasias/psicologia , Neoplasias/terapia , Medicina de Precisão/métodos , Humanos , Conhecimento , Idioma , Filosofia Médica , Qualidade de Vida , Apoio Social
11.
Med Health Care Philos ; 25(1): 47-60, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34460042

RESUMO

In this paper we focus on some new normativist positions and compare them with traditional ones. In so doing, we claim that if normative judgments are involved in determining whether a condition is a disease only in the sense identified by new normativisms, then disease is normative only in a weak sense, which must be distinguished from the strong sense advocated by traditional normativisms. Specifically, we argue that weak and strong normativity are different to the point that one 'normativist' label ceases to be appropriate for the whole range of positions. If values and norms are not explicit components of the concept of disease, but only intervene in other explanatory roles, then the concept of disease is no more value-laden than many other scientific concepts, or even any other scientific concept. We call the newly identified position "value-conscious naturalism" about disease, and point to some of its theoretical and practical advantages.


Assuntos
Filosofia Médica , Humanos
12.
Am J Med ; 135(2): 129-130, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-34508706
13.
Theor Med Bioeth ; 42(3-4): 81-89, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34919172
16.
Crit Rev Eukaryot Gene Expr ; 31(3): 1-3, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34369710

RESUMO

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.


Assuntos
Biologia/ética , Evolução Química , Genética Médica/ética , Saúde Holística , Vida , Vitalismo , Animais , Humanos , Filosofia Médica
17.
J Med Philos ; 46(5): 630-643, 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34370028

RESUMO

Phenomenology informs a number of contemporary attempts to give more weight to the lived experience of patients and overcome the limitations of a one-sidedly biomedical understanding of illness. Susan Bredlau has recently presented a reading of Plato's dialogue Charmides, which portrays Socrates as a pioneer of the phenomenological approach to illness. I use a critical discussion of Bredlau's interpretation of the Charmides to show that the phenomenology of illness also has its shortcomings and needs to be complemented by still other approaches. While Bredlau does make a number of highly apt and relevant suggestions as to how a narrow biomedical approach to illness may be corrected, some (but not all) of which are related to phenomenology, the attribution to Plato's Socrates of a phenomenological approach is mistaken. Characteristically, Socrates shows little interest in the personal experience of a patient. He is more concerned with the patient's lifestyle and conduct and so suggests an alternative or complementary perspective, stressing the importance of education and prevention to health care.


Assuntos
Filosofia Médica , Humanos , Masculino , Qualidade da Assistência à Saúde
18.
J Med Philos ; 46(5): 561-585, 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34423826

RESUMO

This essay provides an account of how to distinguish between health and pathology of trait tokens in medical theory. It (1) proposes to distinguish between two health/pathology concepts-health/pathology pertaining to survival and health/pathology pertaining to reproduction. It (2) defines measures for survival-efficiency and reproduction-efficiency of performances of physiological functions. It (3) provides an account of how, using the efficiency measures, to draw the line between health and pathology. The account draws, but seeks to improve, on Christopher Boorse's biostatistical theory. In relation to that theory, the suggested account has the advantages (1) that it defines efficiency and (2) that it harmonizes with judgments in medical theory in cases of common diseases and "normal aging." Furthermore, the essay argues against a competing idea of how to improve on the biostatistical theory, advocated by Peter Schwartz and Daniel Hausman.


Assuntos
Doença , Patologia , Saúde , Humanos , Filosofia Médica
19.
Arch. argent. pediatr ; 119(4): e298-e302, agosto 2021.
Artigo em Inglês, Espanhol | LILACS, BINACIS | ID: biblio-1280998

RESUMO

Con la llegada de las vacunas contra el SARS-CoV-2, un nuevo aspecto a tener en cuenta en la pandemia es el rechazo a la vacunación. Como la recepción de la vacuna, es voluntaria, se plantea cómo abordar la situación de los miembros del equipo de salud que la rechazan. Se exponen argumentos bioéticos de diversas corrientes: el deontologismo kantiano y lo conceptos de universalidad, humanidad y autonomía; el utilitarismo de Mill, con la autoprotección como único fin por el cual la humanidad está habilitada para interferir con la libertad de acción de sus miembros; el principismo de Beauchamp y Childress y los conceptos de beneficencia y autonomía; el principio de oportunidad de Varo Baena; y el principio de solidaridad, derivado de la ética de los derechos humanos. Se incluyen aportes de filósofos contemporáneos como Roberto Espósito, Jean-Luc Nancy y Alberto Giubilini. Se exponen dos contrargumentos: el de no maleficencia y el de contraproducencia. Por último, se plantea que, dado que el bien común (la salud pública, en este caso) es el determinante íntimo y último de la libertad individual e igual para todos, está por encima del beneficio individual


With the development of SARS-CoV-2 vaccines, a new aspect to be taken into consideration in the midst of the pandemic is vaccine refusal. Since vaccination is voluntary, it is necessary to deal with the fact that some health care team members refuse to receive it. Here I put forward different bioethical arguments: Kantian deontology and the principles of universalizability, humanity, and autonomy; Mill's utilitarianism, with self-protection as the sole end for which humankind is authorized to interfere with its members' freedom of action; Beauchamp and Childress' principlism and the concepts of beneficence and autonomy; Varo Baena's principle of opportunity; and the principle of solidarity resulting from the ethics of human rights. The contributions of contemporary philosophers like Roberto Espósito, Jean-Luc Nancy, and Alberto Giubilini are also included. Two counter-arguments are presented: nonmaleficence and counter-production. Lastly, I suggest that, since common good (in this case, public health) is the intimate and final determining factor of individual freedom and is the same for all, it is above any individual benefit.


Assuntos
Humanos , Vacinação em Massa/ética , Pessoal de Saúde , Ética Baseada em Princípios , Programas Obrigatórios/ética , Vacinas contra COVID-19 , COVID-19/prevenção & controle , Filosofia Médica , Recusa do Paciente ao Tratamento/ética , Liberdade , Solidariedade
20.
Arch Argent Pediatr ; 119(4): e298-e302, 2021 08.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-34309307

RESUMO

With the development of SARS-CoV-2 vaccines, a new aspect to be taken into consideration in the midst of the pandemic is vaccine refusal. Since vaccination is voluntary, it is necessary to deal with the fact that some health care team members refuse to receive it. Here I put forward different bioethical arguments: Kantian deontology and the principles of universalizability, humanity, and autonomy; Mill's utilitarianism, with selfprotection as the sole end for which humankind is authorized to interfere with its members' freedom of action; Beauchamp and Childress' principlism and the concepts of beneficence and autonomy; Varo Baena's principle of opportunity; and the principle of solidarity resulting from the ethics of human rights. The contributions of contemporary philosophers like Roberto Espósito, Jean-Luc Nancy, and Alberto Giubilini are also included. Two counterarguments are presented: nonmaleficence and counter-production. Lastly, I suggest that, since common good (in this case, public health) is the intimate and final determining factor of individual freedom and is the same for all, it is above any individual benefit.


Con la llegada de las vacunas contra el SARSCoV- 2, un nuevo aspecto a tener en cuenta en la pandemia es el rechazo a la vacunación. Como la recepción de la vacuna, es voluntaria, se plantea cómo abordar la situación de los miembros del equipo de salud que la rechazan. Se exponen argumentos bioéticos de diversas corrientes: el deontologismo kantiano y lo conceptos de universalidad, humanidad y autonomía; el utilitarismo de Mill, con la autoprotección como único fin por el cual la humanidad está habilitada para interferir con la libertad de acción de sus miembros; el principismo de Beauchamp y Childress y los conceptos de beneficencia y autonomía; el principio de oportunidad de Varo Baena; y el principio de solidaridad, derivado de la ética de los derechos humanos. Se incluyen aportes de filósofos contemporáneos como Roberto Espósito, Jean-Luc Nancy y Alberto Giubilini. Se exponen dos contrargumentos: el de no maleficencia y el de contraproducencia. Por último, se plantea que, dado que el bien común (la salud pública, en este caso) es el determinante íntimo y último de la libertad individual e igual para todos, está por encima del beneficio individual.


Assuntos
Vacinas contra COVID-19 , COVID-19/prevenção & controle , Programas Obrigatórios/ética , Filosofia Médica , Ética Baseada em Princípios , Recusa do Paciente ao Tratamento/ética , Vacinação/ética , Humanos
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