Wardhana Philos of Medicine

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PHILOSOPHY OF SCIENCE AND MEDICINE

Made Wardhana

Wista Darmada

INTRODUCTION

Philosophy comes from the Greek for "love of wisdom," giving us two important starting points:

love (or passion) and wisdom (knowledge, understanding). Philosophy sometimes seems to be

pursued without passion as if it were a technical subject like engineering or mathematics.

Although there is a role for dispassionate research, philosophy must derive from some passion

for the ultimate goal: a reliable, accurate understanding ourselves and our world. This is also

what atheists should seek. (http://atheism.about.com/od/aboutphilosoph1/a/philosophyintro.htm)

Literally "the love of wisdom" (Greek: philo = love,sophia = wisdom), philosophy at the

dawn of civilization was synonymous with rational inquiry it self. As civilization advanced, two

parts of philosophy eventually became so powerful in their own right that they separated off,claiming for themselves the status of independent disciplines: mathematics was the first, science

(or natural philosophy as it was long called) the second. To philosophy is left whateverquestions these two disciplines cannot solve (at least at a given time), including not only

questions that are traditionally thought to be beyond the two (e.g. "What is the meaning of

life?"), but also theoretical questions at their fringes (e.g. "Can natural selection operate at the

species level?") and conceptual questions at their foundations (e.g. "What is science?").

Philosophy, of course, is best known for the first class of questions, which includes some of the

most difficult and important questions there are, such as whether or not there is a god, and how a

person ought to live.

Philosophy is characterized as much by its methods as by its subject matter. Although

philosophers deal with speculative issues that generally are not subject to investigation through

experimental test, and philosophy therefore is more fully conceptual than science, philosophy

properly done is not mere speculation. Philosophers, just like scientists, formulate hypotheses

which ultimately must answer to reason and evidence. This is one of the things that differentiates

philosophy from poetry and mysticism, despite its not being a science.(

http://www.vuletic.com/hume/ph/philosophy.html)

The principles of philosophy will study about:

1. Examination of basic concepts: the branch of knowledge or academic study devoted to the

systematic examination of basic concepts such as truth, existence, reality, causality, and

freedom

2. School of thought: a particular system of thought or doctrine3. Guiding or underlying principles: a set of basic principles or concepts underlying a particular

sphere of knowledge

4. Set of beliefs or aims: a precept, or set of precepts, beliefs, principles, or aims, underlying

somebody's practice or conduct

5. Calm resignation: restraint, resignation, or calmness and rationality in somebody's behavior

or response to events (http://encarta.msn.com/dictionary_1861725603/philosophy.html)

The Philosophycal Way of Thinking

Philosophy is an activity of thought, a type of thinking. Philosophy is critical and comprehensive

thought, the most critical and comprehensive manner of thinking which the human species hasyet devised. This intellectual process includes both an analytic and synthetic mode of

operation. Philosophy as a critical and comprehensive process of thought involves resolving

Philos of Scien n Med Wa Ok/9/24/2008 1
http://atheism.about.com/od/aboutphilosoph1/a/philosophyintro.htmhttp://atheism.about.com/od/aboutphilosoph1/a/philosophyintro.htmhttp://atheism.about.com/od/aboutphilosoph1/a/philosophyintro.htmhttp://www.vuletic.com/hume/ph/philosophy.htmlhttp://encarta.msn.com/dictionary_1861725603/philosophy.htmlhttp://atheism.about.com/od/aboutphilosoph1/a/philosophyintro.htmhttp://www.vuletic.com/hume/ph/philosophy.htmlhttp://encarta.msn.com/dictionary_1861725603/philosophy.html


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confusion, unmasking assumptions, revealing presuppositions, distinguishing importance,

testing positions, correcting distortions, looking for reasons, examining world-views and

questioning conceptual frameworks. The following is a characteristic philosophical way of

thinking;

Radical

Radical comes from radix (root), what is at the root tells one what is at the top of the tree. the

word 'radical', which comes from the Latin 'radix', for "root." It implies that prayer requires that

we get at the root of things without being distracted by superficialities. We must think deeply

about our lives, which, of course, takes time. It is a contemplative definition. It implies that

through prayer we must not only think deeply but also translate our thinking into action. We

need to behave out of deep thoughtfulness.

Rationalism

In epistemology and in its broadest sense, rationalism is "any view appealing to reason as a

source of knowledge or justification" (Lacey 286). In more technical terms it is a method or a

theory "in which the criterion of truth is not sensory but intellectual and deductive" (Bourke

263). Different degrees of emphasis on this method or theory lead to a range of rationaliststandpoints, from the moderate position "that reason has precedence over other ways of

acquiring knowledge" to the radical position that reason is "the unique path to knowledge"

Within the Western philosophical tradition, "rationalism begins with the Eleatics, Pythagoreans,

and Plato, whose theory of the self-sufficiency of reason became the leitmotifof Neoplatonism

and idealism". Since the Enlightenment, rationalism is usually associated with the introduction

of mathematical methods into philosophy, as in Descartes, Leibniz, and Spinoza. This is

commonly called continental rationalism, because it was predominant in the continental

schools of Europe, whereas in Britain empiricism dominated.

Rationalism is often contrasted with empiricism. Taken very broadly these views are not

mutually exclusive, since a philosopher can be both rationalist and empiricist. Taken to extremes

the empiricist view holds that all ideas come to us through experience, either through the fiveexternal senses or through such inner sensations as pain and pleasure, and thus that knowledge is

essentially based on or derived from experience. At issue is the fundamental source of human

knowledge, and the proper techniques for verifying what we think we know.

Universal

Is the quality ascribed to that which is universal, and considered then as in existence

everywhere, throughout the Universe. In philosophy, universalism is a doctrine or school in

which it is claimed that universal facts can be discovered and which is understood then as being

in opposition to relativism. This sense ofuniversal is more restricted, in that it refers to what is

universal amongst humans. Rights, for example in natural rights, or in the 1789 Declaration of

the Rights of Man and of the Citizen, for those heavily influenced by the philosophy of the

Enlightenment and its conception of a human nature, could be considered as universal.

Conceptual

A concept is an abstract idea or a mental symbol, typically associated with a corresponding

representation in language or symbology, that denotes all of the objects in a given category or

class of entities, interactions, phenomena, or relationships between them. Concepts are abstract

in that they omit the differences of the things in their extension, treating them as if they were

identical. They are universal in that they apply equally to every thing in their extension.

Concepts are also the basic elements of propositions, much the same way a word is the basic

semantic element of a sentence. Unlike perceptions, which are particular images of individualobjects, concepts cannot be visualized. Because they are not, themselves, individual perceptions,

concepts are discursive and result from reason.



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Coherent & Consistency

As a theory of truth coherentism restricts true sentences to those that cohere with some specified

set of sentences. Someone's belief is true if and only if it is coherentwith all or most of her or

his other beliefs. Usually, coherence is taken to imply something stronger than mere consistency.

At the least, coherence must include logical consistency. It also usually requires some degree of

integration of the various components of the system. A system that contains more than one

unrelated explanation of the same phenomenon is not as coherent as one that uses only oneexplanation, all other things being equal.

Systematically

Systematic thinking is a way of life for those who excel in their lives and professions.

Regardless of their independent professions with subtle differences, they all think very much

alike. Although a discussion about systematic thinking is very much relevant to our discussion,

we will focus on how everyone can cultivate the habit of thinking systematically. But first, a

brief synopsis on the steps of systematic thinking is in order.

Comprehensive

In logic, the comprehension of an object is the totality of intensions, that is, properties orqualities, that it possesses. Related to this, in Anglicanism, comprehension (or

comprehensiveness) refers to the theological inclusiveness and liturgical breadth thought to be

integral to the definition of the tradition. In set theory, comprehension is another name for the

axiom schema of specification (or more specifically, the axiom schema of unrestrictedspecification).

Independent

Independent thinking means making sense of the world based on your own observations and

experiences rather than jut depending on the word of others. It means trusting your own ability

to make judgments, even if they contradict what others say. It means acting in accordance with

these judgments, even if you sometimes make mistakes. An independent thinkers knows it's

psychologically better to make your own mistakes than someone else's. Independent thinking is

not necessarily rational or critical.

The Main Branches of Philosophy

Philosophy can be divided into five main branches which address the following questions:

1. Epistemology

The term "epistemology" is based on the Greek words " or episteme" (knowledge or

science) and " or logos" (reason). It was introduced into English by the Scottish

philosopher James Frederick Ferrier (1808-1864).Epistemology or theory of knowledge is the branch of philosophy that studies the nature,

methods, limitations, and validity of knowledge and belief. It attempts to answer the basic

question: What distinguishes true (adequate) knowledge from false (inadequate) knowledge?

Practically, this question translates into issues of scientific methodology: how can one develop

theories or models that are better than competing theories? It also forms one of the pillars of the

new sciences of cognition, which developed from the information processing approach to

psychology, and from artificial intelligence, as an attempt to develop computer programs that

mimic a human's capacity to use knowledge in an intelligent way.

Your belief about "knowledge," where it exists and how you get it, naturally affects your notions

about educational practice. Particular epistemological views influenced the theorists who

developed learning theories, conducted research and developed instructional design methods.If you chose the first statement, your epistemology is associated with behaviorist learning theory

and the instructional design models and theories that have evolved from behaviorism. In the



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philosophical framework shown in the diagram, the behaviorist view is on the

empiricism/objectivism end of the continuum. By contrast, the second statement is on the

rationalism end of the philosophical continuum, associated with cognitivism or constructivism

and the various design models and theories that have developed from those points of view.

2. Metaphysics

The ultimate nature of existence. Relationships between mind and matter, substance andattribute, fact and value. Why are we here? Is there a God? What is substance? Real or not?

Metaphysics is the study of reality. More specifically it is the study of reality that is beyond

the scientific or mathematical realms. The term metaphysics itself literally means beyond the

physical. The metaphysical issues most discussed are the existence of God, the soul, and the

afterlife. Ontology (from the Greek , genitive : of being (part. of : to be) and-:science, study, theory) is the most fundamental branch of metaphysics. Ontology is the

study of being or existence and its basic categories and relationships. It seeks to determine what

entities can be said to "exist", and how these entities can be grouped according to similarities

and differences. Ontology is distinguished from epistemology, the study of knowledge and what

can be known.

3. Axiology

Axiology (from Greek: , axios, "value, worth"; and , logos, "speech" lit. "to talkabout the value") is the study of quality or value. It is often thought to include ethics and

aesthetics - philosophical fields that depend crucially on notions of value - and sometimes it is

held to lay the groundwork for these fields, and thus to be similar to value theory and meta-

ethics.

Ethics (Latin ethica from the Ancient Greek [] "moral philosophy", from theadjective of thos "custom, habit"), a major branch of philosophy, is the study of valuesand customs of a person or group. It covers the analysis and employment of concepts such as

right and wrong, good and evil, and responsibility. It is divided into three primary areas: meta-

ethics (the study of the concept of ethics), normative ethics (the study of how to determine

ethical values), and applied ethics (the study of the use of ethical values).Ethics is the study of moral standards and conduct, (moral philosophy). Good or evil, right

versus wrong and values. Ethics is the study of moral value, right and wrong. Ethics is involved

with placing value to personal actions, decisions, and relations. Important ethical issues today

include abortion, sexual morality, the death penalty, euthanasia, pornography, and the

environment.

Aesthetics, the term aesthetics comes from the Greek "aisthetike" and was coined by

the philosopher Alexander Gottlieb Baumgarten in 1735 to mean "the science of how things are

known via the senses." The term aesthetics was used in German, shortly after Baumgarten

introduced its Latin form (Aesthetica), but was not widely used in English until the beginning ofthe 19th century. However, much the same study was called studying the "standards of taste" or"judgments of taste" in English, following the vocabulary set by David Hume prior to the

introduction of the term "aesthetics."

Aesthetics (also spelled sthetics) is commonly known as the study of sensory or sensori-

emotional values, sometimes called judgments of sentiment and taste. More broadly, scholars in

the field define aesthetics as "critical reflection on art, culture and nature." Aesthetics is a

subdiscipline of axiology, a branch of philosophy, and is closely associated with the philosophy

of art. Aesthetics studies new ways of seeing and of perceiving the world.

4. Logic

Logic (from Classical Greek logos; meaning word, thought, idea, argument, account,reason, or principle) is the study of the principles and criteria of valid inference and

demonstration. As a formal science, logic investigates and classifies the structure of statements



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and arguments, both through the study of formal systems of inference and through the study of

arguments in natural language. The field of logic ranges from core topics such as the study of

fallacies and paradoxes, to specialized analysis of reasoning using probability and to arguments

involving causality. Logic is also commonly used today in argumentation theory. Logic is the

study of right reasoning. It is the tool philosophers use to study other philosophical categories.

Good logic includes the use of good thinking skills and the avoidance of logic fallacies.

In logic, we often refer to the two broad methods of reasoning as the deductive and inductiveapproaches.

Deductive reasoning works from the more general to the more specific. Sometimes this is

informally called a "top-down" approach. We might begin with thinking up a theory about our

topic of interest. We then narrow that down into more specific hypotheses that we can test. Wenarrow down even further when we collect observations to address the hypotheses. This

ultimately leads us to be able to test the hypotheses with specific data -- a confirmation (or not)

of our original theories.

Inductive reasoning works the other way, moving from specific observations to broader

generalizations and theories. Informally, we sometimes call this a "bottom up" approach (please

note that it's "bottom up" and not"bottoms up" which is the kind of thing the bartender says to

customers when he's trying to close for the night!). In inductive reasoning, we begin withspecific observations and measures, begin to detect patterns and regularities, formulate some

tentative hypotheses that we can explore, and finally end up developing some general

conclusions or theories.

These two methods of reasoning have a very different "feel" to them when you're conducting

research. Inductive reasoning, by its very nature, is more open-ended and exploratory, especially

at the beginning. Deductive reasoning is more narrow in nature and is concerned with testing or

confirming hypotheses. Even though a particular study may look like it's purely deductive (e.g.,

an experiment designed to test the hypothesized effects of some treatment on some outcome),

most social research involves both inductive and deductive reasoning processes at some time in

the project.

The Others Branch of Philosophy(http://www.elliotcross.com/branches.html)

Philosophy of Education: Fairly self-explanatory. A minor branch, mainly concerned with what

is the correct way to educate a person. Classic works include Plato's Republic, Locke's Thoughts

Concerning Education, and Rousseau's Emile.

Philosophy of History: Fairly minor branch (not as minor as education), although highly

important to Hegel and those who followed him, most notably Marx. It is the philosophical

study of history, particularly concerned with the question whether history (i.e. the universe

and/or humankind) is progressing towards a specific end? Hegel argued that it was, as did Marx.

Classic works include Vico's New Science, and Hegel and Marx's works.

Philosophy of Language: Ancient branch of philosophy which gained prominence in the last

century under Wittgenstein. Basically concerned with how our languages affect our thought.

Wittgenstein famously asserted that the limits of our languages mark the limits of our thought.

Classic works include Plato's Cratylus, Locke's Essay, and Wittgenstein's Tractatus Logico-

Philosophicus.

Philosophy of Mind: Study of the mind, attempting to ascertain exactly what the mind is, how

it interacts with our body, do other minds exist, how does it work, and so on. Probably the most

popular branch of philosophy right now, it has expanded to include issues of AI. Classic works

include Plato's Republic and Wittgenstein's Philosophical Investigations, although every major

philosopher has had some opinion at least on what the mind is and how it works.

Philosophy of Religion: Theology is concerned with the study of God, recommending the bestreligious practises, how our religion should shape our life, and so on. Philosophy of religion is

http://www.elliotcross.com/branches.htmlhttp://www.elliotcross.com/branches.html


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concerned with much the same issues, but where Theology uses religious works, like the Bible,

as it's authority, philosophy likes to use reason as the ultimate authority.

Philosophy of Science: Study of science concerned with whether scientific knowledge can be

said to be certain, how we obtain it, can science really explain everything, does causation really

exist, can every event in the universe be described in terms of physics and so on. Also popular in

recent times, classic works include Hume's Treatise on Human Nature, Kripke's Naming and

Necessity, Kuhn's Structure of Scientific Revolutions.Philosophy of Medicine/health,

Much other

The Reason to Study PhilosophySome would argue that the best reason to study philosophy is because the questions that it asks

are intrinsically interesting to all human beings and because one cannot live a full human life

without considering such questions. This is the sentiment expressed by Socrates' famous claim

that "the unexamined life is not worth living." Although this claim may be true, there are also

other important, practical reasons to study philosophy.

Most philosophers would agree that one of the great benefits of philosophy is that itchallenges us to think critically about our beliefs and to justify them with good arguments. In

this way, philosophy forces us to think clearly and precisely and to express our ideas in the same

way. The development of critical thinking skills that is achieved through the study of philosophy

is something that can help all of us to make better decisions in many aspects of our lives. We can

benefit personally because we will make better judgments about what is in our own long-term

self-interest. We can benefit professionally because we will be able to think more clearly about

decisions that we have to make at work. Philosophy can also benefit both ourselves and those

around us by providing us with some of the things that are required to be good citizens. How can

we make good decisions when we take part in the political process in our society (either as

voters, as grassroots activists, or as political represe ntatives) unless we have analyzed the

advantages and disadvantages of the various forms of government and unless we are capable ofcritically evaluating various policies? Many philosophers would argue that the study of

philosophy can even make us better human beings by providing us with thoughtful insights into

the question of what is involved in a good life.

Along with these very general benefits, a background in philosophy can be of great utility in

many specific career areas, such as the legal profession, the business world, journalism, science

and the medical profession. In law, the prominent role played by arguments and the application

of general rules to specific cases is very clear. As a result, most law schools are especially

receptive to students who have a background in philosophy. In addition, many businesses

express a strong desire for employees who have developed the thinking and communication

skills emphasized in philosophy. This is not surprising, since business people must be able to

formulate and clarify problems, analyze potential solutions, and defend their ownrecommendations in a clear and rational way. Journalists can also clearly benefit from being able

to present clear and rational analyses of various situations. Moreover, philosophical training

provides an excellent background for dealing with the ethical issues that ari se in any professio

n, particularly the medical profession, and this is something that is increasingly recognized by

medical schools and by various professional bodies.

The Uses of Philosophy

Much of what is learned in philosophy can be applied in virtually any endeavor. This is both

because philosophy touches on so many subjects and, especially, because many of its methods

are usable in any field. General Problem Solving. The study of philosophy enhances, in a way no other activity

does, one's problem-solving capacities. It helps one to analyze concepts, definitions,



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arguments and problems. It contributes to one's capacity to organize ideas and issues, to deal

with questions of value, and to extract what is essential from masses of information. It helps

one both to distinguish fine differences between views and to discover common ground

between opposing positions. And it helps one to synthesize a variety of views or perspectives

into a unified whole.

Communication Skills. Philosophy also contributes uniquely to the development of

expressive and communicative powers. It provides some of the basic tools of self-expressionfor instance, skills in presenting ideas through well-constructed, systematic arguments

that other fields either do not use, or use less extensively. It helps one to express what is

distinctive of one's view; enhances one's ability to explain difficult material; and helps one to

eliminate ambiguities and vagueness from one's writing and speech.

Persuasive Powers. Philosophy provides training in the construction of clear formulations,

good arguments, and apt examples. It thereby helps one develop the ability to be convincing.

One learns to build and defend one's own views, to appreciate competing positions, and to

indicate forcefully why one considers one's own views preferable to alternatives. These

capacities can be developed not only through reading and writing in philosophy, but also

through the philosophical dialogue, in and outside the classroom, that is so much a part of a

thoroughgoing philosophical education. Writing Skills. Writing is taught intensively in many philosophy courses, and many

regularly assigned philosophical texts are unexcelled as literary essays. Philosophy teaches

interpretive writing through its examination of challenging texts, comparative writing

through emphasis on fairness to alternative positions, argumentative writing through

developing students' ability to establish their own views, and descriptive writing through

detailed portrayal of concrete examples: the anchors to which generalizations must be tied.

Striker and technique, then, are emphasized in philosophical writing. Originality is also

encouraged, and students are generally urged to use their imagination and develop their own

ideas.

Relationship Between Knowledge and Science

Knowledge is defined (Oxford English Dictionary) variously as (i) facts, information, and skills

acquired by a person through experience or education; the theoretical or practical understanding

of a subject, (ii) what is known in a particular field or in total; facts and information or (iii)

awareness or familiarity gained by experience of a fact or situation. Philosophical debates in

general start with Plato's formulation of knowledge as "justified true belief". There is however

no single agreed definition of knowledge presently, nor any prospect of one, and there remain

numerous competing theories.

Knowledge acquisition involves complex cognitive processes: perception, learning,

communication, association, and reasoning. The term knowledge is also used to mean theconfident understanding of a subject, with the ability to use it for a specific purpose.

Science (from the Latinscientia, 'knowledge') is a system of acquiring knowledge based on thescientific method, as well as the organized body of knowledge gained through such research.

Science as defined here is sometimes termed pure science to differentiate it from applied

science, which is the application of scientific research to specific human needs, though the two

are often interconnected. Fields of science are commonly classified along two major lines:

natural sciences, which study natural phenomena (including biological life), and

social sciences, which study human behavior and societies.

These groupings are empirical sciences, which means the knowledge must be based onobservable phenomena and capable of being tested for its validity by other researchers working

under the same conditions.



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Mathematics, which is sometimes classified within a third group of science called formal

science, has both similarities and differences with the natural and social sciences. It is similar to

empirical sciences in that it involves an objective, careful and systematic study of an area of

knowledge; it is different because of its method of verifying its knowledge, using a priori rather

than empirical methods. Formal science, which also includes statistics and logic, is vital to the

empirical sciences. Major advances in formal science have often led to major advances in the

physical and biological sciences. The formal sciences are essential in the formation ofhypotheses, theories, and laws, both in discovering and describing how things work (natural

sciences) and how people think and act (social sciences). (wikipedia)

Methods to Acquire Knowledge

1. Tenacity. Persistence of a superstition. Knowledge may originate or be derived from the

following origins or methods:

Persistence of a superstition

2. Intuition. Knowledge that is not based on reasons or inferring. has many related meanings,

usually connected to the meaning "ability to sense or know immediately without reasoning",including:

3. Authority. Acceptance of information because it is acquired from a highly respected person.

Knowledge based on authority may rely upon the reputation of an individual such as Aristotle

or Einstein or perhaps on institutional authority such as that of the Roman Catholic Church or

Oxford University. Note that an authority may adopt knowledge upon other criteria such as

divine revelation or observation as well as upon authority. Authority may have a political

basis in the sense that some political process, perhaps involving status as well as simple

voting, peer review, or comment. This is familiar to participants in academia. Revelation.

Many people believe knowledge may be obtained via revelation or even divine revelation,

which may be directly from God or another spirit, perhaps conveyed through a religious text

or texts, such as the Bible.4.Rationalism or Logic. Knowledge acquired through reasoning . Taking other knowledge as

data, by logical operations knowledge can be inferred. For example the theoretical construct,

the electron, is derived by logical inferences from observations and experiment. Such

knowledge, being derivative, can not be better than the knowledge upon which it is founded.

Modelling a situation sometimes allows those with a hands-on viewpoint to learn how-to do

something. This pragmatic approach is often seen in computer programming.

5. Empiricism Knowledge acquired through experience observation or experience. This may

be more or less sophisticated, ranging from a simple, "I saw" to carefully designed controlled

experimentation.

6. Science, A method or logic of inquiry, scientific methods

PHILOSOPHY OF SCIENCES

Philosophy of science is the study of assumptions, foundations, and implications of science,

especially in the natural sciences and social sciences. The philosophy of science may be divided

into two areas: Epistemology of science and metaphysics of science.

Philosophers of science are interested in: the history of concepts and terms and how they are

currently used in science; the relation between propositions with arguments (Formal logic); the

reasoning connecting hypotheses and conclusions (Scientific method); the manner in which

science explains natural phenomena and predicts natural occurrences (observation); the types of

reasoning that are used to arrive at scientific conclusions (deduction, induction, abduction); theformulation, scope, and limits of scientific understanding; the means that should be used for

determining when scientific information has adequate support (objectivity); and the implications



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of scientific methods and models, along with the technology that arises from scientific

knowledge for the larger society (applied science). Issues of ethics, such as bioethics and

scientific misconduct, are not generally considered part of philosophy of science. These issues

may be studied in ethics or science studies. (wikipedia)

There are different schools of thought in the philosophy of scientific method.

Methodological naturalism maintains that scientific investigation must adhere to empirical study

and independent verification as a process for properly developing and evaluating naturalexplanations for observable phenomena. Methodological naturalism, therefore, rejects

supernatural explanations, arguments from authority and biased observational studies. Critical

rationalism instead holds that unbiased observation is not possible and a demarcation between

natural and supernatural explanations is arbitrary; it instead proposes falsifiability as the

landmark of empirical theories and falsification as the universal empirical method. Critical

rationalism argues for the primacy of science, but at the same time against its authority, by

emphasizing its inherent fallibility. It proposes that science should be content with the rational

elimination of errors in its theories, not in seeking for their verification (such as claiming certain

or probable proof or disproof; both the proposal and falsification of a theory are only of

methodological, conjectural, and tentative character in critical rationalism). Instrumentalism

rejects the concept of truth and emphasizes merely the utility of theories as instruments forexplaining and predicting phenomena.

Scientific Methods

Scientific method is a body of techniques for investigating phenomena and acquiring new

knowledge, as well as for correcting and integrating previous knowledge. It is based on

gathering observable, empirical and measurable evidence subject to specific principles of

reasoning, the collection of data through observation and experimentation, and the formulation

and testing of hypotheses.

Although procedures vary from one field of inquiry to another, identifiable features distinguish

scientific inquiry from other methodologies of knowledge. Scientific researchers propose

hypotheses as explanations of phenomena, and design experimental studies that test these

hypotheses for accuracy. These steps must be repeatable in order to predict dependably any

future results. Theories that encompass wider domains of inquiry may bind many hypotheses

together in a coherent structure. This in turn may assist in the formation of new hypotheses, as

well as in placing groups of hypotheses into a broader context of understanding.

The scientific method is often described today as comprising these main actions: (wikipedia)

1. Observe: Collect evidence and make measurements relating to the phenomenon you intend

to study.

2. Hypothesize: Invent a hypothesis explaining the phenomenon.

3. Predict: Use the hypothesis to predict the results of new observations or measurements.4. Verify: Perform experiments to test those predictions. Testing, or attempting to

experimentally falsify is thought by many to be a better choice of term here.

5. Evaluate: If the experiments contradict your hypothesis, reject it and form another. If they

confirm it, make more predictions and test it further.

These steps are repeated continually, building a larger and larger set of well-tested hypotheses to

explain more and more phenomena. They are generally performed in the orderly manner above,

but not necessarily: for example, theoretical physicists often invent totally new hypotheses

before using them to decide what phenomena to observe.

Why do we need to worry about what we mean by scientific method? It's true that your humble

narrator is inclined to talk to himself on the matter, but what difference does that make? Well,suppose we look at the history of science, particularly those episodes thatwith the benefit of

hindsightwe consider to have contained good ideas or decisions, such as supposing that



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theories should be tested by experiment or that the earth isn't flat. Are there any features in

common that could account for the success? If so, we could perhaps say something like "if you

want to find a good theory, you should do x", or at least "... you shouldn't do y". This way, both

good and bad moves made in the past can inform us today. On the face of it, this seems like a

good idea, so let's see what suggestions for methods were offered historically.

InductionInductive reasoning, moving from specific observations to broader generalizations and theories.

Informally, we sometimes call this a "bottom up", we begin with specific observations and

measures, begin to detect patterns and regularities, formulate some tentative hypotheses that we

can explore, and finally end up developing some general conclusions or theories.

It's often held that early scientists didn't approach their work with the same sophistication as we

do today, but we've already seen that Galileo was both doingexperiments and considering what

the implications were for knowledge. In the early seventeenth century, on the other hand, Bacon

was advocating for science an inductive method: the idea was to gather as much data as possible

about the world and infer general theories therefrom, all the while taking care not to allow any

assumptions or theories to influence the finding of information in the first place. We already

know about some problems with the former; the latter we'll come to in more detail soon, but forthe time being we can at least note that stopping ourselves from having any prior thoughts onwhat we expect to find is a tall order.

Deductive

Deductive reasoning works from the more general to the more specific. Sometimes this is

informally called a "top-down" approach. We might begin with thinking up a theory about ourtopic of interest. We then narrow that down into more specific hypotheses that we can test. We

narrow down even further when we collect observations to address the hypotheses. Thisultimately leads us to be able to test the hypotheses with specific data -- a confirmation (or not)

of our original theories.

Hypothetico-deductive

Sir Isaac Newton developed hypothetico-deductivism in the late 1600s (though the method wasactually named at a later date). The principle is as follows: first, we have an idea or suggested

theory (the hypothesis part) that we come up with for some reason or other; then, we try to figure

out what the consequences of it would be (the deduction part). The final stage is to test for theseexpectations and, by so doing, verify whether the theory is a good one or not. In this method it

doesn't matterwhere the theory comes from, but only how well it's confirmed by experiment.Unfortunately there's a significant problem here that becomes clear when we set the method out

in logical form, as we saw in the earlier article. We want to say:

P1: If theory T is true, then we would expect to see a set of facts or results F.P2: We see F.

C: Therefore, T is true.

This is a logical fallacy called affirming the consequent; the flaw is that although T may be true,

F might instead be due to something else entirely. Look at this argument, for example:

P1: If rain dances are effective, we would expect to see rain after a dance.

P2: Rain is found to follow rain dances.

C: Therefore, rain dances are effective.

In fact, it could be that the rain is caused by something other than the dancing (we would say

that it is) and the dance leader has a fair idea of what signs to look for, only starting a dance at

such times. If that's so, no amount of wiggling is likely to open the floodgates. Hence, theconclusion doesn't follow from the premises. The flaw in this argument is a difficulty for the

hypothetico-deductive method.



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Abduction

The generally overlooked philosopher C.S. Peirce wrote a good deal on this method that dates

back to Aristotle. It's often called inference to the best explanation and reasons thus:P1: Facts of the form B have been observed.

P2: The statement, "If A, then B" can explain B.

C: Therefore, A.

This is much the same as the previous method but the important distinction for Pierce was that A

is the best explanation for B and therefore is the probable explanation. In our example of the

rain dancing, then, it would seem that this isn't the best explanation of the rain, unless yourdancing is quite something.

One problem with this theory is what we mean by the "best" explanation. Another is how it can

cope with Hume's problem (it can't). A third is that making a statement like "A is the most

probable explanation" has proved very difficult indeed and prompted a great deal of (highly

technical) work in inductive justification.

According to the philosopher Hilary Putnam, however, it would be a miracle if a false

hypothesis was nevertheless as successful as some of our scientific theories are and many peopleconsider this a decisive objection. Of course, it isn't; one of several objections is that this scheme

uses inference to the best explanation to justify inference to the best explanationa decidedly

unsatisfactory situation. The general procedure of scientific method :

1. Identify a problem that youre interested in studying.

2. Form a hypothesis specify it exactly

3. Design a research project to address the hypothesis

4. Conduct the research project

5. Examine the data, statistical analyses, evaluate hypothesis

6. Communicate the results

PHILOSOPHY OF MEDICINE

Philosophy of Medicine unit of study introduces the broader philosophical issues that underlie

the theories and practices of medicine and the biomedical sciences. The study will begin by

introducing the philosophy of science and medicine, epistemology, and the concepts of health,

illness and disease, including debates regarding disease causation and the social construction of

disease, particularly mental illness. Also examine issues relating to the generation and use of

knowledge and evidence in medical science and practice, medical reasoning, including the

generation and use of knowledge and evidence particularly in diagnosis and treatment, and

differences between conventional and alternative/non-Western approaches to illness and healing.

The final part of the study will focus on the epistemologies of medical research and practice,including experimental design. Learning activities include lectures, facilitated seminar

discussions, online learning activities and essay assessments.

The main stimulus for the creation of philosophy of medicine was a belief that there was a

widening gulf between technology and human values, ironically most manifest in a field devoted

to the study and care of individual human beings. Edmund Pellegrino, one of philosophy of

medicines founders, hoped that the new discipline would clarify medicines proper goals and,

by redirecting attention to urgent issues of an increasingly powerful social force, help free

current philosophy from an analytical scholasticism. As a result, philosophy of medicine in its

earliest years focused largely on concrete ethical questions involving new medical technology,

such as euthanasia, human cloning, artificial insemination, etc. Further impetus was given tothose concrete concerns by criticism of current medical practice from many sources-feminists

pointed to sexist traditions in the practice patterns, research and profession of medicine,



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alternative medical practitioners advocated their own therapeutic approaches, and mainstream

practitioners themselves complained of the impersonal drift of modern medicine in an era of

high technology and cost controls. More recently, philosophy of medicine broadened its focus to

address public policy issues on the distribution and financing of health care, epistemological

issues about the attainment, growth and certainty of medical knowledge, and metaphysical

issues about causality, personal identity and spirituality in medicine.

The emphasis at times also reflects my belief that medicine can only provide treatment, whilehealing must come from within the patient. As a result, philosophy of medicine here means

philosophy of healing more than professional ethics or phenomenological analysis of

medical practice or patient experience. Those other pursuits may benefit from exercises of this

sort, though even the most subtle of metaphysical insights is bound to leave value judgments in

medicine a matter of drawing well-educated, well-intentioned lines through painfully gray areas

of human lives.

Philosophy of Life and Human EssenceThe meaning of life is the philosophic concept about the purpose and significance of human

existence. It is the subject of much philosophic and scientific study, and much theologic

speculation. Usually, this existential query is expressed interrogatively: (wikipedia)

What is the meaning of life?

Why are we here? For what reason are we here?

What is the origin of life?

What is the nature of life? What is the nature of reality?

What is the purpose of life? What is one's purpose in life??

What is the significance of life?

What is meaningful and valuable in life?

What is the value of life?

What is the reason to live? and For what are we living?

Philosophically, logical positivists ask: What is the meaning of life? and What is the meaning in

asking? To the question: If there are no objective values, then, is life meaningless?Existentialism posits that the person creates life's meaning for him- and herself, thus rejecting

Nihilism, and Humanists seek an explanation answering:I'm here, I exist, now what?Theology being about the human psychologic need for a supernatural ideal, Friedrich Nietzsche

says: God is dead, and Martin Heidegger asks:If God, as the supra-sensory ground and goal, of

all reality, is dead; if the supra-sensory world of the Ideas has suffered the loss of its obligatory,and above it, its vitalizing and up-building power, then nothing more remains to which Man can

cling, and by which he can orient himself.

Religion's answers to: What is the meaning of (my) life? include a moral demand helpful in

assuaging one's grief with death. Unlike religion, mysticism and spirituality require directexperience, in order to learn that life (existence) is an unfolding awakening that transformsunderstanding to insight; hence, the ultimate goal in life is being (living) according to saidmystical or spiritual insight -grasping, thereby, the meaning of life, of all of life, and of reality,

itself.

One man cannot give his life value, only the work of many; minds, hands, bodies. Only through

the lense of what exists before us can life be given value. When we take value as the

determining factor of the meaning of the concept of life, then its meaning can either be an empty

glass or an overflowing one.

Scientists, philosophers and others have long theorised about what it is to be human --

what is it that makes us special? Each group has a different name for it. The religious groups call

this special essence the soul. Scientists for the most would speak of our intelligence, our abilityto make tools, to change our environment to suit our needs. Many philosophers would argue that

the ability to ask the question itself sets us apart from others in the animal kingdom.



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A person is not the body -- which we see -- but the soul -- which we cannot see. It is the

soul that gives life to the body and activates it. And it is the soul that understands; knows; feels;

and, in general, experiences. While the soul has no physical shape, it does have the same

structure as the physical body, but in spiritual form: it, too, has 248 "limbs and organs"; and 365

spiritual "veins, arteries and sinews."

The physical body is a garment tailored to the form of the soul, much like physical items of

clothing are made to fit the needs of the body. Thus the soul is cloaked in the body. It thenenergizes the body and guides it -- like an ax in the hand of a woodchopper -- in what ever it

does or senses. This is why when the soul departs, the body becomes a paralyzed, lifeless

corpse:"Thus the dust returns to the ground, as it was, and the spirit returns to God who gave it.

A human person is a being in relationshipbiologically or corpus (gross body), psychologically

or animus (subtle body), socially, and transcendently or spiritus (soul). The patient isa human

person. Thus, one can say that illness disturbs relationshipsboth inside and outside the body of

the human person. Insidethe body, the disturbances are twofold: a. the relationshipsbetween and

among the various body parts and biochemical processes, and b. the relationship between the

mind and the body. Outside the body, these disturbances are also twofold: a. the relationship

between the individual patient and his or her environment, including the ecological, physical,

familial, social, and political nexus of relationships surrounding the patient; and b. therelationshipbetween the patient and the transcendent. (Sulmasy, The Gerontologist42:24-33 (2002)(http://www.torah.org/features/spirfocus/humanessence.html, Bhagavadgita)

Medical HumanitiesMedical humanities is an interdisciplinary field of medicine which includes the humanities

(literature, philosophy, ethics, history and religion), social science (anthropology, cultural

studies, psychology, sociology), and the arts (literature, theater, film, and visual arts) and their

application to medical education and practice.

The humanities and arts provide insight into the human condition, suffering, personhood, our

responsibility to each other, and offer a historical perspective on medical practice. Attention toliterature and the arts helps to develop and nurture skills of observation, analysis, empathy, and

self-reflection -- skills that are essential for humane medical care. The social sciences help us to

understand how bioscience and medicine take place within cultural and social contexts and how

culture interacts with the individual experience of illness and the way medicine is practiced.

The humanities are those academic disciplines which study the human condition using methods

that are largely analytic, critical, or speculative, as distinguished from the mainly empirical

approaches of the natural and social sciences. Conventionally the humanities include ancient and

modern languages and literature, history, philosophy, religion, visual and performing arts

(including music). Additional subjects sometimes included in the humanities are anthropology,

area studies, communications and cultural studies, although these are often regarded as social

sciences. Scholars working in the humanities are sometimes described as "humanists". However,that term also describes the philosophical position of humanism, which some "antihumanist"

scholars in the humanities reject. (wikipedia)

Medical humanities are an increasingly popular and important part of the medical

landscape. They provide enormous opportunitiesfor doctors and other healthcare professionals

to reflect ontheir practice through study that is refreshingly differentfrom conventional medical

education. Furthermore, as more andmore medical schools offer teaching in medical humanities

thereare increasing career opportunities for those with skills in this field.

Medicine seeks to understand what it is to be human. The primarytool medicine has developed

for obtaining this knowledge hasbeen science, which has been spectacularly successful in many

respects. "The human" is very complex, however, and perhaps there are aspects of us that

science cannot easily reach. Medical humanities seek to bring other sources of humanknowledge tomedicine, particularly medical education. Subjects such asphilosophy, literature,

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options with a clear medical orresearch base. Others, however, having discovered an interestin

one of the humanities, can be given the opportunity to continuestudy in their chosen field. Thus

the introduction of medical humanities as a core part ofthe curriculum may help to moderate the

"conveyor belt" aspect of medical education, an advantage already experienced by schools

running successful options programmes.

When this happens there is a double benefit because it not only provides for individual

differences among students but also

allows them to think more carefully about the variety ofcareers which can arise from the basic training. Medical graduates go off in a wide range of

directions, from ophthalmic surgeon topsychiatrist, from endoscopist or radiologist to general

practitionerspecialising in family problems. These specialties require differenttemperaments as

well as different skills. Thus it could be arguedthat courses that take account of, and allow for,

the developmentof differences in temperament might contribute more to the overall needs of the

discipline of medicine. Since competitive entry into medical school still means students are in

the main obliged to follow uniquely scientific pathways, many have to defer interests in the

humanities. Where the study of humanities is not introduced, at any level, doctors can graduate

from medicine ignorant ofthe very existence of the humanities' contributions to theirdiscipline.

It could be argued that such graduates are educationallydeprived, since they don't know what

they don't know.

4. To provide pockets of expertise and lifelong interests

Where students have been given a choice of discipline within medical humanities (such as in the

system described below) there have developed small groups of students in every cohort, with

specific, extra knowledge. These have come to provide "pockets of expertise" for their fellow

students. It means that withinevery class of medical students, a few will become known among

their peers as the ones with some, albeit limited, knowledge of how, for example, the legal or

political systems work. Studentswho have begun their studies as undergraduates in these areas

may find in them the basis for lifelong interests. Some willhave expertise in medical sociology,

medical archaeology oranthropology, some will have been introduced to medical issues in art,

literature, history, or theology. Students who becomeknown for their particular interests or skills

may be able tooffer informed opinions when their future colleagues are thinkingabout related

problems.

It is also our hope that, at the individual level these interestsmight stand students in good stead

in the future. They may helpby providing an alternative perspective (anthropology, sociology,

history), a breadth of interest (art, literature) or involvement (law, politics, theology) which could

help in coping with therigours of professional life.

Philosophy of Healthcare (wikipedia)

The philosophy of healthcare is the study of the ethics, processes, and people which constitute

the maintenance of health for human beings. (Although veterinary concerns are worthy to note,

the body of thought regarding their methodologies and practices is not dealt with in this article.)

For the most part however, the philosophy of healthcare is best approached as an indelible

component of human social structures. That is, the societal institution of healthcare can be seen

as a necessary phenomena of human civilization whereby man continually seeks to improve,

mend, and alter the overall nature and quality of his life.

The philosophy of healthcare is primarily concerned with the following elemental questions:

Who requires and/or deserves healthcare? Is healthcare a fundamental right of all

people?

What should be the basis for calculating the cost of treatments, hospital stays, drugs,

etc.? How can healthcare best be administered to the greatest number of people?

What are the necessary parameters forclinical trials and quality assurance?

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Who, if anybody, can decide when a patient is in need of "comfort measures"

(euthanasia)?

Ultimately, the purpose, objective, and meaning of healthcare philosophy is to consolidate the

abundance of information regarding the ever-changing fields of biotechnology, medicine, and

nursing. And seeing as healthcare typically ranks as one of the largest spending areas of any

government's budget, it becomes rather important to gain a greater understanding of healthcare

as not only a social institution, but also as a human phenomenon. In addition, healthcare

philosophy attempts to highlight the primary movers of healthcare systems; be it nurses, doctors,

hospital administrators, health insurance companies (HMOs and PPOs), the government

(Medicare and Medicaid), and lastly, the patients themselves.

Ethics in healthcare

The ethical and moral premises of healthcare are convoluted and numerous. In order to

consolidate such an enormous field of ethical thought, it becomes necessary to focus on what

makes healthcare ethics truly different from other forms of morality. And on the whole, it can be

said that healthcare itself is a "special" institution within society. With that said, healthcare ought

to "be treated differently from other social goods" in a society. It is an institution of which weare all a part whether we like it or not. At some point in a every person's life, a decision has to be

made regarding his healthcare. Can he afford it? Does he deserve it? Does he need it? Where

should he go to get it? Does he even want it? And it is this last question which poses the biggest

dilemma facing a person. After weighing all of the costs and benefits of his healthcare situation,

the person has to decide if it is even worth it. It is not simply economic issues that are at stake in

this conundrum. In fact, a person must decide whether or not his life is at its end or if it is worth

salvaging. Of course, in instances where the patient himself is unable to decide due to medical

complications, like a coma, then the decision must come from elsewhere. And defining that

"elsewhere" has proven to be a very difficult endeavor in healthcare philosophy.

BioethicsAccording to French philosopher Luc Ferry, the field of bioethics represents a "sacralization of

the human body," whereby the body effectively "becomes a temple." This viewpoint of bioethics

is rather interesting for it makes an intrinsic connection between the integrity of the human body

and spirituality. Even so, this perspective on bioethics contains a hint of what Ferry refers to as

"transcendental humanism," in which reason has succeeded in subverting religion insofar as

traditional morality is concerned. In a classically French existentialist manner, Ferry proceeds to

assert:

Never before, without a doubt, has the progress of science and technology given rise to

questions with such broad moral and, let us dare to use the word, metaphysicalimplications. It isas though the sense of the sacred remains, in spite of the "death of God," but without our being

given the spirituality or wisdom that should correspond to it.

This assertion can essentially be seen as an effective summary of the philosophical issues raised

in bioethics.

Medical ethics

Whereas bioethics tends to deal with more broadly-based issues like the consecrated nature of

the human body and the roles of science and technology in healthcare, medical ethics is

specifically focused on applying ethical principals to the field of medicine. It is a large and

relatively new area of study in ethics. And one of the major premises of medical ethics surrounds

"the development of valuational measures of outcomes of health care treatments and programs;

these outcome measures are designed to guide health policy and so must be able to be able to beapplied to substantial numbers of people, including across or even between whole societies."

Terms like beneficence and non-maleficence are vital to the overall understanding of medical

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ethics. Therefore, it becomes important to acquire a basic grasp of the varying dynamics that go

into a doctor-patient relationship.

Nursing ethics

Like medical ethics, nursing ethics is very narrow in its focus, especially when compared to the

expansive field of bioethics. For the most part, "nursing ethics can be defined as having a two-

pronged meaning," whereby it is "the examination of all kinds of ethical and bioethical issues

from the perspective of nursing theory and practice." This definition, although quite vague,centers on the practical and theoretical approaches to nursing. The American Nurses Association

(ANA) endorses an ethical code that emphasizes "values" and "evaluative judgments" in all

areas of the nursing profession. And since moral issues are extremely prevalent throughout

nursing, it is important to be able to recognize and critically respond to situations that warrant

and/or necessitate an ethical decision.

Research and scholarship

Considering the rapid pace at which the fields of medicine and health science are developing, it

becomes important to investigate the most proper and/or efficient methodologies for conducting

research. On the whole, "the primary concern of the researcher must always be the phenomenon,

from which th research question is derived, and only subsequent to this can decisions be made asto the most appropriate research methodology, design, and methods to fulfill the purposes of the

research." This statement on research methodology places the researcher at the forefront of his

findings. That is, the researcher becomes the person who makes or breaks his scientific inquires

rather than the research itself. Even so, "interpretive research and scholarship are creative

processes, and methods and methodology are not always singular, a priori, fixed and

unchanging." Therefore, viewpoints on scientific inquiries into healthcare matters "will continue

to grow and develop with the creativity and insight of interpretive researchers, as they consider

emerging ways of investigating the complex social world."

Quality assurance

The primary purpose of quality assurance (QA) in healthcare is to ensure that the quality of

patient care is in accordance with established guidelines. The government usually plays a

significant role in providing structured guidance for treating a particular disease or ailment.

However, protocols for treatment can also be worked out at individual healthcare institutions

like hospitals and HMOs. In some cases, quality assurance is seen as a superfluous endeavor, as

many healthcare-based QA organizations, like QARC, are publicly funded at the hands of

taxpayers. However, many people would agree that healthcare quality assurance, particularly in

the areas cancer treatment and disease control are necessary components to the vitality of any

legitimate healthcare system. With respect to quality assurance in cancer treatment scenarios, the

Quality Assurance Review Center (QARC) is just one example of a QA facility that seeks "to

improve the standards of care" for patients "by improving the quality of clinical trials medicine."

Reproductive rights

Everybody who wishes to have a child wants it to be perfect (at least at birth). Nobody wants

and/or wishes for their child to be born with Down Syndrome or Cerebral Palsy. In fact,

obstetricians have the most medical malpractice lawsuits filed against them. As a result, they

have to pay the highest premiums for malpractice insurance. These high costs inevitably become

a hindrance not only to the doctors, but also to the healthcare industry as a whole. Where is the

regulation? And although patients and their families have the right to appeal and confront a

physician regarding the quality of treatment received, there must be a limit as to how far they

can go. Frivolous lawsuits are clearly becoming a major problem for healthcare providers.

The ecophilosophy of Garrett Hardin constitutes one perspective from which to view thereproductive rights of human beings. For the most part, Hardin argues that it is immoral to have

large families, especially since it does a disservice to society in the sense that there is only a



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finite number of resources in the world. In an essay entitled The Tragedy of the Commons,Hardin states,

To couple the concept of freedom to breed with the belief that everyone born has an equal right

to the commons is to lock the world into a tragic course of action.

This statement essentially summarizes Hardin's major point concerning the negligible right of all

human beings to procreate. Moreover, Hardin is a vocal critic of the United Nations' Universal

Declaration of Human Rights (UDHR), which states that "any choice and decision with regardto the size of the family must irrevocably rest with the family itself, and cannot be made by

anyone else."

With respect to healthcare philosophy, Hardin's ecophilosophical views may seem like a stretch.

Nevertheless, they are important to keep in mind, especially when considering the call for

healthcare as a universal birth right of all people. The increasing strains placed on healthcare

systems are primarily the result of a growing human population. One way of mitigating

healthcare costs is to moderate population growth. The fewer people there are to take care of, the

less expensive healthcare will become. And to apply this logic to what medical ethicist Leonard

J. Weber previously suggested, less expensive healthcare does not necessarily mean poor-quality

healthcare.

Birth and Living

The concept of being "well-born" is not new. On the whole, it takes on a fairly racist undertone.

The Nazis practiced eugenics in order to cleanse the gene pool of what were perceived to be

unwanted or harmful elements. This "race hygiene movement in Germany evolved from a theory

of Social Darwinism, which had become popular throughout Europe" and the United States

during the 1930s. A German phrase that embodies the whole nature of this practice is

lebensunwertes Leben or "life unworthy of life."

In connection with healthcare philosophy, the theory of natural rights becomes a rather pertinent

subject. After birth, man is effectively endowed with a series of natural rights that cannot be

banished under any circumstances. One major proponent of natural rights theory was

seventeenth century English political philosopher John Locke. With regard to the natural rights

of man, Locke states,

If God's purpose for me on earth is my survival and that of my species, and the means to that

survival are my life, health, liberty and property then clearly I don't want anyone to violate

my rights to these things.

Although tarnished by the partiality of religion, Locke's statement can essentially be viewed as

an affirmation of the right to preserve one's life at all costs. This point is precisely where

healthcare as a human right comes into the picture.

The process of preserving and maintaining one's health throughout his life is a matter of grave

concern. Once alive, how should man proceed in exercising his natural right to preserve his life

through good health? At some point in every man's life, his health is going to decline regardlessof all measures taken to prevent such a collapse. Coping with this inevitable decline can prove

quite problematic for some people. For Enlightenment philosopher Ren Descartes, the

depressing and gerontological implications of aging pushed him to believe in the prospects of

immortality through a wholesome faith in the possibilities of reason.

Death and Dying

One of the most basic human rights is the right to live, and thus, preserve one's life. But what

about the right to die, and thus, end one's life? Needless to say, this is a very controversial topic.

Often, religious values of varying traditions tend to seep into the picture in one fashion or

another. Terms like "mercy killing" and "assisted suicide" are frequently used to describe this

process. Proponents of euthanasia claim that it is particularly necessary for patients sufferingfrom a terminal illness. However, opponents of a self-chosen death purport that it is not only

immoral, but wholly against the pillars of reason.

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In a certain philosophical context, death can be seen as the ultimate existential moment in one's

life. Death is the deepest cause of a primordial anxiety (Die Anfechtung) in a person's life. And it

is in this emotional state of anxiety that "the nothing" is revealed to the person. According to

twentieth century German existentialist philosopher Martin Heidegger,

The manner in which nurses, physicians, patients, and administrators interact is crucial

for the overall efficacy of a healthcare system. From the viewpoint of the patients, healthcare

providers can be seen as being in a privileged position, whereby they have the power to alter thepatients' quality of life. And yet, there are strict divisions among healthcare providers that can

sometimes lead to an overall decline in the quality of patient care. When nurses and physicians

are not on the same page with respect to a particular patient, a compromising situation may

arise. Effects stemming from a "gender gap" between nurses and doctors are detrimental to the

professional environment of a hospital workspace.

Aside from role development, another area in healthcare philosophy that necessitates discussion

is palliative care. Otherwise known as hospice care, this area of healthcare philosophy is

becoming increasingly important as more patients are preferring to receive healthcare services in

their homes. Even though the terms "palliative" and "hospice" are typically used in an

interchangeable fashion, they are actually quite different. And the major difference resides in the

fact that hospice care is a benefit associated with Medicare while palliative care is not. As apatient nears the end of his life, it is more comforting to be in a private home-like setting instead

of a hospital. Palliative care has generally been reserved for those who have a terminal illness.

However, it is now being applied to patients in all kinds of medical situations, including chronic

fatigue and other bothersome symptoms.

Complexity and clinical care(BMJ2001;323:685-688)Biological and social systems are inherently complex, so it is hardly surprising that few if any

human illnesses can be saidto have a single "cause" or "cure." This article applies the principles

introduced in the introductory article in this seriesto three specific clinical areas: the control of

blood glucose levels in diabetes, the management of diagnostic uncertainty, and healthpromotion.

A complex adaptive system is a collection of individual agents with freedom to act in ways that

are not always totally predictable,and whose actions are interconnected so that the action of one

part changes the context for other agents. In relation tohuman health and illness there are several

levels of suchsystems.

The human body is composed of multiple interacting and self regulating physiological

systems including biochemical and neuroendocrinefeedback loops

The behaviour of any individual is determined partly by an internal set of rules based on past

experience and partly by uniqueand adaptive responses to new stimuli from the environment

The web of relationships in which individuals exist contains many varied and powerful

determinants of their beliefs, expectations,and behaviour

Individuals and their immediate social relationships are further embedded within wider

social, political, and cultural systems which can influence outcomes in entirely novel and

unpredictableways

All these interacting systems are dynamic and fluid

A small change in one part of this web of interacting systems may lead to a much larger

change in another part through amplificationeffects.

Complexity science suggests an alternative model that illness (and health) result from

complex, dynamic, and unique interactions between different components of the overall system.

Effective

clinical decision making requires a holistic approach that accepts

unpredictability andbuilds on subtle emergent forces within theoverall system. As the examples in this article have

shown, complexity theory saves both clinician and patient from a futile quest forcertainty and



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upholds the use of intuition and personal experience when general scientific rules are to be

applied to the individualin context.

Successful healthservices in the 21st century must aim not merely for change, improvement,and

response, but for changeability, improvability, and responsiveness. Educators are therefore

challenged to enable not just competence, but also capability (box). Capability ensures that the

deliveryof health care keeps up with its ever changing context. Education providers must offer

an environment and process that enables individuals

to develop sustainable abilities appropriatefor a continuouslyevolving organisation. Capability is more than competence, Competence-what

individuals know or are able to do in terms of knowledge, skills, attitude. Capability-extent to

which individuals can adapt to change, generate new knowledge, and continue to improve their

performance

Building Bridges Among Professional and Patient SatisfactionPhysicians today are confronted with increasing demand to ensure and improve care of their

patients. A variety of approaches claim to provide solutions to the problems of health care

delivery.These approaches represent different perspectives on optimal care and the best method

for improving care.

A variety of approaches have been introduced during the lastdecade, and all of them claim to

provide solutions to some of the main problems in patient care. Approaches such as evidence-

based medicine (EBM), total quality management (TQM), assessment, accreditation and

accountability, professional development, patient empowerment, and others have gained

popularity. These approaches represent different perspectives on the best methodsfor improving

care. Some approaches focus on professionals, and others on organizations; some emphasize the

value of self-regulation,and others believe in external control; some prefer a bottom-up method,

and others a top-down method. Although efforts to integrate these approaches can be observed,

different parties in healthcare usually adopt one specific approach without taking into account

the achievements of the others.

Evidence based medicine is the conscientious, explicit, and judicious use of current bestevidence in making decisions about the care of individual patients. The practice of evidence

based medicine means integrating individual clinical expertise with the best available external

clinical evidence from systematic research. By individual clinical expertise we mean the

proficiency and judgement that individual clinicians acquire through clinical experience and

clinical practice. Increased expertise is reflected in many ways, but especially in more effective

and efficient diagnosis and in the more thoughtful identification and compassionate use of

individual patients' predicaments, rights, and preferences in making clinical decisions about their

care.

Integrative MedicineIntegrative Medicine has been defined by the National Center for Complementary andAlternative Medicine as practices that combine "mainstream medical therapies and CAM

therapies for which there is some high-quality scientific evidence of safety and effectiveness"

Additionally, Ralph Snyderman and Andrew Weil state "integrative medicine is not synonymous

with complementary and alternative medicine (CAM). It has a far larger meaning and mission in

that it calls for restoration of the focus of medicine on health and healing and emphasizes the

centrality of the patient-physician relationship".

Complementary and Alternative Medicine (CAM) is an umbrella term under which various

forms of non-traditional, non-Western medicine and healing fall. CAM includes:

Alternative Medicine: practices used in place of conventional medical treatments, often

incorporating spiritual, metaphysical, or religious underpinnings, non-European medical

traditions, or newly-developed approaches to healing



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Complementary Medicine: alternative medicine used in conjunction with conventional

medicine

Integrative medicine combines the discipline of modern science with the wisdom of ancient

healing. For people living with chronic or life-threatening illness, it can transform the physical,

emotional, and spiritual dimensions of their lives. Integrative medicine may also be valuable to

those who are not ill but wish to increase self-awareness, enhance well-being, and help prevent

health-related problems.The American Association of Integrative Medicine (AAIM) recognizes

that health is more than the absence of disease. A multi-disciplinary approach to medicine

provides the maximum therapeutic benefit. AAIM's advocacy for broader treatment options

facilitates a bond between integrative and Western medicine. The end result is a gathering place

for healers, educators and researchers from all specialties to compare notes and combine forces,

benefiting both the patient and the health care provider.

References1. Philosophy, Wikipedia online

2. Audi, R. Philosophy; Brief Guide for Undergraduate.http://www.apa.udel.edu/apa/publications/texts/briefgd.html

3. Pecorino, PA, Introduction of Philosophy. On Line Textbook at :http://www2.sunysuffolk.edu/pecorip/SCCCWEB/INTRO_TEXT/CONTENTS.htm

4. __________, Philosophy of Science. Teach yourself 2003.

5. Wilson, E. Bright. An Introduction to Scientific Research (McGraw-Hill, 1952).

6. Wayne Lewis. Medical Humanities BMJ Career Focus 2003;327:65; doi:10.1136/bmj.327.7413.s65-a

7. Gilroy J. Philosophy of Medicine. http://www.websyte.com/alan/philmed.htm

8. Evans M, Louhiala P, Puustinen R. 2004. Philosophy for Medicine.9. Grant VJ. 2007. Making Room for Medical Humanity. mh.bmj.45-48

10. Rudnick A. 2007. An Introduction curse in Philosophy of Medicine

11. Wilson T, Holt T. 2007. Complexity and Clinical Care. BMJ.; 323: 685688.

http://www.apa.udel.edu/apa/publications/texts/briefgd.htmlhttp://www2.sunysuffolk.edu/pecorip/SCCCWEB/INTRO_TEXT/CONTENTS.htmhttp://www.websyte.com/alan/philmed.htmhttp://www.apa.udel.edu/apa/publications/texts/briefgd.htmlhttp://www2.sunysuffolk.edu/pecorip/SCCCWEB/INTRO_TEXT/CONTENTS.htmhttp://www.websyte.com/alan/philmed.htm


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