Essays discuss the history, philosophy, methodology, and practices of holistic medicine.

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

The question of whether homeopathy is a science is currently discussed almost exclusively against the background of the modern concept of natural science. This approach, however, fails to notice that homeopathy—in terms of history of science—rests on different roots that can essentially be traced back to two most influential traditions of science: on the one hand, principles and notions of Aristotelism which determined 2,000 years of Western history of science and, on the other hand, the modern concept of natural science (...) that has been dominating the history of medicine for less than 200 years. While Aristotle’s “science of the living” still included ontologic and teleologic dimensions for the sake of comprehending nature in a uniform way, the interest of modern natural science was reduced to functional and causal explanations of all phenomena for the purpose of commanding nature. In order to prevent further ecological catastrophes as well as to regain lost dimensions of our lives, the one-sidedness and theory-loadedness of our modern natural–scientific view of life should henceforth be counterbalanced by lifeworld–practical Aristotelic categories. In this way, the ground would be ready to conceive the scientific character of homeopathy—in a broader, Aristotelian sense. (shrink)

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

Since the advent of modernity and Christianity in Africa, indigenous African holistic healing, and especially its psychological aspect, has been given negative publicity. This article examines ways in which African traditional medicine men made and continue to make a significant contribution to healing in their societies. It argues that due to the numerous challenges in contemporary African societies, there is need for a pragmatic approach, in which all innovations that can alleviate human suffering are taken on board and encouraged (...) as long as they do not compromise people’s health. (shrink)

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

Sustainable Medicine is based on the premise that twenty-first century Western medicine--driven by vested interests--is failing to address the root causes of disease. Symptom-suppressing medication and "polypharmacy" have resulted in an escalation of disease and a system of so-called "health care," which more closely resembles "disease care." In this essential book, Dr. Sarah Myhill aims to empower people to heal themselves by addressing the underlying causes of their illness. She presents a logical progression from identifying symptoms, to understanding the underlying (...) mechanisms, to relevant interventions and tests and tools with which to tackle the root causes. As Myhill writes, "It's all about asking the question 'why?'" Sustainable Medicine covers a wide range of symptoms including inflammation (infection, allergy, autoimmunity), fatigue, pain, toxic symptoms, deficiency symptoms, and hormonal symptoms. And Dr. Myhill includes a toolbox of treatments for specific illnesses and ailments, as well as a general approach to avoiding and treating all disease. Finally, she offers a series of case histories to show how people have successfully taken control of their health and healed even in the face of the most discouraging symptoms--all without the harmful interventions of 21st century Western medicine. (shrink)

"This book addresses issues which are central in the philosophy of science, exploring a large and relevant literature. It should be of broad interest in the philosophy of science community." Professor Peter Lipton, Department of History and Philosophy of Science, University of Cambridge, UK. How can the complexities of understanding science be dealt with as a whole? Is philosophical realism still a defensible philosophical position? Exploring such fundamental questions, this book claims that science ought to be understood in terms of (...) universal practices and that such an understanding supports an attractive version of scientific realism. Holism is attracting renewed scholarly attention but is still loosely used in a range of different contexts, from semantics to medicine. This book presents a detailed philosophical analysis of holism, concentrating on two complementary aspects of holism - cognitive and social - to investigate its relevance to science studies. Bridging the gap between analytical, historical and sociological accounts of science, Caruana draws together results from recent research by Davidson, Dummett, Quine, Wright and others, on Wittgenstein's later philosophy. Demonstrating that holism, both cognitive and social, is not only essential for a full understanding of science but also compatible with a particular version of scientific realism, this book presents important new perspectives for the philosophers of science and scholars of the history of science in particular. Louis Caruana is Assistant Lecturer in Philosophy of Science and Nature at the Gregorian University, Rome, Italy. (shrink)

This article isolates ten prepositions, which constitute the undercurrent paradigm of contemporary discourse of health disease and medicine. Discussion of the interrelationship between those prepositions leads to a systematic refutation of this paradigm. An alternative set is being forwarded. The key notions of the existing paradigm are that health is the natural condition of humankind and that disease is a deviance from that nature. Natural things are harmonious and healthy while human made artifacts are coercive interference with natural balance. It (...) is suggested that the current paradigm is influenced by the world of finances and by instrumental reason. The alternative model suggests that human nature cannot be delineated. Humans fashion their own selves and nature by artificial means, medicine among them. The article discusses the implications of the paradigm adapted in various scholarly and popular debates such as the use of sex hormones for contraception, the care of the elderly, holistic medicine and distributive justice in health care. Medicine is not an isolated or a privileged realm. There is no unique entitlement to health care. It is always part of a broader agenda of social values and institutions. A open view of human societies, values and practices as they are situated within concrete material conditions is the platform required for an integrative and creative discourse of health care. (shrink)

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

Psychologists can measure normalcy, define madness, develop therapeutic paradigms, and list the nuances of human behavior with utmost precision. We have biofeedback, psychometrics, psychoanalysis, cognitive therapy, positive psychology, behavior modification, and a host of deeply promising projects in the research and development pipeline. To be sure, our discipline has advanced accurate understanding of the soul's essential properties and has scientifically harnessed this knowledge to clinically mitigate the deep agony of the human mind. But, despite our advances and genuine effectiveness, our (...) discipline remains incomplete. Theoretically, scientifically, and therapeutically, we fall short of the fuller effectuality that awaits us. We need Christ. It is through the Christian revelation that psychology will find its maturity. For psychology there are blessings afoot. These blessings stem from our recognition that the Clinical Christ - the activity of the God of the Christian revelation throughout the realms of our discipline - desires to redeem, relate, heal, love, and empower us. The chapters of this book explore different aspects of the Clinical Christ, Christian Holism, and their implications. A central tenet of Christian Holism is that the Holy Spirit is fully present in the clinical situation, with and within the therapist and the client, and is actively engaged in the treatment process. Ten further tenets proceeding from the central tenet are described. Other chapters include treatment of the importance of forgiveness, reconciliation and dream work in the practice of Christian Holism. There is copious material in other chapters citing significant research data validating health benefits of Christian prayer and spirituality, the need for the Church to restore the healing ministry and energetic components of Christian prayer and spirituality. (shrink)

ArgumentMontpellier vitalists upheld a medical perspective akin to modern “holism” in positing the functional unity of creatures imbued with life. While early vitalists focused on the human organism, Jean-Charles-Marguerite-Guillaume Grimaud investigated digestion, growth, and other physiological processes that human beings shared with simpler organisms. Eschewing modern investigative methods, Grimaud promoted a medically-grounded “metaphysics.” His influential doctrine of the “two lives” broke with Montpellier holism, classifying some vital phenomena as “higher” and others as “lower” and attributing the “nobility” of the human (...) species to the predominance of the former. In place of Montpellier teaching that attributed health to the holistic equilibration of vital activities, Grimaud embraced spiritualist dualisms of soul and body, Creator and created. Celebrating the divinely-ordained “wisdom” evident in involuntary physiological processes, he argued that such life functions were incomprehensible to human investigators. While Grimaud's work encouraged inquiry into the division between the central and “vegetative” nervous systems that became paradigmatic in nineteenth-century neuroscience, it also opened Montpellier vitalism to charges of conservatism and obscurantism that are still lodged against it to the present day. (shrink)

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

This book explores the tradition of the 'science of man' in French medicine of the era 1750-1850, focusing on controversies about the nature of the 'physical-moral' relation and their effects on the role of medicine in French society. Its chief purpose is to recover the history of a holistic tradition in French medicine that has been neglected because it lay outside the mainstream themes of modern medicine, which include experimental, reductionist, and localistic conceptions of health and disease. Professor Williams (...) also challenges existing historiography, which argues that the 'anthropological' approach to medicine was a short-term by-product of the leftist politics of the French Revolution. This work argues instead that the medical science of man long outlived the Revolution, that it spanned traditional ideological divisions, and that it reflected the shared aim of French physicians, whatever their politics, to claim broad cultural authority in French society. (shrink)

The goal of this paper is to promote what I call ‘the embedded thesis’ as a general constraint on how moral reasons behave. Dancy’s reason holism will be used as a foil to illustrate the thesis. According to Dancy’s reason holism, moral reasons behave in a holistic way; that is, a feature that is a moral reason in one context might not be so in another or might even be an opposite reason. The way a feature manages to switch (...) its reason status is by the help of a so-called enabler/disabler. The enabler in itself is not part of the reason, according to Dancy’s reason holism, for it can be either present or absent while the reason feature is present. To put the idea somewhat differently, Dancy’s reason holism presupposes what I call ‘reason individuation’, the view that features that function as reasons can be individuated from those that function as enablers. Yet, reason individuation cannot hold, or so I will argue, due to what I call ‘the embedded thesis’. According to the embedded thesis, the feature that serves as a moral reason in a context cannot be individuated independently from its embedded context while still retaining its reason status. If I am right about the embedded thesis, this will take the wind out of the sails of Dancy’s reason holism. More importantly, it will constitute, I argue, a general constraint on how moral reasons behave. (shrink)

While holist views such as ecocentrism have considerable intuitive appeal, arguing for the moral considerability of ecological wholes such as ecosystems has turned out to be a very difficult task. In the environmental ethics literature, individualist biocentrists have persuasively argued that individual organisms—but not ecological wholes—are properly regarded as having a good of their own . In this paper, I revisit those arguments and contend that they are fatally flawed. The paper proceeds in five parts. First, I consider some problems (...) brought about by climate change for environmental conservation strategies and argue that these problems give us good pragmatic reasons to want a better account of the welfare of ecological wholes. Second, I describe the theoretical assumptions from normative ethics that form the background of the arguments against holism. Third, I review the arguments given by individualist biocentrists in favour of individualism over holism. Fourth, I review recent work in the philosophy of biology on the units of selection problem, work in medicine on the human biome, and work in evolutionary biology on epigenetics and endogenous viral elements. I show how these developments undermine both the individualist arguments described above as well as the distinction between individuals and wholes as it has been understood by individualists. Finally, I consider five possible theoretical responses to these problems. (shrink)

In the last decades it has become clear that medicine must find some way to combine its scientific and humanistic sides. In other words, an adequate notion of medicine requires an integrative position that mediates between the analytic-reductionist and the normative-holistic tendencies we find therein. This is especially important as these different styles of reasoning separate “illness” (something perceived and managed by the whole individual in concert with their environment) and “disease” (a “mechanical failure” of a biological element within (...) the body). While the demand for an integrative view has typically been motivated by ethical concerns, we claim that it is also motivated, perhaps even more fundamentally, by epistemological and methodological reasons. Evidence-based bio-medicine employs experimental and statistical techniques which eliminate important differences in the ways that conscious humans evaluate, live with, and react to disease and illness. However, it is precisely these experiences that underpin the concepts and norms of bio-medicine. Humanistic disciplines, on the other hand, have the resources to investigate these experiences in an intersubjectively testable way. Medicine, therefore, cannot afford to ignore its nature as a human science; it must be concerned not only with disease and illness, but also with the ways in which patients as persons respond to malady. Insofar as attitudes and expectations influence the criteria of illness and disease, they must be studied as part of the genuine subject matter of medicine as a human science. In general, we urge that this is a necessary step to overcome today's trend to split evidence-based and clinical medicine. (shrink)

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

The International Classification of Functioning, Disability and Health (ICF), designed by the WHO, attempts to provide a holistic model of functioning and disability by integrating a medical model with a social one. The aim of this article is to analyze the ICF’s claim to holism. The following components of the ICF’s complexity are analyzed: (1) health condition, (2) body functions and structures, (3) activity, (4) participation, (5) environmental factors, (6) personal factors, and (7) health. Although the ICF claims to (...) be holistic, it presupposes a monistic materialistic ontology. We indicate some limitations of this ontology, proposing instead: (a) a pluralistic–holistic ontology (PHO) and (b) a multidimensional view of the human being, with individual and environmental aspects, in relation to three levels of reality implied by the PHO. For the ICF to attain its holistic claim, the interactions between its components should be based on (a) and (b). (shrink)

This article discusses the nature and significance of the holistic health movement in four ways. First, a general characterization of the movement is proposed, based on shared commitment to five assumptions: (1) a positive view of health as well-being, (2) individual responsibility for health, (3) the importance of health education, (4) control of social and environmental determinants of health, and (5) low technology or “natural” therapeutic techniques. Second, a basic difference among advocates of holistic health/medicine is proposed in (...) terms of the presence or absence of commitment to scientific method. Third, holistic health/medicine is briefly compared with concepts of holism in biology and in the social sciences. Finally, criticisms of each of the basic tenets of the holistic health movement are offered. (shrink)

are often used loosely – especially in medical contexts. In an attempt to remedy this, these terms are explored from the standpoints of: philosophy of science, medicine, genetics, history of genetics and clinical genetics. A sense for ‘reductionism’ is developed in part by focusing on the related histories of classical genetics and clinical genetics. This done, the dichotomy between holism and reductionism, whether in basic genetics or the genetic counseling situation, loses much of its force. CiteULike Connotea Del.icio.us What's this?

Family Medicine first formally confronted systems thinking with the adoption of the biopsychosocial model for understanding disease in a holistic manner; this is a description of a natural system. More recently, Family Medicine has been consciously engaged in developing itself as a system for delivering health care, an artificial system. We make this new system available to all people, whether sick or well, offering to manage not just their diseases, but their lives. However, a major difference between natural and (...) artificial systems is that natural systems have smooth feedback loops to ensures homeostasis, whereas artificial systems do not. They can only adjust themselves by disruptive adaptive and renewal cycles. Further, Family Medicine aspires to base its creation of this artificial system on the key principles of Family Medicine - continuity, comprehensiveness, and compassionate care in the context of family and community. However, there are another set of principles driving the modern Family Medicine system of healthcare, principles that function like the hidden curriculum of medical education. These principles - risk thinking, health as a commodity, and individual responsibility - are part of a deeper current within healthcare called by some biomedicalization. On closer analysis, many of these characteristics are intimately tied with liberal economies that must grow. Yet this economic system is an artificial system that lacks feedback. It is imperative that we in Family Medicine reexamine our commitment to developing artificial systems. (shrink)

Critics of Western medicine have long heralded a “new paradigm” opposed to the reigning materialistic worldview of biomedical science and allopathy. This new paradigm has undergone several name changes (e.g., holistic, alternative, complementary, integrative) and presumably advances a radically new worldview. On closer inspection, it looks more like the opposite pole of the same dualistic worldview and not a radical break with the past. A truly new paradigm prepared to jettison tacit conceptual assumptions would have significant implications for medical (...) research, provided that institutional and professional constraints not inhibit the studies to follow. A research agenda is proposed comprising possible jumping-off points for investigators comfortable with working around the reigning assumptions both of current medical thinking and of a rapidly institutionalizing integrative-medicine worldview. These include proposed medical research on spirituality, alien abductions, hierophanies, thought forms, placebo pharmacology, radionics, arcane medical wisdom, prenatal ensoulment, and musical genetics. (shrink)

What position on dualism does medicine require? Our understanding of that ques- tion has been dictated by holism, as defined by the biopsychosocial model, since the late twentieth century. Unfortunately, holism was characterized at the start with con- fused definitions of ‘dualism’ and ‘reductionism’, and that problem has led to a deep, unrecognized conceptual split in the medical professions. Some insist that holism is a nonreductionist approach that aligns with some form of dualism, while others insist it’s a reductionist view (...) that sets out to eradicate dualism. It’s important to consider each version. Nonreductive holism is philosophically consistent and clinically unprob- lematic. Reductive holism, however, is conceptually incoherent—yet it is the basis for the common idea that the boundary between medical and mental health disorders must be vague. When we trace that idea through to its implementation in medical practice, we find evidence that it compromises the safety of patient care in the large portion of cases where clinicians grapple with diagnosis at the boundary between psychiatry and medicine. Having established that medicine must embrace some form of nonreduc- tionism, I argue that Chalmers’ naturalistic dualism is a stronger prima facie candidate than the nonreductive alternatives. Regardless of which form of nonreductionism we prefer, some philosophical corrections are needed to give medicine a safe and coherent foundation. (shrink)

Personalized Medicine (PM) is an evolving and often missinterpreted concept and no agreement of personalization exist. We examined the PM discourse towards foucauldian archeological and genealogical analysis to understand the meaning of “personalization” in medicine. In the archaeological analysis, the historical evolution is characterized by the coexistence of two epistemologies: the holistic vision and the omic sciences. The genealogical analysis shows how these epistemologies may affect the meaning of “person” and, consequently, the ontology of patients. Additionally, substitutions/confusions of the (...) term PM are related to continuously evolving medical knowledge and new technologies; different etymological roots of “personalization” and “person”; and cultural differences. In conclusion, if the definition of “personalization” in medicine is not clear, patients might get wrong expectations about what is achievable for their health. Therefore, epistemological trends should not be separated as they drive same goals: providing accurate diagnosis and treatments based on large data to predict disease progression. (shrink)

Classical medicine operates in a climate of rational discourse, scientific knowledge accretion and the acceptance of ethical standards that regulate its activities. Criticism has centred on the excessive technological emphasis of modern medicine and on its social strategy aimed at defending exclusiveness and the privileges of professional status. Alternative therapeutic approaches have taken advantage of the eroded public image of medicine, offering treatments based on holistic philosophies that stress the non-rational, non-technical and non-scientific approach to the unwell, disregarding traditional (...) diagnostic categories and concentrating on enhancing subjective comfort and well-being, but remaining oblivious to the organic substrate of disease. This leads to questionable ethics in terms of false hopes and lost opportunities for effective therapy. (shrink)

Adolf Meyer-Abich spent his career as one of the most vigorous and varied advocates in the biological sciences. Primarily a philosophical proponent of holistic thought in biology, he also sought through collaboration with empirically oriented colleagues in biology, medicine, and even physics to develop arguments against mechanistic and reductionistic positions in the life sciences, and to integrate them into a newly disciplinary theoretical biology. He participated in major publishing efforts including the founding of Acta Biotheoretica. He also sought international (...) contacts and worked for long stretches in Chile, the Dominican Republic, El Salvador, and the United States. His career straddled the Nazi period, which led him into a complex dance of support for and resistance to the regime. Despite the relative failure of his conceptual innovations to catch on, his ideas and writings sit squarely within the trajectory of thought and argument that has led to today’s reinvigoration of thought about conceptual integration in evolutionary developmental biology. (shrink)

Healthcare in South Africa is in a crisis. Problems with infrastructure, management, human resources and the supply of essential medicines are at a critical level. This is compounded by a high burden of disease and disparity in levels of service delivery, particularly between public and private healthcare. The government has put ambitious plans in place, which are part of the National Development Plan to ward 2030. In the midst of this we find the individual person and their family and community (...) staggering under the suffering caused by disease, poverty, crime and violence. There is a more than 70% chance that this person and their family and community are trying to make sense of this within a spiritual framework and that they belong to a faith-based community. This article explores the valuable contribution of spirituality, spiritual and pastoral work, the faith-based community and faith-based organisations to holistic people-centred healthcare in South Africa. (shrink)

_ Source: _Volume 12, Issue 1, pp 13 - 38 This paper assembles evidence from the full scope of Julian’s writings that the emperor had a pronounced interest in medicine and human health, which impacted both his rhetorical and real approach to political, philosophical, and religious problems. His initiatives aimed to promote doctors, medical research, and public health. He emphasized a holistic view of bodily and spiritual health in his version of theurgic Neoplatonism. Medical frames of reference also played (...) an appreciable role in his anti-Christian program. Finally, he himself and others styled him as a physician-king on a divine mission to heal the Empire of the Christian disease. (shrink)

In the mid-1970s, the biomedical model of medicine gave way to the biopsychosocial model of medicine; it was billed as a more comprehensive and compassionate model of medicine. After more than a century of disentangling medicine from religion, the medicine and spirituality movement is attempting to bring religion and spirituality back into medicine. It is doing so under a biopsychosociospiritual model. I unpack one model for allowing religion back into medicine called the RCOPE. RCOPE is an instrument designed to categorize (...) religion and spirituality as psychological coping mechanisms. I explore how such instruments are related to the history of statistical measurement and demonstrate the political impetus that governs such enterprises. The biopsychosociospiritual medicine is billed as a more holistic and comprehensive model. This new model of medicine offers total care. However, I demonstrate how this total care becomes totalizing, indeed totalitarian, admitting religion and spirituality back into the fold of medicine under a new secularized medical control. (shrink)

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

We generally accept that medicine’s conceptual and ethical foundations are grounded in recognition of personhood. With patients in vegetative state, however, we’ve understood that the ethical implications of phenomenal consciousness are distinct from those of personhood. This suggests a need to reconsider medicine’s foundations. What is the role for recognition of consciousness (rather than personhood) in grounding the moral value of medicine and the specific demands of clinical ethics? I suggest that, according to holism, the moral value of medicine is (...) secured when conscious states are recognized in everyday medical science. Moreover, consciousness fully motivates traditional principles of clinical ethics if we understand respect for autonomy as respect for the dominion of an experiencer in the private, inescapable realm of bodily experience. When medicine’s foundations are grounded in recognition of consciousness, we understand how patients fully command respect even when they lack capacity to exercise their bodily dominion through decision-making. (shrink)

When the University of Chicago opened its four-year medical program in 1929, the medical departments were established on the same footing as other biological departments. One of the first priorities was to build a department of psychiatry based on an interdisciplinary and holistic research program with important social implications. This plan was soon frustrated by structural factors and conflicts of interest both internal and external to the university. The story illuminates crucial dilemmas of neuropsychiatry in the interwar years and (...) suggests some of the limits to the pursuit of biology at the University of Chicago. (shrink)

Although Niels Bohr's notion of complementarity is usually referred to in the context of quantum mechanics, it is not of physical origin. Bohr derived it from the philosophical idea of a holistic entanglement of knowledge and action. Bohr's complementarity primarily refers to a key element of the pragmatist tradition, the reflective relation between the immediate experience of an object and the awareness of its objectification. Similar relations have been observed by Kurt Goldstein in his studies of brain-injured patients. From (...) a pragmatic point of view, Goldstein's idea of adequacy in biological knowledge might lead to novel approaches to current ethical questions in medicine as well as biotechnology. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Medicine-Based Values?Åge Wifstad (bio)KeywordsEthics committees, judgment, common moralityToulmin's DiagnosisIn his classical article with the unforgettable title "How medicine saved the life of ethics" (Toulmin 1982), Stephen Toulmin claims that medicine saved ethics by giving the philosophers a positive reality check through medical challenges: (1) Ethics in medicine is a serious topic, not just something to discuss at seminars. If, for example, both A and B need treatment and there (...) are only enough resources for one, the fundamental interests of these two people compete against each other. (2) In clinical medicine, the individual case might demand a different approach than that suggested by theory. Similarly, an ethicist who is confronted by a diversity of medical cases becomes aware of the fact that solutions drawn from ethical theory can be irrelevant in practice. (3) The moral philosopher has often focused on the individual and his or her universal commitments. The fact that ethical dilemmas can have deep roots in practical challenges and must be understood within a certain context has been "forgotten." (4) In clinically relevant ethics, it is important to find solutions that all involved parties find reasonable. This revitalizes central Aristotelian schools of thought on, for example, ethical judgment and situational understanding.Today, there is a common understanding that in both the education of doctors and in the implementation of medical knowledge and technology there needs to be ethical guidelines and control. Toulmin wants us to see that the background for this agreement is multifaceted. It was not just the ethicists who saved the doctors. The doctors helped the ethicists to escape their academic isolation.Ethics CommitteesThe establishment of ethics committees is perhaps the most interesting example of this. Here it is especially clear how ethical judgment establishes a basis for decision making: Each case presented to an ethics committee is special because one cannot reference decisions made in similar cases. At the same time, we are expected to handle similar cases equally. Consideration of the concrete, individual case must be balanced with the principle of similar treatment. Second, as a committee member, one must interpret and respect ethical principles that cannot be easily defined. Every principle must be interpreted and implemented within a specific and concrete context. Third, one must consider the law, but seen isolated, the implications of relevant rules can be difficult to determine. Fourth, the status of principles and rules are open for interpretation. The most important example of this is the Declaration of Helsinki, which was established through cooperation between the worlds' doctors unions. The strength and end result of such a document can be discussed. Fifth, multiple but partly conflicting juridical and ethical considerations can be [End Page 179] relevant at the same time. An example: Decisions about confidentiality can prevent data gathering that is crucial in ensuring that a research project is scientifically acceptable. Two important ethical considerations are then put up against one another. As a sixth and final point, it can be mentioned that the ethics committee is expected to make a qualitative, scientific judgment. But what kind of quality judgment and how detailed it should be is up for discussion.Two Definitions of Ethical JudgmentThe fact that the committee must base their holistic decision on ethical judgment means that the committee, in an important sense of the word, stands freely: It can be difficult to refer to specific ethical rules or laws when making an external review of the committee's decision. Unless the committee has clearly not followed known principles and rules, then the committee is able to confront criticism by replying that the decision is based on holistic considerations, where many views have been taken into account. In this way, the usage of ethical judgment makes sure that the committee has freedom to act. The catch here is that the committee's responsibility becomes even more obvious. One cannot simply say that the decision is made based on rules and principles formulated by others, such as the state. The committee must, as a unit, be able to defend their decision.The complexity of the work of the committee can, however, make it more tempting to think about ethics in... (shrink)

Critics have challenged agricultural scientists to address concerns for environmental quality, farm size and structure, international justice, and the health and welfare of consumers and farm labor in research planning. The goal of this research was to determine what is and what could be done to consider value-laden knowledge relevant to these concerns in research planning. Descriptions of a state agricultural experiment station and of a hierarchy of inquiry that included applied systems analysis and reductionist approaches to science revealed the (...) goal-seeking and expert-centered nature of agricultural research. Value-laden and value-free knowledge of agricultural scientists and administrators were heavily represented in broad research goals such as increased productivity and efficiency. In addition, these goals were not evaluated at the levels of inquiry typically practiced by agricultural scientists. A soft systems methodology provided a more holistic level of inquiry that could facilitate consideration of value-laden and value-free knowledge of world views more diverse than those of agricultural scientists and administrators. Scientists could function as co-learners with other participants to identify issues and to conceptualize systems that are relevant to improving research planning. Moreover, researching the practice of soft systems offers opportunities for exploring systems ideas and holistic value theory in relation to agricultural research. (shrink)

Rehabilitation medicine, aka Physical medicine and Rehabilitation , is the medical specialty which focuses on optimizing function, ability, participation and life satisfaction in the light of noncurable disability and/or chronic disease. It is primarily geared towards the “so what” than towards “what” . PM & R is holistic and patient-centred, thus comprising a well-suited arena for dialogue and patient participation. Many patients experience a severe crisis reaction in the aftermath of major trauma or disease. This “existential rupture” calls for (...) a fundamental revaluation of many aspects of daily life. Crisis management will not merely be a matter of mourning and then back to “business as usual,” as this often is either not possible or not the optimal choice given altered life circumstances. We propose that philosophical practice may be an important addition to the rehabilitation process, by facilitating “lifeworld analyses” and thereby making it possible for the patient to find sources of meaning in life despite disability. This “therapy for the sane” comprises PP rather than psychiatric or psychotherapeutic interventions, and may come to be seen as a key aspect in the training of future physiatrists and other rehabilitation specialists. (shrink)