Courteous but not curious: how doctors' politeness masks their existential neglect. A qualitative study of video-recorded patient consultations.K. M. Agledahl,P. Gulbrandsen,R. Forde &A. Wifstad -2011 -Journal of Medical Ethics 37 (11):650-654.detailsObjective To study how doctors care for their patients, both medically and as fellow humans, through observing their conduct in patient–doctor encounters. Design Qualitative study in which 101 videotaped consultations were observed and analysed using a Grounded Theory approach, generating explanatory categories through a hermeneutical analysis of the taped consultations. Setting A 500-bed general teaching hospital in Norway. Participants 71 doctors working in clinical non-psychiatric departments and their patients. Results The doctors were concerned about their patients' health and how their (...) medical knowledge could be of service. This medical focus often over-rode other important aspects of the consultations, especially existential elements. The doctors actively directed the focus away from their patients' existential concerns onto medical facts and rarely addressed the personal aspects of a patient's condition, treating them in a biomechanical manner. At the same time, however, the doctors attended to their patients with courteousness, displaying a polite and friendly attitude and emphasising the relationship between them. Conclusions The study suggests that the main failing of patient–doctor encounters is not a lack of courteous manners, but the moral offence patients experience when existential concerns are ignored. Improving doctors' social and communication skills cannot resolve this moral problem, which appears to be intrinsically bound to modern medical practice. Acknowledging this moral offence would, however, be the first step towards minimising the effects thereof. (shrink)
Fred Dretske, Naturalizing the Mind.K. Aizawa -1996 -Minds and Machines 6:425-430.detailsA review of Dretske's Naturalizing the Mind.
Notes towards Uniting Actor-Network Theory and Josef Mitterer's Non-dualizing Philosophy.K. Abriszewski -2008 -Constructivist Foundations 3 (3):192-200.detailsPurpose: To show the convergences between Josef Mitterer's non-dualizing way of speaking and actor-network theory. Method: Comparative analysis of Mitterer's non-dualizing philosophy and actor-network philosophy. Findings: Profound convergences between the two accounts may lead to a unified account that could redefine traditional philosophical problems. Benefits: The paper extends the range of Mitterer's non-dualizing philosophy and actor-network theory enabling both to face new problems. Among them, extended non-dualizing philosophy may undergo empirical investigations.
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Setting up a discipline: Conflicting agendas of the cambridge history of science committee, 1936-1950.Mayer A.-K. -2000 -Studies in History and Philosophy of Science Part A 31 (4):665-689.detailsTraditionally the domain of scientists, the history of science became an independent field of inquiry only in the twentieth century and mostly after the Second World War. This process of emancipation was accompanied by a historiographical departure from previous, 'scientistic' practices, a transformation often attributed to influences from sociology, philosophy and history. Similarly, the liberal humanists who controlled the Cambridge History of Science Committee after 1945 emphasized that their contribution lay in the special expertise they, as trained historians, brought to (...) the venture. However, the scientists who had founded the Committee in the 1930s had already advocated a sophisticated contextual approach: innovation in the history of science thus clearly came also from within the ranks of scientists who practised in the field. Moreover, unlike their scientist predecessors on the Cambridge Committee, the liberal humanists supported a positivistic protocol that has since been criticized for its failure to properly contextualize early modern science. Lastly, while celebrating the rise of modern science as an international achievement, the liberal humanists also emphasized the peculiar Englishness of the phenomenon. In this respect, too, their outlook had much in common with the practices from which they attempted to distance their project. (shrink)
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Rabbi Nathans System der Ethik und Moral.Kaim Pollák (ed.) -1905 - Budapest,: Druck von A. Alkalay & Sohn.detailsDieses Werk ist ein Reproduktion des Originals, das vor 1903 veröffentlicht wurde. Rabbi Nathan war ein wichtiger jüdischer Gelehrter und Schriftsteller. In 'Rabbi Nathans System der Ethik und Moral' beschreibt er seine Ansichten und Lehren über Ethik und Moral. Das Werk ist ein wichtiger Beitrag zur Entwicklung der jüdischen Moraltheologie und bietet einen Einblick in die vielfältigen und tiefgründigen Debatten, die in der jüdischen Welt seit Jahrhunderten geführt werden. This work has been selected by scholars as being culturally important, and (...) is part of the knowledge base of civilization as we know it. This work is in the "public domain in the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work. Scholars believe, and we concur, that this work is important enough to be preserved, reproduced, and made generally available to the public. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)
Hope--a necessary virtue for health care.K. Wildes -1998 -Bioethics Forum 15 (1):25-29.detailsThis article explores the feasibility of using an appeal to the virtues in bioethical analyses, and the difficulties posed by the fact that most virtues and especially hope, are embedded in particular traditions. Whose virtues, then, shall focus our analyses ? A brief description of Christian hope is used to argue that hope does play a major role in various health care venues and to suggest that the common elements in a secular account of the virtues can be found in (...) an unbiased sharing of one's religious background or way of life. (shrink)
Foregoing prehospital care: should ambulance staff always resuscitate?K. V. Iserson -1991 -Journal of Medical Ethics 17 (1):19-24.detailsApproximately 400,000 people die outside US hospitals or chronic care facilities each year. While there has been some recent movement towards initiating procedures for prehospital Do Not Resuscitate (DNR) orders, the most common situation in the US is that emergency medical systems (EMS) personnel are not authorized to pronounce patients dead, but are required to attempt resuscitation with all of the modalities at their disposal in virtually all patients. It is unfair and probably unrealistic for EMS personnel to have to (...) make a determination of the validity of a non-standard prehospital DNR order (for example, a living will or a durable power of attorney for health care). Existing prehospital DNR protocols range from being very restrictive in the scope of patients allowed to participate and in their implementation, to those that are more liberal. Potential benefits of prehospital DNR orders include freeing up vital personnel and material for use by those who would more fully benefit, and alleviating the enormous emotional strain on patients, families, EMS personnel, and hospital medical staffs involved in unwanted resuscitations that only prolong the dying process. Given this, prehospital DNR orders present several legal and moral problems. These include proper patient identification, the nature of the document itself, precautions incorporated into a DNR system to prevent misuse, potential liability for EMS and hospital personnel, and potential errors in implementation. Functioning prehospital DNR systems need to include: 1) specific legislation detailing the circumstances in which such a document could be used, the wording of such a document, and protection from liability for those implementing the document's directives; 2) having the currently valid document immediately available to the EMS personnel or base station doctors; and 3) acceptable means of identifying the patient. Relatively few US jurisdictions as yet have a prehospital DNR order system, although it is an idea whose time is overdue. Society's imperative to use available technology has pushed us into a situation where a technique to save those with a potential to continue a meaningful and wanted existence is being used indiscriminately to prolong the agony of death. (shrink)