The Anticipatory Corpse: medicine, power, and the care of the dying by
In this original and compelling book, Jeffrey P. Bishop, a philosopher, ethicist, and physician, argues that something has gone sadly amiss in the care of the dying by contemporary medicine and in our social and political views of death, as shaped by our scientific successes and ongoing debates about euthanasia and the "right to die"--or to live. The Anticipatory Corpse: Medicine, Power, and the Care of the Dying, informed by Foucault's genealogy of medicine and power as well as by a thorough grasp of current medical practices and medical ethics, argues that a view of people as machines in motion--people as, in effect, temporarily animated corpses with interchangeable parts--has become epistemologically normative for medicine. The dead body is subtly anticipated in our practices of exercising control over the suffering person, whether through technological mastery in the intensive care unit or through the impersonal, quasi-scientific assessments of psychological and spiritual "medicine." The result is a kind of nihilistic attitude toward the dying, and troubling contradictions and absurdities in our practices. Wide-ranging in its examples, from organ donation rules in the United States, to ICU medicine, to "spiritual surveys," to presidential bioethics commissions attempting to define death, and to high-profile cases such as Terri Schiavo's, The Anticipatory Corpse explores the historical, political, and philosophical underpinnings of our care of the dying and, finally, the possibilities of change. This book is a ground-breaking work in bioethics. It will provoke thought and argument for all those engaged in medicine, philosophy, theology, and health policy.
End-Of-Life Care and Pragmatic Decision Making: a Bioethical Perspective. by
Provides a pragmatic philosophical framework based on a radically empirical attitude toward life and death.
Extreme Measures: finding a better path to the end of life by
An ICU and Palliative Care specialist offers a framework for a better way to exit life that will change our medical culture at the deepest level In medical school, no one teaches you how to let a patient die. Jessica Zitter became a doctor because she wanted to be a hero. She elected to specialize in critical care-to become an ICU physician-and imagined herself swooping in to rescue patients from the brink of death. But then during her first code she found herself cracking the ribs of a patient so old and frail it was unimaginable he would ever come back to life. She began to question her choice. Extreme Measures charts Zitter's journey from wanting to be one kind of hero to becoming another-a doctor who prioritizes the patient's values and preferences in an environment where the default choice is the extreme use of technology. In our current medical culture, the old and the ill are put on what sheterms the End-of-Life Conveyor belt. They are intubated, catheterized, and even shelved away in care facilities to suffer their final days alone, confused, and often in pain. In her work Zitter has learned what patients fear more than death itself- the prospect of dying badly. She builds bridges between patients and caregivers, formulates plans to allay patients' pain and anxiety, and enlists the support of loved ones so that life can end well, even beautifully. Filled with rich patient stories that make a compelling medical narrative, Extreme Measures enlarges the national conversation as it thoughtfully and compassionately examines an experience that defines being human.
Medical Care at the End of Life : a Catholic perspective by
For over thirty years, David F. Kelly has worked with medical practitioners, students, families, and the sick and dying to confront the difficult and often painful issues that concern medical treatment at the end of life. In this short and practical book, Kelly shares his vast experience, providing a rich resource for thinking about life's most painful decisions. Kelly outlines eight major issues regarding end-of-life care as seen through the lens of the Catholic medical ethics tradition. He looks at the distinction between ordinary and extraordinary means; the difference between killing and allowing to die; criteria of patient competence; what to do in the case of incompetent patients; the meaning and use of advance directives; the morality of hydration and nutrition; physician-assisted suicide and euthanasia; and medical futility. Kelly's analysis is sprinkled with significant legal decisions and, throughout, elaborations on how the Catholic medical ethics tradition -- as well as teachings of bishops and popes -- understands each issue. He provides a helpful glossary to supplement his introduction to the terminology used by philosophical health care ethics. Included in Kelly's discussion is his lucid description of why the Catholic tradition supports the discontinuation of medical care in the Terry Schiavo case. He also explores John Paul II's controversial papal allocution concerning hydration and nutrition for unconscious patients, arguing that the Catholic tradition does not require feeding the permanently unconscious. "Medical Care at the End of Life" addresses the major issues that inform this last stage of caregiving. It offers a critical guide to understanding the medical ethics and relevant legal cases needed for clear thinking when individuals are faced with those crucial decisions.
Palliative Care and Ethics by
Hospice is the premiere end of life program in the United States, but its requirement that patients forgo disease-directed therapies and that they have a prognosis of 6 months or less means that it serves less than half of dying patients and often for very short periods of time. Palliative care offers careful attention to pain and symptom management, added support for patients and families, and assistance with difficult medical decision making alongside any and all desired medical treatments, but it does not include a comprehensive system of care as is provided by hospice. The practice of palliative care and hospice is filled with sometimes overt (requests for hastened death in an environment where such acts are legally prohibited) and other times covert (the delay in palliative care referral because the health care team believes it will undermine disease directed treatment) ethical issues.The contributors to this volume use a series of case presentations within each chapter to illustrate some of the palliative care and hospice challenges with significant ethical dimensions across the three overarching domains: 1) care delivery systems; 2) addressing the many dimensions of suffering; and 3) difficult decisions near the end of life. The contributors are among the most experienced palliative care, hospice and ethics scholars in North America and Western Europe. Each has been given relatively free reign to address what they feel are the most pressing ethical challenges within their domain, so a wide range of positions and vantage points are represented. As a result, the volume provides a very diverse ethical exploration of this relatively young field that can deepen, stretch, and at times confront any simple notion of the challenges facing patients, their families, professional caregivers, and policy makers.
Care and Cure: an introduction to philosophy of medicine by
The philosophy of medicine has become a vibrant and complex intellectual landscape, and Care and Cure is the first extended attempt to map it. In pursuing the interdependent aims of caring and curing, medicine relies on concepts, theories, inferences, and policies that are often complicated and controversial. Bringing much-needed clarity to the interplay of these diverse problems, Jacob Stegenga describes the core philosophical controversies underlying medicine in this unrivaled introduction to the field. The fourteen chapters in Care and Cure present and discuss conceptual, metaphysical, epistemological, and political questions that arise in medicine, buttressed with lively illustrative examples ranging from debates over the true nature of disease to the effectiveness of medical interventions and homeopathy. Poised to be the standard sourcebook for anyone seeking a comprehensive overview of the canonical concepts, current state, and cutting edge of this vital field, this concise introduction will be an indispensable resource for students and scholars of medicine and philosophy.
Greek Medicine from Hippocrates to Galen: selected papers by
This volume makes available in English translation a selection of Jacques Jouanna's papers on Greek and Roman medicine, ranging from the early beginnings of Greek medicine to late antiquity.
Hippocrates on Ancient Medicine by
The Hippocratic treatise On Ancient Medicine, a key text in the history of early Greek thought, mounts a highly coherent attack on the attempt to base medical practice on principles drawn from natural philosophy. This volume presents an up-to-date Greek text of On Ancient Medicine, a new English translation, and a detailed commentary that focuses on questions of medical and scientific method; the introduction sets out a new approach to the problem of the works relationship to its intellectual context and addresses the contentious issues of its date, authorship, and reception. The book will be of interest to scholars of ancient medicine and ancient philosophy, as well as anyone concerned with the history of science and scientific method in antiquity.
Hippocratic, Religious, and Secular Medical Ethics: the Points of Conflict by
Where should physicians get their ethics? Professional codes such as the Hippocratic Oath claim moral authority for those in a particular field, yet according to medical ethicist Robert Veatch, these codes have little or nothing to do with how members of a guild should understand morality or make ethical decisions. While the Hippocratic Oath continues to be cited by a wide array of professional associations, scholars, and medical students, Veatch contends that the pledge is such an offensive code of ethics that it should be summarily excised from the profession. What, then, should serve as a basis for medical morality? Building on his recent contribution to the prestigious Gifford Lectures, Veatch challenges the presumption that professional groups have the authority to declare codes of ethics for their members. To the contrary, he contends that role-specific duties must be derived from ethical norms having their foundations outside the profession, in religious and secular convictions. Further, these ethical norms must be comprehensible to lay people and patients. Veatch argues that there are some moral norms shared by most human beings that reflect a common morality, and ultimately it is these generally agreed-upon religious and secular ways of knowing -- thus far best exemplified by the 2005 Universal Declaration on Bioethics and Human Rights -- that should underpin the morality of all patient-professional relations in the field of medicine. Hippocratic, Religious, and Secular Medical Ethics is the magnum opus of one of the most distinguished medical ethicists of his generation.
Hippocratic Writings by
At the beginning, and interspersed throughout, there are discussions on the philosophy of being a physician. There is a large section about how to treat limb fractures, and the section called The Nature of Man describes the physiological theories of the time. The book ends with a discussion of embryology and a brief anatomical description of the heart.
Philosophy of Medicine by
Philosophy of Medicine asks two central questions about medicine: what is it, and what should we think of it? Philosophy of medicine itself has evolved in response to developments in the philosophy of science, especially with regard to epistemology, positioning it to make contributions that are medically useful. This book locates these developments within a larger framework, suggesting that much philosophical thinking about medicine contributes to answering one or both of these two guiding questions. Taking stock of philosophy of medicine's present place in the landscape and its potential to illuminate a wide range of areas, from public health to policy, Alex Broadbent introduces various key topics in the philosophy of medicine. The first part of the book argues for a novel view of the nature of medicine, arguing that medicine should be understood as an inquiry into the nature and causes of health and disease. Medicine excels at achieving understanding, but not at translating this understanding into cure, a frustration that has dogged the history of medicine and continues to the present day. The second part of the book explores how we ought to consider medicine. Contemporary responses, such as evidence-based medicine and medical nihilism, tend to respond by fixing high standards of evidence. Broadbent rejects these approaches in favor of Medical Cosmopolitanism, or a rejection of epistemic relativism and pluralism about medicine that encourages conversations between medical traditions. From this standpoint, Broadbent opens the way to embracing alternative medicine. An accessible and user-friendly guide, Philosophy of Medicine puts these different debates into perspective and identifies areas that demand further exploration.
Philosophy of Medicine: an introduction by
What kind of knowledge is medical knowledge? Can medicine be explained scientifically? Is disease a scientific concept, or do explanations of disease depend on values? What is "evidence-based" medicine? Are advances in neuroscience bringing us closer to a scientific understanding of the mind? The nature of medicine raises fundamental questions about explanation, causation, knowledge and ontology - questions that are central to philosophy as well as medicine. This book introduces the fundamental issues in philosophy of medicine for those coming to the subject for the first time, including: * understanding the physician-patient relationship: the phenomenology of the medical encounter. * Models and theories in biology and medicine: what role do theories play in medicine? Are they similar to scientific theories? * Randomised controlled trials: can scientific experiments be replicated in clinical medicine? What are the philosophical criticisms levelled at RCTs? * The concept of evidence in medical research: what do we mean by "evidence-based medicine"? Should all medicine be based on evidence? * Causation in medicine. * What do advances in neuroscience reveal about the relationship between mind and body? * Defining health and disease: are explanations of disease objective or do they depend on values? * Evolutionary medicine: what is the role of evolutionary biology in understanding medicine? Is it relevant? Extensive use of empirical examples and case studies are included throughout, including debates about smoking and cancer, the use of placebos in randomised controlled trials, controversies about PSA testing and research into the causes of HIV. This is an indispensable introduction to those teaching philosophy of medicine and philosophy of science.