{"title":"‘Isn’t Everyone a Little OCD?’","authors":"Lucienne Spencer, H. Carel","doi":"10.5195/pom.2021.19","DOIUrl":"https://doi.org/10.5195/pom.2021.19","url":null,"abstract":"This article develops the concept of wrongful depathologization, in which a psychiatric disorder is simultaneously stigmatized (because of sanist attitudes towards mental illness) and trivialized (as it is not considered a “proper” illness). We use OCD as a case study to argue that cumulatively these two effects generate a profound epistemic injustice to OCD sufferers, and possibly to those with other mental disorders. We show that even seemingly positive stereotypes attached to mental disorders give rise to both testimonial injustice and wilful hermeneutical ignorance. We thus expose an insidious form of epistemic harm that has been overlooked in the literature.","PeriodicalId":82846,"journal":{"name":"Studies in philosophy of medicine","volume":"385 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80765725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Skills, Scalpels and Robots: The Surgeon as Technician","authors":"Olivier Del Fabbro, X. Muller","doi":"10.5195/PHILMED.2021.21","DOIUrl":"https://doi.org/10.5195/PHILMED.2021.21","url":null,"abstract":"According to Aristotle, medical practice relies on practical knowledge to care for individual patients. This is especially true for surgery, where the surgeon directly acts on a patient using not only technical skills but also acquired experience. We first describe the surgeon’s technical activity, which is directly linked to surgical tools and their historical evolution. Second, given that surgical activity aims at treating patients, we analyze which techniques and concurrent knowledge the surgeon must rely on to perform successful surgical operations. These characteristics are analyzed by using concepts from philosophy of technologies by André Leroi-Gourhan, Gilbert Simondon and John Dewey.","PeriodicalId":82846,"journal":{"name":"Studies in philosophy of medicine","volume":"302 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72437604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Skills, Scalpels and Robots","authors":"Olivier Del Fabbro, Xavier Muller","doi":"10.5195/pom.2021.21","DOIUrl":"https://doi.org/10.5195/pom.2021.21","url":null,"abstract":"According to Aristotle, medical practice relies on practical knowledge to care for individual patients. This is especially true for surgery, where the surgeon directly acts on a patient using not only technical skills but also acquired experience. We first describe the surgeon’s technical activity, which is directly linked to surgical tools and their historical evolution. Second, given that surgical activity aims at treating patients, we analyze which techniques and concurrent knowledge the surgeon must rely on to perform successful surgical operations. These characteristics are analyzed by using concepts from philosophy of technologies by André Leroi-Gourhan, Gilbert Simondon and John Dewey.","PeriodicalId":82846,"journal":{"name":"Studies in philosophy of medicine","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83714977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"How to Interpret Covid-19 Predictions","authors":"S. Schroeder","doi":"10.5195/pom.2021.43","DOIUrl":"https://doi.org/10.5195/pom.2021.43","url":null,"abstract":"The IHME Covid-19 prediction model has been one of the most influential Covid models in the United States. Early on, it received heavy criticism for understating the extent of the epidemic. I argue that this criticism was based on a misunderstanding of the model. The model was best interpreted not as attempting to forecast the actual course of the epidemic. Rather, it was attempting to make a conditional projection: telling us how the epidemic would unfold, given certain assumptions. This misunderstanding of the IHME’s model prevented the public from seeing how dire the model’s projections actually were.","PeriodicalId":82846,"journal":{"name":"Studies in philosophy of medicine","volume":"418 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83317880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Malignant by Vinay Prasad","authors":"Benjamin Chin-Yee","doi":"10.5195/pom.2021.44","DOIUrl":"https://doi.org/10.5195/pom.2021.44","url":null,"abstract":"","PeriodicalId":82846,"journal":{"name":"Studies in philosophy of medicine","volume":"51 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87026014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Alternatives and Medical Dissidence","authors":"A. Broadbent","doi":"10.1093/OSO/9780190612139.003.0008","DOIUrl":"https://doi.org/10.1093/OSO/9780190612139.003.0008","url":null,"abstract":"This chapter introduces the notion of medical dissidence: conscious deviation from the main current of professional opinion. Cosmopolitanism is applied as a way of getting to grips with the popularity of Alternative Medicine despite its common dismissal among the literati. Most efficacy claims are not well supported in Alternative Medicine. However, it is not necessarily irrational to give them credence, or to rely on anecdotal evidence, because testimony is so central to nearly all medical evidence, and people are very differently placed in the reasons they might have to believe or disbelieve testimony. In addition, there may be non-curative value in alternative medicine. Cosmopolitanism does not advise an attitude of “anything goes,” but does urge humility on those of whatever persuasion who dismiss other traditions or people as irrational.","PeriodicalId":82846,"journal":{"name":"Studies in philosophy of medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87740836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Goal of Medicine","authors":"A. Broadbent","doi":"10.1093/OSO/9780190612139.003.0002","DOIUrl":"https://doi.org/10.1093/OSO/9780190612139.003.0002","url":null,"abstract":"In order to say what medicine is, we need to identify the goal of medicine, the business of medicine, and the nature of health and disease. This chapter introduces the Curative Thesis: both the goal and business of medicine are cure. The Curative Thesis is found to be correct that there is one ultimate goal of medicine: cure. Definitions of cure (and therapy) are discussed. The chapter considers and rejects the view that pain relief is a goal of medicine. The Puzzle of Ineffective Medicine and the Argument from the Persistence of Ineffective Medicine are introduced, concluding that the business of medicine cannot be cure. The business of medicine is the use of a competence or skill, and the persistence of ineffective medicine shows that curing is often not a competence doctors always—or even commonly—possess. But we still recognize medical skill, which must therefore be something else.","PeriodicalId":82846,"journal":{"name":"Studies in philosophy of medicine","volume":"111 3S 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74675186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Varieties of Medicine","authors":"A. Broadbent","doi":"10.1093/OSO/9780190612139.003.0001","DOIUrl":"https://doi.org/10.1093/OSO/9780190612139.003.0001","url":null,"abstract":"This chapter surveys the origins of medicine and introduces the concept of “Mainstream Medicine,” which is the globalized descendant of Western medicine. Based primarily on Roy Porter’s work, a broad-brush survey of the history of Mainstream Medicine is provided. The history of Alternative Medicine is also outlined, and a rough distinction drawn between Alternative and Traditional Medicine. The latter has its origins in a distinct geographical region and tradition, while the former typically involves conscious deviations from or rejections of the mainstream. Medical traditions from China, India, and Africa are briefly outlined. The chapter illustrates the geographical and temporal diversity of medical practices, in order to ground both the driving questions of the book—what is medicine, and what should we think of it? Any answer must handle the variety of medicine and be epistemically fair to the various traditions.","PeriodicalId":82846,"journal":{"name":"Studies in philosophy of medicine","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76480532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Medical Nihilism","authors":"A. Broadbent","doi":"10.1093/oso/9780190612139.003.0006","DOIUrl":"https://doi.org/10.1093/oso/9780190612139.003.0006","url":null,"abstract":"One thread running through this book so far has been a concern that medicine is not all it is cracked up to be. This chapter considers the most dramatic version of this stance, namely Medical Nihilism. Nihilism is the view that its object is worthless, accompanied by an emotional reaction of despair. Medical Nihilism is this attitude toward medicine. It was a common stance in the 19th century because of the persistent elusiveness of cures. The chapter considers Wootton’s nihilism about historical Western medicine, but focuses on Stegenga’s recent arguments for low confidence in contemporary medicine. Stegenga’s arguments are ultimately rejected, but the larger lesson is Medical Nihilism relies heavily on the Curative Thesis. Even if Therapeutic Nihilism were warranted (which the chapter denies), this would not warrant Nihilism about the whole of medicine, if medicine is properly characterized by the Inquiry Thesis, as the earlier parts of the book contend.","PeriodicalId":82846,"journal":{"name":"Studies in philosophy of medicine","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74009667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Evidence-Based Medicine","authors":"A. Broadbent","doi":"10.1093/OSO/9780190612139.003.0005","DOIUrl":"https://doi.org/10.1093/OSO/9780190612139.003.0005","url":null,"abstract":"This chapter marks a turn away from asking what medicine is, and toward asking what we should think of it. Evidence-Based Medicine (EBM) is the most influential development in thinking about attitudes to medicine in recent times. EBM has a prescription for medicine: make clinical decisions on the basis of “best evidence,” which is defined in a specific way. We should think more highly of interventions whose use is supported by better evidence. EBM also has a prescription for patients: hold your doctor to account, asking her to justify her proposed intervention in these terms. The chapter evaluates both prescriptions, and argues that, while both have their place, neither is a panacea.","PeriodicalId":82846,"journal":{"name":"Studies in philosophy of medicine","volume":"71 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90895028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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