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PubMed2005

Assessing the postoperative patient: philosophy, knowledge and theory.

The assessment of the postoperative patient is critical in identifying the patient's current condition and to monitor any complications that might occur. However, many nurses fail to realize the implications that philosophical paradigms, knowledge and theoretical concepts bring to the assessment practice and the manner in which assessment is conducted; in particular, within 24 h after surgery. This article seeks to explore the usefulness of philosophy, knowledge and theory as they relate to nursing assessment of the postoperative patient within the initial 24 h after surgery. It is the duty of nurses to select and effectively apply appropriate philosophical dimensions, knowledge and theories in practice and critically evaluate these areas with respect to assessment of the postoperative patient, thus aiming for a holistic assessment of the patient.

Clinical Competence↗
PubMed1996

Nursing research and the philosophy of hermeneutics.

This paper explores some of the implications of hermeneutic philosophy for nursing research. Using illustrative material from recent research into the quality of life of older people in nursing homes, the paper shows that hermeneutics provides a perspective from which to examine the literature, and which guides both the collection and interpretation of data. The paper may be of interest to all scholars interested in the relationship between hermeneutics and the methods of social and nursing research.

Aged↗
PubMedDate not supplied

Puzzling pain conditions: how philosophy can help us understand them.

CONTEXT: Pain is a complicated area of inquiry. To progress in our scientific understanding of the topic, it may be useful to learn how other disciplines are grappling with the subject. Philosophy is one discipline actively engaged in trying to understand pain. OBJECTIVE: We present one philosophical view of pain to help broaden the understanding of pain in those who are trained to look at it from a biomedical perspective. DISCUSSION: One current philosophical theory of pain is the externalist perceptual theory of pain. This theory states that pain is a form of perception and can be likened to other perceptions, for example, visual, tactile, etc. The way a pain feels can be explained as the relationship between this perception and some bodily damage occurring. and just as other perceptions can be mistaken, such as in a visual illusion, pain can also be inaccurate. We explore how the theory deals with puzzling conditions such as phantom limb pain, complex regional pain syndrome, and allodynia. We contrast this view with a competing theory of pain and briefly consider how these philosophical views may impact clinical medicine.

Amputation, Traumatic↗
PubMed1990

The influence of feminist philosophy on nursing practice.

This paper describes how feminist beliefs and values should influence nursing practice. Traditionally held patriarchal values are challenged, and the feminist tenets of gender equity, the basis for value to society and personal sovereignty are discussed. Drawing on experience as a nurse practitioner this writer gives examples of nursing practice that are grounded in feminist philosophy.

Female↗
PubMed1986

Philosophy of science and DSM-III. Philosophical, idea-historical and sociological perspectives on diagnoses.

The validity of a classification system is primarily a question of philosophical premise. DSM-III is from this point of view a theoretical classification system based on hypotheses currently considered reliable and interesting and which--as presupposed--could not be rejected by empirical methods. The relevance or validity of this empirical approach depends on the aim of the DSM-III. An empirical approach may facilitate communication but can only have limited success as a help for planning treatment of psychiatric disorders where motives and meaning are important factors. The choice of hypotheses and the empirically derived concepts used to construct the classification system neglects other important ways of comprehension. Although aspects of rational philosophy may be found in the DSM-III system too, important ways of comprehension like the metaphysical approach is lacking. It is showed how this fact reflects a philosophical trend in the Western world following the Renaissance. By considering the Myth of Faust it is demonstrated how a metaphysical comprehension of life would lead to a different understanding of states of mind currently assumed to be a reflection of individual psychopathology according to empirical or rational comprehension. Thus in the end the validity of a classification system depends on the basic philosophical assumptions chosen. A choice which may be determined more by irrational and cultural forces than conscious contemplation. The content of DSM-III or ICD is also influenced by professional interests; the needs of the society and international political factors.(ABSTRACT TRUNCATED AT 250 WORDS)

Humans↗
PubMed1992

Dental treatment and dental health. Part 2. An alternative philosophy and some new treatment modalities in operative dentistry.

In this, the second of two papers on the relationships between dental treatment and dental health, the philosophical basis of Minimum Intervention Dentistry is presented. This approach to patient care has several distinct treatment modalities. These range from preventive measures and fissure sealants, through monitoring carious lesions for active progression or arrest, to minimal cavity designs such as tunnel preparations and preventive resin restorations which employ adhesive dental restorative materials. This paper discusses these techniques and the implications of this change in philosophy for dental teaching, research and manpower considerations.

Dental Caries↗
PubMed1983

Psychoanalysis and the science of problem-solving man: an appreciation of Popper's philosophy and a response to Will (1980).

Popper's philosophy has been often misrepresented in the debate about the scientific status of psychoanalysis by pseudo-Popperians who use the idea of falsifiability without rejecting positivism and inductive logic. The debate itself is misconceived because it is based on the outdated positivist assumption that what is not science is not important. Partially submerged by this, however, is a very important debate about method. The issues are clearly focused by what is here called "Hill's problem', that of finding a common framework in which the contributions of organic, psychodynamic and social psychiatry can be discusses and applied to clinical problem solving. Will's paper brings out many fundamental problems. This reply discussed misapprehended aspects of Popper's world view and introduces his plural interactionalist metaphysical research programme. It demonstrates the close similarity of Popper's view of science which Lorenz calls 'hypothetical realism' with Bhaskar's 'transcendental realism' which Will advocates for psychoanalysis. The differences hinge on concepts of explanation and the methods of theory testing. It is here argued that Popper's view is better fitted for the task Will proposes. The resemblance of 'hypothetical realism' to the clinical tradition further demonstrates its applicability to Hill's problem.

Humans↗
PubMed2005

The bioethical principles and Confucius' moral philosophy.

This paper examines whether the modern bioethical principles of respect for autonomy, beneficence, non-maleficence, and justice proposed by Beauchamp and Childress are existent in, compatible with, or acceptable to the leading Chinese moral philosophy-the ethics of Confucius. The author concludes that the moral values which the four prima facie principles uphold are expressly identifiable in Confucius' teachings. However, Confucius' emphasis on the filial piety, family values, the "love of gradation", altruism of people, and the "role specified relation oriented ethics" will inevitably influence the "specification" and application of these bioethical principles and hence tend to grant "beneficence" a favourable position that diminishes the respect for individual rights and autonomy. In contrast, the centrality of respect for autonomy and its stance of "first among equals" are more and more stressed in Western liberal viewpoints. Nevertheless, if the Confucian "doctrine of Mean" (chung-yung) and a balanced "two dimensional personhood" approach are properly employed, this will require both theorists and clinicians, who are facing medical ethical dilemmas, of searching to attain due mean out of competing moral principles thus preventing "giving beneficence a priority" or "asserting autonomy must triumph".

Bioethical Issues↗
PubMed1980

A philosophy of a clinically based medical ethics.

Pellegrino and Siegler have argued that medical ethics must be taught 'at the bedside', or clinically. This paper is an attempt to establish the need for clinical teaching of medical ethics both to medical students and to medical ethicists who are not physicians. Through a critique of six positions regarding the aims of medical ethics, four principles are established which are the basis of a philosophy of education for medical ethics. The need for a clinically-based educational programme in medical ethics is thereby established, not on practical grounds, but on solid philosophical ones. The paper concludes with practical examples of a clinically-based medical ethics programme following from the four principles.

Curriculum↗
PubMed1984

Towards a philosophy of veterinary medicine.

The question of animal rights is looked at from a new perspective: animals of similar sentence should be entitled to the same quality of veterinary care and ought not to be treated differently, some more or less humanely than others. The ethical inconsistencies in the moral status of animals in society, and the veterinarian's role and responsibilities, are explored in an attempt to reconcile the dialectic of animal exploitation and animal rights and of the extrinsic and intrinsic worth of animals. The veterinary profession is in the centre of this issue, which necessitates an examination of our profession's ethics and the formulation of a veterinary philosophy. The importance of empathy in the art and practice of veterinary medicine is also discussed.

Animals↗
PubMed2001

"Professionalization" and "confessionalization": the place of physics, philosophy, and arts instruction at Central European academic institutions during the Reformation era.

During the sixteenth and early seventeenth centuries, physics was regularly taught as part of instruction in philosophy and the arts at Central European schools and universities. However, physics did not have a special or privileged status within that instruction. Three general indicators of this lack of special status are suggested in this article. First, teachers of physics usually were paid less than teachers of most other university-level subject-matters. Second, very few Central European academics during this period appear to have made a career out of teaching physics. And third, Reformation Era schools and universities in Central Europe emphasized language instruction; such instruction not only was instrumental in promoting the confessional--i.e., Calvinist, Lutheran, and Roman Catholic--agendas of those same schools and universities, but also helped to prepare students for service in nascent but growing state governments.

Europe↗
PubMed1994

Psychotherapy, neuroscience, and philosophy of mind.

Neuroscience is conceptually founded on a philosophy of mind known as identity theory. This theory claims that mental phenomena are reducible to the physical organ of the brain. But identity theory, and consequentially neuroscience, is unable to address essential human features of intentionality, consciousness, and autonomy, i.e., free will. Intentionally is the quality of having content or "aboutness," consciousness is quality of self-awareness, and autonomy is the ability to make undetermined choices. These essential human features make up our common sense and our psychodynamic understanding of ourselves. Without these features we would have to change our entire way of seeing ourselves and our dynamic psychotherapy would be impossible. We need intentionality in psychotherapy because it is only through the content of our patients' thoughts and feelings that we can help them derive meaning; we need consciousness because it is primarily through introspection that we get access to our patients' inner world; and we need autonomy because unless our patients have the option of doing things differently there is no point to the therapeutic endeavor. Consequently, psychiatry cannot rely solely on neuroscience as its basic science without creating a conception of people devoid of essential human features and without eviscerating its psychotherapeutic capacity.

Awareness↗
PubMed1991

German philosophy, Freud, and the riddle of the woman.

After Kant's critique of empiricism, subjectivist epistemologies cropped up in 19th-century German philosophy. Schopenhauer argued that the true essence of every object was an irrational and sexual will. This underlying will distorted a subject's knowledge of the world. Schopenhauer's notion of this true essence was analogous to his portrayal of women; they too were natural, irrational, and instinctual. Nietzsche postulated a will-to-power that structured and hence distorted a chaotic world. That structureless "real" world Nietzsche symbolized as the essential "truth of a woman," a truth which for Nietzsche was unknowable to the desirous male philosopher. Freud, while maintaining belief in empirical truth, developed a psychology of mis-knowledge which had much in common with Schopenhauer's epistemology. His theory of transference grew from a need to explain how female patients libidinally distorted the reality of their male analysts. Conversely, Freud's later writings on women are hampered by the author's realization of his own precarious and subjective position as man trying to know woman. These counter-transferential concerns ultimately made the woman's psychological essence an unknowable riddle for Freud.

Austria↗
PubMed2005

Philosophy of mind in the Yogacara Buddhist idealistic school.

After some general introduction remarks on Indian philosophy, this essay deals with the structure of mind in the Yogacara Buddhist idealist school. Mind can be conceived as having two 'parts': the receptacle consciousness, constituted by the vasanas, or 'marks' left by any individual experience, which 'remains' in the mind in an unconscious state; and the function consciousness, constituted by these same vasanas transforming themselves into conscious ideas and representations, which are either of a cognizing ego or of congnized objects and beings and similar to the experiences that gave rise to them. Since a beginningless eternity, vasanas have been produced without anything real corresponding to them, in a fantasmagorical process.

Buddhism↗
PubMedDate not supplied

Who is the chaplain anyway? Philosophy and integration of hospice chaplaincy.

Hospice chaplaincy is a rather innocuous term describing a combination of duties and skills. Literature has been slow in coming and clearly defining this growing and unique role. This article looks both through the eye of the terminally ill patient and of the chaplain for further clarification of the method, philosophy, and definition of hospice chaplaincy. Through the use of brief metaphors, the author ascribes new meaning to common place terms, e.g., telephone operator, guide and teacher, and places them in context of the aforementioned perspectives. Highlighted are specific scenarios, questions, and emotional issues common to the psychosocial and psychospiritual relationship of patient and chaplain.

Chaplaincy Service, Hospital↗
PubMed2006

Perspective: a new ethic for health promotion: reflections on a philosophy of health education for the 21st century.

This article describes two models for thinking about the purposes of health education-a medical model and an education model--and traces how concerns about the validity of research have driven preference for the medical model. In the medical model, the purpose of health education is to develop effective interventions that will prevent people from adopting unhealthy behaviors. Here, health educators are expected to replicate the methods identified by researchers to effect targeted changes in health behavior. The article then describes an alternative way of thinking about the purposes of health education. In pursuing a philosophy of education, the purpose of research and practice would be to clarify basic social values and to strengthen one's faculty for making value judgments. Practitioners here use research results as a stimulus for dialogue about the role of good health habits in living the kind of life that community members find most valuable.

Health Education↗
PubMed1990

Philosophy and medicine: the Oxford connection.

Three aspects of the approach to philosophy advocated by the Oxford philosopher J. L. Austin are outlined: his conception of the nature of philosophical problems, essentially as a mixed bag; his method of linguistic analysis, namely, clarification of our concepts by active observation of the ways in which they are actually used rather than by passive reflection on their meanings; and his views on the organisation of philosophical research, that in some areas it should be pursued rather as a science is pursued, as a corporate rather than merely individual venture. It is suggested that Austin's approach provides the basis for a potentially fruitful two-way relationship between philosophical theory and medical practice.

Ethics, Medical↗
PubMedDate not supplied

Quality, philosophy and Riehl's model of nursing.

It is theoretically possible to use Riehl's model of nursing as a vehicle for quality assurance. The individual's view of quality is a critical determinant. Patients should be partners in care, negotiating and instigating outcomes together with nurses whenever possible. A holistic approach and a humanistic philosophy for care in combination are important considerations in determining quality of care. Empowerment of the patient through an internal locus of control should enable care to be individualised. A patient thus empowered may then be able to assume responsibility for his/her health status.

Humans↗