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[Philosophy of medicine in 2000].

In 2000 there is a prevalence of iatrosophistry above iatrophilosophy and philosophy of medicine. The reason of medicine as the religious duty of charity or secular philanthropy has been undergoing a crisis. Various forms of situation ethics has been replacing mortality. Medicine has been increasingly occupied by the neocapitalistic law of value. Illness now has an auction value. Suffering is a kind of debt, liable to insurance, to re-buy or to sell. The patient is utmost interest to pharmaceutical concerns and health factories. Health, formerly nationalized and now becomes privatized. The government, the state, feel released from the social contract, and throws the responsibility upon the private person and the insufficient charity of the poor community. The man is treated as a biological engine, equipped with a psychical computer super structure. The spirit is pushed to the background. An increase of paramedical and often really magic procedures, such as was never before, can be observed. Medicine now, is a team-work. The doctor and the pharmacist has lost his paternal and feudal position. The split between the clinical sciences and the basic research sciences is nearly complete. The flood of medical publications becomes more and more intensive. We note a paradigm changing from "remedy" to "treatment", and from "symptom" to "problem". Medical practice differs when addressed to the rich or the poor, the curable, the incurable and superfluous one. There are signs of a recurrence to anthropopolitic and eugenic methods, or various forms of euthanasia. Medicine is only pushing away suffering and death. In this sense everyone is virtually incurable. Who is alive has the right to live. Mortality exists independently of different people's outlook, but is hardly accepted by scientists. Morality is of categorical value, totally different from ethics and inaccessible by scientific methods. Hence difficulties.

History, 20th Century↗

Reexamining educational philosophy: the issue of professional responsibility, "Cleveland First".

This paper proposes a shift of emphasis in the dental curriculum from measures to protect and improve the oral health of individuals to measures to protect and improve the oral health of the community or society. This shift represents a fundamental change in educational philosophy of the dental school. To illustrate this shift in emphasis, this paper describes a demonstration project to test the feasibility of this approach involving all seventy first-year students in the Case Western Reserve University School of Dentistry in a four-week experience placing dental sealants in erupting molars of second and sixth graders in fifty schools of the Cleveland City School System. In future years, the program is expected to reach all second and sixth graders in the Cleveland School System. The experience is a required integral component of the curriculum, involving every student in the class, and is designed to make a demonstrable difference in oral health in the City of Cleveland. The experience is reinforced with course material on professional responsibility. The school is developing additional intensive experiences for second-, third-, and fourth-year classes involving smoking prevention for adolescents, oral health maintenance for nursing home residents, and dental care delivery in the inner city. The initial year of the program has had effects on students' responses to other elements of the first-year curriculum that go beyond the experience of placing sealants in children's teeth. The focused efforts of dental students every year are expected to have a measurable effect on the disparities in oral health found in the City of Cleveland as well as a measurable effect on dental students' and dentists' attitudes concerning professional responsibility.

Attitude of Health Personnel↗

[A history and philosophy of bio-medical ethics seen from a dentist's point of view].

When we think about ethics or morals, we tend to look at them from the viewpoint of here and now. Actual implications of then and there, however, could be different. That is why we should study history of bio-ethics along with philosophy involved in it. Bio-medical ethics is situated in spatial and cultural dimension as well as temporal and historical. Dentistry has been in a peculiar situation in that although it has evolved from the same root as medicine, it has become a separate discipline. Ethical implications of dentistry, however, share the historical and philosophical background with its mother discipline, i.e., medicine, surgery, barber-surgery and even smithery. This paper tries to grasp the main ideas of bio-medical ethics from the ancient Greek and China, and picks up three of them as guiding principles, i.e., deontology and teleology from the west and self-cultivation from the east. It also tracks down the contents of modern biomedical ethics; from etiquette to ethics, from morals to contract (ethics of autonomy), and ethics of professional responsibility. Finally it reviews and analyzes two different traditions of dental professional regulation from the legal and ethical point of view (U.S. and Europe), and proposes a new direction for the construction of dental ethics in Korea.

Bioethics↗

The problematisation of existence: towards a philosophy of complexity.

By assuming that the Universe is best described as a cellular automaton, and by making use of results from the field of computational mechanics, this paper discusses an extension of the notion of existence from a simple binary opposition to that of a continuum. It is argued that none of the traditional objects of science, or any objects from any discipline, formal or not, can be said to be real in any absolute sense though a substantial realism may be associated with them. By problematising existence it is proposed that an evolutionary philosophy referred to as critical pluralism is more sensitive to the demands of complexity than contemporary scientific approaches. Though many of the conclusions reported herein are not original, the fact that they can be 'proved' in a scientific sense, and explored scientifically, is certainly of interest and is an interpretation of complexity theory that has received little attention.

Humans↗

[A philosophy of aging].

"What I pretend is to speak with lesser words about those immense words. To be more sincere: I would like to speak with immense words about those immense words"; so spoke J.A. Marina in one of his books, The Sentimental Labyrinth. There are few people as appropriate as he to lead us into a philosophy about old age. There are few occasions where wisdom and simplicity go hand in hand in a manner so tight and prolific as is the case with Marina's words. Let us take advantage of him.

Aged↗

Adopting a new philosophy: minimal invasion.

Dentistry is a dynamic profession with new trends evolving. Minimally invasive dentistry is becoming not just a concept but a way of practicing. Creative people are finding ways, materials, and technology that enable patients to experience less hard-tissue or soft-tissue removal, improved prevention and maintenance, and increased attention to a philosophy of "less is more." The World Congress of Minimally Invasive Dentistry was formed to facilitate the sharing of these new concepts. The members embrace change, and dentistry offers the constant opportunity for such. As the standard of care moves toward minimally invasive dentistry, patients will benefit.

Bone Transplantation↗

Caring for seriously ill and dying patients: the philosophy and ethics.

The care of seriously ill and dying patients necessitates a philosophic and ethical basis, without which unacceptable patterns of practice may develop. Several problems are described: inadequate or unskilled communication of information, withdrawal by the physician, patient labelling and poor health care. Palliative care must be based on a philosophy that acknowledges the inherent worth and dignity of each person. In addition, it must take place within the framework of four ethical principles: autonomy, beneficience, nonmaleficience and justice. The first and most important of these is the need to regard patients as unique people with a right to compassion, gentle truth, autonomy in decision-making and excellence in physicial and psychospiritual care. Beneficence obliges us not only to relieve suffering but also to enhance the patient's quality of life whenever possible. Nonmaleficence and justice require allocation of sufficient health care resources of the type necessary to provide high-quality care and prevent patients from coming to harm.

Attitude to Death↗

Who needs nursing philosophies?

Nursing philosophies are often viewed as a time-consuming chore, which will simply gather dust once written. Properly used, however, they can not only ensure the quality of patient care, but can be used as a tool to aid recruitment and monitor resourcing.

Humans↗

[The relationship between nursing practice, nursing, and nursing philosophy].

The activities of the three dimensions of nursing does not occur in isolation. Nursing practice, the field of study of nursing science, has characteristics which influence the scientific practice of nursing. Nursing practice is constituted by the nurse practitioner as a result of the fact that the pre-scientific interpretations of the nurse give form (gestalte) to nursing interactions. From a functional perception in nursing science, the scientific practitioner must take cognisance of the pre-scientific interpretations. Besides the empirical reality, specific values and assumptions form an integral part of this practice of science in Nursing. The third dimension, the philosophy of nursing brings greater clarity in that the activities of the first two dimensions can be organised, analysed and evaluated.

Humans↗

[Philosophy of prevention in stomatology].

The authors make an analysis of the concept of prevention as applied to the field of stomatology, and also discuss the prophylactic strategies, and the means for action. A series of aspects are discussed, including: the why of preventive practice? What is preventive practice? The philosophy of prevention; which are the facilities and the necessary equipment?

Dental Prophylaxis↗

Operationalizing a nursing philosophy.

A traditional philosophy statement can be transformed into a positioning statement that articulates a "vision" for a department of nursing and provides a framework when planning to thrive rather than merely survive in today's changing and competitive health care environment. Internal and external forces appropriately assessed enable nurse executives to empower staff to respond proactively to change and prepare for the future.

Hospital Bed Capacity, 100 to 299↗

Nursing department purpose, philosophy, and objectives: their use and effectiveness.

The managerial structure provided by the documents of Purpose, Philosophy and Objectives is said to promote efficient and effective management. Since the delivery of cost-effective nursing care is particularly important in the current climate of cost containment, the use and effectiveness of this structure was investigated. References to desired nursing care from these documents were identified and tracked for evidence of implementation in 27 nursing departments.

Data Collection↗

Claude Bernard's philosophy of medical science.

The great French physiologist Claude Bernard (1813-1878) spent most of his life in Paris, where he held academic appointments and was active in a variety of research fields. In addition to his many contributions to medical science his views on experimental procedure and on philosophy have had an important influence on the development of medical science.

France↗

[Philosophy and medicine].

Current medicine is a complicated system of knowledge, its construction requiring certain philosophical grounds based on the principles of dialectic materialistic ideology. These principles must rest upon clear understanding of the object and subject of medicine and levels of its investigations. The following problems of medicine require further study: reactive and adaptive essence of disease; correlation of norm and health, pathology and disease, their unity, interrelationships, and qualitative differences, Thus, these problems receive different interpretations causing conflicts. It is necessary to strictly adhere to concepts of dialectic materialism, to strengthen the unity of dialectic materialistic philosophy and natural sciences as recommended by V. I. Lenin.

Communism↗

The philosophy and nature of surgical research.

The author's aim is to stimulate potential surgical scientists to appreciate various aspects of surgical research, including its definition, current image, importance, motivation and philosophy, as well as the personal qualities of a surgical scientist. As guidelines for the potential surgical scientist the nature of the scientific method is described in terms of the following 16 phases of what one might call "the cycle of surgical research": recognize an unsolved clinical problem; think; review the scientific literature; ask an intelligent question; formulate an hypothesis; plan the research protocol; seek collaboration; apply for funding; conduct the investigation; collect and analyse the data; interpret the data; draw valid conclusions; answer the original question; present results at a meeting; publish a scientific paper; apply new knowledge to the original problem.

General Surgery↗

The Mammography Quality Standards Act of 1992. History and philosophy.

The Mammography Quality Standards Act (MQSA) of 1992 established a precedent in the practice of mammography by creating federal quality standards for all parts of the mammography system. Heralded by some as crucial so all US women can reap the full benefits of early detection of breast cancer, MQSA implementation was delegated to the Food and Drug Administration (FDA) on June 2, 1993. In this article the major historical forces that surrounded MQSA's enactment as well as the FDA's philosophy on regulation development, inspections, and compliance under MQSA is summarized.

Female↗

Philosophy and medical education.

The most effective way to integrate philosophy into medical education uses ethical, social, and conceptual problems arising in medical practice such as those about informed consent, confidentiality, competency, resource allocation, the doctor-patient relationship, and death and dying. Medical students become better physicians by learning salient views on these matters and by developing philosophical skills and attitudes to (1) examine key assumptions; (2) broaden their perspectives and gain self-knowledge; (3) develop critical thinking skills about the kind of judgments they make, how bias affects their views, and the scope and limits of their knowledge claims; (4) generate tolerance, openness, and skepticism about dogma; and (5) cultivate empathy. Learning these skills and dispositions using moral, conceptual, and social issues facing them will enable students to recognize these issues when they arise in their medical practices and learn how to respond to them in justifiable ways. It will also strengthen the health care profession and institutions overall by fostering the openness, the questioning mind, and the critical thinking essential to the practice of good medicine.

Clinical Competence↗

Growing up in the hospital: Part II, Nurturing the philosophy of family-centered care.

This article is the second in a series that addresses the issues of "growing up in the hospital." Whereas the first article focused on the child and the complex growth and development issues surrounding indefinite hospitalization, this article will focus on the family, the philosophy of family-centered care, and how nursing practice can nurture this ideal when working with children who must "grow up in the hospital."

Adaptation, Psychological↗