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PubMed1995

Viktor Emil von Gebsattel on the doctor-patient relationship.

This article provides a summary overview of the ideas on medical anthropology and anthropological medicine of the German philosopher-psychiatrist Viktor Emil von Gebsattel (1883-1974), and discusses in more detail his views on the doctor-patient relationship. It is argued that Von Gebsattel's warning against a dehumanization of medicine when the "person" of both patient and physician are not explicitly present in their relationship remains valid notwithstanding the modern emphasis on respect for patient (and provider) autonomy.

Anthropology↗
PubMed2002

The notion of health: a conceptual analysis.

The notion of health used in medicine may have important implications, such as guiding the allocation of medical resources. This paper explores the notion of health through an overview and conceptual analysis of various notions of health found in modern medical and philosophical literature. It argues that health is characterized either positively or negatively (per exclusion), and either mechanistically (as the set of common or ideal states of a species) or holistically (as unimpaired self-organization of organisms). The paper concludes that a sound notion of health characterizes health negatively and holistically, assimilating mechanism as a good approximation in simple cases.

Health↗
PubMed1995

Recent developments in psychiatric nurse education in the countries of central and eastern Europe.

Since the social and political revolutions of 1989 and the years that followed the countries of Central and Eastern Europe (CCEE) have undergone radical changes in their health care systems, and among the most radical of these has been the restructuring and reorganisation of the psychiatric nurse training and education, with a weather eye to the potential of mental health demands that may result from the socio-economic turmoil. This paper, much of which was compiled while on secondment to the WHO, attempts to give a brief overview of the main policy developments in selected countries and to place them within a philosophical, social and pedagogical context. It cannot escape notice that the way in which countries choose to educate their nurses and what they can be expected to achieve in their work, reflects a more global understanding of mental health--and that may be why we should all learn from this experience.

Commonwealth of Independent States↗
PubMedDate not supplied

Concepts in nuclear replacement.

This article describes the pathogenesis of early nuclear failure and current philosophical approaches to artificial, biological, and bioartificial nucleus replacement. Necessary in this review is an overview of current approaches to nucleus replacement with prosthetics and various gel materials.

Arthroplasty, Replacement↗
PubMed2000

Medical informatics and the concept of disease.

This paper attempts to address the general question whether information technologies, as applied in the area of medicine and health care, have or are likely to change fundamental concepts regarding disease and health. After a short excursion into the domain of medical informatics I provide a brief overview of some of the current theories of what a disease is from a more philosophical perspective, i.e. the "value free" and "value laden" view of disease. Next, I consider at some length, whether health care informatics is currently modifying fundamental concepts of disease. To this question I will answer largely in the negative, and I will provide the sketch of some arguments from current research programs in medical informatics why I think this is the case. This argumentation is supported by a detailed account of how the disease profile for beriberi heart disease, used in one of the major medical informatics diagnostic programs, QMR (and its ancestor INTERNIST-1), was developed, and why at least this program essentially follows received views of traditional medicine. The one main exception to the conformity of this program to "received" views of a disease occurs when the program's designers need to fine-tune a disease definition. This fine-tuning is to comport with the expert's perspective on the disease, including his or her epistemic values, as well as the program's other resources for diagnosing components of a disease.

Beriberi↗
PubMed2005

Independence and well-being in later life: three New Zealand studies.

This paper argues that social gerontology is an appropriate methodological lens to investigate independence and well-being in later life and goes on to overview three diverse and independent pieces of research which cross disciplinary boundaries, geographic locations and philosophical terrains. A comparative analysis of the results from these studies identifies that health, economic status and social support influence the concepts of independence and well-being in older people. Nurses, particularly those working in primary health care, are likely to be the first point of contact for many older adults and need to operationalise a holistic assessment framework in order to address all components of ageing that influence independence and well-being in this group of people.

Activities of Daily Living↗
PubMed1999

Neuromuscular control: introduction and overview.

This paper introduces some basic concepts of the interdisciplinary field of neuromuscular control, without the intention to be complete. The complexity and multifaceted nature of neuromuscular control systems is briefly addressed. Principles of stability and planning of motion trajectories are discussed. Closed-loop and open-loop control are considered, together with the inherent stability properties of muscles and the geometrical design of animal bodies. Various modelling approaches, as used by several authors in the Philosophical Transactions of the Royal Society of London, Series B, May 1999 issue, such as inverse and forward dynamics are outlined. An introductory overview is presented of the other contributions in that issue.

Animals↗
PubMed2006

Euthanasia: an overview and the jewish perspective.

BACKGROUND: End-of-life care poses fundamental ethical problems to clinicians. Defining euthanasia is a difficult and complex task, which causes confusion in its practical clinical application. Over the course of history, abuse of the term has led to medical atrocities. Familiarity with the relevant bioethical issues and the development of practical guidelines might improve clinical performance. OBJECTIVE: To define philosophical concepts, to present historical events, to discuss the relevant attitudes in modern bioethics and law that may be helpful in elaborating practical guidelines for clinicians regarding euthanasia and end-of-life care. Concepts found in the classic sources of Jewish tradition might shed additional light on the issue and help clinicians in their decision-making process. METHODS: An historical overview defines the concepts of active versus passive euthanasia, physician-assisted suicide and related terms. Positions found in classical Jewish literature are presented and analyzed with their later interpretations. The relevance and application in modern clinical medicine of both the general and Jewish approaches are discussed. RESULTS: The overview of current bioethical concepts demonstrates the variety of approaches in western culture and legal systems. Philosophically and conceptually, there is a crucial distinction between active and passive euthanasia. The legitimacy of active euthanasia has been the subject of major controversy in recent times in various countries and religious traditions. CONCLUSION: The historical overview and the literature review demonstrate the need to provide clearer definitions of the concepts relating to euthanasia, for in the past the term has led to major confusion and uncontrolled abuse. Bioethical topics should, therefore, be included in medical training and continuing education. There are major debates and controversies regarding the current clinical and legal approaches. We trust that classical Jewish sources might contribute to the establishment of clinical definitions, meaningful approaches and practical guidelines for clinicians.

Attitude to Health↗
PubMedDate not supplied

Statistical process control for the pharmaceutical industry.

An overview of Total Quality Management and Statistical Process Control is provided with a goal of focusing on their implementation. The implementation is presented as three distinct areas. These are the philosophical and behavioral requirements, the statistical monitoring, and the statistical design. The first emphasizes the culture of problem solving and continuous improvement, the second focuses on the control charts, and the third on the Taguchi methods. After this overview, a discussion of common mistakes that occur in practice during the implementation of these methods is provided. Again, managerial mistakes are separated from the more specific technical or statistical mistakes. The paper concludes with recommendations concerning applications specific to the pharmaceutical industry.

Inservice Training↗
PubMed2000

Naturopathy, Nightingale, and nature cure: a convergence of interests.

Naturopathy is making a strong resurgence in many Western countries, and its philosophical and theoretical basis has much in common with nursing theories of health. This article will give an overview of naturopathy, its origins in Hippocratic medicine and nature cure, and its re-emergence during the Victorian era in the context of a renewal of interest in health. The question is posed, 'To what extent did the nature cure movement of last century influence the thinking of Florence Nightingale?' An examination of her writings supports the hypothesis that nature cure was a significant influence on Nightingale's understanding of health and healing. Contemporary nursing theory is also congruent with naturopathic principles in significant ways, and a convergence between the two disciplines is emerging.

History, 19th Century↗
PubMed2001

Qualitative research strategies in rehabilitation.

This article presents an overview of the qualitative research methods that social scientists use to explore human phenomena. The authors describe the philosophical and historical foundations of qualitative research, coupled with illustrations of specific qualitative designs. Applications of qualitative methods in the contemporary rehabilitation literature are also presented.

Journal Article↗
PubMed2001

Ethical considerations on dynamic psychiatry and the tradition of relationship in psychoanalysis. An historical overview.

The historical tradition of psychoanalysis as the therapeutic science of interpersonal processes is traced back to its roots in Freud and discussed in its therapeutic and philosophical implications. The Berlin School of Dynamic Psychiatry enlarges the interpersonal principle with the therapeutic concept of group dynamics, identity and of social energy, giving it an implication of therapeutic optimism and a new ethical significance.

Ethics, Medical↗
PubMed1998

The concept of health and disease.

Examining the naturalist and normativist concepts of health and disease this article starts with analysing the view of C. Boorse. It rejects Boorse's account of health as species-typical functioning, giving a critique of his view based on evolutionary theory of contemporary biology. Then it gives a short overview of the normativist theories of health, which can be objectivist and subjectivist theories. Rejecting the objectivist theories as philosophically untenable, it turns to the subjectivist theories of Gert and Culver, and to the view of Nordenfelt. These theories give quite a good subjectivist account of health and disease, but they do not pay enough attention to the notion of the environment, without which it is impossible to define health and disease. Starting with their definitions but introducing the notion of "reasonable social norms", the article arrives at the following definition of health: The healthier a physical or mental characteristic, process, reaction is, the more it makes it possible for the individual to adapt to reasonable social norms without pain and suffering, and the longer, and happier a life it will be able to ensure him in that society.

Adaptation, Physiological↗
PubMed1987

A panic attack in therapeutic recreation over being considered therapeutic.

Ancillary professions have been called upon to account for therapeutic benefits from their services or be eliminated from the health care system. A singular focus on therapy, however, would negate the unique contribution of therapeutic recreation within, while simultaneously restricting services to health care settings. It is proposed that panic over therapeutic recreation services meeting health care goals has hindered evaluation and solidification of the leisure-based philosophy presented in the NTRS Philosophical Position Statement (NTRS, 1982). It is argued that emphasizing the leisure orientation of the philosophical position statement can secure therapeutic recreation's position within, yet, not deny services to those outside of the health care system. An overview is presented on the adequacy of the position statement philosophy for therapeutic recreation. A potential danger of attempting to explain therapeutic recreation in terms of non-leisure based philosophies is also discussed.

Humans↗
PubMedDate not supplied

Blanket bans on treatment: conflict in healthcare resourcing.

Blanket bans of specific treatments have been controversially introduced by some NHS trusts as a means of rationing health care and prioritizing funding for services. This article examines the perceived value conflicts that emerge in relation to blanket bans on specific treatments. Following an initial overview of rationing in contemporary society the needs and wants of given individuals are compared with those of a wider society. Ethical values and philosophical considerations are explored as an analysis of the continuing debate is attempted.

Attitude to Health↗
PubMed1990

Bioethics: its philosophical basis and application.

Contemporary medicine involves a lot more than technologies that now permit effective medical intervention where none was possible before. Among other things, changes in technology have been accompanied by changes in social and cultural attitudes that are having major effects on health care and medical practice. This article provides a brief overview of many of the more important changes and their relationship to developments in the field of medical bioethics.

Beneficence↗
PubMed1986

Development and organization of services for alcoholics in Leningrad, USSR.

This report provides a brief, general overview of how alcoholism is reported to be dealt with in one of the Soviet Union's largest cities. It attempts to describe both the philosophical and applied approaches practiced, and affords an opportunity to compare these approaches with those in the United States. Specifically, the paper presents a brief historical review and description of services provided to clients at alcohol treatment centers in the city of Leningrad, USSR, and discusses contemporary Soviet attitudes toward alcoholism.

Alcohol Drinking↗