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Results for “Philosophical Approach”

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At least 19 recordsLinked to original sources
PubMed1979

What is medicine?: towards a philosophical approach.

The failure of Western medicine to deal with many of the problems it is currently facing has led to an awareness of the need for a fundamental reappraisal. The way in which medical concepts derived from the nineteenth century have brought technical medical advances in this century and the alliances that medicine has made with statistics and more recently the social sciences, have prevented a questioning of medicine's underlying assumptions. Thus, despite a number of critical initiatives from both within and outside medicine, there has been no coherent development to seriously confront the question 'what is medicine?'. It is suggested that the basis for such a development depends on the return to a philosophical questioning of our conceptual understanding of disease, a subject which has largely been ignored during the past hundred years.

Disease↗
PubMed1991

A philosophic approach to aging.

Who are the old? Is age a category, like sex? Does just getting to a certain age justify certain rewards and certain limits? Is there a role for old physicians working in a hospital? What should age be a criterion for? There are no firm answers, but there should be more discussion.

Aged↗
PubMed1990

Ameloblastoma, a behavioral and histologic paradox (a philosophical approach).

The ameloblastoma, because of its aggressive clinical behavior and its histological feature apparently benign, constitutes a puzzling paradox. Some hypotheses concerning this strange clinical-histologic contradiction are analyzed, as well as the additional paradox represented by the neoplastic parenchyma itself, in which a tissue consisting of cells nominally able to form enamel do not elaborate any of the calcified dental tissues.

Ameloblastoma↗
PubMed1991

Voices and paradigms: perspectives on critical and feminist theory in nursing.

Nurse scientists have explored a variety of research methods and a number of philosophic approaches to expand the discipline's ability to describe and investigate nursing's phenomena of interest. This article discusses the similarities and differences in world views, epistemologies, methodologies, and methods of two of these paradigms: critical theory and feminist theory. Attributes of these two stances are contrasted, and the relationship between the methods of analysis and the philosophic point of view are explored. An example of nursing research is given, with discussion of how the approach would differ if the nurse scientist were using critical versus feminist theory as a frame of reference.

Female↗
PubMed1991

New approaches to the treatment of follicular lymphoma.

The major avenues of clinical research into the treatment of follicular lymphoma, 'more, if so when?', interferon therapy, and antibody therapy, have been presented in the light of present knowledge about the clinical course of the disease. They must be seen within the context of the current philosophical approach to the illness, and the economic climate which prevails, at a time when new drugs, for example fludarabine (Leiby et al, 1987; Reman et al, 1988; Whelan et al, 1991), are showing promise, and differentiating agents are being tested in remission (Cunningham et al, 1985). There can be little doubt that the objective of future research should be to eliminate the disease altogether at the time of initial presentation, since patients entering remission and never having a recurrence have a far greater probability of longevity than those in whom recurrences occur (Lister, 1991). There can also be little doubt that when lymphoma is present and causing symptoms, treatment should be given, since survival is longer for those in whom a response is achieved, at least at presentation, and at first recurrence (Lister, 1991). Since the latter is sadly the reality for the majority, improving treatment at the time of recurrence must also be a priority. Time will tell whether any of the options presently under investigation will be appropriate at all, and if so when. It is certainly the case that some of them will be entirely inappropriate for some patients, because the risk of toxicity will outweigh the potential benefit, especially for the elderly. Further careful identification of prognostic variables may allow for individualization of therapy. It would be comforting to know that the newly found molecular marker of the disease would help us. Its absence may do--but its presence certainly does not, since t(14;18) containing cells may seemingly be present for many years of clinical normality (Price et al, 1991, in press). The challenge to find the right treatment at the right time--or perhaps to identify the 'right patient' for the therapy continues.

Antibodies, Monoclonal↗
PubMed1989

Philosophy and health.

This paper employs a philosophical approach in order to explore the nature of the concept of health. It is designed to provoke further thought and discussion by posing a number of questions such as 'What is health?' and 'How is ill-health experienced?'. The authors argue that some philosophical ability is necessary to enable the professional carer to reflect clearly and logically on both their theory and practice. In addition this paper argues that professional carers should aim to achieve a balance between science and humanism. Also reasons are suggested why a role should be given to non-scientific language in the planning of individual-centred care.

Disease↗
PubMed1992

Method of moments and treatment of nonrandom error.

If one has a convoluted fluorescence decay and wishes to analyze it for a sum of exponential, then one can begin by asking either of two questions: (1) What sum of exponentials best fits the data? (2) What physical decay parameters gave rise to the data? At first these two questions may sound equivalent; in fact, they represent different philosophical approaches to data analysis. In resolving the first question, one adjusts the decay parameters until a calculated curve agrees within arbitrarily chosen limits to the original data. This is what we did in the fourth section of Table II. The fit obtained was decent, but the resulting parameters were wrong. A more difficult approach is to design a method of data analysis which is intrinsically insensitive to the presence of anticipated errors, aiming directly at recovering the decay parameters without regard to the fit. This is what we have done with the method of moments with MD. If particular errors do not have much effect on the recovered parameters, then such a method of data analysis is said to be robust with respect to those errors. Robust methods are widely used in engineering but have not seen much introduction yet to biophysics. Least-squares, the basis of the commonly used data fitting methods for pulse fluorometry, is nonrobust with respect to underlying noise distributions. Isenberg has shown that least-squares is nonrobust with respect to the nonrandom light scatter, time origin shift, and lamp width errors as well. As shown in Isenberg's paper, as well as here, the method of moments with MD is quite robust with respect to these nonrandom errors. Perhaps question (1) could be modified to include all of the errors that might be present in the data; but then, how would one decide which errors to include and whether an error is present? What fitting criterion would tell one this? Why choose a method which depends so strongly on this information when robust alternatives exist? As a rule, fitting should not be used as a criterion for correct decay parameters, unless all of the significant nonrandom errors have been included in the fit. If one fits the data but has not incorporated an important error, then the best fit will necessarily give the wrong answer. The method of moments provides clear criteria for accepting or rejecting an analysis.(ABSTRACT TRUNCATED AT 400 WORDS)

Data Interpretation, Statistical↗
PubMed1987

Ethical considerations of informed consent: a case study.

Presentation is made of a case study concerning a patient with chronic obstructive pulmonary disease who was also discovered to have small cell carcinoma. The patient had indicated many years prior to his hospitalization that if he ever had cancer he would not want to receive chemotherapy. He also indicated to his physician he did not want to hear any 'bad news'. The dilemmas posed by the ethical relationship between consultant and primary care physician and between consultant and patient in such a case are explored. The role of a hospital ethics committee in advising the parties involved is also reviewed.

Carcinoma, Small Cell↗
PubMed1989

Health science, natural science, and clinical knowledge.

The epistemological status of health science, natural science, and clinical knowledge is explored. It is shown that 'health science', a term increasingly used in association with the clinical knowledge of the therapies, nursing, and other health occupations, is not fully a science in the sense of the natural sciences. It is rather a hybrid which relates applications of natural science, behavioral science, and the humanities to problems in health. The same may be said of clinical knowledge which entails, as essentials, humanistic considerations involving the personal concerns of the patient, in addition to the more evident external aspects of diagnosis and treatment. The recent introduction of the term 'health science' reflects scientism in its approach to health issues. It also reflects confusion about the nature of clinical knowledge.

Behavioral Sciences↗
PubMed1990

Medicine and dialogue.

Physicians have for some time been questioning the prevailing view of medicine as applied biology. It is urged that medicine needs to be reconceived so as to provide appropriate emphasis on the patient's experience and understanding of illness. After reviewing these arguments and the scientific paradigm underlying the received view in light of certain themes in medicine's history and of current thinking, Pellegrino's thesis is analyzed: medicine should be understood as an inherently moral enterprise, a form of praxis focused on "the healing relationship". Understanding the illness experience and the professed healer's "compassion" supports Pellegrino's view, and suggests that the healing relationship is perhaps best conceived as a form of dialogue.

Communication↗
PubMed1991

Conceptual issues in nursing ethics research.

Empirical studies that have attempted to describe nurses' ethical practice have used conceptual frameworks derived primarily from the disciplines of bioethics and psychology. These frameworks have not incorporated important concepts developed by nursing theorists over the past two decades. This article points out flaws in the past research frameworks and proposes a synthesis of ethical theory, nursing practice contexts, and empirical research methods to enrich theoretical development in nursing ethics.

Ethical Analysis↗
PubMed1991

Nurses and physicians on nutritional support: a comparison.

During the last decade, several court cases have focused attention on the moral and legal aspects of withholding or withdrawing food and fluids from certain patients. The courts have not been unanimous in their judgements on these matters. In attempting to explore this issue, this article reviews both the nursing and medical literature on the withdrawing and withholding of food and fluids with particular attention to empirical studies. Several themes which emerge from the literature are used to explore the similarities and differences between the practices of nursing and medicine where nutritional support is concerned.

Attitude of Health Personnel↗
PubMed1991

Empathy as an ethical and philosophical basis for nursing.

This article reconstructs the concept of empathy. Current conceptualizations in nursing, psychology, and lay usage and philosophic approaches are examined. Factors of empathetic situations are defined. Key issues of the object, moral implications, and the locus of empathy are discussed using illustrations from fictional and professional literature. In the proposed concept, a common humanity is the object of empathy, and the empathetic process occurs within individuals. Ability to empathize varies with the broadness of the base with which each individual is able to perceive the common humanity within another. Moral implications include a duty to base actions in empathy.

Empathy↗
PubMed1991

Principle-oriented ethics and the ethic of care: a creative tension.

Research to date in the field of nursing ethics has overlooked the nature of the guiding moral framework in nursing practice, while focusing primarily on the moral reasoning and moral behaviors among nurses. This research depicts two moral frameworks--a principle-oriented ethic and the ethic of care--as they are experienced by practicing critical care nurses. The interdependence of these two frameworks as they inform the moral experience of the nurse is demonstrated in the analysis of a complex nurse narrative that depicts the nurse's moral struggle.

Beneficence↗