Pub Date : 2024-01-01DOI: 10.1353/pbm.2024.a929017
Erica K Salter, Lainie Friedman Ross, D Micah Hester
This article describes the process engaged by 17 expert scholars in the development of a set of six consensus recommendations about the normative foundations of pediatric decision-making. The process began with a robust pre-reading assignment, followed by three days of in-person symposium discussions that resulted in a publication in Pediatrics entitled "Pediatric Decision-Making: Consensus Recommendations" (Salter et al. 2023). This article next compares the six recommendations to existing statements about pediatric decision-making (specifically those developed by the American Academy of Pediatrics), highlighting similarities and differences. Finally, the article discusses the value of finding consensus in the field of pediatric bioethics.
本文介绍了 17 位专家学者参与制定一套有关儿科决策规范基础的六项共识建议的过程。这一过程始于一项强有力的预读任务，随后是为期三天的面对面座谈会讨论，最终在《儿科学》上发表了题为 "儿科决策：共识建议"（Pediatrics：共识建议》（Salter et al.）本文接下来将这六项建议与现有的儿科决策声明（特别是美国儿科学会制定的声明）进行了比较，强调了两者的异同。最后，文章讨论了在儿科生命伦理学领域寻求共识的价值。
{"title":"How We Found Consensus on Pediatric Decision-Making and Why It Matters.","authors":"Erica K Salter, Lainie Friedman Ross, D Micah Hester","doi":"10.1353/pbm.2024.a929017","DOIUrl":"https://doi.org/10.1353/pbm.2024.a929017","url":null,"abstract":"<p><p>This article describes the process engaged by 17 expert scholars in the development of a set of six consensus recommendations about the normative foundations of pediatric decision-making. The process began with a robust pre-reading assignment, followed by three days of in-person symposium discussions that resulted in a publication in Pediatrics entitled \"Pediatric Decision-Making: Consensus Recommendations\" (Salter et al. 2023). This article next compares the six recommendations to existing statements about pediatric decision-making (specifically those developed by the American Academy of Pediatrics), highlighting similarities and differences. Finally, the article discusses the value of finding consensus in the field of pediatric bioethics.</p>","PeriodicalId":54627,"journal":{"name":"Perspectives in Biology and Medicine","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141201375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.1353/pbm.2024.a929023
Mark Christopher Navin, Jason Adam Wasserman, Douglas S Diekema, Thaddeus M Pope
Pediatric intervention principles help clinicians and health-care institutions determine appropriate responses when parents' medical decisions place children at risk. Several intervention principles have been proposed and defended in the pediatric ethics literature. These principles may appear to provide conflicting guidance, but much of that conflict is superficial. First, seemingly different pediatric intervention principles sometimes converge on the same guidance. Second, these principles often aim to solve different problems in pediatrics or to operate in different background conditions. The potential for convergence between intervention principles-or at least an absence of conflict between them-matters for both the theory and practice of pediatric ethics. This article builds on the recent work of a diverse group of pediatric ethicists tasked with identifying consensus guidelines for pediatric decision-making.
{"title":"Limits on Parental Discretion in Medical Decision-Making: pediatric intervention principles converge.","authors":"Mark Christopher Navin, Jason Adam Wasserman, Douglas S Diekema, Thaddeus M Pope","doi":"10.1353/pbm.2024.a929023","DOIUrl":"https://doi.org/10.1353/pbm.2024.a929023","url":null,"abstract":"<p><p>Pediatric intervention principles help clinicians and health-care institutions determine appropriate responses when parents' medical decisions place children at risk. Several intervention principles have been proposed and defended in the pediatric ethics literature. These principles may appear to provide conflicting guidance, but much of that conflict is superficial. First, seemingly different pediatric intervention principles sometimes converge on the same guidance. Second, these principles often aim to solve different problems in pediatrics or to operate in different background conditions. The potential for convergence between intervention principles-or at least an absence of conflict between them-matters for both the theory and practice of pediatric ethics. This article builds on the recent work of a diverse group of pediatric ethicists tasked with identifying consensus guidelines for pediatric decision-making.</p>","PeriodicalId":54627,"journal":{"name":"Perspectives in Biology and Medicine","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141201381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-01DOI: 10.1353/pbm.2023.a909725
Barry F. Saunders
abstract: This essay proposes an unconventional approach to teaching "religion and medicine" to American medical students. Received frameworks for such teaching—articulated around faith denomination or "spirituality"—may imply that religiosities and their health effects are grounded in theology or transcendence, respectively. These frameworks may reify, or misrepresent relationships between, religion and science—for example, in supporting notions of conflict, or of an essentially secular character of technical progress. They can neglect ways in which biomedicine and its institutions are themselves engaged with and productive of religious values. In order to move toward fuller student appreciation of diverse religious materialities and embodiments in health and biomedicine, the essay proposes " the sacred, in practice " as an organizing rubric. This pedagogical intervention pivots on notions of sacrality in anthropologies of religion and offers students a wide path to consider a spectrum of material, gestural conditions, and activities—transformative techniques, intensely valued objects, trusted texts, rituals—that mark and propagate religious valences and commitments within and around contemporary biomedicine. This sacred-in-practice approach meshes with standard theological and spiritual framings of the religion/health/medicine nexus, yet offers more capacious and flexible connections to work for which medical students are training, involving vulnerable bodies and material technologies of tremendous life- and world-shaping potency.
{"title":"Sacred-in-Practice: A Framework for Teaching Religion, Health, and Medicine","authors":"Barry F. Saunders","doi":"10.1353/pbm.2023.a909725","DOIUrl":"https://doi.org/10.1353/pbm.2023.a909725","url":null,"abstract":"abstract: This essay proposes an unconventional approach to teaching \"religion and medicine\" to American medical students. Received frameworks for such teaching—articulated around faith denomination or \"spirituality\"—may imply that religiosities and their health effects are grounded in theology or transcendence, respectively. These frameworks may reify, or misrepresent relationships between, religion and science—for example, in supporting notions of conflict, or of an essentially secular character of technical progress. They can neglect ways in which biomedicine and its institutions are themselves engaged with and productive of religious values. In order to move toward fuller student appreciation of diverse religious materialities and embodiments in health and biomedicine, the essay proposes \" the sacred, in practice \" as an organizing rubric. This pedagogical intervention pivots on notions of sacrality in anthropologies of religion and offers students a wide path to consider a spectrum of material, gestural conditions, and activities—transformative techniques, intensely valued objects, trusted texts, rituals—that mark and propagate religious valences and commitments within and around contemporary biomedicine. This sacred-in-practice approach meshes with standard theological and spiritual framings of the religion/health/medicine nexus, yet offers more capacious and flexible connections to work for which medical students are training, involving vulnerable bodies and material technologies of tremendous life- and world-shaping potency.","PeriodicalId":54627,"journal":{"name":"Perspectives in Biology and Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135735571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-01DOI: 10.1353/pbm.2023.a909731
Sathyaraj Venkatesan, Livine Ancy A
abstract: Assistive care technologies, developed to replace, support, or extend human capabilities and to address the surging demands of care, have been gaining prominence recently. The current trend summons a posthuman approach through decentering the privileged role of humans in several spaces of caregiving, such as hospitals and eldercare homes. The existence of these cutting-edge assistive technologies, exciting as they are, hints at a possible future when the distinction between humans and technology will be blurred, thus transforming care relations. However, these technological advances carry equal promises and dangers. While care robots may reduce the burden of caregiving, they also threaten to minimize human contact with vulnerable populations. This critical assessment reviews technological advances in care and close-reads several single-panel cartoons to theorize the impact of technologies on caring relations. The article also examines the neoliberal underpinnings of such technologies and the moral dangers of their unreflective use.
{"title":"Futures of Care: Care Technologies and Graphic Medicine","authors":"Sathyaraj Venkatesan, Livine Ancy A","doi":"10.1353/pbm.2023.a909731","DOIUrl":"https://doi.org/10.1353/pbm.2023.a909731","url":null,"abstract":"abstract: Assistive care technologies, developed to replace, support, or extend human capabilities and to address the surging demands of care, have been gaining prominence recently. The current trend summons a posthuman approach through decentering the privileged role of humans in several spaces of caregiving, such as hospitals and eldercare homes. The existence of these cutting-edge assistive technologies, exciting as they are, hints at a possible future when the distinction between humans and technology will be blurred, thus transforming care relations. However, these technological advances carry equal promises and dangers. While care robots may reduce the burden of caregiving, they also threaten to minimize human contact with vulnerable populations. This critical assessment reviews technological advances in care and close-reads several single-panel cartoons to theorize the impact of technologies on caring relations. The article also examines the neoliberal underpinnings of such technologies and the moral dangers of their unreflective use.","PeriodicalId":54627,"journal":{"name":"Perspectives in Biology and Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135735800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-01DOI: 10.1353/pbm.2023.a909730
Tia Powell
abstract: This essay explores what it means to age happily, beginning with concepts of aging and happiness and proceeding to factors that promote or undermine happy aging. Relationships, contribution, and personal growth all add value to an aging life. Community also matters, as does the acceptance that a happy older age requires neither perfect health nor immense wealth.
{"title":"Imagine This: Happy Aging in America","authors":"Tia Powell","doi":"10.1353/pbm.2023.a909730","DOIUrl":"https://doi.org/10.1353/pbm.2023.a909730","url":null,"abstract":"abstract: This essay explores what it means to age happily, beginning with concepts of aging and happiness and proceeding to factors that promote or undermine happy aging. Relationships, contribution, and personal growth all add value to an aging life. Community also matters, as does the acceptance that a happy older age requires neither perfect health nor immense wealth.","PeriodicalId":54627,"journal":{"name":"Perspectives in Biology and Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135735979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-01DOI: 10.1353/pbm.2023.a909729
Hajung Lee
abstract: This study examines the origin and religious roots of taegyo , Korean traditional prenatal education, and raises concerns about potential negative impacts of contemporary taegyo practice from feminist and disability perspectives. Taegyo has been accepted without much criticism due to its deep integration into prenatal care culture, and most existing literature focuses on taegyo 's positive impacts on fetal health and development from scientific or nursing perspectives. This article analyzes a 19th-century taegyo manual, Taegyo Singi , and Seon and Won Buddhist literatures on taegyo in order to understand the religio-cultural concepts and contexts of taegyo . The article then discusses the potential downsides of taegyo practice today, considering its patriarchal, mother-blaming, ablest roots in Korean history and culture. The author raises concerns about social oppression, the control of women's bodily autonomy, and the disproportionate responsibility burden that taegyo places on Korean women. The article concludes with suggestions for future research and for well-balanced taegyo practice.
{"title":"Negative Impacts of Taegyo : Feminist and Disability Perspectives","authors":"Hajung Lee","doi":"10.1353/pbm.2023.a909729","DOIUrl":"https://doi.org/10.1353/pbm.2023.a909729","url":null,"abstract":"abstract: This study examines the origin and religious roots of taegyo , Korean traditional prenatal education, and raises concerns about potential negative impacts of contemporary taegyo practice from feminist and disability perspectives. Taegyo has been accepted without much criticism due to its deep integration into prenatal care culture, and most existing literature focuses on taegyo 's positive impacts on fetal health and development from scientific or nursing perspectives. This article analyzes a 19th-century taegyo manual, Taegyo Singi , and Seon and Won Buddhist literatures on taegyo in order to understand the religio-cultural concepts and contexts of taegyo . The article then discusses the potential downsides of taegyo practice today, considering its patriarchal, mother-blaming, ablest roots in Korean history and culture. The author raises concerns about social oppression, the control of women's bodily autonomy, and the disproportionate responsibility burden that taegyo places on Korean women. The article concludes with suggestions for future research and for well-balanced taegyo practice.","PeriodicalId":54627,"journal":{"name":"Perspectives in Biology and Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135735792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-01DOI: 10.1353/pbm.2023.a909723
Pieter R. Adriaens
abstract: Most of Charles Darwin's ideas have withstood the test of time, but some of them turned out to be dead ends. This article focuses on one such dead end: Darwin's ideas about the connection between piloerection and mental illness. Piloerection is a medical umbrella term to refer to a number of phenomena in which our hair tends to stand on end. Darwin was one of the first scientists to study it systematically. In The Expression of the Emotions in Man and Animals (1872), he discusses piloerection in the context of his analysis of the expressions involved in fear and anger, relying heavily on the evidence provided by one of his correspondents, the British psychiatrist James Crichton Browne. This essay reveals how Darwin's initial doubts about the similarity between piloerection in animals and psychiatric patients were eased when studying photographic portraits of female psychiatric patients sent to him by Crichton Browne. It considers arguments against Darwin's reading of these portraits and the apparent contrast between this reading and his own skepticism, in later years, about the value of documentary photography. The article concludes with some notes regarding the reception of Darwin's ideas about psychopathology.
{"title":"Disputing Darwin: On Piloerection and Mental Illness","authors":"Pieter R. Adriaens","doi":"10.1353/pbm.2023.a909723","DOIUrl":"https://doi.org/10.1353/pbm.2023.a909723","url":null,"abstract":"abstract: Most of Charles Darwin's ideas have withstood the test of time, but some of them turned out to be dead ends. This article focuses on one such dead end: Darwin's ideas about the connection between piloerection and mental illness. Piloerection is a medical umbrella term to refer to a number of phenomena in which our hair tends to stand on end. Darwin was one of the first scientists to study it systematically. In The Expression of the Emotions in Man and Animals (1872), he discusses piloerection in the context of his analysis of the expressions involved in fear and anger, relying heavily on the evidence provided by one of his correspondents, the British psychiatrist James Crichton Browne. This essay reveals how Darwin's initial doubts about the similarity between piloerection in animals and psychiatric patients were eased when studying photographic portraits of female psychiatric patients sent to him by Crichton Browne. It considers arguments against Darwin's reading of these portraits and the apparent contrast between this reading and his own skepticism, in later years, about the value of documentary photography. The article concludes with some notes regarding the reception of Darwin's ideas about psychopathology.","PeriodicalId":54627,"journal":{"name":"Perspectives in Biology and Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135735784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-01DOI: 10.1353/pbm.2023.a909728
Timothy E. Murphy, Jennifer A. Parks
abstract: Birth certificates typically designate parents as "mothers" or "fathers," although some US states offer nongendered designations. The authors argue that gendered characterizations offer scant legal or moral value and that states should move to degender parental status on birth certificates but retain that information in registrations of birth. Registrations of birth identify the person giving birth to a child, when, and where, and they report demographic and health information useful for civic and public health purposes. Birth certificates typically report a child's name, sex, date and location of birth, and parentage so far as known. As documents establishing parents' standing in relation to children and vice versa, as well as age and presumptive citizenship, birth certificates add no legal or moral value by gendering parents. Gendering parents on birth certificates obliges the state to rely on exclusionary criteria of "mother" and "father." By contrast, degendering parental status withdraws the need for such criteria and confers benefits on people with transgender and nonbinary identities, as well as undercutting any problematic presumption that parents have responsibilities to their children qua mother or qua father.
{"title":"Degendering Parents on Birth Certificates","authors":"Timothy E. Murphy, Jennifer A. Parks","doi":"10.1353/pbm.2023.a909728","DOIUrl":"https://doi.org/10.1353/pbm.2023.a909728","url":null,"abstract":"abstract: Birth certificates typically designate parents as \"mothers\" or \"fathers,\" although some US states offer nongendered designations. The authors argue that gendered characterizations offer scant legal or moral value and that states should move to degender parental status on birth certificates but retain that information in registrations of birth. Registrations of birth identify the person giving birth to a child, when, and where, and they report demographic and health information useful for civic and public health purposes. Birth certificates typically report a child's name, sex, date and location of birth, and parentage so far as known. As documents establishing parents' standing in relation to children and vice versa, as well as age and presumptive citizenship, birth certificates add no legal or moral value by gendering parents. Gendering parents on birth certificates obliges the state to rely on exclusionary criteria of \"mother\" and \"father.\" By contrast, degendering parental status withdraws the need for such criteria and confers benefits on people with transgender and nonbinary identities, as well as undercutting any problematic presumption that parents have responsibilities to their children qua mother or qua father.","PeriodicalId":54627,"journal":{"name":"Perspectives in Biology and Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135735985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-01DOI: 10.1353/pbm.2023.a909732
Sathyaraj Venkatesan, Livine Ancy A
abstract: Assistive care technologies, developed to replace, support, or extend human capabilities and to address the surging demands of care, have been gaining prominence recently. The current trend summons a posthuman approach through decentering the privileged role of humans in several spaces of caregiving, such as hospitals and eldercare homes. The existence of these cutting-edge assistive technologies, exciting as they are, hints at a possible future when the distinction between humans and technology will be blurred, thus transforming care relations. However, these technological advances carry equal promises and dangers. While care robots may reduce the burden of caregiving, they also threaten to minimize human contact with vulnerable populations. This critical assessment reviews technological advances in care and close-reads several single-panel cartoons to theorize the impact of technologies on caring relations. The article also examines the neoliberal underpinnings of such technologies and the moral dangers of their unreflective use.
{"title":"Futures of Care: Care Technologies and Graphic Medicine","authors":"Sathyaraj Venkatesan, Livine Ancy A","doi":"10.1353/pbm.2023.a909732","DOIUrl":"https://doi.org/10.1353/pbm.2023.a909732","url":null,"abstract":"abstract: Assistive care technologies, developed to replace, support, or extend human capabilities and to address the surging demands of care, have been gaining prominence recently. The current trend summons a posthuman approach through decentering the privileged role of humans in several spaces of caregiving, such as hospitals and eldercare homes. The existence of these cutting-edge assistive technologies, exciting as they are, hints at a possible future when the distinction between humans and technology will be blurred, thus transforming care relations. However, these technological advances carry equal promises and dangers. While care robots may reduce the burden of caregiving, they also threaten to minimize human contact with vulnerable populations. This critical assessment reviews technological advances in care and close-reads several single-panel cartoons to theorize the impact of technologies on caring relations. The article also examines the neoliberal underpinnings of such technologies and the moral dangers of their unreflective use.","PeriodicalId":54627,"journal":{"name":"Perspectives in Biology and Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135735802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-01DOI: 10.1353/pbm.2023.a909724
S. Nassir Ghaemi
abstract: William Osler (1849–1919) is often considered the most influential physician in the emergence of science-based medicine. However, his approach to clinical medicine tends to be misunderstood, and its relevance to psychiatry has not been explored systematically. Osler's approach to the patient had four components: biological reductionism about disease, a scientific approach to clinical diagnosis, therapeutic conservatism, and a humanistic approach to the person. These concepts conflict with the pragmatic, eclectic, anti-reductionistic assumptions of contemporary psychiatry, as codified in its interpretation of a "biopsychosocial" model. This model leads to unscientific practice, with excessive use of medications given for symptoms, and inattention to identifying and treating diseases. This article suggests that implementing Osler's philosophy of medicine in psychiatry would greatly benefit the latter. It would inaugurate a new "biohumanistic" approach to psychiatry.
{"title":"In the Tradition of William Osler: A New Biohumanistic Model of Psychiatry","authors":"S. Nassir Ghaemi","doi":"10.1353/pbm.2023.a909724","DOIUrl":"https://doi.org/10.1353/pbm.2023.a909724","url":null,"abstract":"abstract: William Osler (1849–1919) is often considered the most influential physician in the emergence of science-based medicine. However, his approach to clinical medicine tends to be misunderstood, and its relevance to psychiatry has not been explored systematically. Osler's approach to the patient had four components: biological reductionism about disease, a scientific approach to clinical diagnosis, therapeutic conservatism, and a humanistic approach to the person. These concepts conflict with the pragmatic, eclectic, anti-reductionistic assumptions of contemporary psychiatry, as codified in its interpretation of a \"biopsychosocial\" model. This model leads to unscientific practice, with excessive use of medications given for symptoms, and inattention to identifying and treating diseases. This article suggests that implementing Osler's philosophy of medicine in psychiatry would greatly benefit the latter. It would inaugurate a new \"biohumanistic\" approach to psychiatry.","PeriodicalId":54627,"journal":{"name":"Perspectives in Biology and Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135735989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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