The Crisis of Medicine: Philosophy and the Social Construction of Medicine

Wildes, Kevin Wm.

doi:10.1353/ken.2001.0008

Cited by 17 publications

(7 citation statements)

References 9 publications

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“…Wildes [27], in a critique of Pellegrino's philosophy, highlights the potential problem of 'silence' contained within this position however. Wildes argues that "to focus solely on the physician-patient encounter is an incomplete phenomenology (of medical practice) since the encounter is shaped by the presence of others, as well as the structures that make the encounter possible" [[27]:79].…”

Section: The Internal Morality Of Medical Care: Pellegrino's Ethical mentioning

confidence: 99%

“…Wildes argues that "to focus solely on the physician-patient encounter is an incomplete phenomenology (of medical practice) since the encounter is shaped by the presence of others, as well as the structures that make the encounter possible" [[27]:79]. For Wildes and others medical care is at its core a form of social practice, intimately entwined with the social structures, relations of power and institutional settings that make it possible and without which it would not exist.…”

Section: The Internal Morality Of Medical Care: Pellegrino's Ethical mentioning

confidence: 99%

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The ethics of everyday practice in primary medical care: responding to social health inequities

Furler

Palmer

2010

Philos Ethics Humanit Med

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BackgroundSocial and structural inequities shape health and illness; they are an everyday presence within the doctor-patient encounter yet, there is limited ethical guidance on what individual physicians should do. This paper draws on a study that explored how doctors and their professional associations ought to respond to the issue of social health inequities.ResultsSome see doctors as bound by a notion of care that is blind to a patient's social position, while others respond to this issue through invoking notions of justice and human rights where access to care is a prime focus. Both care and justice orientations however conceal important tensions linked to the presence of bioethical principles underpinning these. Other normative ethical theories like deontology, virtue ethics and utilitarianism do not provide adequate guidance on the problem of social health inequities either.ConclusionThis paper explores if Bauman's notion of "forms of togetherness" provides the basis of a relational ethical theory that can help to develop a response to social health inequities of relevance to individual physicians. This theory goes beyond silence on the influence of social position of health and avoids amoral regulatory approaches to monitoring equity of care provision.

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Section: The Internal Morality Of Medical Care: Pellegrino's Ethical mentioning

confidence: 99%

Section: The Internal Morality Of Medical Care: Pellegrino's Ethical mentioning

confidence: 99%

The ethics of everyday practice in primary medical care: responding to social health inequities

Furler

Palmer

2010

Philos Ethics Humanit Med

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“…Although new paradigms and images have emerged, no [single] one has become dominant for the field of the profession." 21 In spite of bioethics and the philosophy of medicine, the medical profession still seems insecure in determining itself, and one would expect that any clarification, coming from literary narrative for example, might help reach a better understanding of what medical practice is about. This is especially so in the light of the tendency to see the "proposed (goals) of medical practice [as] socially established".…”

Section: Discussionmentioning

confidence: 99%

Literary narrative in medical practice

Kottow

Kottow²

2002

Med Humanities

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It is generally accepted that the practice of medicine could be improved by turning to the humanities in general, and to narrative and text interpretation in particular. Neverthless, there is hardly any agreement as to the nature of the clinical text, whether it be the patient's narrative that needs to be richly understood, or the patient as patient who must be both personally and clinically deciphered.We suggest that literary narratives depicting medical situations might serve as testimonials of the way medicine has or is being practised in a variety of social settings, and of the ways patients experience disease and medical care. By reading these texts, health care professionals could compare the situations and values involved in such narratives with current medical practices, thus perceiving how clinical encounters have changed and improved or, perhaps, continue to carry a burden of past flaws.

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“…That is, it is not sufficient to understand another person's lived experience and perspective; it also is important to understand the social, cultural, socioeconomic, or other environmental "conditions" (as Daniels called them) that inform and shape that lived experience and perspective. 16,18 …”

Section: Reflective Equilibriummentioning

confidence: 99%

Moral Agency as Enacted Justice: A Clinical and Ethical Decision-Making Framework for Responding to Health Inequities and Social Injustice

et al. 2011

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This is the second of 2 companion articles in this issue. The first article explored the clinical and ethical implications of new emphases in physical therapy codes of conduct reflecting the growing evidence regarding the importance of social determinants of health, epidemiological trends for health service delivery, and the enhanced participation of physical therapists in shaping health care reform in a number of international contexts. The first article was theoretically oriented and proposed that a re-thinking of ethical frameworks expressed in codes of ethics could both inform and underpin practical strategies for working in primary health care. A review of the ethical principle of "justice," which, arguably, remains the least consensually understood and developed principle in the ethics literature of physical therapy, was provided, and a more recent perspective-the capability approach to justice-was discussed. The current article proposes a clinical and ethical decision-making framework, the ethical reasoning bridge (ER bridge), which can be used to assist physical therapy practitioners to: (1) understand and implement the capability approach to justice at a clinical level; (2) reflect on and evaluate both the fairness and influence of beliefs, perspectives, and context affecting health and disability through a process of "wide reflective equilibrium" and assist patients to do this as well; and (3) nurture the development of moral agency, in partnership with patients, through a transformative learning process manifest in a mutual "crossing" and "re-crossing" of the ER bridge. It is proposed that the development and exercise of moral agency represent an enacted justice that is the result of a shared reasoning and learning experience on the part of both therapists and patients.

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The Crisis of Medicine: Philosophy and the Social Construction of Medicine

Cited by 17 publications

References 9 publications

The ethics of everyday practice in primary medical care: responding to social health inequities

The ethics of everyday practice in primary medical care: responding to social health inequities

Literary narrative in medical practice

Moral Agency as Enacted Justice: A Clinical and Ethical Decision-Making Framework for Responding to Health Inequities and Social Injustice

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