Wednesday, December 12, 2012

Medicine and Philosophy

What do medicine and philosophy have in common? Why should philosophy as a mode of inquiry be of interest to physicians? How can philosophy be a productive and rewarding endeavor for physicians? How is philosophy relevant to the practice of medicine? What can philosophy contribute to the practice of medicine?
      Medicine and philosophy may mutually support and enhance each other in a number of ways. Philosophy has traditionally included such fields of study as epistemology, metaphysics, ethics, aesthetics, logic, and political philosophy, and each of these disciplines may have practical applications to medicine.
      Epistemology may clarify the way in which health care providers (individual practitioners as well as group providers, administrators, and hospitals) form beliefs and opinions, make decisions, and respond to various sources of evidence. Social epistemology may also reveal the social dimensions of knowledge and information, and it may clarify the relevance of social institutions (such as scientific journals, hospital committees, professional licensing boards, and government agencies) to knowledge.
      Metaphysics and ontology may provide models of social reality that are useful in analyzing various kinds of interactions between physicians and patients, between patients and physicians and third parties, and between physicians and society.
      Ethics (particularly, biomedical ethics) is relevant to the practice of medicine, because it addresses such questions as: What ethical principles should guide the physician-patient relationship? Do physicians in private practice have a moral obligation to provide services to patients who cannot afford to pay? Do physicians entering private practice have a moral obligation to practice in geographic areas that are underserved with regard to the availability of health care services? Do physicians in private practice have a moral obligation to accept public health insurance payments as full reimbursement for services provided?
         Other ethical questions regarding health care that are of great concern to society include: How can equitability of access to health care best be achieved? Should an individual's access to health care be based on his/her medical need rather than his/her ability to pay? What constitute fair and just principles of health care resource allocation? What corrective measures should be taken to address health care inequities? What should be done to prevent wasteful and unnecessary overutilization of medical services? What should be done to ensure that services are appropriate, timely, and cost-effective? What responsibilities do wealthy nations have to address global health care needs? 
         Biomedical ethics is also an important field of study for physicians because it addresses issues of professional conduct, such as appropriate prescription writing, appropriate provision of services, adherence to reasonable standards of care, respect for patient dignity, respect for patient privacy and confidentiality, respect for the patient's right of informed consent, adherence to standards of professional integrity, and fulfillment of the responsibility to maintain professional competence.
      Aesthetics (specifically, medical aesthetics) is relevant to such fields as dermatology, plastic surgery, reconstructive surgery, and prosthetics.
      Political philosophy is relevant to the practice of medicine insofar as it may be concerned with such questions as: What is justice? How can social justice best be achieved? What constitutes justice with regard to access to health care? Does a just society provide universal access to health care? How can justice in health care delivery best be achieved? 
      The philosophy of language may be relevant to medicine insofar as it may explore styles of communication (among health care providers, between providers and patients, and between providers and the general public), and may clarify issues related to cultural competence, workplace communication, and peer to peer communication. It may also be useful in determining how scientific problems can be presented more cogently and understandably to the general public. Medical semiotics (the recognition, interpretation, and evaluation of medical signs and symptoms) may also be an area of intersection between medicine and the philosophy of language.
      The philosophy of medicine may be relevant to the way in which physicians view the practice of medicine and the way in which they view themselves as practitioners. It may be concerned with such questions as: What is medicine? Is medicine an art or a science? What is good health? What is an acceptable quality of life, from a health standpoint? How can health care providers enable patients to attain their best possible quality of health? How can a patient best be recognized as a whole person and not just as a collection of disease processes?

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