In this book the author explores the shifting philosophical boundaries of modern medical knowledge and practice occasioned by the crisis of quality-of-care, especially in terms of the various humanistic adjustments to the biomedical model. To that end he examines the metaphysical, epistemological, and ethical boundaries of these medical models. He begins with their metaphysics, analyzing the metaphysical positions and presuppositions and ontological commitments upon which medical knowledge and practice is founded. Next, he considers the epistemological issues that face these medical models, particularly those driven by methodological procedures undertaken by epistemic agents to constitute medical knowledge and practice. Finally, he examines the axiological boundaries and the ethical implications of each model, especially in terms of the physician-patient relationship. In a concluding Epilogue, he discusses how the philosophical analysis of the humanization of modern medicine helps to address the crisis-of-care, as well as the question of “What is medicine?” The book’s unique features include a comprehensive coverage of the various topics in the philosophy of medicine that have emerged over the past several decades and a philosophical context for embedding bioethical discussions. The book’s target audiences include both undergraduate and graduate students, as well as healthcare professionals and professional philosophers. “This book is the 99th issue of the Series Philosophy and Medicine...and it can be considered a crown of thirty years of intensive and dynamic discussion in the field. We are completely convinced that after its publication, it can be finally said that undoubtedly the philosophy of medicine exists as a special field of inquiry.”

What kind of knowledge is medical knowledge? Can medicine be explained scientifically? Is disease a scientific concept, or do explanations of disease depend on values? What is "evidence-based" medicine? Are advances in neuroscience bringing us closer to a scientific understanding of the mind? The nature of medicine raises fundamental questions about explanation, causation, knowledge and ontology – questions that are central to philosophy as well as medicine. This book introduces the fundamental issues in philosophy of medicine for those coming to the subject for the first time, including: • understanding the physician–patient relationship: the phenomenology of the medical encounter. • Models and theories in biology and medicine: what role do theories play in medicine? Are they similar to scientific theories? • Randomised controlled trials: can scientific experiments be replicated in clinical medicine? What are the philosophical criticisms levelled at RCTs? • The concept of evidence in medical research: what do we mean by "evidence-based medicine"? Should all medicine be based on evidence? • Causation in medicine. • What do advances in neuroscience reveal about the relationship between mind and body? • Defining health and disease: are explanations of disease objective or do they depend on values? • Evolutionary medicine: what is the role of evolutionary biology in understanding medicine? Is it relevant? Extensive use of empirical examples and case studies are included throughout, including debates about smoking and cancer, the use of placebos in randomised controlled trials, controversies about PSA testing and research into the causes of HIV. This is an indispensable introduction to those teaching philosophy of medicine and philosophy of science.

This textbook introduces the reader to basic problems in the philosophy of science and ethics, mainly by means of examples from medicine. It is based on the conviction that philosophy, medical science, medical informatics, and medical ethics are overlapping disciplines. It claims that the philosophical lessons to learn from the twentieth century are not that nature is a ‘social construction’ and that ‘anything goes’ with respect to methodological and moral rules. Instead, it claims that there is scientific knowledge, but that it is never completely secure; that there are norms, but that they are situation-bound; and that, therefore, it makes good sense to search for scientific truths and try to act in a morally decent way. Using philosophical catchwords, the authors advocate ‘fallibilism’ and ‘particularism’; a combination that might be called ‘pragmatic realism’.

The author of Medical Nihilism examines the philosophical complications and controversies underlying medicine. The philosophy of medicine has become a vibrant and complex intellectual landscape, and Care and Cure is the first extended attempt to map it. In pursuing the interdependent aims of caring and curing, medicine relies on concepts, theories, inferences, and policies that are often complicated and controversial. Bringing much-needed clarity to the interplay of these diverse problems, Jacob Stegenga describes the core philosophical controversies underlying medicine in this unrivaled introduction to the field. The fourteen chapters in Care and Cure present and discuss conceptual, metaphysical, epistemological, and political questions that arise in medicine, buttressed with lively illustrative examples ranging from debates over the true nature of disease to the effectiveness of medical interventions and homeopathy. Poised to be the standard sourcebook for anyone seeking a comprehensive overview of the canonical concepts, current state, and cutting edge of this vital field, this concise introduction will be an indispensable resource for students and scholars of medicine and philosophy. Praise for Care & Cure “An exceptionally clear, accessible, and organized introduction to key concepts and central debates in the philosophy of medicine. There is as yet no single-author, comprehensive introduction to this new field. Stegenga’s excellent book fills this lacuna.” —Anya Plutynski, Department of Philosophy, Washington University in St. Louis, author of Explaining Cancer: Finding Order in Disorder “Care and Cure cogently argues that while scholarship on ethics and the practice of medicine are in plenitude, there is a dearth of scholarship grappling with a host of other philosophical questions and issues concerning medicine as a discipline. A balanced overview.” —Mark H. Waymack, Department of Philosophy, Loyola University Chicago “As an introductory text in the philosophy of medicine, Care and Cure offers a comprehensive overview of the field which is accessible to beginners in philosophy. Notably for a philosophical book on medicine, it is not a work in medical ethics, but in applied philosophy of science. Well-written and well-structured, Stegenga’s book is a very welcome addition to the philosophy of medicine literature.” —Hane Maung, Department of Philosophy, School of Social Sciences, University of Manchester

This introduction to the philosophy of medicine surveys the landscape of western philosophy as it pertains to healthcare in an accessible way. Written by a doctor for doctors and other health professionals, framing the 'toolbox' of philosophy within the community of medicine, it encourages examination of the implicit assumptions made in the construction of medical knowledge and practice. Taking the reader step by step through the concepts that underpin modern philosophy, they will be challenged to reflect upon the premises within clinical practice which might benefit from scrutiny and challenge, including the nature of scientific knowledge, the limits of our biomedical model, the cultural and relational context, and the failure to recognise or manage adequately the fact/value distinction in medicine and healthcare. The book is an ideal textbook for students of medicine and medical philosophy and will also be of interest to bioethicists, medical sociologists, clinical commissioners and to practicing clinicians in medicine and the allied health professions seeking to improve their understanding of philosophy and ethics and sharpen their critical thinking skills.

This book exposes, and fills, a notable void in the educational content generally covered in modern schools of medicine. It provides an introduction to the field at large in terms of content that is relevant for each of the specialties and subspecialties of medicine; and to this end, it addresses the modern counterpart of the Hippocratic philosophy that was at the root of the genesis of modern medicine. The much-needed but still-missing introductory content for the interdisciplinary 'medical common,' provided in this book, addresses mainly the most elementary concepts and principles of medicine. Those concepts flow, hierarchically, from the essence of (health and) ill-health/illness for one and that of medicine for another, both of these critically formulated; and those principles are dictates of logic and ethics, both specific to medicine. While a modern physician is expected to be competent as a scholar in his/her particular discipline of medicine, study of this book is essential for the development of that competence -- for learning, for example, to make a tenable distinction between scientific medicine and medical science, and between knowledge-based medicine (scientific and other) and its opinion-based substitutes ('evidence-based' and other). "To me it is astonishing and to medicine actually shameful that it has taken up to year 2015 before there is a work in which the essence of medicine is described and discussed." -- J. Steurer, University of Zurich "[In this book], Miettinen beautifully elucidates the concepts and principles of knowledge-based diagnosis, and prognosis, within medicine. Now, after six decades of keen observation and study, and critical reflection on medicine and medical research, Miettinen, in this book, shares the fundamental understandings he has reached; ..." -- T. J. VanderWeele, Harvard University "The aim of this book ... is admirable. The composition of the book -- from the key concepts to logical and ethical principles -- is very clear and systematic. I am convinced that this kind of book is needed." -- I. Niiniluoto, University of Helsinki

This volume introduces a new subseries of Philosophy and Medicine, Classics of Medical Ethics. The purpose of this new subseries is to bring out scholars' editions of major works in the history of medical ethics and philosophy of medicine. This new subseries will target for publication texts that are long out of print and difficult to access. Each volume will contain an introduction to the writings on medical ethics and philosophy of medicine produced by the original author. Each volume will also contain a guide to the primary and major secondary Hterature, to facilitate teaching and scholarship in bioethics, philosophy of medicine, and history of medicine. Texts will be presented in their origi nal style and will provide pagination of the original, so that citations can be made either to the original text or to the page numbers in these vol umes. Finally, each volume will be well indexed, again to facilitate teaching and research. Bioethics and philosophy of medicine - the former more so than the latter - have an insufficiently developed understanding of themselves as having a history. As a consequence, these fields lack the maturity that critical dialogue of the past with the present provides for other fields and disciplines of the humanities. To the extent that this problem is due to the fact that major primary historical sources are not readily available, this subseries will contribute to the further development and maturation of bioethics and philosophy of medicine as fields of the humanities.