Medical humanities midterm 2

What does philosophia mean

love of wisdom

Who was Rene Descartes?

French philosopher, mathematician, and scientist, known as father of philosophy

Where/when did Rene Descartes live

1596-1650 in the Netherlands

What was Rene Descartes primary discipline, legacy

-Cartesianism: reason is the primary source of knowledge

-mathematical certainty is the epitome of knowledge

-cogito ergo sum: I think therefore I am

Who was Giambattista Vico?

-Father of philosophy of history

-critic of rationalism

Where/when did Giambattista vico live

1668-1774 in Naples Italy

Primary discipline of vico

Alternative epistemology aka acquaintance knowledge

Vicos alternative epistemology

Mode of perception best suited to understanding cultures and persons and ways of thought and feeling and expression

According to Dr. Eric Cassell what is the fundamental goal of medicine

Relief of suffering

What are the 4 notions from the Hastings Group that serves as guideposts to determine goals and limits of modern medicine?

1. Disease prevention

2. Relief of pain and mitigation of suffering

3. Care and cure of those with the ailment, and care for those who cannot be cured

4. Avoidance of premature death

Social constructionalist approach

Medicines ends are externally determined and thus culturally variable

Through social constructionalist approach medicine is best thought of as

An evolving fund of knowledge and a changing range of clinical practice that has no fixed essence

Essentialist approach

Medicines proper ends are constituted as a response intrinsic in medicines practice to the universal human experience of illness

According to essentialist approach principles are

The heart of moral life

What is the significance of "The principles of biomedical ethics"

Formulation and promotion of 4 key principles that guide ethical decision making in medicine and biomedical contexts

Who wrote "the principles of biomedical ethics" and when

Tom L beauchamp and james f Childress 1979

How did "the principles of biomedical ethics" inform and shape field of medical ethics

Introduced a clear, principled framework for thinking about ethical issues in healthcare, the book has guided generation of clinicians, ethicists, and policymakers in making morally sound decisions

4 pillars of bioethics laid out by Beauchamp and Childress

Autonomy, beneficence, non-maleficence, justice

Autonomy

Respecting a patients right to make their own decisions about their care

Beneficence

The duty to do good for a patient

Non-maleficence

Duty to cause no harm to patient; closely associated with maxim primum non nocere which means "first do no harm"

Justice

Treating all people equally and fairly

health

means wholeness

to heal

to make whole

origin for english words health and heal

Greek: 'hygeia', sense of living well and caring rightly for one's body

World Health Organization Definition of Health

state of complete physical, mental, and social well-being, and not merely the absence of disease

Health is not merely the absence of disease but

a state of well-being that includes a sense that life has purpose and meaning

· Who was Edmund Pellegrino?

Roman Catholic who was skeptical of the 'salvation theme' of the humanities to save medicine from its 'sins'

what field was pellegrino important in

philosophy of medicine

Biomedical (naturalist) model

disease as objective matter, based on biological facts. Interferes with proper or normal physiologic functioning

Normative model

sees health as a concept that is factual but also with an assessment of whether this is good or bad, culturally and historically conditioned

What is significant about the article "They Decide Who Lives, Who Dies"?

deeply human exploration of the medical, ethical, and social issues that arise when the resources necessary to save lives are limited, and it calls attention to the challenges faced by those making life-altering decisions in times of crisis

what was "they decide who lives, who dies" about

-describes proceedings of a Lay Committee(not doctors) appointed by medical society in Seattle

-widespread public debate

who wrote "they decide who lives, who dies" and when

1962 life magazine by journalist Evan Osnos

What was the Tuskegee Syphilis Study?

unethical medical study conducted by the U.S. Public Health Service (PHS) that spanned from 1932 to 1972

what were participants in Tuskegee Syphilis study told

they were receiving treatment for "bad blood,"

· What is the Nuremberg Code? When was it adopted and why?

-Code created and ratified in 1947 in response to Nazi atrocities in WWII

-10 point statement delimiting permissible medical experimentation on human subjects

Who is William May?

was an influential American bioethicist and theologian, widely recognized for his contributions to the fields of bioethics, medical ethics, and moral philosophy

what did William May write

"The Physician's Covenant: Images of the Healing Professional" (1987)

codes

concerned with style, and external behavior. Even uses the word aesthetics here

covenant

involves a gift, an exchange of promises and a change in identity

contracts

legalistic and minimalist, only specify what is required and what is owed

Who is Michel Foucault?

french philosopher who emphasized that knowledge cannot be separated from power; believed in medical gaze

medical gaze

localized, reductionalist way of thinking about disease and ill health; viewing people as a collection of organs

Affordable Care Act

goal of making healthcare more affordable and accessible for Americans, particularly those who were uninsured or underinsured

affordable care act was also known as

obama care

affordable care act passed in

march 23, 2010

primary objectives of affordable care act

-expand access

-lower costs

-improve quality

affordable care act affect on health insurance

-individual mandate: everyone must have insurance

-staying on parents plan until 26

-providing tax credits to help pay premiums

-cost sharing(deductibles/ co-pays)

-medicaid expansion

5 major world religions

Christianity, Islam, Judaism, Buddhism, Hinduism

What is the FICA model for spiritual assessment

F(ask patieints about faith), I(ask patients importance of their faith/belief), C(ask patients about their faith community), A(how would patients like faith addressed)

who developed FICA

Christina Puchalski

What is Arthur Kleinman's model of cultural competency?

asking certain culturally sensitive, open-ended questions

what questions did Kleinman model ask

What do you call your problem? What name do you give it?

What do you think has caused your problem?

Why do you think it started when it did?

How severe is it? Will it get better soon or take longer?

What do you fear most about your sickness?

What are chief problems your sickness has caused you?

What kind of treatment do you think you should receive?

What are the most important results you hope to see from treatment?

Who were the major influencers initially in the development of the field of bioethics?

Albert Jonsen, Joseph Fletcher, Paul Ramsey

· What religious traditions have most strongly influenced the field of bioethics?

Christianity and Judaism

· What is the major bioethics organization in the US?

American Society for Bioethics and Humanities(ASBH)

what is ASBH

formed in 1998 by merging Society for Bioethics Consultation, Society for Health and Human values, and American association of Bioethics

What was the case of Ashley X about?

-at 6, Removed uterus, gave her growth hormones, appendectomy

-Not medically necessary

-Child's body altered to fit the needs of a caregiver

-Lack of autonomy

'big questions' in bioethics

are broad, fundamental ethical issues that address overarching moral principles, theories, and values

'Little Questions' in Bioethics

specific, practical, and often context-dependent; focus on concrete ethical dilemmas encountered in clinical practice, research, or policy

Who is Karen Ann Qluinlan?

21-year-old woman from New Jersey who fell into a persistent vegetative state (PVS) after consuming alcohol and drugs at a party in 1975. She was placed on a ventilator to sustain her breathing but showed no signs of recovery or consciousness, though her heart continued to beat . primary issue in Karen Ann Quinlan’s case was whether her parents should be allowed to discontinue her ventilator and let her die naturally, or whether the hospital should continue life-sustaining treatment

ruling on Karen Ann Quinlan case

treatment In 1976, the New Jersey Supreme Court ruled in favor of Karen Quinlan’s parents, after the ventilator was removed, Karen Quinlan’s body continued to function for another nine years

Who is Terri Schiavo?

a 41-year-old woman from Florida who suffered a cardiac arrest in 1990 due to a potassium imbalance caused by an eating disorder. As a result, she went into a persistent vegetative state (PVS) and was left with severe brain damage. The major decision in Terri Schiavo's case was whether to remove her feeding tube, which was the primary way of sustaining her life. Schiavo’s husband, Michael Schiavo, argued that Terri would not want to live in her current state and sought to have her feeding tube removed. However, Terri’s parents, Bob and Mary Schindler, believed that she could recover and fought to keep her alive through continued medical interventions.

ruling on Terri Schiavo case

. Florida Supreme Court ruled in favor of Michael Schiavo, allowing the feeding tube to be removed

· What was "An Unquiet Mind" about?

recounts her own experiences with bipolar disorder, a condition also known as manic-depressive illness, offering a first-person perspective on both the challenges and complexities of living with the illness

what type of book was an unquiet mind

both a memoir and a clinical exploration of bipolar disorder.

when and who wrote an unquiet mind

Kay Redfield Jamison in 1995

Who is Dr. Jeff Levin?

a medical sociologist and a leading researcher in the field of religion and health

what was the focus of Dr Jeff Levins work

explores ways spirituality, religion, and faith practices can influence health outcomes, especially in the context of chronic illness, mental health, and overall well-being

Who is Dr. Harold Koenig?

- a psychiatrist and geriatric medicine specialist; also a prominent figure in the study of relationship between religion and mental health

what was the focus of Dr. Harold Koenigs work

- relationship between religion, spirituality, and mental health, particularly among older adults

Intrinsic religious motivation refers to

engaging in religious or spiritual practices because they are personally meaningful or fundamental to one’s core values and identity

Intrinsic example

person who prays or meditates because they feel it brings them closer to a higher power or provides them with a sense of peace and inner fulfillment

Extrinsic religious motivation refers to

engaging in religious or spiritual practices for external benefits or rewards, such as social approval, material gains, or personal advantages

Extrinsic example

Attending church or participating in religious events primarily because it is expected by one’s family or community, or because it helps to maintain social connections

What was the study about prayer and coronary-bypass patients funded by the Templeton Foundation?

prominent investigation into the potential therapeutic effects of prayer on physical health, particularly in patients undergoing coronary artery bypass graft (CABG) surgery

results of the study about prayer and coronary-bypass

No Significant Improvement in Recovery, Unexpected Negative Results