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This book offers the first extended study published in English on the Hippocratic treatise On Regimen, one of the most important pre-Platonic documents of the discussion of human nature and other topics at the intersection of ancient medicine and philosophy.

This is the first volume to comprehensively introduce the ways in which interdisciplinary thinking across the humanities and social sciences might contribute to, critique and develop medical understanding of the human individually and collectively.

We argue that individuals who have access to vaccines and for whom vaccination is not medically contraindicated have a moral obligation to contribute to the realisation of herd immunity by being vaccinated. Contrary to what some have claimed, we argue that this individual moral obligation exists in spite of the fact that each individual vaccination does not significantly affect vaccination coverage rates and therefore does not significantly contribute to herd immunity. Establishing the existence of a moral obligation to be vaccinated (both for adults and for children) despite the negligible contribution each vaccination can make to the realisation of herd immunity is important because such moral obligation would strengthen the justification for coercive vaccination policies. We show that two types of arguments—namely a utilitarian argument based on Parfit’s Principle of Group Beneficence and a contractualist argument—can ground an individual moral obligation to be vaccinated, in spite of the imperceptible contribution that any single vaccination makes to vaccine coverage rates. We add a further argument for a moral obligation to be vaccinated that does not require embracing problematic comprehensive moral theories such as utilitarianism or contractualism. The argument is based on a “duty of easy rescue” applied to collectives, which grounds a collective moral obligation to realise herd immunity, and on a principle of fairness in the distribution of the burdens that must be borne to realise herd immunity.

Reflection has been proclaimed as a means to help physicians deal with medicine’s inherent complexity and remedy many of the shortcomings of medical education. Yet, there is little agreement on the nature of reflection nor on how it should be taught and practiced. Emerging neuroscientific concepts suggest that human thought processes are largely nonconscious, in part inaccessible to introspection. Our knowledge of the world is fraught with uncertainty, ignorance and indeterminacy, and influenced by emotion, biases and illusions, including the illusion of not having illusions. Neuroscience also documents that lifelong learning processes may hone nonconscious cognition to high levels of sophistication, allowing rapid and precise perceptions, judgments and actions in complex situations. We argue that knowledge of mechanisms underlying human thought may be useful in designing educational programs to foster desired attributes such as curiosity, critical self-awareness and intuitive acumen in medical professionals. The juxtaposition of neuroscientific insights with ideas from Kant on reflective judgement, van Manen on tact, and Aristotle on phronésis, supports a concept of reflection that manifests as wise practice. We suggest that reflection in medical education should be (a) an imperative for educators seeking to guide learners to manage the complexity and “messiness” of medical practice, and (b) a role-modelling mode of medical practice characterized by self-correcting behaviors that culminate in good and right professional actions. An example illustrates reflective practice in the teaching and learning of physicianship.

The health humanities is a rapidly rising field, advancing an inclusive, democratizing, activist, applied, critical, and culturally diverse approach to delivering health and well-being through the arts and humanities. It has generated new kinds of interdisciplinary research, knowledge, and communities of practice globally. It has also acted to bring greater coherence and political force to contributions across a range of related disciplines and traditions. In this volume, a formidable set of authors explore the history, current state, and future of the health humanities, in particular how its vision of the arts and humanities: Promotes creative public health. Opens new routes to health and well-being. Informs and drives better health care. Interrogates relationships between ill health and social equality. Develops humanist theory in relation to health and social care practice. Foregrounds cultural difference as a resource for positive change in society. Tests the humanity of an increasingly globalized health-care system. Looks to overcome structural and process obstacles to cross-disciplinary ventures. Champions co-construction, co-design, and mutuality in solving health and well-being challenges. Showcases less familiar, prominent, or celebrated creative practices. Includes multiple perspectives on the value and health benefits of the arts and humanities not limited to or dominated by medicine. Divided into two main sections, the Companion looks at \"Reflections and Critical Perspectives,\" offering current thinking and definitions within health humanities, and \"Applications,\" comprising a wide selection of applied arts and humanities practices from comedy, writing, and dancing to yoga, cooking, and horticultural display.

This is a revised and expanded edition of a classic in palliative medicine, originally published in 1991, with three added chapters and a new preface summarizing our progress in the area of pain management. The obligation of physicians to relieve human suffering stretches back into antiquity. But what exactly, is suffering? One patient with cancer of the stomach, from which he knew he would shortly die, said he was not suffering. Another, someone who had been operated on for a minor problem—in little pain and not seemingly distressed—said that even coming into the hospital had been a source of pain and suffering. With such varied responses to the problem of suffering, inevitable questions arise. Is it the doctor's responsibility to treat the disease or the patient? And what is the relationship between suffering and the goals of medicine? According to the author of this book, these are crucial questions, but ones that have unfortunately remained only queries void of adequate solutions. It is time for the sick person, the author believes, to be not merely an important concern for physicians but the central focus of medicine. With this in mind, he argues for an understanding of what changes should be made in order to successfully treat the sick while alleviating suffering, and how to actually go about making these changes with the methods and training techniques firmly rooted in the doctor's relationship with the patient.

Advance directives for withholding life-saving treatment are controversial for dementia patients whose previously expressed wishes conflict with their currently expressed desires. To illustrate this ethical dilemma, McMahan conceives a hypothetical case in which an intellectually proud creative woman signs an advance directive stipulating her refusal to receive life-saving treatment if she contracts a fatal condition with dementia. However, when she develops dementia and forgets this advance directive, she contracts pneumonia and now expresses a desire to live. In response to such dilemmas, scholars like Norman Cantor have defended the moral authority of advance directives by giving credence to one’s prior competent wishes over one’s current incompetent preferences. I argue that their arguments, which are rooted in the principle of respect for autonomy, operate under ableist assumptions about incompetent persons and exclude other important features of respect. I propose an ethics of care model as an alternative moral approach that reconceptualises respect as a matter of caring about people’s contemporaneous interests, even if they are not competently conceived. It fosters the virtues of care by encouraging healthcare providers to recognise dementia patients as legitimate narrative agents capable of authoring their own evolving life story. I argue that the ethics of care model not only provides an ethical defence of the creative woman’s current incompetent desire to live despite her advance directive, but also vindicates our moral intuitions about what it means to demonstrate respect to dementia patients.

The interconnectedness of all people and the value of recognising diverse perspectives are important aspects within the Ubuntu concept.5 Second, a key aspect of Ubuntu is its emphasis on the benefits of interpersonal connections and teamwork in achieving shared objectives.7 In the context of epistemic injustice in MML, this may refer to acknowledging the value of caregivers’ expertise and patients’ experiences, as well as fostering communication and cooperation between patients and healthcare professionals with various viewpoints and levels of knowledge. [...]another significant aspect of Ubuntu involves valuing empathy, understanding and actively listening to others.8 In the same breath, the eradication of paternalism and power disparities is equally important to Ubuntu. Furthermore, by emphasising the value of community involvement and the forward-looking responsibility, Ubuntu may be used to address the problem of epistemic injustice in MML. [...]the Ubuntu perspective can also contribute to the development of a more just and equitable medical system that places a higher priority on diverse perspectives, interconnectedness of all people, empathy and listening, as well as addressing power disparities in communities.