Unit name | The Philosophy and History of Medicine |
---|---|
Unit code | PHIL30082 |
Credit points | 20 |
Level of study | H/6 |
Teaching block(s) |
Teaching Block 1 (weeks 1 - 12) |
Unit director | Dr. Grose |
Open unit status | Not open |
Pre-requisites |
PHIL20046 Realism and Normativity |
Co-requisites |
None |
School/department | Department of Philosophy |
Faculty | Faculty of Arts |
The aim of this unit is to introduce some key elements of the philosophy of medicine in their historical context. Its particular focus is the philosophy of medical science and its historical evolution and also the philosophy of mind, particularly in relation to neural science. The unit will serve to enhance students philosophical skills, including critical thinking and analytical reasoning. The aim is to develop students with enhanced awareness of the epistemological and historical basis of medical thought who will in turn be able to question constructively the assumptions of contemporary medical
If you get ill, you are very lucky you live now rather than 200 years ago, when simple infections would often prove fatal, surgery was carried out without pain relief, and almost all illnesses were treated with blood letting and medicines based on the poisons mercury and antimony. It might appear that current medicine magnificently demonstrates the triumph of applied science. But the truth of this claim is in fact far from obvious. This unit examines some of the philosophical questions arising from the history of the making of modern medicine, from the new hospitals of the French Revolution, through the so-called laboratory revolution of the late-nineteenth century and the golden era of twentieth century medicine to the AIDS pandemic and the growth of the alternative medicine movement. Questions addressed include:
• What is disease? And what is health? Are these biological concepts? Or do they have a subjective or a social component?
• How did the introduction of mass hospitals in the late eighteenth century transform the relationship between doctor and patient, and with what result on the doctor’s means of diagnosis on the one hand and opportunities for expanding medical knowledge on the other? (We look here at Michel Foucault’s notion of ‘the clinical gaze’.)
• Did medical science lead directly to improvements in medical care? Or were the two unrelated until the late nineteenth century before which time doctors did more harm than good?
• Was there a laboratory revolution in nineteenth century medicine? What difference did the microbiological discoveries of Pasteur, Koch, and others really make to medicine?
• How can generic medical knowledge produced by randomised controlled trials be applied to the diagnosis and treatment of individuals? Does ‘evidence-based medicine’ enable scientific advances to extend to the GP’s surgery? Or does it allow a flawed methodology to trump the skill and experience of doctors in understanding individual patients?
• Do complementary and alternative medical practices encapsulate different modes of medical knowledge from scientific medicine? Or are they at best expensive placebos and at worst dangerous and discredit quack remedies?
• We are often told that studies show that environmental factor X causes disease Y, and then are told that this is contradicted by other studies. How do we determine causation in epidemiology?
The Unit is structured around five broad learning themes each of which will be explored using one or more sub-topics or specific case studies. The student completing this unit should be able to demonstrate knowledge and understanding of the following themes particularly with reference to the cited case studies and examples (which will be drawn upon selectively and augmented by the Unit director).
1. Classical medical thought how Greek and Roman physicians viewed the medical universe and constructed knowledge about it.
2. The Nineteenth Century a century of huge change in the institutions and scientific basic of medicine.
3. The epistemology of medical science how medical knowledge is constructed and validated
4. The mind-body question the relationship between the mind and bodily health and disease and between mind and the physical brain.
5. Reductionism and holism in medical thought
Formative:
Summative:
The following books are strongly recommended background reading to the history of medicine and the historiography of medicine: ASS= Arts and Social Science Library. MED= Medical Library (down University Walk)
Porter, R. (1999) The Greatest Benefit to Mankind (Fontana) (ISBN: 0006374549). ASS (R131 POR), MED. Burnham, J. C. (2005) What is Medical History? (Cambridge: Polity) (978-0745632254).
Also recommended (and a very good read) but controversial is:
David Wootton (2007) Bad Medicine: Doctors Doing Harm Since Hippocrates (Oxford: Oxford University Press)
The best book on philosophy of medicine is:
Jeremy Howick (2011) The Philosophy of Evidence-Based Medicine (Oxford: Wiley–Blackwell)
An interesting, if contentious, introduction to some topics in medical epistemology is:
Harry Collins and Trevor Pinch (2005) Dr. Golem: How to Think about Medicine (London: University of Chicago Press). A useful introduction to key themes in the epistemology of medicine. (ISBN: 0226113663) ASS (RC81 COL ) MED (AA8a COL).