Any science is built on assumptions that are non-empirical, and rarely debated.
A seminar at NMBU invited a group of clinicians from around Norway to discuss philosophical biases in medicine with us and each other. We discussed the challenge of pursuing genuine person centered healthcare for individual patient in a system of New Public Management, standardisation and silo medicine. The invited participants had backgrounds from psychology, nursing, general practice, psychiatry, physiotherapy, osteopathy, rehabilitation, speech language pathology, and more.(more…)
A reminder of the great mind and gentle humanity of Stephen Tyreman. I was honoured to be sent this to publish on the blog, and hope that through writings such as this, he can continue to enlighten and inform us. He wrote it in response to a piece by Monica Noy on “cognitive dissonance”.
Cranial Concept, Reality and Perception
Thanks Monica for this honest and thought-provoking piece and also to Penny for drawing my attention to Monica’s thoughts. It takes a lot of courage to speak out against the prevailing assumptions, practices and mores of any group and particularly of osteopathy which continues to be defensive and therefore somewhat ‘touchy’ about its identity and status in respect to other parts of healthcare.
I suppose I’m a bit closer to Penny’s view on the cranial concept, which is that while the theoretical ‘foundation’ of cranial work is very suspect with…
Technology should make our life better, easier and safer. And yet, medicines, pesticides, nanotechnologies, biotechnologies et cetera, may represent a potential threat to health and environment. Some of the new technologies might be safe for most, but they could still be harmful for vulnerable individuals, communities or ecosystems. (more…)
In this blog (and linked article), physiotherapist Matt Low explains how he uses patient narratives, mind-maps and the vector model of causation to help his patients. The result is a person-centered approach that emphasises causal complexity, individual context and the idea that at least some of the causes of pain can be counteracted and thus controlled by the patient. Matt is a collaborator of CauseHealth and this is his second article describing his unique approach to chronic pain.
I was fortunate enough to have been invited by Physio First to contribute to their journal ‘In Touch’ and I chose to write about managing complexity with the different types of ‘evidence’ that we deal with in a healthcare setting.
This is an area of interest for me and I still grapple with many areas of clinical practice. These include balancing the normative and narrative examination, evaluating and weighting the evidence appropriately for the person seeking care in front of me and also reconciling and communicating the reasoning process within a person centred framework. Clearly, this is work in progress and I hope this reflective piece demonstrates a movement in this direction.
I hope this paper is informative and useful in that it shares some of my deliberations, thoughts and perspectives in clinical care.
We have seen a lot of interest in the CauseHealth approach and issues during these last years, especially among clinicians who see a need for a more person centered healthcare. Can this be useful also outside the clinic? Yes, according to senior medical advisor at the WHO Uppsala Monitoring Center for Drug Safety, Ralph Edwards. In a recent perspectives article in the UMC report, he argues that dispositionalism can be useful for dealing with complexity, individual variation and the patient’s unique context. (more…)
What if one would weave a text by means of threads coloured by the recent topics of the on-going CauseHealth project. One thread would be causality, and how it is understood and applied in current biomedicine. Another would be ontology in the sense of how a human being and the human body is conceptualised in medicine and how this concept underpins the Western health care systems. A third thread would be methodology, and how the predominant methods for knowledge production, group based, randomised trials often including thousands of patients, might be radically challenged by the concept of N=1. A fourth thread would be stories in the sense of biographies before a person fell ill, and stories in the sense of testimonies of being ill – and how these have been systematically avoided as possible source of contamination in medical knowledge production. A fifth thread would then be knowledge condensates as these have grown both in number and normativity in the shape of clinical guidelines in all medical specialties during the latest years. Together, these threads can form quite different pictures, dependent on the frame applied. (more…)
Part of the CauseHealth team went to ECAP9 and spoke about why deep understanding of causation, mechanisms and the local context is essential for drug safety. We were also excited to be in a session with Ralph Edwards, former Director of the Uppsala Monitoring Centre for drug safety, which acts as the official advisor for the World Health Organisation (WHO). Thanks for having us, Barbara!
The symposium “Philosophy of Pharmacology: Theoretical Foundations, Methodological Evolution, and Public Health Policy” took place at LMU Munich on 22 August, 2017, as part of the Ninth Congress of Analytic Philosophy (ECAP9) of the European Society of Analytic Philosophy (ESAP). The congress was jointly organized by Barbara Osimani, Jürgen Landes, and Roland Poellinger. The program featured contributions by four speakers:
Ralph Edwards (Uppsala Monitoring Centre of the World Health Organization)
At the overlap of philosophy and health science, this symposium offered a panorama of the complex network of interests found in pharmacology (financial, reputational etc.) as well as the scientific and social ecosystem in which pharmacology is embedded. A special focus was on current debates regarding 1) standards for evidence evaluation, 2) methodological evolution, and 3) pragmatics as well as epistemic asymmetry of causal assessment of risk…
One idea promoted by CauseHealth is that, when evaluating evidence, pre-existing theoretical frameworks count as much as the data. For instance, data from a certain trial assume a particular significance depending on the general background theoretical understanding we have when we interpret them. In this new CauseHealth article, Elena Rocca and Fredrik Andersen show that, when evaluating health risks related to the use of genetically modified plants in agriculture, different ontological starting points play an essential role for the final risk evaluation. (more…)