ABSTRACT
RESUMEN: Se considera y valora el concepto de paciente como persona, tanto en el lenguaje común, en el lenguaje médico y de la persona enferma. Se exponen las visiones de la persona como paciente; la visión mecánica y las visiones humanistas: la fenomenológica, la noción de persona de Cassell, el yo y el otro de Tauber, la visión bio-psico-social de Engel y la medicina centrada en la persona. Humanizar la medicina para resolver la crisis actual de la atención médica.
ABSTRACT: The concept of the patient as a person is considered and valued, both in common language, medical language and of the sick person. The visions of the person as a patient are exposed; the mechanical vision and the humanistic visions: phenomenological, Cassell person notion, Tauber self and the other, Engel bio-psicho-social and the person centered medicine. Humanize medicine to solve the current health crisis.
Subject(s)
Patients , PersonsABSTRACT
Se revisa inicialmente la axiología filosófica: concepto, desarrollo histórico y teorías axiológicas. Se trata el tema de valores: definición, clasificación y jerarquización. Se ingresa a la axiología médica, concepto y desarrollo histórico. Se revisa el sistema de valores de la profesión médica y sus funciones: valores morales, cognitivos y culturales.
Philosophical axiology is initially reviewed: concept, historical development and axiological theories. It deals with the issue of values: definition, classification and hierarchy. We enter to medical axiology, concept and historical development. The value system and functions of the medical profession are reviewed: moral, cognitive and cultural values.
Subject(s)
Unified Health System , Classification , Ethics, MedicalABSTRACT
Puede decirse que el pensamiento filosófico y la medicina surgieron juntos en los inicios de la civilización griega, cuna de la cultura occidental. En el presente ensayo, se hace una revisión histórica desde la filosofía Pitagórica hasta los paradigmas de Kuhn, mostrando autores y obras de la antigüedad, modernidad y época contemporánea, que ilustran la influencia recíproca entre la filosofía y la medicina.
It is possible to say that philosophical thought and medicine emerged together at the beginning of the Greek civilization, cradle of western culture. In the present trial, a historical review is made, from Pythagorean philosophy to Kuhns' paradigms, showing authors and works from antiquity, modernity and contemporary epoch, illustrating the reciprocal influence between philosophy and medicine
Subject(s)
Philosophy , Thinking , Western World , MedicineABSTRACT
La filosofía de la medicina es un importante campo de estudio que se ocupa de temas y problemas filosóficamente relevantes en el estudio y práctica de la medicina. Este ensayo es una primera aproximación, ubicándola en el contexto histórico desde tiempos hipocráticos hasta la medicina contemporánea. Se exponen intentos de delimitación del campo específico, desde criterios de médicos y filósofos de la antigüedad hasta el concepto actual de la primacía de la relación médico-paciente, abarcando áreas fundamentales como ontología, epistemología y ética. Se destaca el debate desde la década de los 70, mostrando las tendencias actuales negativa, amplia y específica sobre su posibilidad como disciplina específica, culminando con la presentación de los cuatro modelos de filosofía de la medicina propuestos por Edmund Pellegrino.
Philosophy of medicine is an outstanding study field concerning philosophically relevant subjects and problems in medical study and practice. This paper is a first approach, showing the historical context since Hippocratic to present times. Delimitation attempts for specifying the field are shown, from ancient physicians and philosopher's criteria to present primacy of the physician-patient relationship, covering fundamental areas as ontology, epistemology and ethics. Present debate starting the seventies is pointed out, displaying negative, broad and specific tendencies for its consideration as a specific discipline, concluding with the four philosophy of medicine models proposed by Edmund Pellegrino.
Subject(s)
Physician-Patient RelationsABSTRACT
Se explica el origen de los términos cirugía plástica y rinoplastia, así como los inicios de la especialidad y de esta cirugía nasal. Se exponen cuáles fueron las necesidades que atendieron y qué lugar ocuparon la reparación y la reconstrucción en la historia y la filosofía de la medicina. La cirugía plástica se instaló como la disciplina quirúrgica encargada de buscar la recuperación de la identidad perdida. (AU)
The origin of the terms of "plastic surgery" and "Rhinoplasty" is explained, as well as the beginning of the specialty and this nasal surgery. It explains what his need was and how he filled that gap, the repair and reconstruction in the history and philosophy of medicine. It was installed as the surgical discipline in charge of seeking the recovery of the lost identity. (AU)
Subject(s)
History, Ancient , History, Medieval , History, 15th Century , History, 16th Century , History, 17th Century , History, 18th Century , History, 19th Century , History, 20th Century , Rhinoplasty/history , Plastic Surgery Procedures/history , Philosophy, Medical , History of MedicineABSTRACT
La filosofía de la medicina es un interesante campo de estudios que se ocupa de temas y problemas filosóficamente relevantes en la práctica e investigación en medicina. Sin embargo, a pesar de que en otras latitudes la filosofía de la medicina goza de reconocimiento, en Colombia ha recibido poca atención, en particular porque el auge de la bioética ha opacado otro tipo de reflexiones sobre el quehacer médico. En este artículo, partiendo de una mirada general sobre la formación del campo, se argumenta que una filosofía crítica de la medicina debe ser promovida como reflexión amplia y crítica sobre la génesis y posibles salidas a la crisis que el sistema de salud y las profesiones de la salud han experimentado en Colombia en las últimas dos décadas. Esta filosofía crítica de la medicina ha de contribuir entonces a formar médicos y profesionales de la salud para ser capaces de transformar el éthos de sus propias profesiones y el de los servicios de salud.
Philosophy of Medicine is an interesting field of study concerned with issues and problems that are philosophically relevant in practice and research in Medicine. However, although Philosophy of Medicine enjoys recognition in other latitudes, in Colombia it has received little attention, in particular, because of the rise of bioethics, which has overshadowed other kinds of reflections on the medical task. In this paper, departing from an overview about the formation of the field, it is argued that a Critical Philosophy of Medicine should be promoted as a deep and critical reflection on the genesis and possible way outs to the crisis that the healthcare system and the medical profession have experienced in Colombia in the last two decades. A Critical Philosophy of Medicine must then contribute to training physicians and health professionals to be able to transform the ethos of their professions as well as of the health care services.
A filosofia da medicina é um campo excitante de estudos que lidam com temas e problemas filosoficamente relevantes na prática e investigação em medicina. No entanto, embora em outras instâncias da filosofia da medicina tem reconhecimento, na Colômbia tem recebido pouca atenção, especialmente porque o auge da bioética tem ofuscado outro tipo de reflexões sobre o do-que-fazer médico. Neste artigo, a partir de uma visão geral sobre a formação do campo, argumenta-se que uma filosofia crítica da medicina deve ser promovida como reflexão ampla e crítica sobre a gênese e possíveis soluções para a crise que o sistema de saúde e as profissões da saúde têm experimentado na Colômbia nas últimas duas décadas. Esta filosofia crítica da medicina deve, então, contribuir a formar médicos e profissionais da saúde para serem capazes de transformar o ethos de suas próprias profissões e o dos serviços de saúde.
ABSTRACT
<p><i>Emi Sampaku </i>(1707-1781) is one of the great <i>Koiho </i>(old medical school) practitioners along with <i>Yoshimasu Todo who </i>is from the same province as <i>Sampaku</i>.In general, he was depicted as an “intensive medicine dozer” ; however it doesn't seem to be his factual depiction.<br>This kind of misapprehension is caused by a scarcity in exploration on him, especially his philosophy of medicine, nevertheless being such a great master in that field. Now in this paper I would look over the quintessence of his remedy and the theory of medicine to clarify his philosophy of medicine through investigations on his volumes such as <i>Emikun Ijidan, Emineiko Sensei Igen, Emi Sensei Iho Ryakusetsu, Toho Shiron. </i><br>As a result of my survey, it has been clarified that <i>Sampaku </i>took his way of remedy on accordance with the curate diagnoses which were brought about through his <i>Shinshi</i>-<i>jikken </i>“Experience and Verification”. Put it in another way, <i>Sampaku </i>took intensive medicine for vomiting/purgative remedy merely under the necessity. He is one of “a man of discerning eyes”.</p>
ABSTRACT
Se analizan las distintas vertientes y los objetivos de la formación en Humanidades Médicas en distintos ámbitos, con la finalidad de concienciación sobre la necesidad de la creación de una estructura docente con esa finalidad en la Universidad de la República bajo la égida de la Facultad de Medicina.
Analysis of the different aspects and the training objectives in the field of Medical Humanities in various settings, to raise awareness on the need for creating a teaching structure for that purpose at the University of the Republic, under the umbrella of the School of Medicine.
ABSTRACT
Vemos uma tendência da psiquiatria contemporânea de reduzir a experiência subjetiva da doença a achados neurofisiológicos. Na contramão desse movimento estão os trabalhos de Bill Fulford e Georges Canguilhem. O primeiro aposta na precedência da illness sobre a disease; Canguilhem defende a ideia de que o pathos precede o logos e ambos afirmam a inseparabilidade entre fatos e valores. Trazem, assim, a ênfase na dimensão sócio-simbólica da experiência subjetiva, marcando a centralidade da clínica para a interrogação sobre o sofrimento humano.
A trend can be seen in contemporary psychiatry toward reducing the subjective experience of illness to neurophysiological findings. Research by Bill Fulford and Georges Canguilhem goes against this trend. Fulford holds that illness comes before disease, while Canguilhem defends the idea that illness precedes disease. They both hold to the inseparability of facts and values. They emphasize the socio-symbolic dimension of subjective experience, thus stressing the importance of clinical approaches for dealing with human suffering.
On observe dans la psychiatrie contemporaine une tendance à réduire l'expérience subjective de la maladie à des découvertes neurophysiologiques. Les travaux de Bill Fulford et de Georges Canguilhem se situent à contrecourant de ce mouvement. Le premier revendique l'antécédence de la illness par rapport à la disease. Canguilhem soutient que le pathos précède le logos et tous deux affirment l'inséparabilité entre les faits et les valeurs. Ils mettent ainsi en avant la dimension socio-symbolique de l'expérience subjective et soulignent la centralité de la clinique pour la réflexion sur la souffrance humaine.
Observamos una tendencia de la psiquiatría contemporánea en reducir la experiencia subjetiva de la enfermedad a hallazgos neurofisiológicos. En dirección contraria a ese movimiento están los trabajos de Bill Fulford y Georges Canguilhem. El primero apuesta por la precedencia de la illness sobre la disease; Canguilhem defiende la idea de que el pathos precede al logos y ambos afirman la inseparabilidad entre hechos y valores. Traen, así, el énfasis en la dimensión socio-simbólica de la experiencia subjetiva, marcando la centralidad de la clínica para la investigación del sufrimiento humano.
Subject(s)
Humans , Philosophy, Medical , PsychiatryABSTRACT
NAKAGAMI Kinkei 中神琴渓 is one of the greatest practitioners in the Edo 江戸 era Japan. His remedy and his philosophy of medicine on which his remedy is based is a treasured part in the history of Japanese Kampo 漢方 medicine. However I can hardly find any researches on this point.<br>Then in this paper, I enrolled these Kinkei's works <i>Seiseidozakki</i>, <i>Seiseidoyoseiron</i>, etc., and took an overview on them philologically first to clarify his remedy practically, then I considered his philosophy of medicine.<br>After that, I can show that Kinkei's remedies were delivered in various fields:(1)acupuncture (hemospasia/phlebotomy), (2)bathing, (3)moxibustion/moxa cautery, (4)galenical/medication. Kinkei, taking over his mentors' ideas and remedies, but established his own modality of remedy based on his innovative philosophy of medicine, which actually is derived from his accurate and unrestricted diagnoses.<br>As we have come this far, we can assert that Kinkei's remedy is always unrestricted assortments of various methods. That is what he described “unfettered remedy” and he described that he “unfetters himself away from the fixed rule”<規則を離れる>.
ABSTRACT
La investigación científica ha posibilitado nuevas esperanzas en la curación de diversas patologías provocadas por procesos degenerativos o por daño directo sobre órganos y tejidos. Una de las líneas de estudio más prometedoras es la utilización de células pluripotenciales, siendo su fuente principal los embriones obtenidos en las técnicas de fertilización asistida. Mas los cuestionamientos éticos respecto a la utilización y destrucción de ellos ha llevado al ingenio humano a desarrollar entidades que semejan embriones pero que no lo serían esencialmente. Si esto fuera cierto, su utilización para obtener esas valiosas células no sería objetable. Estos pseudoembriones desafían a nuestra inteligencia a establecer su verdadero estatuto ontológico. Este trabajo busca reflexionar sobre la dificultad para aplicar los distintos criterios que utiliza nuestra inteligencia para identificar o no, en una serie de entidades naturales y creadas por el hombre, la presencia de un individuo humano con todos sus derechos y dignidad.
Scientific research has made possible new hopes for the cure of diverse pathologies provoked by degenerative processes or by direct damage on organs and tissues. One of the fields of study most promising is the use of pluripotential cells, being their main origin embryos obtained by assisted reproduction techniques. But, the ethical questioning with respect to their use and destruction has guided human talent to develop entities similar to embryos, but not essentially. If this were true, their use to obtain these valuable cells will not be ethically objectionable. These pseudo embryos challenge our intelligence to establish their true ontological statute. This article reflects about the difficulty in applying the different criteria that our intelligence uses to identify or not the presence of a human being with all his/her rights and dignity in a series of natural and created by man entities.
A investigação científica tem possibilitado novas esperanças na cura de diversas patologias provocadas por processos degenerativos ou por dano direto sobre órgãos e tecidos. Uma das linhas de estudo mais promissoras é a utilização de células pluripotenciais, sendo sua fonte principal os embriões obtidos nas técnicas de fertilização assistida. Mas os questionamentos éticos a respeito da utilização e destruição deles tem levado a engenhosidade humana a desenvolver entidades que se assemelham a embriões, mas que não seriam essencialmente. Se isto for certo, sua utilização para obter essas valiosas células não seria objetável. Estes pseudo-embriões desafiam a nossa inteligência a estabelecer seu verdadeiro estatuto ontológico. Este trabalho busca refletir sobre a dificuldade para aplicar os distintos critérios que utiliza a nossa inteligência para identificar ou não, numa série de entidades naturais e criadas pelo homem, a presença de um indivíduo humano com todos os seus direitos e dignidade.
Subject(s)
Beginning of Human Life , Research Embryo Creation/ethics , Philosophy, Medical , Stem Cells , Nuclear Transfer Techniques/ethics , Cellular Reprogramming/ethicsABSTRACT
La medicina se constituyó como una actividad enseñable con metodología propia a partir de la escuela hipocrática. Como actividad, se relaciona con todas aquellas que buscan la producción de algo, en este caso la salud de los pacientes, considerada ésta como un bien particular de ellos. El médico entonces -como todo productor- debe traspasar una intervención existente primero en su mente a un sujeto carente de salud o en riesgo de perderla. Este trabajo busca reflexionar sobre cómo consigue el médico concebir en su intelecto una acción que, plasmada en un paciente en particular, constituya para él un efecto considerado curativo. La tesis fundamental en esta reflexión es que, además de utilizar criterios útiles para un hombre considerado universalmente, debe crear una intervención diseñada a la medida de un ser humano particular, poseedor de toda una complejidad personal.
Medicine became a teaching activity with its own methodology since the Hippocratic School. As activity, it relates to those which seek to produce something, in this case the health of patients, considering this as a particular good for them. The physician, then -as all producer- must transfer an existing intervention first in his/her mind to a subject lacking health or in risk of losing it. This study tries to reflect on how the physician achieves to imagine in his/her reasoning an action that, performed in a particular patient, it will constitute in him/her a healing effect. The fundamental thesis in this reflection is that, besides using useful criteria considering a universal human being, he/she must create an intervention designed to suit a specific human being, who has a full personal complexity.
A medicina se constituiu como uma atividade, resultante de ensino com metodologia própria, a partir da escola hipocrática. Como atividade, se relaciona com todas aquelas que buscam a produção de algo, neste caso, a saúde dos pacientes, considerada esta como um bem particular. Desse modo, o médico -enquanto produtor- deve ultrapassar à sua visão primeira, de intervenção junto a um sujeito carente de saúde ou em vías de perdêla. Esse trabalho buscará refletir sobre como o médico consegue conceber uma ação que, plasmada em um paciente com suas particularidades, se constitua de efeito considerado curativo. A tese fundamental desta reflexão é mais que utilizar critérios úteis, considerados universais, para o ser humano, deve-se acreditar em uma intervenção desenhada na medida de um ser humano particular, possuidor de toda uma complexidade pessoal.
Subject(s)
Humans , Bioethics , Ethics, Medical , Humanities/ethics , Philosophy, MedicalABSTRACT
Introducción: La historia de la medicina posibilita reflexionar sobre el caduceo como la síntesis de la dialéctica de la vida sensible y la espiritual. Esto abre un horizonte de comprensión y permite recuperar la leyenda de Esculapio y su culto con los diferentes elementos simbólicos que la componen. La leyenda: Los referentes históricos y mitológicos de la existencia de Esculapio dan consistencia a la leyenda en un ambito de realidad y ficción perdurando en la tradición médica occidental como el referente místico de la deidad para el ejercicio de la medicina. El culto: Se basa en la incubación y sintetiza ritos de sanación y practicas terapéuticas, tanto médicas como quirúrgicas, ademas de ejercicio, curas de sueño y actividades recreativas. El símbolo: El origen lingüístico de su nombre, el simbolismo de los actores de la leyenda y la representación iconogrßfica de sus atributos, convergen en el caduceo para representar la síntesis de ideas y prßcticas médicas asociadas con la vida humana. Conclusiones: La imagen de Esculapio trasciende la divinidad del olimpo y se sitúa como el arquetipo de la curación; por tanto, el caduceo es consistente con la representación de un sistema-mundo que domina el ejercicio de la medicina contemporanea.
Introduction: Medicine history gives us the chance to reflect about the Caduceus as the synthesis of the dialectic of the sensible and spiritual life. This opens and horizon of comprehension and allow us to recover the legend of Asclepius and it´s cult with the different symbolic elements that structure it. The legend: The historic and mythological references about AsclepiusÆ existence gives structure to the legend in a real and not-real environment perduring in the occidental medicine tradition as a mystical reference to the deity for the medical practice. The cult: ItÆs based in the incubation and synthesizes healing rites and therapeutical practices, as medical as surgical; exercise, sleep cures and amusement activities. The symbol: The linguistic origin of AsclepiusÆ name, the symbolism of the legend protagonists and the iconographic representation of their attributes, converge in the Caduceus to represent the medical practices and ideas synthesis, all them related to the human life. Conclusion: Asclepius perception transcends the Olympic divinity and situates him as the healing archetype; that´s why Caduceus is consistent with the system-world representation that rules the actual medical practice.
Subject(s)
Emblems and Insignia , History , PhilosophyABSTRACT
Introducción: El sentido originario de la salud quedó oculto al surgir la medicina posibilitando la medicalización de la vida. Hacer frente a esta tendencia requiere recuperar la salud desde la existencia humana. Objetivo: Dar respuesta a la pregunta por el sentido originario de la salud analizando la esencia y finitud del ser humano además de la salud como existenciario. Material y método: Se realizó una investigación hermenéutica que incluyó las siguientes fases: analítica, comprensiva, reconstructiva y crítica. Las categorías de análisis fueron: sentido originario, modo de ser, existencia, ser-en-el-mundo, ser-sano, estar-sano y saberse-sano. Los principales autores confrontados fueron: Aristóteles, Hipócrates, Hans-Georg Gadamer y Martín Heidegger. Resultados: El análisis hermenéutico de la salud la devela como un modo de ser, donde ser-sano, estar-sano y saberse-sano son dimensiones existenciales que posibilitan al hombre incluirse en el mundo de la vida. Comprender la salud como un modo de existir del ser humano rehabilita la autoconciencia de la salud como un fundamento ontológico y vivencial para comprender la responsabilidad de vivir. Conclusión: El sentido originario de la salud consiste en la posibilidad del ser humano de realizarse en la vida fáctica. Esto implica que ontológicamente la salud es un modo de ser.
Introduction: The original meaning of health was hidden with the arrival of medicine, allowing for the medicalization of life. To face this tendency, we require the recovery of health from human existence. Objective: To answer the question on the original meaning of health, analyzing the essence and finitude of human being and health as penitentiary. Material and methods: A hermeneutical research was conducted, including the following phases: analytical, comprehensive, reconstructive and critical. The categories for analysis were: original meaning, way-of-being, existence, being-in-the-world, being-healthy, and knowing-oneself-healthy. The main authors that we analyzed were Aristotle, Hippocrates, Hans-Georg Gadamer and Martin Heidegger. Results: Hermeneutical analysis of health unveils it as a way-of-being, where being-healthy and knowing-oneself-healthy are existential dimensions that allow man to include himself in life. Understanding health as a way of existing of the human being, recovers self-conscience of health as the ontologic and existential principle for understanding the responsibility of living. Conclusion: The original meaning of health consists in the possibility of realization of the human being in factual life, thus implying that ontologically, health is a way-of-being.