Physicians' philosophy of care: a comparison of complementary and conventional medicine

BACKGROUND: This project is part of an evaluation of complementary and alternative medicine (CAM) aimed at providing a scientific basis for the Swiss Government to include 5 CAM methods in basic health coverage: anthroposophic medicine, homeopathy, neural therapy, phytotherapy and Traditional Chinese Medicine (TCM). OBJECTIVES: The objective was to explore the philosophy of care (convictions and values, priorities in medical activity, motivation for CAM, criteria for the practice of CAM, limits of the used methods) of conventional and CAM general practitioners (GPs) and to determine differences between both groups. MATERIALS AND METHODS: This study was a cross-sectional survey of a representative sample of 623 GPs who provide complementary or conventional primary care. A mailed questionnaire with open-ended questions focusing on the philosophy of care was used for data collection. An appropriate methodology using a combination of quantitative and qualitative approaches was developed. RESULTS: Significant differences between both groups include philosophy of care (holistic versus positivistic approaches), motivation for CAM (intrinsic versus extrinsic) and priorities in medical activity. Both groups seem to be aware of limitations of the therapeutic methods used. The study reveals that conventional physicians are also using complementary medicine. DISCUSSION: Our study provides a wealth of data documenting several aspects of physicians' philosophy of care as well as differences and similarities between conventional and complementary care. Implications of the study with regard to quality of care as well as ethical and health policy issues should be investigated further.

The Family Preservation Philosophy and Therapy With Lesbian Clients

Family preservation is generally viewed in terms of a rather narrow practice definition. However, it's underlying philosophy offers a strong framework for building a positive, nonbiased helping alliance with lesbian clients in a therapeutic setting. The family preservation philosophy offers a unique heuristic for helping professionals to work with lesbians. Family preservation values teach that the therapist must start with the client's reality, recognize the particular needs of that client, and use the client's strengths in treatment. Also inherent in this perspective is respect and sensitivity to the lesbian client's "cultural context, experience, and history" (Family Preservation Institute, 1995). In other words, in the family preservation philosophy there is no assumption of heterosexuality in the therapeutic relationship; rather there is an assumption of unconditional positive regard. Further, clients are engaged in a dialogue and encouraged to name the challenges they encounter in their own words, from their own perspective. All of these principles will help empower lesbian clients. Lesbians may avoid traditional mental health services in times of need, preferring to depend on alternative services or friendship support networks. The choice not to seek help through mainstream agencies may be based on previous negative experience or on an assumption of the homophobic attitudes which are often inherent in such services. Traditional services are usually based on the medical model. Services based on the family preservation philosophy, however, have the capability of creating therapeutic relationships in which there is no assumption of heterosexuality, where the lesbian client is respected and viewed as a whole, healthy individual.

The philosophy of human nature /

Microfilm. Ann Arbor, Mich., University Microfilms (n.d.) (American culture series, Reel 305.14)

The elements of natural or experimental philosophy /

Includes indexes.

'Animal electricity' in the long eighteenth century with special reference to the Edinburgh medical school

Coleridge, looking back at the end of the ‘long eighteenth century’, remarked that the whole of natural philosophy had been ‘electrified’ by advances in the understanding of electrical phenomena. In this paper I trace the way in which these advances affected contemporary ‘neurophysiology.’ At the beginning of the long eighteenth century, neurophysiology (in spite of Swammerdam’s and Glisson’s demonstrations to the contrary) was still understood largely in terms of hollow nerves and animal spirits. At the end of that period the researches of microscopists and electricians had convinced most medical men that the old understanding had to be replaced. Walsh, Patterson, John Hunter and others had described the electric organs of electric fish. Gray and Nollet had demonstrated that electricity was not merely static, but flowed. Franklin had alerted the world to atmospheric electricity. Galvani’s frog experiments were widely known. Volta had invented his ‘pile.’ But did ‘animal electricity’ exist and was it identical to the electricity physicists studied in the inanimate world? Was the brain a gland, as Malpighi’s researches seemed to confirm., and did it secrete electricity into the nervous system? The Monros (primus and secundus), William Cullen, Luigi Galvani, Alessandro Volta, Erasmus Darwin, Luigi Rolando and François Baillarger all had their own ideas. This paper reviews these ‘long-eighteenth century’ controversies with special reference to the Edinburgh medical school and the interaction between neurophysiology and physics.

Compromise or Quit Medical Practice: Is there Another Option for Catholic Health Care Professionals

More and more, medical practitioners are being told that they must either compromise their beliefs and provide whatever services patients demand or they should quit medical practice. This paper will explore other options that would offer a more just and respectful solution for our pluralistic society.

Healthcare and the Common Good: Restructuring the Economy of Medical Knowledge through Communitarian Political Theory

The pharmaceutical industry wields disproportionate power and control within the medical economy of knowledge where the desire for profit considerably outweighs health for its own sake. Utilizing the theoretical tools of political philosophy, this project restructures the economy of medical knowledge in order to lessen the oligarchical control possessed by the pharmaceutical industry. Ultimately, this project argues that an economy of medical knowledge structured around communitarian political theory lessens the current power dynamic without taking an anti-capitalist stance. Arising from the core commitments of communitarian-liberalism, the production, distribution, and consumption of medical knowledge all become guided processes seeking to realize the common good of quality healthcare. This project also considers two other theoretical approaches: liberalism and egalitarianism. A Medical knowledge economy structured around liberal political theory is ultimately rejected as it empowers the oligarchical status quo. Egalitarian political theory is able to significantly reduce the power imbalance problem but simultaneously renders inconsequential medical knowledge; therefore, it is also rejected.

Fear, trust and Aborigines : The historical experience of state institutions and current encounters in the health system

Troubled dynamics between residents of an Aboriginal town in Queensland and the local health system were established during colonisation and consolidated during those periods of Australian history where the policies of 'protection' (segregation), integration and then assimilation held sway. The status of Aboriginal health is, in part, related to interactions between the residents' current and historical experiences of the health and criminal justice systems as together these agencies used medical and moral policing to legitimate dispossession, marginalisation, institutionalisation and control of the residents. The punitive regulations and ethnocentric strategies used by these institutions are within the living memory of many of the residents or in the published accounts of preceding generations. This paper explores current residents' memories and experiences.

The criminalisation of medical mistakes in Canada : a review

The issue of health professionals facing criminal charges of manslaughter or criminal negligence causing death or grievous bodily harm as a result of alleged negligence in their professional practice was thrown into stark relief by the recent acquittal of four physicians accused of mismanaging Canada’s blood system in the early 1980s. Stories like these, as well as international reports detailing an increase in the numbers of physicians being charged with (and in some cases convicted of) serious criminal offences as the result of alleged negligence in their professional practice, have resulted in some anxiety about the apparent increase in the incidence of such charges and their appropriateness in the healthcare context. Whilst research has focused on the incidence, nature and appropriateness of criminal charges against health professionals, particularly physicians, for alleged negligence in their professional practice in the United Kingdom, the United States, Japan, and New Zealand, the Canadian context has yet to be examined. This article examines the Canadian context and how the criminal law is used to regulate the negligent acts or omissions of a health care professional in the course of their professional practice. It also assesses the appropriateness of such use. It is important at this point to state that the analysis in this article does not focus on those, fortunately few, cases where a health professional has intentionally killed his or her patients but rather when patients’ deaths or grievous injuries were allegedly as a result of that health professional’s negligent acts or omissions when providing health services to that patient.