Medical Nihilism

"Medical nihilism is the view that we should have little confidence in the effectiveness of medical interventions. This book argues that medical nihilism is a compelling view of modern medicine. If we consider the frequency of failed medical interventions, the extent of misleading evidence in medical research, the thin theoretical basis of many interventions, and the malleability of empirical methods in medicine, and if we employ our best inductive framework, then our confidence in the effectiveness of medical interventions ought to be low" --

This book argues that if we consider the ubiquity of small effect sizes in medicine, the extent of misleading evidence in medical research, the thin theoretical basis of many interventions, and the malleability of empirical methods, and if we employ our best inductive framework, then our confidence in medical interventions ought to be low.

This book argues that if we consider the ubiquity of small effect sizes in medicine, the extent of misleading evidence in medical research, the thin theoretical basis of many interventions, and the malleability of empirical methods, and if we employ our best inductive framework, then our confidence in medical interventions ought to be low.

Philosophy of Medicine asks two central questions about medicine: what is it, and what should we think of it? Philosophy of medicine itself has evolved in response to developments in the philosophy of science, especially with regard to epistemology, positioning it to make contributions that are medically useful. This book locates these developments within a larger framework, suggesting that much philosophical thinking about medicine contributes to answering one or both of these two guiding questions. Taking stock of philosophy of medicine's present place in the landscape and its potential to illuminate a wide range of areas, from public health to policy, Alex Broadbent introduces various key topics in the philosophy of medicine. The first part of the book argues for a novel view of the nature of medicine, arguing that medicine should be understood as an inquiry into the nature and causes of health and disease. Medicine excels at achieving understanding, but not at translating this understanding into cure, a frustration that has dogged the history of medicine and continues to the present day. The second part of the book explores how we ought to consider medicine. Contemporary responses, such as evidence-based medicine and medical nihilism, tend to respond by fixing high standards of evidence. Broadbent rejects these approaches in favor of Medical Cosmopolitanism, or a rejection of epistemic relativism and pluralism about medicine that encourages conversations between medical traditions. From this standpoint, Broadbent opens the way to embracing alternative medicine. An accessible and user-friendly guide, Philosophy of Medicine puts these different debates into perspective and identifies areas that demand further exploration.

The philosophy of medicine has become a vibrant and complex intellectual landscape, and Care and Cure is the first extended attempt to map it. In pursuing the interdependent aims of caring and curing, medicine relies on concepts, theories, inferences, and policies that are often complicated and controversial. Bringing much-needed clarity to the interplay of these diverse problems, Jacob Stegenga describes the core philosophical controversies underlying medicine in this unrivaled introduction to the field. The fourteen chapters in Care and Cure present and discuss conceptual, metaphysical, epistemological, and political questions that arise in medicine, buttressed with lively illustrative examples ranging from debates over the true nature of disease to the effectiveness of medical interventions and homeopathy. Poised to be the standard sourcebook for anyone seeking a comprehensive overview of the canonical concepts, current state, and cutting edge of this vital field, this concise introduction will be an indispensable resource for students and scholars of medicine and philosophy.

In Para-States and Medical Science, P. Wenzel Geissler and the contributors examine how medicine and public health in Africa have been transformed as a result of economic and political liberalization and globalization, intertwined with epidemiological and technological changes. The resulting fragmented medical science landscape is shaped and sustained by transnational flows of expertise and resources. NGOs, universities, pharmaceutical companies and other nonstate actors now play a significant role in medical research and treatment. But as the contributors to this volume argue, these groups have not supplanted the primacy of the nation-state in Africa. Although not necessarily stable or responsive, national governments remain crucial in medical care, both as employers of health care professionals and as sources of regulation, access, and – albeit sometimes counterintuitively - trust for their people. “The state” has morphed into the “para-state” — not a monolithic and predictable source of sovereignty and governance, but a shifting, and at times ephemeral, figure. Tracing the emergence of the “global health” paradigm in Africa in the treatment of HIV, malaria, and leprosy, this book challenges familiar notions of African statehood as weak or illegitimate by elaborating complex new frameworks of governmentality that can be simultaneously functioning and dysfunctional. Contributors. Uli Beisel, Didier Fassin, P. Wenzel Geissler, Rene Gerrets, Ann Kelly, Guillaume Lachenal, John Manton, Lotte Meinert, Vinh-Kim Nguyen, Branwyn Poleykett, Susan Reynolds Whyte

If we were to ask what is the root cause of our current and unprecedented environmental crisis, climate change, many, particularly on the progressive Left, would refer to the excesses of capitalism—and they’d be right. In Eco-Nihilism: The Philosophical Geopolitics of the Climate Change Apocalypse, Wendy Lynne Lee demonstrates that there are no versions of conquest capital compatible with the fact of a finite planet and that a logic whose operating premise is growth is destined to not only exhaust our planetary resources, but also generate profound social injustice and geopolitical violence in its pursuit. Nonetheless, it is clear that the violence and injustice of capital is selective—some benefit greatly while others are subjugated to its pathological drive to profit. Hence, Lee argues that any comprehensive analysis of what Jason Moore has dubbed the Capitalocene must include an equally probing account of human chauvinism, that is, the axes along which capital is supplied with resources and labor. Defined in terms of race, sex, gender, and species, these axes come ready-made to the advantage of capitalist commodification. Without an understanding of how and why, humanity will remain doomed to settling for a sustainably unjust world as opposed to realizing a just and desirable one. Indeed, on our current trajectory, we may not even achieve the sustainable. The introduction of climate change into the mix of environmental deterioration, the ever-widening economic gap between global North and global South, and the accelerating violence of terrorism, civil war, and human slavery make of a warming planet a combustible world. The only way out requires ending the myth of endless resources, a rejection of climate change denial, and a radical re-valuation of human-centeredness, not as a locus of power, but as an opportunity to take moral and epistemic responsibility for a world whose biotic diversity and ecological integrity make the struggle to realize it worthwhile. This solution demands not only an end to capitalism, but the deliberate reclamation of value—aesthetic, moral, and civic—and a radical transformation of both personal and collective conscience. Lee appeals to the experiential aesthetics of John Dewey and the feminist concept of the standpoint of the subjugated. She argues for a version of the precautionary principle informed by an environmentally and socially responsible concept of the desirable future as the clearest path away from the precipice.

This is the first book that analyzes and systematizes all the general ideas of medicine, in particular the philosophical ones, which are usually tacit. Instead of focusing on one or two points — typically disease and clinical trial — this book examines all the salient aspects of biomedical research and practice: the nature of disease; the logic of diagnosis; the discovery and design of drugs; the design of lab and clinical trials; the crafting of therapies and design of protocols; the moral duties and rights of physicians and patients; the distinctive features of scientific medicine and of medical quackery; the unique combination of basic and translational research; the place of physicians and nurses in society; the task of medical sociology; and the need for universal medical coverage. Health care workers, medicine buffs, and philosophers will find this thought-provoking book highly useful in their line of work and research.