在西方医药审判中的一个亮点--科学哲学

科学证据不仅在司法审判中起着极其重要的作用,而且在科研成果的评价中也是不可取代的,但是在审判和科研成果评估中,对“科学是什么”这样一个更深层次的问题－科学哲学问题,历来没有得到应有的重视,通过美国止吐药本涤汀前后历时20年的审判历程,突出科学哲学在医药审判实践中的地位。     

达尔文医学与中医学

达尔文医学是博物学（进化论）传统与生理医学传统（终因和近因生物学）最后的结合,尝试着对这门新兴学科作出理论基础和研究内容的建构。在此基础上,达尔文医学与中医学的可通之处在如下三个层次上作出了探讨：医学理念的整体性,理论基础的哲学思辨性和学科结构中的修辞性。     

The Future of Psychology in Academic Health Care Centers

A promising opportunity exists to continue psychology's move beyond its traditional mental health emphasis into a general health care discipline. Abundant empirical evidence supports that psychologists treat a wide array of physical disorders as well as psychological components of medical problems. The immediate issues confronting psychology's full emergence into the health care world are discussed and recommendations are offered to assure the success of this initiative. Office of the Senior Vice President and Provost     

A Method for Introducing the Concepts of Chaos Theory to Medical Students

Chaos theory is beginning to find applications in the field of medicine. The theory of chaos should be introduced to students to help them as they make the transition from learning the scientific literature to actually applying this newly acquired knowledge in clinical situations. Chaos theory will give the students a powerful conceptual framework from which they can better understand the limits of predictability in clinical situations. Failure to understand the limits of predictability in chaotic natural systems will invariably lead to frustration in both patients and physicians.     

Incurable suffering from the “hiatus theoreticus”? Some epistemological problems in modern medicine and the clinical relevance of philosophy of medicine

Up to now neither the question, whether all theoretical medical knowledge can at least be described as scientific, nor the one how exactly access to the existing scientific and theoretical medical knowledge during clinical problem-solving is made, has been sufficiently answered. Scientific theories play an important role in controlling clinical practice and improving the quality of clinical care in modern medicine on the one hand, and making it vindicable on the other. Therefore, the vagueness of unexplicit interrelations between medicine's stock of knowledge and medical practice appears as a gap in the theoretical concept of modern medicine which can be described as Hiatus theoreticus in the anatomy of medicine. A central intention of the paper is to analyze the role of philosophy of medicine for the clarification of the theoretical basis of medical practice. Clinical relevance and normativity in the sense of modern theory of science are suggested as criteria to establish a differentiation between philosophy of medicine as a primary medical discipline and the application of general philosophy in medicine.     

The trauma triangle

Recent research supports the hypothesis that more active engagement of the patient in occurring illnesses improves quality of life and probably even life expectancy.In this study experience and theoretical knowledge from psychotherapy is transplanted to clinical practice in order to improve the physician's engagement in the patient-disease relationship. By defining severe and long-term illnesses as a psychotrauma, the transfer of the psychotherapeutical model leads to the creation of a new triangular relationship: patient-illness-doctor. Practical examples are used as illustrations for the conceptual differences between psychotherapy and clinical medicine. Options for dialogue show the difference between adaptation (learning to live with) and adjustment (active coping strategies and controlling). The hypothesis is that a better dialogue will reduce illness-related stress, giving the patient better and more effective access to personal psychic and physical support systems.     

Involvement of cardiac,respiratory and gastrointestinal functions in neural responses to stressful events

In the stress concept, fight and flight situations as well as other CNS-controlled reaction patterns for alertness to danger have to be followed by or integrated with a restorative “build-up” process in order to maintain homeostasis. The “build-up” process can be studied physiologically for example after regular exercise or training. Under these conditions there is a decrease in resting sympathetic adrenergic activity and an increase in the parasympathetic vagal activity. A theoretical model for the “build-up” process in psychosomatic gastroenterology has previously been presented. The present paper deals with the “build-up” process in cardiovascular and respiratory tract diseases seen in athletes. Anorexia nervosa related to excess physical training is also discussed as well as the “build-up” process in severe obesity and psychosomatic gastroenterological disorders.     

BEHAVIORAL RESEARCH IN PREVENTIVE DENTISTRY: EDUCATIONAL AND CONTINGENCY MANAGEMENT APPROACHES TO THE PROBLEM OF PATIENT COMPLIANCE

This study examined the effects of reinforcement on compliance with an oral hygiene education program. Patients 18 years of age or older who enrolled in an ongoing program at a periodontal practice received 3–5 sessions of instruction in preventive dental care. Using a between-subjects design, patients who entered the program during alternating months also had a portion of their fees refunded contingent upon improvements in their dental plaque scores. Pre- and posttreatment data showed that all subjects exhibited lower plaque levels following the program, but that greater improvements were seen in patients who were exposed to the fee reduction contingency. Plaque scores taken at a 6-month follow-up revealed some relapse for the Fee Reduction subjects. However, their scores were still substantially better than pretreatment, and better than those of the Education only subjects, whose data differed little from untreated Controls. Methodological and practical issues related to behavioral research in preventive dentistry are discussed.     

A “new rhetoric” for a “new dialectic”: Prolegomena to a responsible public argument

This essay offers, as a counterpart to pragma-dialectical argument, a “new rhetoric” produced in the situated discourse of a public forum when a community addresses matters of common urgency and undertakes informed action. Such a rhetoric takes the principles of discourse ethics as its informing dialectic by identifying an interlocutor as one who is obligatedboth to argue effectively,and also to hold open, even reinforce, norms of communicative reason. Implications concerning the study of fallacies and theethos obligations of communicative reasoning are discussed.