INTRODUCTION TO

MEDICAL PHILOSOPHY
By: E.Suryadi & Trijoko H.
Faculty of Medicine GMU

If the people in medicine have

knowledge they stand in a position to
carry out the applied aims of medicine
with greater effectiveness.
Medicine's unique connection with
ethics heightens the importance of
correct application of knowledge .
Epistemology falls short of being an
applied field, but can contribute to the
goals of medicine and bioethics.

What is philosophy?
Greek:

philosophia
Philein = love, philos = friendship
Sophia = wisdom
Wisdom love = true (based on) & good
(the effect is)
Outlook on life
Characteristics of philosophy thinking:
inclusive comprehensive, reflective,
synoptic, speculative, radical, conceptual,
systematic, freedom, responsible and
implicative, not only factual

The role of philosophy

Philosophy

as a attitude
Philosophy as a method
Philosophy as a problem cluster
Philosophy as a theory cluster
Philosophy as a logical analysis
Philosophy as an activity to acquire
comprehensive view

Three problems of the

philosophy notion
1.

Existential problems
-Quantity: monism; dualism;
pluralism
-Quality : spiritualism; materialism
-Process or changing: mechanism;
teleology; vitalism;
organism

 2.

Knowledge problems

-Pertain to a resource: rationalism;

empirics; realism; criticism.
-Pertain to an essential: idealism;
empirics; positivism;
pragmatism

 3.Values

problems

-Idealism ethic : moral/ spiritual

-Deontologism ethic: obligation
-Teleology ethic :production, outcome,
result
-Hedonism : pleasant, enjoyment,
happiness
-Utilitarism : goodness

Philosophy and science

Philosophy

as mater scientiarum (a science

mother)
Philosophy as a basic of science development
The

sciences preference in a specific aspect

and philosophy endeavor for unity of sciences
Philosophy view comprehensive reality so that
a something become consistent

Philosophy of health
1. Vitalism
2500 years ago in ancient Greece
Hippocrates offered a healing theory
based on the idea of the internal energy
of healing the organism
(called: physic)
so that physician = doctor to protect
the healing energy and to maintain its
vital power and strength

2. Atomism
Democritus idea was that our organism is
nothing but minor particles coming
together and falling apart.
Democritus couldnt imagine the presence
of the healing energy in the particles we
consist of and tried to prove that its
existence is impossible.
In practice physicians are its master and
instead of expecting a low natural process
to eliminate a harmful substance from the
body.

3. Regeneration

Regeneration is a philosophy of
regaining the balance among many
organism energies that are sometimes
opposed.

A natural energy of healing called

physic (Hippocrates) or Chi (Chinese).

Every human has the right to be

healthy and is bound to be healthy

Alternative medicine
Traditional

Chinese Medicine does not only

focus on the body but also focuses on the
body and its environment.

Acupressure,

Acupuncture, Exercise, Food

Therapies, Herbal Medicine and Meditation
are the modalities of treatment commonly
associated with Traditional Chinese Medicine

These

techniques are not only used as

treatments but they also are performed to
assist in the prevention of disease

Oriental Medicine Philosophy

When the body is in balance
between Yin and Yang health is
predominant.
When the Yin and Yang are
imbalanced, diseases occurs.

Health is an expression of balance,

Oriental medicine views disease as
physical expressions of an imbalance
within the body.
Oriental Medicine Physicians look at
the symptoms. along with other
diagnostic methods, to identify patterns
of disharmony.
Each of the body organ systems must
be in balance within itself as well as
within its relationship to the other organ
systems.

Philosophy of Medicine
Plato emphasized virtue,and said that
good medicine is that which attains good
ends.
This is now known as teleological ethics.
From ancient times there was emphasis on
codes, oaths and other formulations.
The Hippocratic oath defined morally
acceptable conduct towards patients,
considered duties to patients and referred to
priestly vows and sacred art.

The practice of medicine consisted

of the arts of preserving health,
prolonging life and curing diseases
but also required a habit of nice
discernment, knowledge of the world,
an ability to deal with prejudice and a
controlled temperament.
The moral qualities of humanity
and sympathy were to be combined
with firmness of mind, good humour,
candour, decorum and good
communication with patients.

John Gregory (1724 1773) was

particularly concerned with Scottish
Moral Sense Theory, which was based
on motivation and character not action
and consequence.
It stressed humanity leading to
empathy, discretion, confidentiality and
tolerance.
He condemned commercial selfinterest, argued that reason could not
be the basis of morality and thought
that instinct needed training and
control.

Should physicians in particular study

philosophy?
With some important reservations, then we
find ourselves lining up behind the great
Roman philosopher and physician Galen,
when he writes:
"We must practice philosophy if we are true
followers of Hippocrates.
And, if we practice philosophy, there is nothing to
prevent us, not only from reaching a similar
attainment, but even from becoming better than
him."

The title of the work from which this

is taken is The Best Doctor is

Also a Philosopher.

Although
same object, same data, same knowledge
same faith.
but
difference perception and difference
response
because
difference philosophy!?

Patient

Doctor Management!?

In line with an element of Professor

Caplan's
definition of the philosophy of medicine,
I will attempt to explicate the key
concepts in
philosophy in medicine of
uncertainty'

and
'underdetermination.'

Two basic types of uncertainty

"The

first results from incomplete or

imperfect mastery of available
knowledge," and,

The

second depends upon limitations in

current medical knowledge

Uncertainty

knowledge

is inherent to medical

 With

'underdetermination' substituted
for 'uncertainty' we see that there can
be no instance of the negative: there is
never a case where the evidence does
not underdetermine the theory. So,
perhaps nothing is lost by removing this
part of the premise
It is not a simple case of
underdetermination because it is a
conflict between methods and not
theories.

A number of claims that

must be attended by
1. The public doctor:
wants certainty and

clarity
2. Science can rarely provide (1)
3. The data are uncertain
4. Scientists are in disagreement

A number of claims that

must the
bepublic
attended
by
5. To deceive
is unethical
doctor:
6. To mask the reality of [presumably]
(1) through (4) to avoid
'confusion' is unethical, because it
is an instance of (5)
7. To misguide health policy is
imprudent

A number of claims that

must be attended by
doctor:

8. To mask the reality of [presumably] (1)

through (4) is imprudent because it is an

instance of (7)

9. Patients, practitioners, and the public

officials have the right to know when the
facts are certain and when they are not.

A number of claims that must

be attended by doctor:
10. Patients, practitioners, and the
public officials have the right to
know when the evidence
underdetermines
the theory and when it does not.

 Imre

Lakatos says: Philosophy of science

without history of science is empty, history
of science without philosophy of science is
blind

Philosophy

of medicine without history of

medicine is empty, history of medicine
without philosophy of medicine is blind.

If

you want to become the best doctor you

must learn about philosophy and history of
medicine