Person-Centeredness

2018 ◽  
Author(s):  
J. Donald Boudreau ◽  
Eric J. Cassell ◽  
Abraham Fuks
Keyword(s):  
Nineteenth Century ◽  
Medical Education ◽  
Medical Practice ◽  
Patient Centeredness ◽  
Early Nineteenth Century ◽  
Clinicopathologic Correlation ◽  
Sharp Focus ◽  
Definition Of

The historical roots of the term patient-centeredness are presented. The point is made that, although the term possesses considerable rhetorical power, in reality many institutions that wave the banner of patient-centeredness remain resolutely disease focused. This has been the case since the early nineteenth century, when clinicopathologic correlation became an imperative of medical practice. That the doctor’s primary mandate is to ferret out disease remains a tenacious precept in contemporary medical practice as well as in medical education. This chapter argues that a medicine anchored in a new and bold definition of sickness, one with a laser-sharp focus on a person’s functioning, necessarily opens many avenues for a practice centered on the person.

Physicianship and the Rebirth of Medical Education

2018 ◽  
Author(s):  
J. Donald Boudreau ◽  
Eric Cassell ◽  
Abraham Fuks
Keyword(s):  
Medical Education ◽  
Educational Process ◽  
Medical Attention ◽  
Patient Centeredness ◽  
Goals Of Medicine ◽  
The Subject ◽  
Definition Of ◽  
And Function ◽  
William Osler ◽  
The Relationship

This book reimagines medical education and reconstructs its design. It originates from a reappraisal of the goals of medicine and the nature of the relationship between doctor and patient. The educational blueprint outlined is called the “Physicianship Curriculum” and rests on two linchpins. First is a new definition of sickness: Patients know themselves to be ill when they cannot pursue their purposes and goals in life because of impairments in functioning. This perspective represents a bulwark against medical attention shifting from patients to diseases. The curriculum teaches about patients as functional persons, from their anatomy to their social selves, starting in the first days of the educational program and continuing throughout. Their teaching also rests on the rock-solid grounding of medicine in the sciences and scientific understandings of disease and function. The illness definition and knowledge base together create a foundation for authentic patient-centeredness. Second, the training of physicians depends on and culminates in development of a unique professional identity. This is grounded in the historical evolution of the profession, reaching back to Hippocrates. It leads to reformulation of the educational process as clinical apprenticeships and moral mentorships. “Rebirth” in the title suggests that critical ingredients of medical education have previously been articulated. The book argues that the apprenticeship model, as experienced, enriched, taught, and exemplified by William Osler, constitutes a time-honored foundation. Osler’s “natural method of teaching the subject of medicine” is a precursor to the Physicianship Curriculum.

WOMEN, MARGINALITY AND THE ZULU STATE: WOMEN'S INSTITUTIONS AND POWER IN THE EARLY NINETEENTH CENTURY

1998 ◽  
Vol 39 (3) ◽  
pp. 389-415 ◽  
Author(s):  
SEAN HANRETTA
Keyword(s):  
South Africa ◽  
Nineteenth Century ◽  
State Government ◽  
Gender Relations ◽  
Historical Change ◽  
Political Organization ◽  
Internal Conflict ◽  
Early Nineteenth Century ◽  
The Past ◽  
Definition Of

For a number of years the historiography of Southern Africa has been dominated by a materialist framework that has focused upon modes of production and forms of socio-political organization as the determining factors in historical change. Those historians concerned with the history of women in pre-colonial societies – even those who have privileged gender relations in their analyses – have largely been content to construct women's history by applying the insights of socio-economic and political analyses of the past to gender dynamics, and by projecting the insights of anthropological analyses of present gender relations into the past. Some of these historians have concluded that until the arrival of capitalism no substantial changes in the situations, power or status of women took place within Zulu society, even during the period of systemic transformation known as the mfecane in the early nineteenth century.More recently, Zulu gender history has become part of a larger debate connected to the changing political and academic milieu in South Africa. Representatives of a revived Africanist tradition have criticized materialist historians for writing Zulu history from an outsider's perspective and of focusing overly on conflict and power imbalances within the nineteenth-century kingdom in an effort to discredit contemporary Zulu nationalism. To counter this, historian Simon Maphalala has stressed the harmony of nineteenth-century Zulu society, the power advisors exercised in state government, and the lack of internal conflict. Maphalala also claims that women's subordinate role in society ‘did not cause any dissatisfaction among them’, and argues that ‘[women] accepted their position and were contented’. In recent constitutional debates many South African intellectuals including members of the Congress of Traditional Leaders of South Africa (CONTRALESA), invoked this ‘benign patriarchy’ model of pre-colonial gender relations to oppose the adoption of gender-equality provisions in the new constitution. As Cherryl Walker has noted, the hegemonic definition of traditional gender relations to which such figures have made rhetorical appeals often masks not only the historicity of these relations but also hides dissenting opinions (often demarcated along gender lines) as to what those relations are and have been.

scholarly journals Of Other Places: The Garden as a Heterotopic Site in Contemporary Art

2008 ◽  
Vol 10 (1) ◽  
pp. 60-71
Author(s):  
Melanie Dana Nakaue
Keyword(s):  
Nineteenth Century ◽  
Contemporary Art ◽  
Michel Foucault ◽  
Community Gardens ◽  
Northern Europe ◽  
Early Nineteenth Century ◽  
Found Objects ◽  
Time Space ◽  
Definition Of ◽  
A Site

According to Michel Foucault, a heterotopia is a site where the differentiation between a location and its temporality is related to theoretical and societal concerns that challenge the notion of history, location, and subjectivity. Contemporary artists such as Stan Douglas and Hew Locke utilize the garden as heterotopic space for intervention in their work in order to investigate and challenge linear notions of time, space and subjectivity. Stan Douglas examines the historical and social underpinnings of the community gardens in early nineteenth century Northern Europe, otherwise known as the potsdamer schrebergärten, and recreates the tableau of the garden in his piece, Der Sandman. Similarly, artist Hew Locke draws upon the art of the topiary and creates an assemblage topiary sculpture, titled Black Queen, where found objects are utilized to recontextualize the concept of the garden topiary as a site of a postcolonial experience. This article investigates the way that nature, in this case the garden, is utilized and represented in contemporary art. By analyzing and applying Foucault’s lecture, “Of Other Spaces” and definition of heterotopias to the work of artists such as Douglas and Locke, the paper aims to illuminate the connection between site and subjectivity, and the multiplicity of meaning that results from the garden as being the quintessential site of postmodern experience.

The ‘reasonable patient’ of 2025 envisioned (Preprint)

2021 ◽  
Author(s):  
Jack Dowie ◽  
Mette Kjer Kaltoft
Keyword(s):  
Decision Making ◽  
Medical Education ◽  
Medical Research ◽  
Supreme Court ◽  
Integrated Care ◽  
Medical Practice ◽  
Uk Supreme Court ◽  
Definition Of ◽  
The Uk ◽  
Made In

UNSTRUCTURED . The verdict of the UK Supreme court in the case of Bellman versus Boojum-Snark Integrated Care Trust (2025) will have profound implications for all medical practice, medical education and medical research, as well as the regulation of medicine and allied healthcare fields. Major changes will result from the judgment made in favour of Bellman’s negligence claim, reflecting an expanded and more precise definition of informed and preference-based consent, compared with that in Montgomery (2015) and also with the principles laid out in the UK GMC guidance on Decision Making and Consent (2020). (In case of doubt, this is a vision paper.)

scholarly journals The Role of Statistics and Statisticians in the Future of Astrostatistics

2014 ◽  
Vol 10 (S306) ◽  
pp. 400-406
Author(s):  
Joseph M. Hilbe
Keyword(s):  
Nineteenth Century ◽  
Statistical Analysis ◽  
Future Generations ◽  
Short Term ◽  
Early Nineteenth Century ◽  
Working Groups ◽  
Formal Relationship ◽  
To Come ◽  
Definition Of

AbstractGiven the generic definition of statistics, it is clear that astronomers have engaged in statistical analysis of some variety since astronomy first emerged as a science. However, from the early nineteenth century until the beginning of the twenty-first the two disciplines have been somewhat estranged – there was no formal relationship between the two. This has now changed, as is evidenced by the recent creation of the International Astrostatistics Association (IAA), the ISI astrostatistics committee, astrostatistics working groups authorized by the IAU and AAS, and this Symposium. The challenge for us to come is in establishing how statisticians and astronomers relate in developing the discipline of astrostatistics. I shall propose a direction for how the discipline can progress in both the short term and well as for future generations of astrostatisticians.

Part II: Reformers in Medical Education and Practice

2001 ◽  
Vol 9 (2) ◽  
pp. 59-68 ◽  
Author(s):  
Martin A Entin
Keyword(s):  
Medical Education ◽  
Professional Practice ◽  
Medical Practice ◽  
Care Society ◽  
Analytical Quality ◽  
Financial Gain ◽  
John Hunter ◽  
History Of ◽  
Definition Of ◽  
Historical Article

Background Part I was published in Can J Plast Surg 2000;8(1):25–29. It established that standards of professional practice shift constantly. When a standard falls short of professional expectation or when a physician becomes more concerned with financial gain rather than patient care, society needs the action of a reformer. Part II continues the study and begins with the contribution of reformer John Hunter (1728–1793), and follows with the contributions of seven other reformers, concluding with Wilder Penfield (1891–1976). Study Design The reformers were physicians and scientists who were selected throughout the history of medicine: they conformed to our definition of reformers, namely, a person whose action changed the structure or ideology of medical practice. Results The present historical article shows that reforms are produced by people possessing critical judgement and analytical quality who influenced the direction of medical practice. Conclusion Reforms have been achieved through intuitive leaps, alterations of conventional practice, painstaking research or administrative restructuring.

The Structure of French Romantic Histories of Religions

Numen ◽  
1998 ◽  
Vol 45 (3) ◽  
pp. 258-286
Author(s):  
Arthur McCalla
Keyword(s):  
Nineteenth Century ◽  
A Priori ◽  
Philosophy Of History ◽  
Structural Elements ◽  
Religious Thought ◽  
Early Nineteenth Century ◽  
Christian Doctrine ◽  
History Of ◽  
The Common ◽  
Definition Of

AbstractThis article analyzes the histories of religions of Louis de Bonald, Antoine Fabre d'Olivet, Pierre-Simon Ballanche, and Ferdinand d'Eckstein. Rather than offer yet another definition of Romanticism, it seeks to establish a framework by which to render intelligible a set of early nineteenth-century French histories of religions that have been largely ignored in the history of the study of religion. It establishes their mutual affinity by demonstrating that they are built on the common structural elements of an essentialist ontology, an epistemology that eludes Kantian pessimism, and a philosophy of history that depicts development as the unfolding of a preexistent essence according to an a priori pattern. Consequent upon these structural elements we may identify five characteristics of French Romantic histories of religions: organic developmentalism; reductionism; hermeneutic of harmonies; apologetic intent; and reconceptualization of Christian doctrine. Romantic histories of religions, as syntheses of traditional faith and historical-mindedness, are at once a chapter in the history of the study of religion and in the history of religious thought.

The M Yarn: Price and Social Imagination in Early Industrial Britain

2014 ◽  
Vol 15 (03) ◽  
pp. 417-441
Author(s):  
Paul Anthony Custer
Keyword(s):  
Nineteenth Century ◽  
Price Competition ◽  
Close Reading ◽  
Early Nineteenth Century ◽  
Social Imagination ◽  
Definition Of ◽  
The Relationship ◽  
Small Thing

This essay explores market talk in early nineteenth-century Britain through a close reading of the correspondence of the cotton-spinning firm McConnel & Kennedy of Manchester between 1798 and 1813. I argue that two distinct “narratives” of price and value emerge from these letters, and that the cleave between them pointed both to a deep anxiety about the market, and to a clear and clever bargaining strategy. McConnel & Kennedy clung stubbornly to a definition of “value” that they understood to be fictive, in order to avoid frank surrender to what they saw as cannibalistic price-competition. Rhetoric was, then, no small thing to them. They conceived supply and value as being inversely related, and this idea, I argue, was implicit also in wider contemporary anxieties about the relationship between proliferation and meaning.

scholarly journals Making Sense of Madness : Mental Disorders and the Practices of Case History Writing in the Early Nineteenth Century

2021 ◽  
Vol 10 (2) ◽  
pp. 211-242
Author(s):  
Janka Kovács
Keyword(s):  
Nineteenth Century ◽  
Medical Practice ◽  
Case History ◽  
Methodological Approach ◽  
Psychological State ◽  
History Writing ◽  
Early Nineteenth Century ◽  
Making Sense ◽  
Specialized Care ◽  
Eighteenth And Nineteenth Centuries

The article focuses on interpretations of madness in early nineteenth-century Hungary medical practice from a comparative perspective. By relying on the methodological approach of the anthropology of writing and the analytical considerations offered by Michel Foucault’s 1973–1974 lectures on Psychiatric Power, the article discusses the formalized and standardized practices of case history writing. It draws on sources from the teaching clinics at the universities of Pest and Edinburgh, as well as the largest mental asylums in the Habsburg Monarchy in Vienna (est. 1784) and Prague (est. 1790), and the ideal type of mental asylums at the turn of the eighteenth and nineteenth centuries, the York Retreat (est. 1796). In doing so, an attempt is made to reconstruct both the physicians’ gaze and (to a certain extent) the patients’ view, and by examining the therapeutical regime of each hospital and its correlations with the institutional background, uncover whether madness was perceived as a pathological somatic or psychological state in the medical practice of these institutions. This is in and of itself a fundamental question if we seek to understand changing attitudes towards the mad and their curability in a period of transition from a “world without psychiatry” to a “world of psychiatry,” when specialized care was still not an option for many, especially in the East Central European region.

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