scholarly journals Listening to and letting pain speak: poetic reflections

2017 ◽  
Vol 12 (2) ◽  
pp. 95-103 ◽  
Author(s):  
Richard B Hovey ◽  
Valerie Curro Khayat ◽  
Eugene Feig
Keyword(s):  
Lived Experience ◽  
Lived Experiences ◽  
Medical Humanities ◽  
Medical Knowledge ◽  
Evidence Based ◽  
Family Narratives ◽  
Scientific Approach ◽  
Knowledge Practice ◽  
Humanities In Medicine ◽  
Based Medicine

The humanities invite opportunities for people to describe through their metaphors, symbols and language a means in which to interpret their pain and reinterpret their new lived experiences. The patient and family all live with pain and can only use their pain narratives of that experience to confront or even to begin to understand the quantifiable discipline of medicine. The patient and family narratives act to retain meaning within a lived pained experience. These narratives add meaning to the person as a stay against only having a clinical–pathological understanding of what is happening to our body and as a person. We need to understand the pathology pain while also being mindful of suffering. In this article, the theoretical and scientific approach to pain research and clinical practice intersects with the philosophical, ontological and reflective lived experience of the person living with pain. Through unique pain narratives, poetry and stories as a means of offering empathy and understanding as healing, the humanities in medicine bring into meaning another kind of therapy equal to the evidence-based medicine clinicians and researchers use to seek a cure. In this way, the medical humanities are addressing the person’s healing through the reduction of suffering and isolation by letting pain speak while others can focus in on their medical knowledge/practice and research while ‘finding’ a cure. Listening to pain opens-up to the possibility that much can be learned through multiple expressions of the pain narrative. This article provides an invitation to learn how we might articulate and listen to pain carefully and differently.

Using narratives for medical humanities in medical training

2018 ◽  
pp. 129-139
Author(s):  
Alexander Kiss ◽  
Claudia Steiner
Keyword(s):  
Medical Education ◽  
Medical Humanities ◽  
Medical Training ◽  
Narrative Medicine ◽  
Illness Narratives ◽  
Evidence Based ◽  
Good Doctor ◽  
The University ◽  
Based Medicine ◽  
Humanities Curriculum

The University of Basel, Switzerland has developed a longitudinal medical humanities curriculum based on illness narratives and narrative medicine. The ultimate learning goal of medical humanities as taught in Basel is to foster narrative competence. A good doctor needs to be a good listener, a good storyteller, and should ideally be able to co-create an illness narrative together with a patient. Medical humanities consist of mandatory and optional elements. Blending evidence-based medicine, which is based on larger numbers of patients with similar characteristics, with narrative-based medicine, which is based on patients’ uniqueness, this programme provides medical students with the opportunity to develop and practice narrative medicine over the course of the six years of medical studies. This chapter discusses the programme and its place in medical education.

scholarly journals New journals for publishing medical case reports

2016 ◽  
Vol 104 (2) ◽  
Author(s):  
Katherine G. Akers, PhD
Keyword(s):  
Case Reports ◽  
Medical Knowledge ◽  
Evidence Based ◽  
Vast Number ◽  
Educational Value ◽  
Hierarchy Of Evidence ◽  
Predatory Publishing ◽  
Reputable Journal ◽  
Acceptance Rates ◽  
Based Medicine

Because they do not rank highly in the hierarchy of evidence and are not frequently cited, case reports describing the clinical circumstances of single patients are seldom published by medical journals. However, many clinicians argue that case reports have significant educational value, advance medical knowledge, and complement evidence-based medicine. Over the last several years, a vast number (~160) of new peer-reviewed journals have emerged that focus on publishing case reports. These journals are typically open access and have relatively high acceptance rates. However, approximately half of the publishers of case reports journals engage in questionable or ‘‘predatory’’ publishing practices. Authors of case reports may benefit from greater awareness of these new publication venues as well as an ability to discriminate between reputable and non-reputable journal publishers.

scholarly journals Absurdity in Medicine. Stanisław Trzebiński’s Philosophy of Medicine

2021 ◽  
pp. 9-23
Author(s):  
Jarosław Barański ◽  
Wojciech Mackiewicz
Keyword(s):  
Evidence Based Medicine ◽  
Philosophy Of Medicine ◽  
Medical Knowledge ◽  
Second World War ◽  
Evidence Based ◽  
World War ◽  
Medicine And Literature ◽  
Knowledge And Practice ◽  
Based Medicine ◽  
Second World

Stanisław Trzebiński (1861–1930), professor at Stefan Batory University in Vilnius, was one of the most distinguished representatives of the Polish School of Philosophy of Medicine before the Second World War. He undertook studies in neurology, philosophy of medicine, and literature. The article explores Trzebiński’s philosophical ideas, especially his call for rationality in medicine and the concept of absurdity in medicine as a precondition for the development of medical knowledge and practice. Today this method is an essential background in Evidence-Based Medicine and confirms cultural and scientific forms of cognition.

scholarly journals The Ethic of Responsibility: Max Weber’s Verstehen and Shared Decision-Making in Patient-Centred Care

2019 ◽  
Author(s):  
Ariane Hanemaayer
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Medical Humanities ◽  
Medical Knowledge ◽  
Shared Decision ◽  
Patient Centred Care ◽  
Physician Decision Making ◽  
Patient Values ◽  
Based Medicine ◽  
The Relationship

AbstractWhereas evidence-based medicine (EBM) encourages the translation of medical research into decision-making through clinical practice guidelines (CPGs), patient-centred care (PCC) aims to integrate patient values through shared decision-making. In order to successfully integrate EBM and PCC, I propose a method of orienting physician decision-making to overcome the different obligations set out by a formally-rational EBM and substantively-rational ethics of care. I engage with Weber’s concepts “the ethic of responsibility” and verstehen as a new model of clinical reasoning that reformulates the relationship between medical knowledge and social values, while demonstrating the relevance of the classical sociological cannon to contemporary medical humanities.

Does evidence-based medicine training improve doctors’ knowledge, practice and patient outcomes? A systematic review of the evidence

2018 ◽  
Vol 41 (5) ◽  
pp. 532-538 ◽  
Author(s):  
Mary R. Simons ◽  
Yvonne Zurynski ◽  
Jeremy Cullis ◽  
Michael K. Morgan ◽  
Andrew S. Davidson
Keyword(s):  
Systematic Review ◽  
Patient Outcomes ◽  
Evidence Based Medicine ◽  
Evidence Based ◽  
Knowledge Practice ◽  
Based Medicine

The place of service-user expertise in evidence-based practice

2016 ◽  
Vol 17 (1) ◽  
pp. 3-20 ◽  
Author(s):  
Kate Davies ◽  
Mel Gray
Keyword(s):  
Lived Experience ◽  
Service User ◽  
Evidence Based Practice ◽  
Evidence Based ◽  
Service Users ◽  
Pragmatic Approach ◽  
Strong Argument ◽  
User Expertise ◽  
User Knowledge ◽  
Based Medicine

Summary This article considers the place of service-user knowledge and expertise within an evidence-based practice perspective. It makes a strong argument that client involvement is a core principle of Sackett et al.'s foundational approach in evidence-based medicine. In so doing, it draws on research on service-users' perceptions and experiences of evidence-based practice. Findings For service users, evidence-based practice lacks relevance and trustworthiness unless it explicitly factors in the expertise of service users themselves. Evidence-based practice is seen to have merit as a tool for enhancing accountability, but service users see a role for themselves at individual and representative levels in the process of evidence-based practice. They place a high value on the expertise derived from lived experience, and recognise that fluctuations in capacity and changes in circumstances of many service users require a flexible approach to their participation in decision making. A pragmatic approach to the conceptualisation of evidence is recommended, which not only maintains scientific rigour inherent in evidence-based practice but also more strongly emphasises the process of analysing evidence appropriate to a particular individual's preferences and circumstances. Applications For human service practitioners, this study emphasises the need to develop professional skills in assessing the capacities, circumstances and preferences of clients and analysing and applying evidence for practice in ways that conform to a client-centred approach. It also indicates a need for researchers and practitioners to recognise and value service-user expertise.

scholarly journals Etyczne aspekty farmakoterapii

Etyka ◽  
1998 ◽  
Vol 31 ◽  
pp. 147-167
Author(s):  
Zbigniew Szawarski
Keyword(s):  
Clinical Judgment ◽  
Psychiatric Treatment ◽  
Human Subjects ◽  
Medical Knowledge ◽  
Evidence Based ◽  
Clinical Knowledge ◽  
Human Subjects Research ◽  
Practical Syllogism ◽  
The Right ◽  
Based Medicine

Said Paracelsus – “All substances are poisonous; there is none that is not a poison. The right dose distinguishes a poison and a remedy.” Most clinical problems can be boiled down to the following practical syllogism: “If a patient has a condition p, then he should be treated with q, r, or t or whatever combination of them. The patient X has the condition p. Therefore, the patient X should be treated with q, or r, or t, or whatever combination of them.” It is evident that the conclusion of this syllogism is a result of two different kinds of knowledge: first, medical knowledge understood as general and universal knowledge of health, disease and treatment which is contained in standard medical textbooks and which, according to the present fashion, is called evidence based medicine; and second, clinical knowledge which is specific knowledge of a particular patient in terms of his unique narrative identity. (Recently, this kind of knowledge has been named narrative based medicine). Acquisition and application of medical and clinical knowledge are governed by ethical rules. The basic rules of human subjects research ethics are presented and discussed. I conclude that even a perfect evidence based medical knowledge is not enough to make a correct clinical judgment. Because every individual may have a specific reaction to a drug, each treatment is always experimentation on human. One of those rules is respect for moral autonomy of the patient which is reflected in the moral, legal, and clinical doctrine of informed consent; another, the principle of an acceptable risk-benefit balance. Both these principles are examined in the context of psychiatric treatment.

Multidisciplinary team discussion in onkology

2020 ◽  
Vol 1 (1) ◽  
pp. 108-111
Author(s):  
A.E. Kalinin ◽  
◽  
V.V. Guschin ◽  
◽  
Keyword(s):  
Multidisciplinary Team ◽  
Medical Knowledge ◽  
Standard Of Care ◽  
Evidence Based ◽  
Optimal Management ◽  
Related Services ◽  
Complex Patient ◽  
Based Medicine ◽  
Decision Making Tool

The multidisciplinary team (MDT) conference has evolved as an essential instrument in the optimal management of a complex patient in the era of ever-changing medical knowledge. MDT discussions may improve the quality of diagnosis and treatment as well as provide an additional formal opportunity for collaboration among colleagues. MDT conference has become the standard of care and decision making tool in oncology. Such meetings include medical staff from all oncology-related services, and the decision is encouraged to be supported by the principles of evidence-based medicine. This paper provides an overview of the goals, pitfalls, and general recommendations for holding a productive MDT discussion.

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