Made Wardhana

What is philosophy?

Gr philosophia ‘Love of Wisdom’ By Jenicek ja Hitchcock (2005) philosphy is the study of fundamental questions, that is, questions about concepts and principles.

Main branches of philosophy are metaphysics and ontology (being and reality); epistemology (knowledge); logic (inference); and ethics (values).

Literally "the love of wisdom" (Greek: philo = love, sophia = wisdom), philosophy at the dawn of civilization was synonymous with rational inquiry itself.

Two important starting points: love (or passion) and wisdom (knowledge, understanding).

Philosophy sometimes seems to be pursued without passion as if it were a technical subject like engineering or mathematics.

Although there is a role for dispassionate research, philosophy must derive from some passion for

the ultimate goal: a reliable, accurate understanding ourselves and our world.

Philosophy has been called many things and it can have many meanings

Those single words or statements on the right side are only some of them

What words would you add?

Wisdom Reality Theories Meaning of Life Nature of being

human Life perspectives

(By Roger Hiemstra, January, 2001)

Philosophy?

1. Examination of basic concepts: the branch of knowledge or academic study devoted to the systematic examination of basic concepts such as

truth, existence, reality, causality, and freedom

2. School of thought: a particular system of thought or doctrine

3. Guiding or underlying principles: a set of basic principles or concepts underlying a

particular sphere of knowledge4. Set of beliefs or aims: a precept, or set of

precepts, beliefs, principles, or aims, underlying somebody's practice or conduct

5. Calm resignation: restraint, resignation, or calmness and rationality in somebody's behavior or response to events

The Main Branches of Philosophy

1.Epistemology

2.Ontology/Metaphysics

3.Axiology Aesthetics - Ethic

1. Epistemology Epistemology is the branch of philosophy that studies

knowledge. It attempts to answer the basic question: What distinguishes true (adequate) knowledge from false (inadequate) knowledge? Practically, this question translates into issues of scientific methodology: how can one develop theories or models that are better than competing theories? It also forms one of the pillars of the new sciences of cognition, and from artificial intelligence, as an attempt to develop computer programs that mimic a human's capacity to use knowledge in an intelligent way.

Logic knowledge

Logic is the study of right reasoning. It is the tool philosophers use to study other philosophical categories. Good logic includes the use of good thinking skills and the avoidance of logic fallacies.

Logical positivism - some characteristics

Unified science (methodological monism) ... Mathematical physics becomes the ideal science

Theory-reduction and logical analysis are seen as tools for unified science

Construction of general knowledge through induction and deduction: ”the hypothetical-deductive method”

Deductive reasoning works from the more general to the more specific. Sometimes this is informally called a "top-down" approach. We might begin with thinking up a theory about our topic of interest. We then narrow that down into more specific hypotheses that we can test. We narrow down even further when we collect observations to address the hypotheses. This ultimately leads us to be able to test the hypotheses with specific data -- a confirmation (or not) of our original theories.

Inductive reasoning works the other way, moving from specific observations to broader generalizations and theories. Informally, we sometimes call this a "bottom up" approach (please note that it's "bottom up" and not "bottoms up" which is the kind of thing the bartender says to customers when he's trying to close for the night!). In inductive reasoning, we begin with specific observations and measures, begin to detect patterns and regularities, formulate some tentative hypotheses that we can explore, and finally end up developing some general conclusions or theories.

2. Metaphysics

Metaphysics is the study of “reality.” More specifically it is the study of reality that is beyond the scientific or mathematical realms. The term “metaphysics” itself literally means “beyond the physical.” The metaphysical issues most discussed are the existence of God, the soul, and the afterlife.

Metaphysica Generalis (ontologi); ilmu tentang yg ada atau pengada.

Metaphysica Specialis terdiri atas: 1. Antropologi; menelaah ttg hakikat

manusia, terutama hub. jiwa & raga.

2. Kosmologi; menelaah ttg asal usul & hakikat alam semesta. 3. Theologi; Kajian ttg Tuhan secara

rasional.

(C.Wolff)

2.Axiology

is the study of quality or value.

It is often thought to include ethics and aesthetics - philosophical fields that depend crucially on notions of value - and sometimes it is held to lay the groundwork for these fields, and thus to be similar to value theory and meta-ethics.

3. Ethics

Ethics is the study of moral value, right and wrong. Ethics is involved with placing value to personal actions, decisions, and relations. Important ethical issues today include abortion, sexual morality, the death penalty, euthanasia, pornography, and the environment.

5. Aesthetics

Aesthetics is the study of art and beauty. It attempts to address such issues as:--What is art?--What is the relationship between beauty and art?--Are there objective standards by which art can be judged?

The Others Branch of Philosophy

Philosophy of EducationPhilosophy of HistoryPhilosophy of LanguagePhilosophy of LawPhilosophy of MathematicsPhilosophy of MindPhilosophy of PoliticsPhilosophy of ReligionPhilosophy of Science

Other SubfieldsPhilosophy of History, Philosophy of Mathematics, Philosophy of Medicine, Philosophy of Education, Philosophy of Linguistics, Philosophy of Criticism, Philosophy of Culture, etc

The Reason to Study Philosophy

Most philosophers would agree that one of the great benefits of philosophy is that it challenges us to think critically about our beliefs and to justify them with good arguments.

In this way, philosophy forces us to think clearly and precisely and to express our ideas in the same way.

The development of critical thinking skills that is achieved through the study of philosophy is something that can help all of us to make better decisions in many aspects of our lives.

We can benefit personally because we will make better judgments about what is in our own long-term self-interest.

The Uses of Philosophy

• General Problem Solving. The study of philosophy enhances, in a way no other activity does, one's problem-solving capacities.

• Communication Skills. Philosophy also contributes uniquely to the development of expressive and communicative powers.

• Persuasive Powers. Philosophy provides capacities can be developed not only through reading and writing in philosophy, but also through the philosophical dialogue,

• Writing Skills. Philosophy teaches interpretive writing through its examination of

challenging texts, comparative writing through emphasis on fairness to alternative positions.

Philosophy of Sciences

The philosophy of science seeks to understand the nature and justification of scientific knowledge and its ethical implications.

It has proven difficult to provide a definitive account of the scientific method that can decisively serve to distinguish science from non-science.

Thus there are legitimate arguments about exactly where the borders are.

There is nonetheless a set of core precepts that have broad consensus among published philosophers

of science and within the scientific community at large.

Knowledge or a system of knowledge covering general truths or the operation of general laws especially as obtained and tested through scientific method

Such knowledge or such a system of knowledge concerned with the physical world and its phenomena : NATURAL SCIENCE(Merriam-Webster Online Dictionary)

The issue of knowledge is important in both science and philosophy. A measure of quality of knowledge is truth.

What is science?

Knowledge and Science

Knowledge (Oxford English Dictionary) variously as

i. facts, information, and skills acquired by a person through experience or education; the theoretical or practical understanding of a subject,

ii. what is known in a particular field or in total; facts and information or

iii. awareness or familiarity gained by experience of a fact or situation.

iv. Plato's formulation of knowledge as "justified true belief". There is however no single agreed definition of knowledge presently, nor any prospect of one, and there remain numerous competing theories.

Science (from the Latin scientia, 'knowledge') is a system of acquiring knowledge based on the scientific method, as well as the organized body of knowledge gained through such research.

Science as defined here is sometimes termed pure science to differentiate it from applied science, which is the application of scientific research to specific human needs, though the two are often interconnected. Fields of science are commonly classified along two major lines:

Natural sciences, which study natural phenomena (including biological life), and

Social sciences, which study human behavior and societies.

There are several ways to understand truth, but the most popular approach is probably the correspondence theory of truth which means that proposition is true in case when it corresponds to the reality.

Absolute and relative truths. Science seems to move toward absolute truth, because theories are becoming more and more exact and fitting better with reality during scientific research.

Truth

Methods of Acquiring Knowledge

Tenacity Intuition Authority Rationalism Empiricism Science

Tenacity a willingness to accept ideas as valid knowledge b/c these ideas have been accepted for so long or have been so often repeated that they acquire an aura of truth (menerima ide yang sudah lama terjadi di masyarakat)

Intuition operates without intellectual effort or sensory processing, it’s a form of direct-access knowledge (berdasarkan insting)

Authority the acceptance of an idea as valid knowledge because some respected source claims it is valid

Scientific Methods

Scientific method is a body of techniques for investigating phenomena and acquiring new knowledge, as well as for correcting and integrating previous knowledge.

It is based on gathering observable, empirical and measurable evidence subject to specific principles of reasoning, the collection of data through observation and experimentation, and the formulation and testing of hypotheses.

Rationalism a way of thinking in which

knowledge is developed thru reasoning.

information is carefully stated and logical rules are

followed to arrive at an acceptable conclusion

Empiricism involves gaining knowledge through observation—that is, knowing something by experiencing it through our senses.

Scientific Methods

The scientific method is often described today as comprising these main actions: (wikipedia)

1. Observe: Collect evidence and make measurements relating to the phenomenon you intend to study.

2. Hypothesize: Invent a hypothesis explaining the phenomenon.

3. Predict: Use the hypothesis to predict the results of new observations or measurements.

4. Verify: Perform experiments to test those predictions. Testing, or attempting to experimentally falsify is thought by many to be a

better choice of term here. 5. Evaluate: If the experiments contradict your

hypothesis, reject it. If they confirm it, make more predictions and test it further.

PHILOSOPHY Of MEDICINE

Philosophy Ontologi

Epistemologi

Aksiologi

Biomedical Science

Human being

Psychological

Transcedental

Existence

Values

Basic need

Gap – Med Technology & Human Values

Philosophy of medicine

H. Tristram Engelhardt Jr defines the issue in Routledge Encyclopedia of

Philosophy as follows:

“The philosophy of medicine can be generally

defined as encompassing those issues in

epistemology, axiology, logic, methodology and

metaphysics generated by or related to medicine”

PHILOSOPHY in MEDICINE

Though medicine and philosophy have been intertwined throughout their histories, systematic philosophical reflection on medicine began only in the 19th century.

There was a widening gulf between technology and human values, ironically most manifest in a field devoted to the study and care of individual human beings.

As a result, philosophy of medicine in its earliest years focused largely on concrete MEDICAL ETHICS questions involving new medical technology, such as euthanasia, human cloning, artificial insemination, etc.

More recently, philosophy of medicine broadened its focus to address public policy issues on the distribution and financing of health care, epistemological issues about the attainment, growth and certainty of medical knowledge, and metaphysical issues about causality, personal identity and spirituality in medicine.

Those other pursuits may benefit from exercises of this sort, though even the most subtle of metaphysical insights is bound to leave value judgments in medicine a matter of drawing well-educated, well-intentioned lines through painfully gray areas of human lives.

Medicine seeks to understand what it is to be human.

The primary tool medicine has developed for obtaining this knowledge has been science, which has been spectacularly successful in many respects.

"The human" is very complex, however, and perhaps there are aspects of us that science cannot easily reach. Medical humanities seek to bring other sources of human knowledge to medicine, particularly medical education.

MEDICAL HUMANITY

(HUMANIORA)

What is medicine?

There are different opinions on that issue

Scientific medicine and alternative medicine

The central situation in medicine is the physician-patient relationship or therapeutic relationship which goals in improvement of patient condition.

Medicine

Online Medical Dictionary http://cancerweb.ncl.ac.uk/

A scientifically-based discipline dedicated to the prevention and treatment of disease and injury.

MedlinePlus Medical Dictionaryhttp://www.nlm.nih.gov/medlineplus/mplusdictionary.html

the science and art dealing with themaintenance of health and theprevention, alleviation, or cure of disease

Speculative medicine as the attempt to discover the basic philosophical principles that lie behind the practice of medicine.

Logic of medicine brings togeteher attempts to clarify the character of scientific reasoning in medicine.

Philosophy of medicine as a subspeciality of philosophy of science.

Other explorations of philosophical issues that have special salience in medicine, e.g. bioethics stands in this division

(Tr Engelhardt JR, KWM Wildes. Encyclopedia of Bioethics, 3rd ed, 3 vol. Pp. 1738-9)

Interpretations of the Philosophy of Medicine

Central Concepts of Medicine

Health-disease distinction.Basic principles are (i) existence of some norms and (ii) possibility to modify abnormal

situations. Hereis a lot of issues from natural sciences andpsychology.

The therapeutic relationship.Ideal situation would be that human relations

aresymmetrical but disease makes them clearlyasymmetrical. Here is a lot of issues from

psychologyand social sciences.

• Health – a state of optimal physical, mental, social wellbeing and spiritual, and not merely the absence of disease and infirmity

• disease – any deviation from or interruption of the normal structure or functions of any part, organ, or system (or combination of thereof) of the body that is manifested by a characteristic set of symptoms and signs and whose etiology, pathology, and prognosis may be known or unknown.

Dorland’s Illustrated Medical Dictionary, 28th ed., p. 736

Scientific/Modern & Alternative medicine

The scientific (conventional) medicine is grounded on scientific knowledge and methods. The health care systems in the developed countries are build up on the basis of the scientific medicine and it is accepted and cultivated in medical faculties.

Alternative medicine is a vague term which covers numerous isolated practicies, e.g. Homeopathy, anthroposophical medicine, yoga, biofeedback, etc.

The human body is composed of multiple interacting and self regulating physiological systems including biochemical and neuroendocrine feedback loops

The behaviour of any individual is determined partly by an internal set of rules based on past experience and partly by unique and adaptive responses to new stimuli from the environment

The web of relationships in which individuals exist contains many varied and powerful determinants of their beliefs, expectations, and behaviour

The humanities are those academic disciplines which study the human condition using methods that are largely analytic, critical, or speculative, as distinguished from the mainly empirical approaches of the natural and social sciences.

(wikipedia)

Medical humanities is an area of academic study worth considering if you have interests in any of the varied subjects it includes or if you have a reflective approach to medicine.

There are enormous opportunities for developing both as a practitioner and as an academic, while career opportunities in this area are likely to increase as more medical education incorporates humanities elements.

HUMANITIES IN MEDICINE

1. To increase understanding of the human condition

study of the humanities may be integrated into medicine by means of new and as yet little understood pathways

2. To expose students to the critical analysis of ideas

3. To make more allowance for individual differences

4. To provide pockets of expertise and lifelong interests

Complexity and Clinical Care (BMJ 2001;323:685-688)

Biological and social systems are inherently complex, so it is hardly surprising that few if any human illnesses can be said to have a single "cause" or "cure."

A complex adaptive system is a collection of individual agents with freedom to act in ways that are not always totally predictable, and whose actions are interconnected so that the action of one part changes the context for other agents. In relation to human health and illness there are several levels of such systems.

Building Bridges Among Professional and Patient Satisfaction

Physicians today are confronted with increasing demand to ensure and improve care of their patients. A variety of approaches claim to provide solutions to the problems of health care delivery. These approaches represent different perspectives on optimal care and the best method for improving care.The last decade, and all of them claim to provide solutions to some of the main problems in patient care. Approaches such as :

evidence-based medicine (EBM), total quality management (TQM), accreditation and accountability, professional development, patient empowerment, and others

Integrative Medicine

Integrative Medicine has been defined by the National Center for Complementary and Alternative Medicine as practices that combine "mainstream medical therapies and CAM therapies for which there is some high-quality scientific evidence of safety and effectiveness" Complementary and Alternative Medicine (CAM) is an umbrella term under which various forms of non-traditional, non-Western medicine and healing fall. Alternative Medicine: practices used in place of conventional medical treatments, often incorporating spiritual, metaphysical, or religious underpinnings, non-European medical traditions, or newly-developed approaches to healing

Integrative medicine (IM) combines the discipline of modern science with the wisdom of ancient healing.

For people living with chronic or life-threatening illness, it can transform the physical, emotional, and spiritual dimensions of their lives.

IM may also be valuable to those who are not ill but wish to increase self-awareness, enhance well-being, and help prevent health-related problems.

A multi-disciplinary approach to medicine provides the maximum therapeutic benefit.

AAIM's advocacy for broader treatment options facilitates a bond between integrative and Western medicine.

Physicians must develop empathy and incorporate humanistic attitudes

Humanities education provides a context for the vicarious experience of illness and sufferingIt helps teach the virtues of respect, compassion, honesty and the meaning of community “Critical episodes” become a catalyst for trainee emotional developmentEmpathy facilitates problem solving with difficult patients

Medical Humanities Objectives

Physicians must gain narrative knowledge exercise observation and perception skills engage in hypothesis testing view medical stories as case studies

They can improve their narrative competence recognize framing of medical history appreciate imagery, symbols and metaphor learn the importance of tone and irony

Dan Brock, Brown University (1999):Bioethics concerns the ethical issues arising in medicine and from advances in biological science.

There are 3 central areas:1. Relations between health care professionals

and patients2. Justice in the allocation of health care3. Issues that arise from dramatic advances in

biological knowledge and technology

A G E N D A U N T U K B I O E T I K A

*Bioetika adalah perluasan dari etika kedokteran yang tradisional

*Etika kedokteran memfokuskan hubungan dokter-pasienTema-tema tradisional tetap penting tapi sekarang dalam konteks modern:di satu pihak → demokratisasi dan hak-hak pasien (kritik atas paternalisme)di lain pihak → pelayanan medis yang teknologis dan anonym (tim medis) + biaya tinggi 

Conclusion

Medical Humanities education can provide breadth and depth to training

Trainees must learn to “read” their patients and understand their stories

Perhaps physicians equipped with these skills deliver more effective medical care

Four modules

- health from social, economical, political and ideological point of view

- historical and cultural engagements of concepts of health and illness

- healing and art- health and illness at different stages of life

INTRODUCTION International Standard in Basic Medical Education

(WFME, 2003) 1)

Competence – based curriculum (Knowledge, skills, attitude/behaviors/ ethics

Development of Science & Technology : New technology and New techniques – economics issues – ethical problems (Fig.1)

Medical practice – Clinical decision making : scientific, ethics, legal and humanities based.

Methods of Obtaining Knowledge

1. Observation or experience. This may be more or less sophisticated, ranging from a simple, "I saw" to carefully designed controlled experimentation.

2. Reason or logic. Taking other knowledge as data, by logical operations knowledge can be inferred.

3. Testimony. Knowledge based on the acceptance of testimony involves accepting what others say.

This seems to be a common way we get knowledge but is seen by philosophers as problematic.

4. Authority. Knowledge based on authority may rely upon the reputation of an individual such as Aristotle or Einstein Authority may have a political basis in the sense that some political process, perhaps involving status as well as simple voting, peer review, or comment.

5. Revelation. Many people believe knowledge may be obtained via revelation or even divine revelation, which may be directly from God or another spirit, perhaps conveyed through a religious text or texts, such as the Bible, Vedanta, Quran etc

Medical Education

Medical Practice

MD

Clinical Decision Making

Education Standards Medical Education Standards

Medical Care Standards

1. Scientific (EBM)

2. Ethics (Moral principles)

3. Legal (Act, Regulation)

4. Humane

“Stake holders”

Quality Assurance (Jaminan mutu)

Social Accountibility

Biomedical EthicsEvidence Based Medicine

Integrative MedicineMedico legal aspect

Total Quality Management (TQM), Accreditation and Accountability,

Professional development, Patient empowerment,

Patients –Physician relationshipand others

Area of Study