32 research outputs found
Vitalism and the Resistance to Experimentation on Life in the Eighteenth Century
There is a familiar opposition between a âScientific Revolutionâ ethos and practice of experimentation, including experimentation on life, and a âvitalistâ reaction to this outlook. The former is often allied with different forms of mechanism â if all of Nature obeys mechanical laws, including living bodies, âiatromechanismâ should encounter no obstructions in investigating the particularities of animal-machines â or with more chimiatric theories of life and matter, as in the âOxford Physiologistsâ. The latter reaction also comes in different, perhaps irreducibly heterogeneous forms, ranging from metaphysical and ethical objections to the destruction of life, as in Margaret Cavendish, to more epistemological objections against the usage of instruments, the âanatomicalâ outlook and experimentation, e.g. in Locke and Sydenham. But I will mainly focus on a third anti-interventionist argument, which I call âvitalistâ since it is often articulated in the writings of the so-called Montpellier Vitalists, including their medical articles for the EncyclopĂ©die. The vitalist argument against experimentation on life is subtly different from the metaphysical, ethical and epistemological arguments, although at times it may borrow from any of them. It expresses a Hippocratic sensibility â understood as an artifact of early modernity, not as some atemporal trait of medical thought â in which Life resists the experimenter, or conversely, for the experimenter to grasp something about Life, it will have to be without torturing or radically intervening in it. I suggest that this view does not have to imply that Nature is something mysterious or sacred; nor does the vitalist have to attack experimentation on life in the name of some âvital forceâ â which makes it less surprising to find a vivisectionist like Claude Bernard sounding so close to the vitalists
A Re-conceptualization of Access for 21st Century Healthcare
Many e-health technologies are available to promote virtual patientâprovider communication outside the context of face-to-face clinical encounters. Current digital communication modalities include cell phones, smartphones, interactive voice response, text messages, e-mails, clinic-based interactive video, home-based web-cams, mobile smartphone two-way cameras, personal monitoring devices, kiosks, dashboards, personal health records, web-based portals, social networking sites, secure chat rooms, and on-line forums. Improvements in digital access could drastically diminish the geographical, temporal, and cultural access problems faced by many patients. Conversely, a growing digital divide could create greater access disparities for some populations. As the paradigm of healthcare delivery evolves towards greater reliance on non-encounter-based digital communications between patients and their care teams, it is critical that our theoretical conceptualization of access undergoes a concurrent paradigm shift to make it more relevant for the digital age. The traditional conceptualizations and indicators of access are not well adapted to measure access to health services that are delivered digitally outside the context of face-to-face encounters with providers. This paper provides an overview of digital âencounterlessâ utilization, discusses the weaknesses of traditional conceptual frameworks of access, presents a new access framework, provides recommendations for how to measure access in the new framework, and discusses future directions for research on access