MedWorm provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest medical blog items that have been tagged with 'epistemology'. Sat, 03 Sep 2011 02:50:01 +0100 http://www.medworm.com/index.php?rid=3331315&cid=t_133820_99_f&fid=35344&url=http%3A%2F%2Fzackarysholemberger.blogspot.com%2F2010%2F03%2Fcase-of-what.html Recently I was staying with relatives, which gave me the chance to read the New York Times in print. It felt old-timey. I chanced upon an article in Lisa Sanders's Cases series, whose tropes can be summarized as follows:1. Woman faints.2. The doctors can't figure out what's wrong with her.3. Bad Doctor says it's all in her head:A neurologist in New York carefully examined her and her now thick chart and pronounced definitively that there was nothing wrong with her and that she should try to relax and maybe take up yoga.4. Good Doctor notices a few key features and makes the diagnosis: Ledereich watched as the patient calmly sat up. “I know what you’ve got!” he told her excitedly. Her sudden collapse looked as if a switch had been thrown and all her muscles just turned off. Ledereich ... Zackary Sholem Berger blogs http://www.medworm.com/rss/comments.php?id=3331315 Wed, 03 Mar 2010 05:22:00 +0100 3331315 http://www.medworm.com/index.php?rid=3045052&cid=t_133820_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2009%2F12%2F01%2Fsmall-but-long-rant-on-occupational-therapy-science%2F Hands up the occupational therapists who like statistics!  Thought not. What about those who read journal articles comparing one treatment with another?  Use a treatment model consistently – or use a set of hypotheses and test to see which ones apply to the person we’re working with? Hmmm….  Are occupational therapists ‘epistemiphobic[1]’? or simply naive about science. I recently read an assignment on clinical reasoning written by a very competent and educated occupational therapy graduate.  In it the views of Kuhn, cited in Mattingly and Fleming were described where ‘clinical reasoning within a biomedical frame is like puzzle solving, in that a clearly identifiable correct answer exists (e.g., a pathology, a cluster of physiologic deficits), and the player’s task is... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=3045052 Tue, 01 Dec 2009 01:57:55 +0100 3045052 http://www.medworm.com/index.php?rid=2414835&cid=t_133820_99_f&fid=35344&url=http%3A%2F%2Fzackarysholemberger.blogspot.com%2F2009%2F05%2Fevidence-based-medicine-pragmatic.html In the spring issue of Perspectives in Biology and Medicine, Maya Goldenberg dissects the contradictions of evidence-based medicine (EBM). (I found the article through philpapers.org, which I didn't know about before.) On the one hand, EBM's commitments to pragmatismare readily apparent in EBM’s clear allegiance to experimental methods of inquiry that set aside past habitual thinking in favor of purely empirical investigation. Indeed, EBM’s promise of “the application of the best research evidence to medical decision-making” (EBMWG 1992) could have been achieved by strictly pragmatic scientific methodology. On the other hand, EBM lays claim to the marble statuary of objectivism, which is problematic.[The] objectivist ontology,where the evidence “speaks” and reliable knowledge f... Zackary Sholem Berger blogs http://www.medworm.com/rss/comments.php?id=2414835 Fri, 15 May 2009 12:00:00 +0100 2414835 http://www.medworm.com/index.php?rid=2224737&cid=t_133820_127_f&fid=38263&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fdeepesthealth%2FBMCc%2F%7E3%2F8tpLbZ567nM%2F I’m writing my thesis, which partly explains… you know… the silence. Anyway, in a brazen display of my newly born lack of worry about what others think about me, I offer this brief paragraph. It was lifted, reworked and reentered into my thesis in another form - but this is the raw stuff that came from my mind unbidden. All scientific systems rest on claims about the universe that are fundamentally unknowable.  For instance, the currently popular system of Western science rests on a notion of the universe as fundamentally uniform.  This is an untestable hypothesis, but it is used in research every day.  Chinese medicine, similarly, contains information that is most simply described as metaphysical – untestable and unknowable information that is taken as given.  The ... Deepest Health: Exploring Classical Chinese Medicine blogs http://www.medworm.com/rss/comments.php?id=2224737 Sat, 28 Feb 2009 20:23:05 +0100 2224737 http://www.medworm.com/index.php?rid=2033342&cid=t_133820_99_f&fid=35344&url=http%3A%2F%2Fzackarysholemberger.blogspot.com%2F2008%2F12%2Fbuilding-philosophy-of-medicine-for.html Ultimately, because of vast historical and social forces, physicians by and large remain oriented towards an unattainable and inappropriate positivist ideal, and thereby severely compromise the deeper values of their own moral agenda. This choice—encouraged by the professionalization process—largely explains why medical ethics serves such a minor role in medical education; why complaints of medicine’s dehumanization are rampant; and why myriad studies, surveys, and testimonies attest to the lack of physician empathy. Indeed, if medicine aspires to an objective ideal at the expense of its unique value-laden agenda, the profession will be hounded by complaints that it has forsaken its ancient calling for a Faustian pact. A self-conscious moral epistemology—an epistemology that remai... Zackary Sholem Berger blogs http://www.medworm.com/rss/comments.php?id=2033342 Fri, 12 Dec 2008 03:25:00 +0100 2033342 http://www.medworm.com/index.php?rid=1467911&cid=t_133820_99_f&fid=35344&url=http%3A%2F%2Fzackarysholemberger.blogspot.com%2F2008%2F05%2Fsaving-life-according-to-doctors.html A conversation in the bikur cholim room:"Doctor, if a man had chest pain, can he walk home for two hours [on Shabbos]?""It depends what kind of pain.""The doctors said it wasn't heart pain. Can he walk home? I don't think it's safe to walk home. The rabbi said he could take a car home."From this conversation (which went on for some time) I learned a number of things. One of them was that the guy in question (who got to ride back to Borough Park on late Friday night via car service - I wonder if he got dropped off a couple of blocks from home?) has 11 kids in his house. No wonder he's having chest pain.The other was that the Satmar rebbe (the recently deceased one? one or more of his quarreling heirs?) apparently was of the opinion that presenting to the hospital with chest pain was enough ... Zackary Sholem Berger blogs http://www.medworm.com/rss/comments.php?id=1467911 Mon, 26 May 2008 04:01:00 +0100 1467911 http://www.medworm.com/index.php?rid=1426580&cid=t_133820_99_f&fid=35344&url=http%3A%2F%2Fzackarysholemberger.blogspot.com%2F2008%2F05%2Fwhat-do-you-know-and-when-do-you-know.html Doctors and patients think differently. One way to understand this difference is to ask the question: how do doctors and patients know? If we try to understand our own ways of knowledge (epistemology), how our patients might know, and how the two differ, this might be productive for our practice of medicine and our patients' health.See my poster on the topic below. When you're done looking at the poster, check out the thought-provoking companion exercises. Lastly, make yourself a cup of tea (Lapsang Souchong), sit down, take a minute, and write down your epistemology on a piece of paper. Please e-mail that epistemology to me; I'd like to start a database of such statements-of-epistemology. So far I have an N of . . . 1. src="'http://docs.google.com/EmbedSlideshow?docid="d2w6274_278gshmt3f8... Zackary Sholem Berger blogs http://www.medworm.com/rss/comments.php?id=1426580 Wed, 07 May 2008 21:45:00 +0100 1426580 http://www.medworm.com/index.php?rid=1378018&cid=t_133820_99_f&fid=35344&url=http%3A%2F%2Fzackarysholemberger.blogspot.com%2F2008%2F04%2Fbits-of-work-or-passover-primary-care.html Yesterday I taught a class to (better: had a discussion with) my colleagues in the Primary Care program about risk perception.Today I gave a presentation about some ongoing research: (to what extent) do patients and the medical chart differently report the doctors' reason for their hospital admission?You can attend the talk too! (Source: Zackary Sholem Berger) Zackary Sholem Berger blogs http://www.medworm.com/rss/comments.php?id=1378018 Thu, 17 Apr 2008 03:33:00 +0100 1378018 http://www.medworm.com/index.php?rid=889652&cid=t_133820_99_f&fid=35344&url=http%3A%2F%2Fzackarysholemberger.blogspot.com%2F2007%2F09%2Fmedical-epistemology-or-why-doctors-and.html Medical epistemologyOr: why doctors and patients think so differently.I gave a talk yesterday on this topic at NYU's primary care residency program. The outline (together with a bibliography) is here. More later if interest. (Source: Zackary Sholem Berger) Zackary Sholem Berger blogs http://www.medworm.com/rss/comments.php?id=889652 Fri, 21 Sep 2007 03:34:00 +0100 889652