Meaning-making is the process by which a system responds to an indeterminate signal. This article focuses on meaning-making in living systems. It proposes several guidelines for studying the process of meaning-making in living systems in general, and in the immune system in particular. Drawing on a general framework for studying meaning-making in living systems, I suggest three basic organizing concepts for studying meaning-making—variability of the signal, context markers, and transgradience. Those concepts present a radical alternative to the information-processing approach that governs biological research and may shed new light on biological processes.
The concept of placebo has evolved over time. Generally believed to be the basis of the premodern pharmacopoeia, the placebo has been adopted in practice as a harmless but unscientific approach towards alleviating symptoms. Currently, many medical scientists view placebos pejoratively as confounding elements in the analysis of randomized control trials.This article examines the changing attitudes towards placebos and the persistent controversies that surround their administration. The possible role of the placebo response as a functional salutogenic brain mechanism is considered, and elements of Edelman's neurobiological model of self and attractor theory are combined to explain how a unitary response by the central nervous system might yield diverse placebo effects. It is concluded that placebo responses are rooted in the complexity of mind/body interactions and that their underlying physiological mechanisms may be elucidated via methods that directly examine brain activity as the basis of subjective experience.
Cells of multicellular organisms are semi-fluid creatures. Even when they form specific cell-cell adhesions, they cannot create a defined shape or a tissue-specific architecture. Cartilaginous organs, such as ears and noses, exemplify the fact that form is imprinted in the extracellular matrix (ECM), which leads to the conclusion that cells must have the ability to shape the ECM in which they reside. This seems to be true for most tissues. The role of the ECM as an integrator of cells into functional assemblies with defined architecture is unique to multicellular organisms. The evolution of multicellularity became possible as a consequence of cells acquiring two new properties: first, cell surface macromolecular complexes that function in cell-cell binding; and, second, an ECM that integrates cells into three-dimensional structures. These two new properties allowed the evolution of the two basic types of cells—epithelial and mesenchymal. The appearance of the latter, a fibroblast-like cell with abundant filopodia, enabled the sculpturing of the ECM and the formation of complex tissue-specific architectures.
The idea of reducing pathology to biology has an extensive history, and the initial forms of the enterprise were unsuccessful. This article discusses the philosophical literature surrounding the notion of reduction in the sciences in general and of biology in particular; reviews several 19th-century programs that promoted the reduction of medicine to other biological disciplines; and examines the post-war origins of the notion of biomedicine. It shows how biology and medicine tend to interact in the constitution of new biomedical knowledge and how the notion of a pathological process resulting in a lesion remains central to the understanding of disease. The article proposes that while strict reduction has yet to be realized, one can speak of a continuing and successful realignment of biology and pathology since the Second World War.
From both within and without bioethics, growing criticism of the predominant methods and practices of the field can be heard. These critiques tend to lament an emphasis on logically derived rules and philosophical theories that inadequately capture how and why people have the moral attitudes they do, and they urge the use of more empirically grounded social sciences—history, sociology, and anthropology—to draw attention to the complex factors behind such attitudes. However, these critiques do not go far enough, as they do not question why debate over ethical categories should have such a central role in voicing concerns about medicine.The importance of using other forms of inquiry, especially that of history, to examine aspects of medical practice and the emergence of bioethics itself is not simply to refine bioethical moral analysis. Instead, history can be employed to counter the preoccupation with translating concerns about medicine into moral terms and to move towards what is more sorely needed: a true medical humanism.
Hall, Daniel E.
Koenig, Harold George.
Meador, Keith G.
Despite recent advances in the field of religion and health, meaningful findings will increasingly depend on the capacity to conceptualize "religion" properly. To date, scientists' conception of religion has been shaped by the Enlightenment paradigm.However, recent developments in philosophy make the "objectivity" of the Enlightenment paradigm problematic, if not untenable. Contrary to common understanding, the secularism essential to the Enlightenment paradigm does not enjoy any special privilege over religious ways of seeing the world, because both religious and secular worldviews constitute self-referentially complete interpretations of the human condition. If there is no objective frame of reference from which to measure religiousness, then the study of religion and health is fundamentally contingent on the specific languages and contexts in which particular religions find expression. While applying this cultural-linguistic approach to religion would require significant changes in the existing methods for studying religion and health, such changes may generate a deeper understanding of this relationship.
Both medicine and the history of medicine have seen many changes in the last four decades. The way we tell the story of medical developments no longer concentrates on the important doctors and their ideas. The influences of social history in the 1960s and 1970s and cultural history in the 1980s and 1990s have broadened and enriched the interpretations of our medical past. The social historians have helped us to include politics, economics, and the leading ideas of any period we wanted to study; the cultural approach has added ethnography as well as an emphasis on language or discourse.Today there is a new history of medicine, one far more willing to cross disciplinary boundaries to ask questions about how we know what we know and why we do what we do.This article highlights some of the work in the adjoining fields of medical anthropology and of literature and medicine to demonstrate new interests, new questions, and new methods of inquiry. However, although we have cast our nets far more widely in the process of professionalizing the history of medicine, there is a question about whether we have lost the appeal to one of our core constituencies: medical students and physicians. We need to welcome some of the new changes in medical history as in medicine itself; the common goal is to achieve a better understanding of what we have done and what we are doing.
Practical knowledge of heredity predates history. Indigenous peoples laid the foundations of modern agriculture by developing plants such as corn. However, the language and metaphors of the Human Genome Project treat modern genetics as if it had no historical antecedents and fail to acknowledge these early contributions to the science of heredity. The results of this blindness are twofold: it exacerbates reluctance of native peoples to take part in genetic research and to garner the benefits of genetic medicine, and it encourages "biopiracy," as modern scientists "discover" and patent native plants.