33072 - Philosophy of Medicine

Learning outcomes

At the end of the course, students will be able to: Know the main lines of debate in philosophy and medical literature on the concepts of health and disease, evidence and the hierarchy of evidence, and to recognize the role of values in research and clinical practice.

Course contents

This course introduces to the contemporary debate in the philosophy of medicine, and provides the basic notions and competences that enable future doctors to reflect critically on the concepts and methodologies implicit in medical research and clinical practice.

It does not require any preliminary acquaintance with philosophy.

It is recommended for students from the third year on, who have already come into contact with research and clinical issues, but obviously it is not precluded to first-year students.

Themes:

1. Disease

What makes a certain condition a disease or pathology? Normativist and naturalist definitions. The problem of the threshold between disease and risk factors. Controversial diseases: is old age a disease? What about obesity? Other examples from psychiatric nosology. We will see how the concept of disease one adopts affects public health policies, treatment and research.

2. Health

Medicine aims to preserve and restore people's health But what is health? Different concepts of health, from the absence of disease to complete well-being. Well-being, quality of life and other constructs are based both on evidence and on the values of society and the preferences of indivuduals. Again, different concepts of health and well-being determine different policies and models of care.

3. Evidence

What is Evidence-based Medicine? What do we mean by evidence or evidence in medicine? Why is the evidence sorted in a hierarchy, that is, some studies are "better" than others for confirming a hypothesis or answering a clinical question? The concept of cause in medicine. Guidelines and the role of the individual clinician's judgment. More recent critiques and changes to the classic EBM paradigm.

4. Medicine, society and values

What values guide medical research and what interests shape it?. The notion of conflict of interest. Social epistemology of medicine: the role of patients and of the so-called "big Pharma" and private partners. Overdiagnosis and medicalization: is there "too much medicine"? Issues of equitable distribution of resources in healthcare systems.

Readings/Bibliography

For the exam, you need to study the course slides and any other short articles or parts of articles discussed in class and indicated in the slides from time to time.

All material is uploaded to Virtual after each lecture.

Readings for further study, not mandatory:

Lalumera, E. (2021) Medicina e metodo sperimentale. Un'introduzione filosofica. Bologna: Esculapio.

Stegenga, J (2021) Curare e prendersi cura. Introduction to the philosophy of medicine. Arezzo: Aboca

Lalumera, E. (2023) Stare bene. Un'analisi filosofica. Bologna: il Mulino.

Teaching methods

Traditional lectures, open discussion.

Assessment methods

Written exam with multiple-choice questions on the 3 modules of the integrated course Philosophy of Medicine and Bioethics.

Teaching tools

Power point files, videos and articles posted on Virtuale

Office hours

See the website of Elisabetta Lalumera