On May 13-15, 1982, some 50 scientists and scholars - physicians, philos ophers and social scientists - convened at Hasselby Castle in Stockholm for the first Nordic Symposium on the Philosophy of Medicine. The topics for the symposium included (1) the concepts of health and disease, (2) classification in medicine, and (3) causality and causal explanations in medicine. The majority of the participants were Scandinavian but the symposium was also able to welcome four distinguished guests from other parts of the world, Professors Stuart F. Spicker and H. Tristram Engelhardt, Jr., U.S.A., Dr Anne M. Fagot, France, and Dr Werner Morbach, West Germany. The latter represented Professor Kazem Sadegh-zadeh, who unfortunately was prevented from attending. One of the main purposes of this symposium was to bring together people in Scandinavia who at present work within the field of Philosophy of Medi cine. This group is still relatively small but is growing rapidly, and the scholarly activity has recently been notable. This fact is clearly demonstrated by the presentation of 'Philosophy of Medicine in Scandinavia' in the Appendix of this volume.

This book presents a logical system of critical appraisal, to allow readers to evaluate studies and to carry out their own studies more effectively. This system emphasizes the central importance of cause and effect relationships. Its great strength is that it is applicable to a wide range of issues, and both to intervention trials and observational studies. This system unifies the often different approaches used in epidemiology, health services research, clinical trials, and evidence-based medicine, starting from a logical consideration of cause and effect. The author's approach to the issues of study design, selection of subjects, bias, confounding, and the place of statistical methods has been praised for its clarity and interest. Systematic reviews, meta-analysis, and the applications of this logic to evidence-based medicine, knowledge-based health care, and health practice and policy are discussed. Current and often controversial examples are used, including screening for prostate cancer, publication bias in psychiatry, public health issues in developing countries, and conflicts between observational studies and randomized trials. Statistical issues are explained clearly without complex mathematics, and the most useful methods are summarized in the appendix. The final chapters give six applications of the critical appraisal of major studies: randomized trials of medical treatment and prevention, a prospective and a retrospective cohort study, a small matched case-control study, and a large case-control study. In these chapters, sections of the original papers are reproduced and the original studies placed in context by a summary of current developments.

This open access book is a unique resource for health professionals who are interested in understanding the philosophical foundations of their daily practice. It provides tools for untangling the motivations and rationality behind the way medicine and healthcare is studied, evaluated and practiced. In particular, it illustrates the impact that thinking about causation, complexity and evidence has on the clinical encounter. The book shows how medicine is grounded in philosophical assumptions that could at least be challenged. By engaging with ideas that have shaped the medical profession, clinicians are empowered to actively take part in setting the premises for their own practice and knowledge development. Written in an engaging and accessible style, with contributions from experienced clinicians, this book presents a new philosophical framework that takes causal complexity, individual variation and medical uniqueness as default expectations for health and illness.

Why is understanding causation so important in philosophy and the sciences? Should causation be defined in terms of probability? Whilst causation plays a major role in theories and concepts of medicine, little attempt has been made to connect causation and probability with medicine itself. Causality, Probability, and Medicine is one of the first books to apply philosophical reasoning about causality to important topics and debates in medicine. Donald Gillies provides a thorough introduction to and assessment of competing theories of causality in philosophy, including action-related theories, causality and mechanisms, and causality and probability. Throughout the book he applies them to important discoveries and theories within medicine, such as germ theory; tuberculosis and cholera; smoking and heart disease; the first ever randomized controlled trial designed to test the treatment of tuberculosis; the growing area of philosophy of evidence-based medicine; and philosophy of epidemiology. This book will be of great interest to students and researchers in philosophy of science and philosophy of medicine, as well as those working in medicine, nursing and related health disciplines where a working knowledge of causality and probability is required.

Theory of illness causation is an important issue in all biomedical sciences, and solid etiological explanations are needed in order to develop therapeutic approaches in medicine and preventive interventions in public health. Until now, the literature about the theoretical underpinnings of illness causation research has been scarce and fragmented, and lacking a convenient summary. This interdisciplinary book provides a convenient and accessible distillation of the current status of research into this developing field, and adds a personal flavor to the discussion by proposing the etiological stance as a comprehensive approach to identify modifiable causes of illness. Key Features • Provides a synthesis of the epidemiological and philosophical concepts in this growing research area • Gives an accessible overview of current methods in biomedical causal metaphysics ̶ what is a cause of illness? ̶ and epistemology ̶ how do we identify it? • Proposes a novel approach that integrates modern epidemiological methodology and recent theories from philosophy of science Written for postgraduate students and researchers in the health and biomedical sciences, including those undertaking courses in the philosophy of medicine/science, public and global health, introduction to epidemiology, research methods, and advanced reasoning, the content will also be of interest to practicing public health workers, biomedical scientists, and physicians. ABOUT THE AUTHOR Olaf Dammann is Professor and Vice Chair of Public Health and Community Medicine at Tufts University School of Medicine, Boston, Massachusetts, USA; as well as a Professor in the Department of Gynecology and Obstetrics at Hannover Medical School, Hannover, Germany. Cover image: Mask used by "Eskimo" shaman in causation of illness. Credit: Wellcome Collection. CC BY https://creativecommons.org/licenses/by/4.0

What is epidemiology? What are the causes of a new disease? How can pandemics be prevented? Epidemiology is the study of the changing patterns of disease and its main aim is to improve the health of populations. It's a vital field, central to the health of society, to the identification of causes of disease, and to their management and prevention. Epidemiology has had an impact on many areas of medicine; from discovering the relationship between tobacco smoking and lung cancer, to the origin and spread of new epidemics. However, it is often poorly understood, largely due to misrepresentations in the media. In this Very Short Introduction Rodolfo Saracci dispels some of the myths surrounding the study of epidemiology. He provides a general explanation of the principles behind clinical trials, and explains the nature of basic statistics concerning disease. He also looks at the ethical and political issues related to obtaining and using information concerning patients, and trials involving placebos. ABOUT THE SERIES: The Very Short Introductions series from Oxford University Press contains hundreds of titles in almost every subject area. These pocket-sized books are the perfect way to get ahead in a new subject quickly. Our expert authors combine facts, analysis, perspective, new ideas, and enthusiasm to make interesting and challenging topics highly readable.

How do communities protect and improve the health of their populations? Health care is part of the answer but so are environmental protections, social and educational services, adequate nutrition, and a host of other activities. With concern over funding constraints, making sure such activities are efficient and effective is becoming a high priority. Improving Health in the Community explains how population-based performance monitoring programs can help communities point their efforts in the right direction. Within a broad definition of community health, the committee addresses factors surrounding the implementation of performance monitoring and explores the "why" and "how to" of establishing mechanisms to monitor the performance of those who can influence community health. The book offers a policy framework, applies a multidimensional model of the determinants of health, and provides sets of prototype performance indicators for specific health issues. Improving Health in the Community presents an attainable vision of a process that can achieve community-wide health benefits.

First edition published in 2002. Second edition published in 2008.

Many published books that comment on the medical model have been written by doctors, who assume that readers have the same knowledge of medicine, or by those who have attempted to discredit and attack the medical practice. Both types of book have tended to present diagnostic categories in medicine as universally scientifically valid examples of clear-cut diseases easily distinguished from each other and from health; with a fixed prognosis; and with a well-understood aetiology leading to disease-reversing treatments. These are contrasted with psychiatric diagnoses and treatments, which are described as unclear and inadequate in comparison. The Medical Model in Mental Health: An Explanation and Evaluation explores the overlap between the usefulness of diagnostic constructs (which enable prognosis and treatment decisions) and the therapeutic effectiveness of psychiatry compared with general medicine. The book explains the medical model and how it applies in mental health, assuming little knowledge or experience of medicine, and defends psychiatry as a medical practice.

Getting the right diagnosis is a key aspect of health care - it provides an explanation of a patient's health problem and informs subsequent health care decisions. The diagnostic process is a complex, collaborative activity that involves clinical reasoning and information gathering to determine a patient's health problem. According to Improving Diagnosis in Health Care, diagnostic errors-inaccurate or delayed diagnoses-persist throughout all settings of care and continue to harm an unacceptable number of patients. It is likely that most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences. Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment, providing unnecessary or harmful treatment, or resulting in psychological or financial repercussions. The committee concluded that improving the diagnostic process is not only possible, but also represents a moral, professional, and public health imperative. Improving Diagnosis in Health Care, a continuation of the landmark Institute of Medicine reports To Err Is Human (2000) and Crossing the Quality Chasm (2001), finds that diagnosis-and, in particular, the occurrence of diagnostic errorsâ€"has been largely unappreciated in efforts to improve the quality and safety of health care. Without a dedicated focus on improving diagnosis, diagnostic errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity. Just as the diagnostic process is a collaborative activity, improving diagnosis will require collaboration and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policy makers. The recommendations of Improving Diagnosis in Health Care contribute to the growing momentum for change in this crucial area of health care quality and safety.