This patient most likely has Minimal Change Disease.
References and Further Reading 1. Metaphysics Traditionally, metaphysics pertains to the analysis of objects or events and the forces or factors causing or impinging upon them. One branch of metaphysics, denoted ontology, investigates problems and questions concerning the nature and existence of objects or events and their associated forces or factors.
Another branch of metaphysics involves the examination of presuppositions that inform a given ontology. For philosophy of medicine, the most controversial debate centers around the presuppositions of reductionism and holism.
In addition, the debate between realism and antirealism has important traction within the field. Holism The reductionism-holism debate enjoys a lively history, especially from the middle to the latter part of the twentieth century.
Reductionism, broadly construed, is the diminution of complex objects or events to their component parts. In other words, the properties of the whole are simply the addition or summation of the properties of the individual parts.
Such reductionism is often called metaphysical or ontological reductionism to distinguish it from methodological or epistemological reductionism.
Methodological reductionism refers to the investigation of complex objects and events and their associated forces or factors by using technology that isolates and analyzes individual components only.
Epistemological reductionism involves the explanation of complex objects and events and their associated forces or factors in terms of their individual components only. Life scientists often sort these parts into a descending hierarchy. Jan Smuts introduced the term in the early part of the twentieth century, especially with respect to biological evolution, to account for living processes—without the need for immaterial components.
The relevance of the reductionism-holism debate pertains to both medical knowledge and practice. Reductionism influences not only how a biomedical scientist investigates and explains disease, but also how a clinician diagnoses and treats it.
For example, if a biomedical researcher believes that the underlying cause of a mental disease is dysfunction in brain processes or mechanisms, especially at the molecular level, then that disease is often investigated exclusively at that level.
In turn, a clinician classifies mental diseases in terms of brain processes or mechanisms at the molecular level, such as depletion in levels of the neurotransmitter serotonin. Subsequently, the disease is treated pharmacologically by prescribing drugs to elevate the low levels of the neurotransmitter in the depressed brain to levels considered normal within the non-depressed brain.
Although the assumption of reductionism produces a detailed understanding of diseases in molecular or mechanistic terms, many clinicians and patients are dissatisfied with the assumption. Rather than simply treating the disease, such information is vital for treating patients with chronic cases.
Rather than striving exclusively for restoration of the patient to a pre-diseased state, the clinician assists the patient in redefining what the illness means for their life. Antirealism Realism is the philosophical notion that observable objects and events are actual objects and events, independent of the person observing them.
In other words, since it exists outside the minds of those observing it, reality does not depend on conceptual structures or linguistic formulations. Proponents of realism also espouse that even unobservable objects and events, like subatomic particles, exist.
Historically, realists believe that universals—abstractions of objects and events—are separate from the mind cognizing them. For example, terms like bacteria and cell denote real objects in the natural world, which exist apart from the human minds trying to examine and understand them.
Furthermore, scientific investigations into natural objects like bacteria and cells yield true accounts of these objects.
Anti-realism, on the other hand, is the philosophical notion that observable objects and events are not actual objects and events as observed by a person but rather they are dependent upon the person observing them.
In other words, these objects and events are mind-dependent—not mind-independent. Anti-realists deny the existence of objects and events apart from the mind cognizing them.
Human minds construct these objects and events based on social or cultural values. Historically, anti-realists subscribe to nominalism, in which universals do not exist and predicates of particular objects do.
Finally, they question the truth of scientific accounts of the world since no mind-independent framework can be correct absolutely. Antirealists hold that such truth is framework dependent, so when one changes the framework, truth itself changes.
The debate among realists and anti-realists has important implications for philosophers of medicine, as well as for the practice of clinical medicine. For example, a contentious issue is whether disease entities or conditions for the expression of a disease are real or not.
Realists argue that such entities or conditions are real and exist independent of medical researchers investigating them, while anti-realists deny their reality and existence.
Take the example of depression. According to realists, the neurotransmitter serotonin is a real entity that exists in a real brain—apart from clinical investigations or investigators. For anti-realists, however, serotonin is a laboratory or clinical construct based on experimental or clinical conditions.
Changes in that construct lead to changes in understanding the disease.Free practice tests and other test resources organized in categories including: academic, career, personality, intelligence, and more.
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