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Journal NotaBene Issue 61 (2023) Editor: Julia Vasseva-Dikova

Topic of the issue: Philosophy - Medicine - Technologies

Language and Practice of Medicine

Abstract: The language of a science is related to the conceptual specificity of its subject matter, and this is why in the beginning of the paper the subject of medicine is considered as being based on the notions of health and illness. The theoretical system of medicine is defined as a scientific region, which accepts and consistently coordinates theoretical models from physics, chemistry, biology, and psychology, and thus the features of its language are explicated. The next part of the paper is dedicated to medical practice focused on the relationship between physician and patient.
Keywords: language and practice in medicine, health, disease, doctor-patient relationships, health policies

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Evidence in Medicine – Theory, Practice and Experiment

Abstract: The modern medicine is a cognitive field with a strong influence into the modern society. The role and place of medical theory and practice is of the great importance to the world and to humanity. This text brings out to the front view the philosophical question about evidence in modern medicine. The central topic of the contemporary philosophy of medicine is focused to the process of evidence in medicine. The article presents this question in the context of the relationship: research/researchers - clinicians - patients. In the course of analysis, the idea of evidence-based medicine (EBM) and the criteria for hierarchy of evidence venerated by this movement are presented. In addition, the role and importance of the two criteria central to this movement, named randomized controlled trials (RCT's) and the hierarchy of evidence, are presented and analyzed. Special importance is given to the transition from science-based medicine to statistics-based medicine.
Keywords: philosophy of medicine, evidence; EBM, RCT’s, research/researchers - clinicians - patients, science-based medicine, statistics-based medicine.

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Science, Art or Something Third is Medicine? Part 1

Abstract. The study aims to answer its title question. It is argued that medicine is neither a science nor an art in the modern sense of these terms, but a complex, organic, coordinated, subordinated and dynamic system of fundamental (basic) and clinical (applied) scientific disciplines that forms a specific scientific field, and the application in practice of the knowledge acquired from them constitutes what is called the healing or „medical art“. The argumentation is based on two „coordinate systems“: the contemporary definitions of „science“ and „art“ accepted as working.
Keywords: medicine, science, art, concept, laws, scientific evidence.

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Science, Art or Something Third is Medicine? Part 2

Abstract. The study aims to answer its title question. It is argued that medicine is neither a science nor an art in the modern sense of these terms, but a complex, organic, coordinated, subordinated and dynamic system of fundamental (basic) and clinical (applied) scientific disciplines that forms a specific scientific field, and the application in practice of the knowledge acquired from them constitutes what is called the healing or „medical art“. The argumentation is based on two „coordinate systems“: the contemporary definitions of „science“ and „art“ accepted as working.
Keywords: medicine, science, art, concept, laws, scientific evidence.

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The Doctor-Patient Relationship In Holistic Practice

Abstract: Patients tend to be more satisfied if the doctor takes a holistic approach. Respecting the patient's opinion and his active participation in the treatment process is a prerequisite for the success of the therapeutic process in the long term. The unifying idea is that change is needed and it must include a philosophical and spiritual justification. This is not within the power of Western medicine alone but should be done by integration of the traditional medical practices. Traditional practices are fully compatible with conventional medicine, but only under the general paradigm of holistic medicine. Bulgaria is in a good position to do that, with preserved and unique heritage. The selection of the center can be done by comparing the available spiritual practices and adapting the chosen one for better understanding by the 21st century person. Medicine has a future only in a holistic context, just as its past is inextricably linked to spiritual rituals and practices.
Keywords: medicine, tradition, holistic, relationship, center

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Intelligent Agents in Medicine – A Philosophical Perspective

Abstract: The article examines the use of artificial agents in the medical environment, considering both the positive and negative effects of their use in healthcare. The introduction of artificial intelligence into the realm of care delivery naturally raises ethical concerns, emphasizing concepts such as responsible and moral artificial intelligence. Designing ethical artificial agents capable of performing tasks traditional to humans poses complex dilemmas, and leads to the conclusion that we have a responsibility to correctly integrate them into critical areas such as health and care. In this sense, the philosophical perspective on artificial agents in health and care raises important questions about their acceptance, regulation, and ethical implications, highlighting the need for continued philosophical inquiry into the field of application of artificial agents in medicine.
Keywords: artificial agents, intelligent agents, artificial intelligence, medicine, care, healthcare.

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Medical and Philosophical Ideas in the Treatise „On the Sacred Disease“ from the Hippocratic Corpus

Abstract: The article presents the treatise "On the Sacred Disease" from the Hippocratic corpus in the context of medical and philosophical development in the V-IV c. BC in Greece as one of the most important texts in the establishment and development of rational medicine. In the beginning, brief notes on the Hippocratic corpus and modern views on the authorship of the treatises are given. The ideas of rejecting the divine nature of epilepsy, the encephalocentric theory and the pathological etyology of diseases are analysed.
Keywords: Corpus Hippocraticum, treatise De morbo sacro, medical and philosophical ideas, principles of the rational medicine, ancient understandings of the epilepsy, encephalocentric theory

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Hume and the Disease of the Learned

Abstract: The aim of this paper is to consider the concept of melancholy through Hume’s works. In this regard his "Letter to a Physician" and the Conclusion of Book I of "A Treatise of Human Nature" will be examined. My goal is to present the meaning of melancholy in Hume’s theoretical philosophy, on the one hand, and its meaning in the context of early modern medicine, on the other.
Keywords: melancholy, disease of the learned, humoral theory, causation, skepticism.

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Podium

Karl Popper: On the Scientific Status of Psychoanalysis

Abstract: The current article presents the problem of the scientific status of psychoanalysis, mediated by the ideas of Karl Popper, specifically his critique to Freud’s psychoanalysis. The link between what is accepted as scientifically grounded knowledge and the offered theories in the field of psychoanalysis is a key part in the current text. It follows the status of theories in the psychology and their relation to the problem of demarcation, essential for Karl Popper’s ideas. One of the books with importance in this regard is Karl Popper’s “Conjectures and refutations” and some of its ideas will be presented here.
Keywords: psychoanalysis, problem of demarcation, verification, falsifiability, non-scientific theory, observation, experimenting, test, ad-hoc hypotheses, D-N model, circularity.

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Towards Uniform Semantic Interpretation

Abstract: Artificial Intelligence methodologies for natural language processing has steadily converged towards heavy deployment of Large Language Models. The underlying operational principle of these models relies on mining massive sets of text corpuses, where the semantic elicitation between the entities of the text is interpreted as statistical interdependency (correlation) between words located close to each other in a sentence. The problem with this approach is that probable semantic connection could only be established, if such connections exist in the already mentioned large text corpuses, furthermore, in order for models further to generalize over unseen examples, this plethora of training examples must be provided, in a vastly jumbled and diverse texts, which is inherently problematic, if the model has to be updated with new correlations, since new text corpuses has to be carefully selected or synthetically generated in order not to strongly weaken initial correlations. As a rule of thumb, in contrast to the artificial large language models, humans, need but a few examples, in order to embed a possible semantic model that governs any new concept, independently of the informational structure of the examples, be that text, images, graphs, etc. Although, human cognition is a constantly proliferated domain of research, most researchers would agree that humans are able to elicit semantic, not only by learning interdependencies between entities, but also semantic relationship rules that governs those entities. This knowledge about the rules and entities is then constantly updated throughout our life. This paper explores one possibility of creating such hybrid computational model, where semantic relationships rules are created out of graph structured data and are used to improve semantic interpretation in natural language processing by unification of two learning paradigms on graph textual representation, to improve semantic interpretation.
Keywords: Artificial Intelligence, natural language processing, hybrid models, graph, graph neural, network.

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Babylon

Poiesis