‘The medical gaze’: Foucault, anthropology and contemporary psychiatry in Ireland

Michel Foucault developed the concept of ‘the medical gaze’, describing how doctors fit a patient’s story into a ‘biomedical paradigm, filtering out what is deemed as irrelevant material’ (Misselbrook, 2013). Doctors are perceived within this model to focus on selecting the biomedical elements of patients’ problems only, filtering out all other elements of a person’s life story, but this paper argues that in the subspecialty of psychiatry, this is not the case, and such a filter is not so easily applied.

Discursive construction of social representations expressed by seekers of psychosocial healthcare services in Brazil

Background: The current paper discusses the results of a study realized with 66 seekers of 12 psychosocial healthcare services (CAPS) in Brazil, by investigating their social representations. Aims: Throughout a quali-quantitative approach, unstructured interviews have been conducted and focused on two themes: one related to mental suffering and another to the CAPS itself. Method: The data were processed adopting the Iramuteq software for text-mining-analysis. Results: Out of the findings emerged four lexical classes due to the discursive representation of: (1) CAPS (39.7%); (2) social life (29.7%); (3) family (13.6%) and (4) medication and care (17%), where the utterance NÃO (NO) occupies a central position. Accordingly, the NO is associated with ‘not there’ and ‘not here’, contrasting the care provided outside the CAPS, represented as inhumane or inadequate, to that provided inside the CAPS, linked to feelings of ‘not being discriminated, mistreated and unrecognized’. The underlying social representations expressed in the interviews show an opposition between what was experienced outside and what was experienced inside the CAPS. Conclusion: The care received in CAPS units is the expression of a new psychosocial paradigm in a process of implementation, focused on participation and interdisciplinarity, as opposed to the biomedical paradigm focused on the disease.

How Disruptive Solutions Could Improve the Prevailing Healthcare Paradigm. A Novel Perspective the Treatment of Mental Health Conditions Using the Strannik Mathematical Model

There are few technologies which offer the potential to disrupt the prevailing biomedical paradigm. The author discusses the existence of the first technology to be based upon a precise and sophisticated simulation of how the brain regulates the autonomic nervous system and associated structures which has the potential to significantly disrupt the prevailing biomedical paradigm through the emergent neurological paradigm i.e. by understanding how the brain works and how this can be applied with diagnostic and/or therapeutic effect. Known commonly by the trade name ‘Strannik’ the associated package of Strannik software programmes have been shown in initial research, in 15-20 clinical studies conducted over the period 1997-2017, that Strannik Virtual Scanning (SVS) is able to determine the onset and progression of the complete spectrum of pathologies 2%-23% more accurately than the current plethora of medical tests; screen pathological onset from the presymptomatic level; define each pathology in terms of its genotype and phenotype; determine ca. 5-15 pathologies in each of 30+ organs, provide results in ca. 10 minutes - 15 minutes; more safely/non-invasively than contemporary methods of diagnosing and treating disease; achieve therapeutic outcomes with the neuromodulation technique Strannik Light Therapy (SLT) which initial studies indicate is 75%-96% therapeutic effectiveness i.e. which appear to exceed that which is possible using biomedicine; and to do as at considerably lower cost by comparison with biomedical tests and treatments. The author discusses the limitations of biomedicine and how such a neurological approach, in the form of the Strannik technology, could be applied to address such limitations and provide an alternative and cost-effective approach to the provision of healthcare, in particular (but not exclusively), regarding the management of lifestyle-related mental health conditions.

Wernicke-Kleist-Leonhard phenotypes of endogenous psychoses: a review of their validity

While the ICD-DSM paradigm has been a major advance in clinical psychiatry, its usefulness for biological psychiatry is debated. By defining consensus-based disorders rather than empirically driven phenotypes, consensus classifications were not an implementation of the biomedical paradigm. In the field of endogenous psychoses, the Wernicke-Kleist-Leonhard (WKL) pathway has optimized the descriptions of 35 major phenotypes using common medical heuristics on lifelong diachronic observations. Regarding their construct validity, WKL phenotypes have good reliability and predictive and face validity. WKL phenotypes come with remarkable evidence for differential validity on age of onset, familiality, pregnancy complications, precipitating factors, and treatment response. Most impressive is the replicated separation of high- and low-familiality phenotypes. Created in the purest tradition of the biomedical paradigm, the WKL phenotypes deserve to be contrasted as credible alternatives with other approaches currently under discussion.

From mere urbanity to urban bioethical standards

An interest in research, deliberation, and reflection on urbanity has been present for a long time. Due to rapid urbanisation in the last few decades, such interest has intensified, attracting scholars from different disciplines and creating new platforms for discussion. The first indicators of a ‘bioethical’ interest in urban life are already present in Van Rensselaer Potter’s early papers (urban ethics. However, more extensive research into urban bioethics remained on hold until recently, mainly due to the dominance of the biomedical paradigm within modern mainstream bioethics. In 2017, the European Bioethics in Action project (funded by the Croatian Science Foundation) ended, resulting in a list of general bioethical standards related to animals, plants, and human health. The aim of this paper is to present the rationale for developing bioethical standards in a specific urban context.

Biographical dimension of terminal illness or is there an alternative to medicine?

The article analyzes the biographical case of cancer with problematized attitude to traditional medicine. The author examines the biographical choices of the informant and the problem of not following the medicalist treatment strategy. Optics using analytic methods and social theory, the author seeks to show that living biographer’s disease and agree with the diagnosis of a life inextricably linked with the social relations within which these terms aventureuse, namely in the framework of relations “doctor-patient”. The analysis of this social dyad using the methods of anthropology and narratology brings us closer to the understanding of disease as a phenomenon mediated by the cultural codes of society, the dominant model of which is the biomedical paradigm of studying the “diseased body”.

New National Curricular Guidelines of medical courses: opportunities to resignify education

ABSTRACT The new National Curriculum Guidelines aim at restructuring and adapting medical curricula. The objective is to conduct a critical-reflective analysis of the restructure of a medical course’s curricular matrix. This action research was conducted at a Brazilian federal university. The material was analyzed using the discourse analysis method. Among the results, the proposal of a curriculum that values life and transfers the biomedical paradigm to incorporate other dimensions in healthcare is highlighted. The need to strengthen a curricular matrix based on social demands and preferably focused on primary care is indicated. The establishment of longitudinal and transversal relationships among the competency areas of the 2014 National Curricular Guidelines and the curricular components is proposed. The intention is to foster the understanding of determinants and relationships between diseases and the communities’ ways of living.

Body, movement and health: connections from the point of view of complexity

ABSTRACT Understanding the relationship between body, health, and movement beyond biological determinism and the current biomedical paradigm should consider other emerging interpretations that consider the multiplicity of the innumerable dimensions of which the triad can be composed as well as the different relationships that could exist between them. The paradigm of complexity is presented in this essay with the purpose of supporting other interpretations of physical activity that are less simplifying, linear and causal and that can incorporate openness, incompleteness, uncertainty and transdisciplinarity. The theory of complexity represents a stimulating and potent contribution to the dynamic study of the health-disease process and the physical activity in this panorama.

Integrative Nursing in Sweden

This chapter describes the existing “core” of caring/nursing in the Nordic tradition and how that can be merged with the concepts of integrative nursing to form a vision and strategy for the future. Terms such as integrative nursing are unfamiliar among nurses in Sweden, but the concepts of holistic care and healing have been taught for a long time and are well integrated in education and legislation. This chapter discusses possible barriers, such as the level of decision-making in Swedish healthcare as well as the role and attitude towards legislation in the light of the dominant biomedical paradigm. Further discussion explores how integrative nursing may serve as a bridge between the caring, nursing, and biomedical perspectives in its effort to identify and construct evidence from the basis and understanding of complex interventions and complex systems science. Practical steps for progression are identified and suggested.