Made

What is philosophy?
Gr philosophia Love of Wisdom
By Jenicek ja Hitchcock (2005)

philosphy is the study of fundamental

questions, that is, questions about concepts
and principles.
Main branches of philosophy are metaphysics
and ontology (being and reality); epistemology
(knowledge); logic (inference); and ethics
(values).

Literally "the love of wisdom" (Greek: philo = love, sophia

= wisdom), philosophy at the dawn of civilization
was synonymous with rational inquiry itself.
Two important starting points: love (or passion) and
wisdom (knowledge, understanding).
Philosophy sometimes seems to be pursued without
passion as if it were a technical subject like
engineering or mathematics.
Although there is a role for dispassionate research,
philosophy must derive from some passion for the
ultimate goal: a reliable, accurate understanding
ourselves and our world.

Philosophy?

Philosophy has been called many

things and it can have many
meanings
Those single words or statements
on the right side are only some of
them
What words would you add?

Wisdom
Reality
Theories
Meaning of Life
Nature of being
human
Life perspectives

(By Roger Hiemstra, January, 2001)

1.

2.
3.
4.
5.

Examination of basic concepts:the branch of

knowledge or academic study devoted to the
systematic examination of basic concepts such as
truth, existence, reality, causality, and freedom
School of thought:a particular system of thought or
doctrine
Guiding or underlying principles:a set of basic
principles or concepts underlying a particular
sphere of knowledge
Set of beliefs or aims:a precept, or set of precepts,
beliefs, principles, or aims, underlying somebody's
practice or conduct
Calm resignation:restraint, resignation, or calmness
and rationality in somebody's behavior or response
to events

The Main Branches of Philosophy

1.Epistemology
2.Ontology/Metaphysics
3.Axiology
Aesthetics - Ethic

1. Epistemology
Epistemology is the branch of philosophy that studies
knowledge.
It attempts to answer the basic question: What
distinguishes true (adequate) knowledge from
false
(inadequate) knowledge?
Practically, this question translates into issues of
scientific methodology: how can one develop theories or
models that are better than
competing theories?
It also forms one of the pillars of the new sciences of
cognition, and from artificial intelligence, as an
attempt to develop computer programs that mimic a
human's capacity to use knowledge in an
intelligent
way.

Logic knowledge
Logic is the study of right reasoning. It is
the tool philosophers use to study other
philosophical categories. Good logic includes
the use of good thinking skills and the
avoidance of logic fallacies.

Logical positivism - some characteristics

Construction of general
knowledge through
induction and deduction:
the hypotheticaldeductive method

Unified science (methodological monism) ... Mathematical

physics becomes the ideal science
Theory-reduction and logical analysis are seen as tools for
unified science

Deductive reasoning works from the more general to

the more specific. Sometimes this is informally called a

"top-down" approach. We might begin with thinking up a
theory about our topic of interest. We then narrow that
down into more specific hypotheses that we can test. We
narrow down even further when we collect observations
to address the hypotheses. This ultimately leads us to be
able to test the hypotheses with specific data -- a
confirmation (or not) of our original theories.

Inductive reasoning works the other way, moving from

specific observations to broader generalizations and

theories. Informally, we sometimes call this a "bottom up"
approach (please note that it's "bottom up" and not
"bottoms up" which is the kind of thing the bartender
says to customers when he's trying to close for the
night!). In inductive reasoning, we begin with specific
observations and measures, begin to detect patterns and
regularities, formulate some tentative hypotheses that
we can explore, and finally end up developing some general
conclusions or theories.

2. Metaphysics
Metaphysics is the study of reality. More
specifically it is the study of reality that is
beyond the scientific or mathematical realms.
The term metaphysics itself literally means
beyond the physical. The metaphysical issues
most discussed are the existence of God, the
soul, and the afterlife.

Metaphysica Generalis (ontologi);

ilmu tentang yg ada atau pengada.
Metaphysica Specialis terdiri atas:
1. Antropologi; menelaah ttg hakikat
manusia, terutama hub. jiwa & raga.
2. Kosmologi; menelaah ttg asal usul &
hakikat alam semesta.
3. Theologi; Kajian ttg Tuhan secara
rasional.

(C.Wolff)

2.Axiology
is the study of quality or value.
It is often thought to include ethics and aesthetics philosophical fields that depend crucially on notions of
value - and sometimes it is held to lay the groundwork
for these fields, and thus to be similar to value
theory and meta-ethics.

3. Ethics
Ethics is the study of moral value, right and
wrong. Ethics is involved with placing value to
personal actions, decisions, and relations.
Important ethical issues today include
abortion, sexual morality, the death penalty,
euthanasia, pornography, and the
environment.

5. Aesthetics
Aesthetics is the study of art and beauty. It
attempts to address such issues as:
--What is art?
--What is the relationship between beauty and
art?
--Are there objective standards by which art
can be judged?

The Others Branch of Philosophy

Philosophy
Philosophy
Philosophy
Philosophy
Philosophy
Philosophy
Philosophy
Philosophy
Philosophy

of
of
of
of
of
of
of
of
of

Education
History
Language
Law
Mathematics
Mind
Politics
Religion
Science

Other Subfields
Philosophy of History, Philosophy of Mathematics,
Philosophy of Medicine, Philosophy of Education, Philosophy
of Linguistics, Philosophy of Criticism, Philosophy of Culture,
etc

The Reason to Study Philosophy

Most philosophers would agree that one of the great
benefits of philosophy is that it challenges us to think
critically about our beliefs and to justify them with
good arguments.
In this way, philosophy forces us to think clearly and
precisely and to express our ideas in the same way.
The development of critical thinking skills that is
achieved through the study of philosophy is something
that can help all of us to make better decisions in many
aspects of our lives.
We can benefit personally because we will make better
judgments about what is in our own long-term
selfinterest.

The Uses of Philosophy

General Problem Solving. The study of philosophy

enhances, in a way no other activity does, one's problemsolving capacities.

Communication Skills. Philosophy also contributes

uniquely to the development of expressive and
communicative powers.

Persuasive Powers. Philosophy provides capacities can

be developed not only through reading and writing in
philosophy, but also through the philosophical
dialogue,

Writing Skills. Philosophy teaches interpretive

writing through its examination of challenging
texts, comparative writing through emphasis on
fairness to alternative positions.

Philosophy of Sciences
The philosophy of science seeks to understand the nature
and justification of scientific knowledge and its
ethical implications.
It has proven difficult to provide a definitive account of
the scientific method that can decisively serve to
distinguish science from non-science.
Thus there are legitimate arguments about exactly where
the borders are.
There is nonetheless a set of core precepts that have
broad consensus among published philosophers of
science and within the scientific community at
large.

What is science?
Knowledge or a system of knowledge covering general
truths or the operation of general laws especially as
obtained and tested through scientific method
Such knowledge or such a system of knowledge
concerned with the physical world and its phenomena
: NATURAL SCIENCE
(Merriam-Webster Online Dictionary)

The issue of knowledge is important in both science and

philosophy. A measure of quality of knowledge is
truth.

Knowledge and Science

Knowledge (Oxford English Dictionary) variously as
i.

facts, information, and skills acquired by a person

through experience or education; the theoretical or
practical understanding of a subject,

ii. what is known in a particular field or in total; facts and

information or
iii. awareness or familiarity gained by experience of a
fact or situation.
iv. Plato's formulation of knowledge as "justified true
belief". There is however no single agreed definition of
knowledge presently, nor any prospect of one, and
there remain numerous competing theories.

Science (from the Latin scientia, 'knowledge')

is a system of acquiring knowledge based on the scientific

method, as well as the organized body of knowledge
gained through such research.

Science as defined here is sometimes termed pure

science to differentiate it from applied science, which is

the application of scientific research to specific human
needs, though the two are often interconnected.
Fields of science are commonly classified along two major
lines:
Natural sciences, which study natural phenomena
(including biological life), and
Social sciences, which study human behavior and
societies.

Truth
There are several ways to understand truth, but the
most popular approach is probably the correspondence
theory of truth which means that proposition is true in
case when it corresponds to the reality.
Absolute and relative truths. Science seems to move
toward absolute truth, because theories are becoming
more and more exact and fitting better with reality
during scientific research.

Methods of Acquiring Knowledge

Tenacity
Intuition
Authority
Rationalism
Empiricism
Science

Tenacity a willingness to accept ideas as valid

knowledge b/c these ideas have been accepted
for so long or have been so often repeated that
they acquire an aura of truth (menerima ide yang sudah
lama terjadi di masyarakat)

Intuition operates without intellectual effort or

sensory processing, its a form of direct-access
knowledge (berdasarkan insting)
Authority the acceptance of an idea as valid
knowledge because some respected source
claims it is valid

Scientific Methods
Scientific method is a body of techniques for
investigating phenomena and acquiring new knowledge, as
well as for correcting and integrating previous knowledge.
It is based on gathering observable, empirical and
measurable evidence subject to specific principles of
reasoning, the collection of data through
observation
and experimentation, and the formulation and testing of
hypotheses.

Rationalism a way of thinking in which

knowledge is developed thru reasoning.
information is carefully stated and logical rules are
followed to arrive at an acceptable conclusion
Empiricism involves gaining knowledge
through observationthat is, knowing something
by experiencing it through our senses.

Scientific Methods
The scientific method is often described today as comprising these
main actions: (wikipedia)

1. Observe: Collect evidence and make measurements

relating to the phenomenon you intend to study.
2. Hypothesize: Invent a hypothesis explaining the
phenomenon.
3. Predict: Use the hypothesis to predict the results
of new observations or measurements.
4. Verify: Perform experiments to test those
predictions. Testing, or attempting to
experimentally falsify is thought by many to be a
better choice of term here.
5. Evaluate: If the experiments contradict your
hypothesis, reject it. If they confirm it, make more
predictions and test it further.

PHILOSOPHY Of MEDICINE
Philosophy

Biomedical Science

Ontologi

Human being

Epistemologi

Psychological

Aksiologi

Transcedental

Gap Med Technology & Human Values

Existence
Values

Philosophy of medicine
H. Tristram Engelhardt Jr defines the issue in Routledge Encyclopedia of
Philosophy as follows:

The philosophy of medicine can be generally

defined as encompassing those issues in
epistemology, axiology, logic, methodology and
metaphysics generated by or related to medicine

PHILOSOPHY in
MEDICINE
Though medicine and philosophy have been intertwined

throughout their histories, systematic

philosophical
reflection on medicine began only in the 19th century.
There was a widening gulf between technology and
human values, ironically most manifest in a field
devoted to the study and care of individual
human
beings.
As a result, philosophy of medicine in its earliest
years focused largely on concrete MEDICAL
ETHICS questions involving new medical
technology, such as euthanasia, human cloning,
artificial insemination, etc.

More recently, philosophy of medicine broadened its focus

to address public policy issues on the distribution
and financing of health care, epistemological issues
about the attainment, growth and certainty of
medical knowledge, and metaphysical issues about
causality, personal identity and spirituality in
medicine.
Those other pursuits may benefit from exercises of this
sort, though even the most subtle of metaphysical
insights is bound to leave value judgments in medicine a
matter of drawing well-educated,
well-intentioned
lines through painfully gray areas
of human lives.

Medicine seeks to understand what it is to be

human.
The primary tool medicine has developed for
obtaining this knowledge has been science,
which has been spectacularly successful in
many respects.
"The human" is very complex, however, and
perhaps there are
aspects of us that science
cannot easily reach. Medical
humanities seek
to bring other sources of human
knowledge
to medicine, particularly medical education.

MEDICAL
HUMANITY
(HUMANIORA)

What is medicine?
There are different opinions on that issue

Scientific medicine and alternative medicine

The central situation in medicine is the

physician-patient relationship or therapeutic
relationship which goals in improvement of
patient condition.

Medicine
Online Medical Dictionary http://cancerweb.ncl.ac.uk/

A scientifically-based discipline dedicated to

the prevention and treatment of disease
and injury.
MedlinePlus Medical Dictionary
http://www.nlm.nih.gov/medlineplus/mplusdictionary.html

the science and art dealing with the

maintenance of health and the
prevention, alleviation, or cure of disease

Interpretations of the Philosophy of Medicine

Speculative medicine as the attempt to discover the
basic philosophical principles that lie behind
the
practice of medicine.
Logic of medicine brings togeteher attempts to
clarify the character of scientific reasoning in
medicine.
Philosophy of medicine as a subspeciality of
philosophy of science.
Other explorations of philosophical issues that
have special salience in medicine, e.g.
bioethics
stands in this division
(Tr Engelhardt JR, KWM Wildes. Encyclopedia of Bioethics, 3rd ed, 3 vol. Pp. 1738-9)

Central Concepts of Medicine

Health-disease distinction.
Basic principles are
(i) existence of some norms
and (ii) possibility to modify abnormal situations. Here
is a lot of issues from natural sciences and
psychology.
The therapeutic relationship.
Ideal situation would be that human relations are
symmetrical but disease makes them clearly
asymmetrical. Here is a lot of issues from psychology
and social sciences.

 Health a state of optimal physical, mental, social

wellbeing and spiritual, and not merely the
absence of disease and infirmity
disease any deviation from or interruption of the
normal structure or functions of any part,
organ, or system (or combination of thereof) of
the body that is manifested by a characteristic
set of symptoms and signs and whose etiology,
pathology, and prognosis may be known or
unknown.
Dorlands Illustrated Medical Dictionary, 28th ed., p. 736

Scientific/Modern & Alternative medicine

The scientific (conventional) medicine is grounded on
scientific knowledge and methods. The health care
systems in the developed countries are build up on the
basis of the scientific medicine and it is accepted and
cultivated in medical faculties.
Alternative medicine is a vague term which covers
numerous isolated practicies, e.g. Homeopathy,
anthroposophical medicine, yoga, biofeedback, etc.

The human body is composed of multiple interacting

and self regulating physiological systems including
biochemical and neuroendocrine feedback loops
The behaviour of any individual is determined partly
by an
internal set of rules based on past
experience and partly by unique and adaptive
responses to new stimuli from the
environment
The web of relationships in which individuals exist
contains
many varied and powerful
determinants of their beliefs,
expectations, and
behaviour

The humanities are those academic disciplines

which study the human condition using methods
that are largely analytic,
critical, or speculative,
as distinguished from the mainly
empirical
approaches of the natural and social sciences.
(wikipedia)

Medical humanities is an area of academic

study worth
considering if you have interests in
any of the varied subjects it includes or if you have a
reflective approach to medicine.
There are enormous opportunities for
developing both as
a practitioner and as an
academic, while career opportunities in this area are
likely to increase as more
medical education
incorporates humanities elements.

HUMANITIES IN MEDICINE
1. To increase understanding of the human
condition
study of the humanities may be integrated into
medicine
by means of new and as yet little
understood pathways
2. To expose students to the critical analysis of
ideas
3. To make more allowance for individual
differences
4. To provide pockets of expertise and lifelong
interests

omplexity and Clinical Care

(BMJ 2001;323:685-688)

Biological and social systems are inherently complex,

so it is
hardly surprising that few if any human
illnesses can be said to have a single "cause" or
"cure."
A complex adaptive system is a collection of
individual agents with freedom to act in ways that
are not always totally predictable, and whose
actions are interconnected so that the action of one
part changes the context for other agents. In relation
to human health and illness there are
several
levels of such systems.

lding Bridges Among Professional and

ient Satisfaction
Physicians today are confronted with increasing
demand to ensure and improve care of their
patients.
A variety of approaches claim to provide solutions
to the
problems of health care delivery.
These approaches represent different perspectives
on optimal care and the best method for improving
care.
The last decade, and all of them claim to provide
solutions to
some of the main problems in
patient care. Approaches
such as :
evidence-based medicine (EBM),
total quality management (TQM),
accreditation and accountability,
professional development,

ntegrative Medicine
Integrative Medicine has been defined by the
National Center for
Complementary and Alternative
Medicine as practices that
combine "mainstream
medical therapies and CAM therapies
for which
there is some high-quality scientific evidence of
safety and effectiveness"
Complementary and Alternative Medicine (CAM)
is an umbrella
term under which various forms of
non-traditional, non-Western medicine and healing
fall.
Alternative Medicine: practices used in place of
conventional
medical treatments, often
incorporating spiritual, metaphysical, or religious
underpinnings, non-European
medical traditions,
or newly-developed approaches to healing

Integrative medicine (IM) combines the discipline of

modern
science with the wisdom of ancient
healing.
For people living with chronic or life-threatening
illness, it
can transform the physical, emotional, and
spiritual
dimensions of their lives.
IM may also be valuable to those who are not ill but
wish to
increase self-awareness, enhance wellbeing, and help prevent health-related problems.
A multi-disciplinary approach to medicine provides the
maximum therapeutic benefit.
AAIM's advocacy for broader treatment options
facilitates a bond between integrative and Western
medicine.

Physicians must develop empathy and incorporate

humanistic attitudes
Humanities education provides a context for the
vicarious experience of illness and suffering
It helps teach the virtues of respect, compassion,
honesty and the meaning of community
Critical episodes become a catalyst for trainee
emotional development
Empathy facilitates problem solving with difficult
patients

Medical Humanities Objectives

Physicians must gain narrative knowledge

exercise observation and perception skills

engage in hypothesis testing
view medical stories as case studies

They can improve their narrative competence

recognize framing of medical history

appreciate imagery, symbols and metaphor
learn the importance of tone and irony

AGENDA UNTUK BIOETIKA

Dan Brock, Brown University (1999):
Bioethics concerns the ethical issues arising in
medicine and from advances in biological science.
There are 3 central areas:
1.
Relations between health care
professionals and
patients
2.
Justice in the allocation of health care
3.
Issues that arise from dramatic advances in
biological knowledge and technology

*Bioetika adalah perluasan dari etika kedokteran yang tradisional

*Etika kedokteran memfokuskan hubungan dokter-pasien
Tema-tema tradisional tetap penting tapi sekarang dalam konteks
modern:
di satu pihak demokratisasi dan hak-hak pasien (kritik atas
paternalisme)
di lain pihak pelayanan medis yang teknologis dan anonym (tim
medis) + biaya tinggi

Conclusion

Medical Humanities education can provide

breadth and depth to training
Trainees must learn to read their patients and
understand their stories
Perhaps physicians equipped with these skills
deliver more effective medical care

Four modules
- health from social, economical, political and
ideological point of view
- historical and cultural engagements of concepts
of health and illness
- healing and art
- health and illness at different stages of life

INTRODUCTION

International Standard in Basic Medical Education

(WFME, 2003) 1)
Competence based curriculum (Knowledge, skills,
attitude/behaviors/ ethics
Development of Science & Technology : New technology
and New techniques economics issues ethical
problems (Fig.1)
Medical practice Clinical decision making : scientific,
ethics, legal and humanities based.

Methods of Obtaining Knowledge

1. Observation or experience. This may be more or less
sophisticated, ranging from a simple, "I saw" to
carefully designed controlled experimentation.
2. Reason or logic. Taking other knowledge as data, by
logical operations knowledge can be inferred.
3. Testimony. Knowledge based on the acceptance of
testimony involves accepting what others say. This seems
to be a common way we get knowledge but is seen by
philosophers as problematic.

4. Authority. Knowledge based on authority may rely upon

the reputation of an individual such as Aristotle or
Einstein Authority may have a political basis in the sense
that some political process, perhaps involving
status
as well as simple voting, peer review, or
comment.
5. Revelation. Many people believe knowledge may be
obtained via revelation or even divine revelation,
which
may be directly from God or another spirit, perhaps
conveyed through a religious text or texts, such as the
Bible, Vedanta, Quran etc

Medical Education

Stake holders

MD

Education Standards
Medical Education Standards

Medical Practice

Clinical Decision
Making

1.
2.
3.

Quality Assurance
(Jaminan mutu)
Social Accountibility

4.

Medical Care Standards

Scientific (EBM)
Ethics (Moral principles)
Legal (Act, Regulation)
Humane

Area of Study
Biomedical Ethics
Evidence Based Medicine
Integrative Medicine
Medico legal aspect
Total Quality Management (TQM),
Accreditation and Accountability,
Professional development,
Patient empowerment,
Patients Physician relationship
and others