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Science is a great and glorious enterprise-the most successful, I argue, that human beings have ever engaged in. To reproach it for its inability to answer all the questions we should like to put to it is no more sensible than to reproach a railway locomotive for not flying or, in general, not performing any operation for which it was not designed.
What do you understand about the statement above? Explain why it may be argued that science should be expected to answer all the questions that are put to it. Discuss giving examples, the extent to which science has its limits.

Answer

Science has made astonishing progress in increasing our knowledge about how the Universe works. However as the writer points out there are other forms of knowledge as well as the observational and deductive logic that science relies on. A person will use emotional knowledge to tell him whether he likes a piece of music or a painting. The quote tells us critics who complain that science does not have all the answers are right but that does not detract from the value of scientific work.

In an increasingly secular world many people see science as replacing religion. People are attracted to the open values of science and its evidence based approach. They feel that scientific methods could be applied to other forms of knowledge such as psychology and economics. The involvement of science in fields such as the arts has led to the expectation that eventually science will tell us everything, even such matters as why we are attracted to certain people as humans are just products of their biology.

Science will always have limits. Every new discovery will lead to many more questions. In a near infinite universe we cannot know everything. ‘The greater the island of knowledge the longer the shoreline of uncertainty’. Science cannot tell us how to resolve an argument, how to love or what is right or wrong. Empathy, [emotional knowledge] and ethics are different but important forms of knowledge. Science can be used in good or bad ways, for example the germ theory of disease can be used to prevent transmission of disease or in biological warfare. Scientific development should always be within an ethical framework.

We Don’t Live in a World Of Reality, We live in a World of Perception. What do you understand the above statement to mean? Provide examples of how we live in a world of reality and how we live in world of perceptions. What is the common ground between reality and perception.

Answer

Descartes, the famous philosopher imagined a world controlled by an evil demon creating false illusions; he concluded that the only way he could be sure that he existed was because he could think. The film, the Matrix, was based on this idea.  Our view of the world is limited by our perception. Our vision, often regarded as our most important sense only detects a narrow range of electromagnetic wavelengths. Our other senses are similarly limited.

We live in a world of reality to the extent that our senses do not seem to lie. If I touch my desk it feels solid and occupies the space my vision tells me it does. When I call my sister she does hear me. This tells me that we do live in a world of reality. However science tells me that my desk is made up of atoms with enormous spaces between them and even within the atoms there is much more space than solid. Are my senses deceiving me by making it appear solid? We all know of examples of when perception is completely misleading such as in mirages.

It is important to realise that our picture of the Universe is limited by the perception of our senses. We only perceive a small fraction of the Universe. In the old story of the blind men and the elephant, one blind man felt the tail and declared it to be like a snake, another leg and said it was like a tree and so on. All of them were right but all were also wrong. We are stumbling around in the Universe in a similar blind way, reality and perception come together at times but we rarely see the full picture.

Parents who withhold vaccines from their children have betrayed their duty of care.
Write an essay in which you address the following points:
Why would parents withhold vaccines from their children? In what ways would doing so betray their duty of care? How can a doctor best advise a parent who is considering withholding a vaccine from a child?

Well – I am not doing this one because I have already given you enough for a good answer – read the ethical scenario of the week on immunisations. My blogs are useful and have a purpose!

He who conceals his disease cannot expect to be cured. Why would someone conceal their disease? How should a doctor handle this scenario? What is the most important ethical principle?

‘Denial is an important defence mechanism’. Patients may conceal their disease from a doctor for a number of reasons such as shyness, embarrassment and denial. Denial is one of the commonest reasons for the patient to hide a suspected disease. It may be an important coping mechanism.

The doctor needs to show great respect, empathy and sensitivity to win the patient’s confidence. Being non judgemental is an important principle in medical ethics. Gentle exploration of a patient’s symptoms and understanding should take place, preferably conversation should be patient led. At an early stage the doctor should regard building a rapport and gaining trust to be the most important process. However the doctor should inform the patient that nearly everything is easier to treat in its early stages. He should inform the patient that ‘his door is always open’ if he should wish to reconsider.

Beneficence must be balanced with autonomy. Patients often fear a power imbalance in the doctor-patient relationship and feel that they may be forced to do something they do not want. It must always be stressed that nothing will be done without their consent and they will be helped to make an informed judgement in all cases. Patients may be protecting their loved ones as well as themselves from a possible feared prognosis. As long as the patient has capacity the doctor should respect the patient’s views and try and understand their fears. Patients have the right not to know as well as to know about themselves. Autonomy in this situation is the most important principle.

 

Not everything that can be counted counts and not everything that counts can be counted (Albert Einstein). What do you think is meant by this statement?Give examples of things that count in medicine which cannot be counted. To what degree should they count?

This essay question and the one below are describing the importance  of subjective experience such as  ’the art of medicine’

There is more to healing than the application of scientific knowledge.Explain this statement. What else is important in medicine

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Answer

Medicine is both a science and an art. It has a proud scientific basis;, the application of evidence based medicine and rigor of scientific logic but a consultation with a doctor often involves a lot more than making a diagnosis and treating.

The ‘art’ of medicine renders all appointments interesting and none routine. A good doctor-patient relationship and the development of trust is therapeutic in itself. Patients are much more likely to follow advice and treatment. We are familiar with the term ‘the doctor as the drug’. A doctor’s reassurance has been shown to reduce pain scores, panic attacks and other conditions even if no treatment is given. In General Practice, where patients are seen with many different conditions over a long period of time, even visits for minor conditions can augment an important  relationship where communication skills, sensitivity and empathy all play their part, often subconsciously.

I am reminded of the story of a team of management consultants who were asked to make efficiency savings for an orchestra. They saw that there were a number of violins all ‘doing the same job’ and cut the violins down to one. Then they started to look at other instruments. More and more cuts followed. At the end they had replaced the entire orchestra with a CD player – it did the same job and cost less didn’t it?  But of course something was lost!

 

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