Perspectives

Worldviews Matter in Medical Practice

Authors: Scott McAninch, MD

Abstract

Medical providers and patients may hold radically different opinions regarding various medical issues, which may result in subtle or overt conflict between individuals and in the public square. I suggest that one of the primary reasons why people arrive at such divergent opinions on the same issue is a difference in their worldviews. A worldview1 may be thought of as one’s mental framework, which is made up of a set of interconnected presuppositions about reality, that are held consciously or unconsciously, consistently or inconsistently, through which each person interprets information and the answers to the big questions of life. One’s worldview guides them in interpreting the meaning of information and informs us if it “makes sense,” is “reasonable,” and “seems right.”
Posted in: Medicine & Medical Specialties1

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References

1. Naugle D. Worldview: The History of the Concept. Grand Rapids, MI:William B. Eerdmans Publishing; 2002.
2. Andrews JD. Cultural, Ethnic, and Religious Reference Manual for Healthcare Providers. Scotts Valley, CA: CreateSpace; 2013.
3. Galanti G. Caring for Patients from Different Cultures. Philadelphia:University of Pennsylvania Press; 2015.
4. Pew Research Center. Religious Landscape Study. https://www.pewforum.org/religious-landscape-study. Accessed October 9, 2019.
5. Papineau D. Naturalism. https://plato.stanford.edu/entries/naturalism/. Published February 22, 2007. Accessed October 18, 2019.
6. Sagan C. Cosmos. New York: Random House;1980:4.
7. Pinker S. Enlightenment Now: The Case for Reason, Science, Humanism, and Progress. New York:Penguin Books; 2019:430.
8. Dawkins R. The God Delusion. Boston:Houghton Mifflin; 2006:189.
9. Novella S, Novella B, Santa Maria C, et al. The Skeptics’ Guide to the Universe: How to Know What’ Really Real in World Increasingly Full of Fake. New York: Grand Central Publishing; 2018:145.
10. Melchert N. The Great Conversation: A Historical Introduction to Philosophy. New York: Oxford University Press; 2019:G-1.
11. Lewontin R. Billions and billions of demons. New York Review of Books, January 9, 1997:31.
12. Novella S, Novella B, Santa Maria C, et al. The Skeptics’ Guide to the Universe: How to Know What’s Really Real in World Increasingly Full of Fake. New York: Grand Central Publishing; 2018:3-4.
13. Shermer M. Are you an atheist or agnostic? https://michaelshermer.com/2012/04/are-you-an-atheist-or-agnostic. Published April 10, 2012. Accessed July 19, 2019.
14. Oppy G. A Companion to Atheism and Philosophy. Hoboken, NJ: Wiley-Blackwell; 2019:84.
15. Sorell T. Scientism: Philosophy and the Infatuation with Science. London: Routledge; 1991:1.
16. Ruse M. Darwinism Defended. Reading, PA:Addison-Wesley1982:322.
17. Russell B. Religion and Science. New York: Oxford University Press; 1970:243.
18. Novella S. Shaping opinions about science and medicine. https://sciencebasedmedicine.org/shaping-opinions-about-science-and-medicine. Published July 24, 2019. Accessed October 10, 2019.
19. Hall H. Functional medicine: pseudoscientific silliness. https://www.skeptic.com/reading_room/why-functional-medicine-is-bogus. Published 2017. Accessed July 22, 2019.
20. Bunge M. Medical Philosophy: Conceptual Issues in Medicine. Hackensack, NJ: World Scientific Publishing; 2013:12.
21. British Humanist Association. Complementary and alternative medicine. https://humanism.org.uk/campaigns/public-ethical-issues/homeopathy. Accessed October 10, 2019.
22. Dobzhansky T. Genetics and the Origin of Species. New York: Columbia University Press; 1937:12.
23. Darwin C. On the Origin of Species by Means of Natural Selection, or The Preservation of Favoured Races in the Struggle for Life. Mineola, NY:Dover Publications;1859;:107.
24. Gould SJ. Wonderful Life: The Burgess Shale and the Nature of History. New York: Norton;1989.
25. Simpson GG. The Meaning of Evolution: A Study of the History of Life and of Its Significance for Man. New Haven, CT: Yale University Press;1967:345.
26. Dawkins R. River Out of Eden: A Darwinian View of Life. New York: Basic Books;1995;:132.
27. Gould SJ. Ever Since Darwin: Reflections in Natural History. New York:W.W. Norton; 1977:147.
28. Lewis R. Finding Purpose in a Godless World: Why We Care Even If the Universe Doesn’t. Amhurst, NY: Prometheus Books 2018:208.
29. Ruse M. Evolutionary theory and Christian ethics. In: The Darwinian Paradigm. London: Routledge; 1989:262-269.
30. Pinker S. Enlightenment Now: The Case for Reason, Science, Humanism, and Progress. New York: Penguin Books; 2019:324.
31. American Humanist Association. Humanist manifesto III. https://americanhumanist.org/what-is-humanism/manifesto3. Accessed October 10, 2019.
32. Humanists International. The Amsterdam Declaration. https://humanists.international/what-is-humanism/the-amsterdam-declaration. Accessed October 10, 2019.
33. Harris S. The Moral Landscape: How Science Can Determine Human Values. New York: Free Press; 2010.
34. Diller JW, Nuzzolilli AE. The science of values: The Moral Landscape by Sam Harris. Behav Anal 2012;35:265-273.
35. Kleinman A, Eisenberg L, Good B. Culture, illness, and health care: clinical lessons from anthropologic and cross-cultural research. Ann Intern Med 1978;88:251-258.
36. British Humanist Association. Abortion and sexual and reproductive rights. https://humanism.org.uk/campaigns/public-ethical-issues/sexual-and-reproductive-rights. Accessed July 24, 2019.
37. Rae SB. Moral Choices: An Introduction to Ethics. New York:Zondervan Academic;2018;:145-149.
38. Warren MA. On the Moral and Legal Status of Abortion. Monist 1973;57:43-61.
39. Vaughn L. Bioethics: Principles, Issues, and Cases. New York: Oxford University Press; 2018:344-356.
40. Thomson JJ. A defense of abortion. Philos Public Aff 1971;1:47-66.
41. Singer P. Practical Ethics. New York: Cambridge University Press; 2011:150.
42. Giubilini A, Minerva F. After-birth abortion: why should the baby live? J Med Ethics 2013;39:261-263.
43. Ayer AJ. The Humanist Outlook. London:Pemberton; 1968:9.
44. Sample I. Stephen Hawking: “There is no heaven it’s a fairy story.” https://www.theguardian.com/science/2011/may/15/stephen-hawking-interview-there-is-no-heaven. Published May 15, 2011. Accessed October 18, 2019.
45. How should hospitals handle atheist patients? https://friendlyatheist.patheos.com/2009/03/31/how-should-hospitals-handle-atheist-patients/. Published March 31, 2009. Accessed July 30, 2019.
46. Smith-Stoner M. End-of-life preferences for atheists. J Palliat Med 2007;10:923-928.
47. British Humanist Association. Assisted dying. https://humanism.org.uk/campaigns/public-ethical-issues/assisted-dying. Accessed July 26, 2019.
48. Nugent M. Atheist Ireland submission on draft bill for advance healthcare directives. https://atheist.ie/2014/03/atheist-ireland-submission-on-draft-bill-for-advance-healthcare-directives. Published August 3, 2014. Accessed July 29, 2019.
49. Thompson RP, Upshur REG. Philosophy of Medicine: An Introduction. London: Routledge; 2018:158.
50. Crick F. The Astonishing Hypothesis: The Scientific Search for the Soul. New York: Scribner; 1995:3.
51. Thompson RP, Upshur REG. Philosophy of Medicine: An Introduction. London: Routledge; 2018: 159.
52. Buckley A. Is consciousness just an illusion? https://www.bbc.com/news/science-environment-39482345. Published April 4, 2017. Accessed July 22, 2019.
53. Sullivan J. Models of mental illness. In: The Routledge Companion to Philosophy of Medicine , Solomon M, Simon JR, Kincaid H, eds. New York: Routledge; 2017:455.
54. Murphy D. Conceptual foundations of biological psychiatry. In: Philosophy of Medicine, Gifford F, ed. New York: North Holland; 2011:514.
55. Stegenga J. Care and Cure: An Introduction to Philosophy of Medicine. Chicago: University of Chicago Press; 2018.
56. Kingma E. Naturalist accounts of mental disorder. In: Fulford B, Morris K, Sadler JZ, et al, eds. The Oxford Handbook of Philosophy and Psychiatry. New York:Oxford University Press; 2013: 363.
57. Thompson RP, Upshur REG. Philosophy of Medicine: An Introduction. London: Routledge; 2018:43.
58. Murphy D. Conceptual foundations of biological psychiatry. In: Philosophy of Medicine, Gifford F, ed. New York: North Holland; 2011:438.
59. Jiménez JP, Botto A, Herrera L, et al. Psychotherapy and genetic neuroscience: an emerging dialog. Front Genet 2018;9:257.
60. Gluckman P, Beedle A, Bulklajas T, et al. Principles of Evolutionary Medicine. New York: Oxford University Press; 2016:281.
61. Smart N. Worldviews: Crosscultural Explorations of Human Beliefs. Princeton, NJ: Prentice-Hall; 2000.
62. Sire JW. The Universe Next Door: A Basic Worldview Catalog. Downers Grove, IL: IVP Academic: 2009.