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Concepts of Man – Concepts of Health: A Glimpse of Their Relationship in Antiquity With Relevance to Our Day and Age. Referring to ancient miraculous healing narratives, this article argues that concepts of health are inextricably intertwined with concepts of man. However, the relatively autonomous idea of medical treatments based on scientific reasoning is not an invention of modern secularization. It already existed in antiquity – even among people of faith. Gods and other religious authorities were regarded as mediating factors; they were not held responsible for diseases or cures. Examples from Christian and pagan traditions show that the interplay between ideas of man and concepts of health were extremely complex and diverse. Obviously, this was true already in antiquity – but it is even more evident in the present. Dualistic confrontations (e. g., pre-modern versus modern times, pre-scientific healing vs. academic medicine) are of little help to achieve universal health care and global health.
The Concept of Health in Immunology and Infection Biology: Nine Opportunities for the Future. Looking at our individual immune systems, one might get the impression that health is mostly a personal matter. However, infection biology immediately points to the fact that health is the outcome of a global joint effort undertaken not only by all humans, but actually by all living beings. From the very large to the very small, health is based on a fragile balance and the successful collaboration of numerous single entities in a highly sensitive and complex network that connects our innermost world with that of the outside. Diseases have been with us forever, and in the course of time, they shaped our political and cultural community. Yet, they also are one of the main drivers of evolutionary development. In that capacity, they have promoted progress from simple life forms to complex beings, i. e., ourselves. Thus, health can also be seen as the product of innumerable tiny coincidences. Politics, academia and society should ensure prevention of future detrimental (or harmful) coincidences with such tragic outcomes.
Patients’ Perspectives on Health. The following chapter presents a number of patient statements on health and disease provided by several German patient associations. In these statements, patients describe their personal experience with health and disease and how they cope with their situations. Some also emphasize what they have done to improve their wellbeing. These first-hand reports offer a glimpse of the factors that support and inhibit individual people in their everyday struggles to create and maintain their own understanding of health.
The Amazon Basin: A Forgotten Cultural Landscape and Its Medicine. While the Amazon region’s ecological importance remains uncontested, its role as a cultural hotspot is largely unknown to most people. Yet, recent archeological findings revise the image of a lush but inhospitable landscape whose farm produce could not sustain advanced civilization. The indigenous people today are only a tiny remainder of a far bigger population that developed impressive agricultural and forest engineering skills – until it was wiped out by diseases brought in from Europe. In fact, modern medicine benefits greatly from biological knowledge of indigenous Amazonians even today. This resource could prove to be much more valuable than any short-term profit realized by slash-and-burn farming or the extraction of raw materials. Therefore, it is all the more important to protect this endangered region. Scientific research will not only help to rescue indigenous biomedical knowledge, it will also give back respect and dignity to socalled savages and their cultural achievements.
The Emergence of Modern Medicine and a New Understanding of Health and Disease: Rudolf Virchow and the Berlin Medical Society. At the beginning of the 19th century, the most important cities for medicine were Paris and Vienna. Berlin had less than 200,000 inhabitants and no university.Within a short period of time, this changed dramatically – and progress in medicine was a main catalyst. At the end of the 19th century, around two million people lived in Berlin and the city had become the world metropolis of modern medicine. This article examines the main causes and the central figures of this astonishing development. The driving force behind this advance was the rise of a new sort of medicine, i. e., a medicine based on evidence and science. Here, the Berlin Medical Society and its long-time president Rudolf Virchow played a central role. His concept of cellular pathology changed the definitions, methods and understanding of health and disease. Thus, it is no exaggeration to state that Virchow served as one of the most important founding fathers of modern medicine.
The Normative Practice of Health and Disease. „Health“ and „disease“ are frequently used terms with a high relevance for our everyday lives. Their spectrum of meaning is very extensive, but also ambivalent, because they are not adequately captured by a purely medical-scientific approach. The forms of knowledge associated with „disease“ and „health“ are rather diverse and allow different ways of looking at them side by side in a justified manner. Against this background, the relationship between scientific and life world approaches to these phenomena is of central importance, because this results in very different claims to an interpretative sovereignty of „health“ and „disease“. For these states not merely have an associated dimension, but an essentially practical-normative one, so that they cannot simply be reduced to a biological function or dysfunction. This becomes especially clear when the assignment of dysfunctional conditions to the concept of disease results in immediate options for action that are not simply limited to a chapter expansion of medical textbooks, but may lead to fundamental personal and social changes. For this side of „disease“ and „health“ reflects not only medical developments, but also normative attitudes in science and society. These in turn are also decisive for the communicative structure in the doctorpatient relationship.
The World Health Organization (WHO), Pandemics, and COVID-19: How to Proceed With a Multilateral Concept of Global Health? The WHO grew to 194 member states, and with globalization, geopolitical shifts, and internal reorganizations, the lines of influence have become more complex. In 2020, the United States severely endangered multilateralism in health. Recently, the Biden administration has revived US commitment as a major global health player. Yet, the lack of coherence in supporting collective action on global health remains a problem. Global health geopolitics are shifting and China and India have acquired enough power to shape the global health agenda. At the instigation of Germany, health has become a regular topic at Group of Twenty (G20) and G7 meetings – a critical factor during the COVID-19 pandemic. The WHO’s director general frequently states that health is a political choice. Many countries made unfortunate, if not questionable political choices in their responses to COVID-19. But as a matter of fact, they took the wrong turn much earlier when they neglected investments in pandemic preparedness and in the WHO. Countries have the political choice right now to seriously strengthen the WHO, its funding, and its legal power, or to weaken or even destroy one of the most important agencies in the UN system.
Local Concepts of Health and Illness in Transition: Examples from Papua New Guinea. Papua New Guinea societies integrate traditional medicine, biomedicine, shamanic practices, and Christian healing techniques into herbal therapies. During an episode of illness, patients pragmatically apply different diagnostic and therapeutic procedures. Concepts of person and body are central to indigenous illness etiologies and therapeutic practices. This contribution offers an insight into local concepts of health in Papua New Guinea, shows interfaces of local medical systems with biomedical approaches, and addresses the constant change to which medical systems are subject.
Health in Judaism: An Intercultural Discourse on Lack of Understanding and Misunderstanding in the Past and Present. Hardly any other religion pays as much attention to physical health as Judaism. Beginning with the Torah, the contrast between „healthy“ and „sick“ is already conceptualized and associated with the will of God and his plan of creation. In addition to the stereotype that Jews are sicker than their fellow human beings, there is an early claim that their state of health is better than that of other peoples. The religious writings of Judaism contain a large number of regulations that show how much the Greco- Roman doctrine of dietetics has been internalized, expanded and adapted to one’s own spiritual needs. There is broad consensus among today’s rabbis that health care, as described above all in the Talmud, was time-related and therefore should be based on today’s standards and findings while remaining in compliance with religious laws.
Concepts of Health in Psychiatry. In talking about concepts of health in psychiatry,we are not talking about an essentialist concept of health, where there is some essential thing that health might be. There is a straightforward sense in which psychiatric „health“ simply means the absence of psychiatric disease. Marking out our concepts of health in psychiatry would then involve marking out the boundaries between normal and abnormal psychic phenomena. However, there is no single, neat concept of health in psychiatry; nor are there concepts of health that neatly cohere into one overarching theory of health. This is not because psychiatry is vague. It is because psychiatry reflects the complexity of the whole person.
The Feeling of Being Healthy: New Perspectives on Modern Medicine. „Well-being“ and mental health have become increasingly important in the definitions of health since 1945. Has this also changed the feeling of being healthy? The chapter demonstrates that the intuitive feeling of being healthy when the body does not cause any discomfort has been increasingly delegitimized in the last hundred years. It identifies three developments as responsible for this shift: the establishment of the risk factor model, the reconceptualization of health as result of a constant process of rebalancing health and illness, and the emphasis on the subjective component of health.
Taming the European Leviathan: Health as Politics. A Research Project. This article outlines the research project „Taming the European Leviathan: The Legacy of Post-War Medicine and the Common Good“. It is funded by a Synergy Grant of the European Research Council and unites European researchers comparing health policies (from drug research to prevention) in West- and East-European countries, e.g., Bulgaria, Germany, France, Czechoslovakia, Hungary, and the United Kingdom. The common goal is to provide a different perspective on post-war Europe, a perspective that emphasizes commonalities rather than differences.
Health Data as a Public Good. Routine health data, which are collected by health insurers and other agencies in the health care system, offer enormous potential for health monitoring and research. Germany has been slow to make such data available for socially beneficial purposes, partly due to concerns about privacy and data protection. Against this background, we discuss some of the most important potential uses of routine health data and call for a broader societal debate about the benefits, risks, and appropriate regulation of routine health data usage.We then review theWestern Australian Data Linkage System as an example of a data infrastructure that is characterized by high levels of stakeholder and patient involvement and a sophisticated method of privacy protection. While Germany does not need to copy this approach, we hope that the experiences of Western Australia and other countries will stimulate and inform the overdue debate about a modern, responsible, and sustainable approach to socially beneficial health data usage in Germany.
Controversies Over the Concept of Mental Disorders. Just like persons suffering from somatic diseases, those experiencing mental disorders, maladies, or diseases should be provided with care and protection from certain social demands. Yet, any disease concept should be precise enough to avoid classification of behavior as pathological while it is merely socially undesirable in the current political system. This paper reviews various conflicting concepts of disease, illness and sickness. In addition, it provides a narrower definition of a so-called clinically relevant mental malady. This definition is characterized by a) an impairment of mental functions relevant for human life (the disease aspect of a mental malady) and b) personal harm either due to suffering (the illness aspect) or impaired activities of daily living that severely limit social participation (the sickness aspect). This chapter claims that any definition of disease-relevant mental dysfunctions should be critically reflected regarding its philosophical and anthropological foundation and ethical consequences. Criteria of disease, illness and sickness should no longer be defined by groups of professionals selected by the WHO or other institutions, but instead require public debates that include organizations of patients and relatives.
Wohin mit uns?
(2021)
Jährlich erkranken etwa 16.500 junge Menschen im Alter von 18–39 Jahren an Krebs. Und so wenig, wie man selbst darauf vorbereitet ist, so wenig ist es die Gesellschaft an sich. Mich traf es das erste Mal mit 26 Jahren. Zu diesem Zeitpunkt befand ich mich in der Vorbereitung auf das zweite Staatsexamen der Humanmedizin. Einer längeren Phase mit Infekten folgte schließlich eine auffällige Bildgebung und eine Woche vor dem Examen dann eine OP am Brustkorb, um Lymphgewebe zur Diagnostik zu gewinnen. Am zweiten Tag des Examens erfuhr ich, dass es tatsächlich Krebs war – und genau eine Woche später begann schon die Therapie. Das Examen wollte ich unbedingt schreiben, da ich nicht auch noch ein halbes Jahr an Vorbereitung einfach verlieren wollte, und bin froh, dass ich es geschafft habe. Diese erste Therapie habe ich psychisch sehr gut verkraftet und es ist mir eher zugutegekommen, selbst Mediziner zu sein, da ichwusste, dass die Prognose sehr gut war. Was ich nicht wusste: dass man als Student keinerlei finanzielle Absicherung im Krankheitsfall hat. BAföG bekam ich nie, es würde aber eh nach drei Monaten ausgesetzt werden und Anspruch auf ein Krankengeld besteht als Student nicht – man fällt also auf Hartz IV bzw. Sozialhilfe oder hat das Glück, dass man von den Eltern unterstützt wird. In meinem Fall Letzteres. Aber ich habe über meine Erkrankung andere Betroffene kennengelernt, die akut in existenzielle Nöte geraten sind – ich finde das unerträglich und doch ist es eine Realität in Deutschland.
The Āyurvedic Concept of Health. Āyurveda denominates the most important traditional medical system in South Asia. It looks back on an extensive corpus of literature from the past two thousand years. Since the 1980s, Āyurvedic medical practice has been increasingly spread outside South Asia. One reason for its success might be that Āyurveda places great emphasis on the maintenance of health, prevention, and regeneration. It also developed a broad and differentiated spectrum of diagnostic and therapeutic options, which, based on its own systematic paradigm, have been elaborated in detail over millennia. Āyurveda’s canonical texts not only provide systematic descriptions and definitions of the Āyurvedic understanding of health, they also contain detailed treatises regarding their relevance for everyday life and concrete medical instructions. This article provides basic information about the Āyurvedic understanding of health and contextualizes it within the everyday practice of both conventionally and Āyurvedically trained medical doctors in Germany.
One Health and Human-Animal Relationships: Do We Make Our Animals Sick? Since the very beginning of human-animal relationships, humankind took advantage of animals, as of nature in general. While many people today perceive themselves as animal-loving, in reality we tend to systematically deprive our farm animals and pets of their own nature and health. On our quest to perfect our exploitation of the animal world, we reached a dimension that started to profoundly worry veterinary professionals, animal welfare activists, and also the informed public. Ultimately, this destructive relationship leads to detrimental consequences for both parties: e. g., the extinction of wild animals, or the transmission of diseases from one to the other. However, one could argue that the suffering we cause to animals clearly and by far exceeds the harm caused by, for example, the animal-derived COVID-19. Is this a too provocative hypothesis? This article is an invitation to take a closer look at various facets of our current humananimal relationship with its consequences for both.
Die Diagnose Krebs ist für jeden Betroffenen ein einschneidendes Erlebnis, aber in einem so jungen Lebensalter ist es besonders dramatisch.Viele Gedanken sind schon bei Diagnosestellung von enormer Bedeutung: Kann ich meine Ausbildung jemals beenden? Wann kann ich wieder in die Welt und etwas erleben? Kann ich jemals noch Kinder bekommen? Auch finanzielle Sorgen und die Angst des sozialen Abstiegs rücken in den Vordergrund. Dass man in seiner Altersklasse nicht alleine ist, zeigen Studien. Jedes Jahr erkranken etwa 16.500 junge Menschen zwischen 18 und 39 Jahre an Krebs.