610 Medizin und Gesundheit
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Evolutionary Medicine and its Holistic Concept of Health. Recent years have seen tremendous advances in our understanding of biological processes on genomic, cellular, and evolutionary levels.We owe this progress in great part to modern genetic techniques, steady improvements in imaging technology, and ground-breaking molecular tools.These findings not only helped turning Darwin’s hypothesis on the origin of species into an exact science, they also require us to integrate the complex interactions between biology, environment, and behavior into our ways of thinking. As a result, a new scientific rationale for a holistic concept of health and disease emerged: Evolutionary Medicine. The holistic approach of Evolutionary Medicine provides a new perspective on human biology: Why are people so frail, why do we get sick? Most importantly, it helps us comprehend how to better preserve health – as opposed to merely focusing on the treatment of diseases. For example, it is the misalignment between our evolutionary ‘old’ biology and our fast-changing, man-made environment (e. g., urbanization and nutrition with processed food) that helps to comprehend the emergence of civilization diseases.
Ein Teil der Gemeinschaft
(2021)
Keine Regionalgruppe vor Ort? Dann gründe ich halt eine – fand eine Betroffene mit Lupus erythematodes. Ein Erfahrungsbericht. Im Jahr 2000 bekam ich im Alter von 28 Jahren die Diagnose „Systemischer Lupus erythematodes“ (SLE) – mit Beteiligungen der Haut, des Zentralen Nervensystems, der Niere und des Herzens. Im Krankenhaus bekam ich zwar Informationen zur weiteren Therapie, nicht aber elementare Informationen über die Krankheit. Weil ich noch kein Internet hatte, ging ich in die Bibliothek und fand nach einigem Suchen auch ein medizinisches Nachschlagewerk aus den 60er Jahren. Darin wurde einiges über die Krankheit erklärt, auch, dass meine Lebenserwartung nur bei drei bis fünf Jahren liegen würde.
Introduction – Reflections on Concepts of Health in Their Context. Contrary to what is often believed, health is not simply an objective condition that is easily determined and measured by strict medical criteria in clinical or scientific settings. It is a multifaceted phenomenon whose perception and understanding is influenced profoundly by people’s personal experience, cultural background and social environment. Correspondingly, there is great variety in concepts and definitions of health, both today and in a historical perspective. This collection of studies examines a number of such contextual factors that influence concepts, values and practices related to health, both present and past. It also makes a number of recommendations relevant to medical professionals, politicians, patients and other healthcare stakeholders as to how healthcare systems can be improved and enriched. It advocates a holistic approach to the understanding of health and disease, which involves embracing historical and philosophical concepts in medical reasoning, learning from health practices originated in other parts of the world and establishing interdisciplinary ways of thinking in biomedical research and clinical care.
Als ich im Januar 2018 nach Potsdam zog, war ich hoch motiviert: Mein Studium hatte ich erfolgreich beendet und nun musste ich nur noch die letzte Hürde überwinden, um meinen Traumberuf Grundschullehrerin zu erreichen: das Referendariat. Fünf Tage hat es gedauert, bis sich mein Leben ändern sollte. In meinem WG-Zimmer voller Umzugskartons ertastete ich eines Abends eine Verhärtung in meiner Brust. Zwei Tage später hatte ich einen Termin bei einem Gynäkologen. Im Ultraschall sah man einen Tumor von etwa 1,5 cm Größe, der abgeklärt werden musste. „Machen Sie sich keine großen Sorgen. Ich hatte noch nie eine Patientin in ihrem Alter, bei der es etwas Bösartiges war.“ Mit diesen Worten verabschiedetet mich der Mediziner.
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.
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 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.
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.
Health in the Presence of the Ancestors: African Healers between Acceptance and Denial: A Case Study from South Africa. Health and well-being for all is the ambitious aim of the third of the Sustainable Development Goals (SDGs) of the United Nations (UN). The no less ambitious definition of health of the World Health Organization (WHO) defines that health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. While in biomedical contexts treatment concentrates on physical healing, in the South African context the idea of healing and well-being subsumes a combination of physical, mental and social treatment and includes the ancestors and medicinal plants as an important category in the healing process. The ancestors in particular are representatives of the social past that reaches into the present. Healing as such has a multifaceted dimension even beyond the definition of health as proposed by the WHO.
Doing Health: Chinese and Other Perspectives. In ancient China, health was related to the individual person and their unique life. Both medical and philosophical texts testify to this: Maintaining vitality in the course of one’s own lifespan was a priority. Daily caring for one’s health revolved around Qi 氣 – a universal medium that is at the same time material and spiritual, emotional and neutral, unitary and diverse, as well as biological, psychological and physiological. Health thus becomes a verb, an act, a property to be preserved, a wavering and oscillating between pleasure and strength. Not least because of the pandemic, the demand for ‘traditional’ healing expertise rose worldwide. Against this background, early Chinese views on life are of unprecedented importance: From their perspective, a reorientation of public and global health policies seems inevitable.
Physician Health in the Workplace. Physicians are exposed to a variety of risks in their everyday work. There is an obvious risk, especially in view of the current pandemic, of contracting communicable diseases like COVID-19, HIV and Hepatitis C. The commercialization of healthcare and associated cost-saving measures – particularly in the field of human resources – lead to unhealthy workloads and, correspondingly, an increased risk of suffering from psychological disorders like burnout and depression. Scientific studies reveal a correlation between psychological stress and the quality of patient care. The health of medical personnel must be given high priority in the interest of both patients and those working in the healthcare system. This requires adequate funding with staffing that is appropriate to the patient and the task at hand, thus ensuring humane and high-quality patient care. In addition, physicians must be relieved of performing non-medical tasks, and their resilience must be strengthened through individual and operational measures.
Health, Lifestyle and Responsibility: Historical Roots and Current Perspectives. The question to what extent health and disease are matters of individual and collective human responsibility was first raised and systematically discussed in ancient Greek medicine and philosophy in the 5th and 4th century BCE. This chapter discusses the consequences of these discussions for the definition of the aims and methods of the medical art, in particular the preservation and enhancement of health and the prevention of disease through lifestyle-related prophylactic and therapeutic measures. It also considers some of the implications of these ancient discussions for today’s theory and practice of preventative and lifestyle-related medicine.
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.
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.
Der Denkanstoß 8 „Gesundheitsregion Berlin-Brandenburg“ gibt Anregungen und Anstöße für die Gestaltung der Metropolregion Berlin-Brandenburg als Gesundheitsregion. Gesundheit bedeutet in diesem Zusammenhang mehr als die reine Medizin. Eine Gesundheit von morgen impliziert die Integration eines ganzheitlichen und sozial ausgerichteten Blickes auf Medizin und Heilung ganz im Sinne der Nachhaltigkeitsziele der Vereinten Nationen. Wesentlich ist aber auch, dass Innovationen und die Wirtschaft als treibende Kräfte der Gesundheitsregion betrachtet werden. Mit Beiträgen von Bernadette Klapper, Patricia Hänel, Christopher Baum, Christof von Kalle, Ulrich Frei, Annette Grüters-Kieslich, Angelika Eggert et al.:
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Gesundheitsstadt Berlin: Wir brauchen ein vernetztes ambulantes und stationäres Versorgungssystem
(2021)
Beitrag zum Denkanstoß 8 „Gesundheitsregion Berlin-Brandenburg“
Die Beiträge zum Denkanstoß 8 „Gesundheitsregion Berlin-Brandenburg“ bilden die Grundlage für die in dem Denkanstoß veröffentlichten Empfehlungen für die Gestaltung der Metropolregion Berlin-Brandenburg als Gesundheitsregion. Gesundheit bedeutet in diesem Zusammenhang mehr als die reine Medizin. Eine Gesundheit von morgen impliziert die Integration eines ganzheitlichen und sozial ausgerichteten Blickes auf Medizin und Heilung ganz im Sinne der Nachhaltigkeitsziele der Vereinten Nationen. Wesentlich ist aber auch, dass Innovationen und die Wirtschaft als treibende Kräfte der Gesundheitsregion betrachtet werden. Mit Beiträgen von Bernadette Klapper, Patricia Hänel, Christopher Baum, Christof von Kalle, Ulrich Frei, Annette Grüters-Kieslich, Angelika Eggert et al.
Beitrag zum Denkanstoß 8 „Gesundheitsregion Berlin-Brandenburg“
Die Beiträge zum Denkanstoß 8 „Gesundheitsregion Berlin-Brandenburg“ bilden die Grundlage für die in dem Denkanstoß veröffentlichten Empfehlungen für die Gestaltung der Metropolregion Berlin-Brandenburg als Gesundheitsregion. Gesundheit bedeutet in diesem Zusammenhang mehr als die reine Medizin. Eine Gesundheit von morgen impliziert die Integration eines ganzheitlichen und sozial ausgerichteten Blickes auf Medizin und Heilung ganz im Sinne der Nachhaltigkeitsziele der Vereinten Nationen. Wesentlich ist aber auch, dass Innovationen und die Wirtschaft als treibende Kräfte der Gesundheitsregion betrachtet werden. Mit Beiträgen von Bernadette Klapper, Patricia Hänel, Christopher Baum, Christof von Kalle, Ulrich Frei, Annette Grüters-Kieslich, Angelika Eggert et al.
Ich stand im Badezimmer und hatte plötzlich das Gefühl, doppelt zu sehen. Beunruhigt ging ich zum Arzt, der mich gleich in die Klinik weiterleitete: Ich hatte einen kurzen Schlaganfall erlitten, dessen Folgen anschließend nicht mehr festgestellt werden konnten. Was die Ärzte bei den Tests aber sehr wohl sahen: Mein Blutdruck war erhöht, wenn auch nur leicht. Und das, obwohl ich mich doch einmal pro Woche im Sportverein fit hielt. Aber es reichte nicht, das wurde mir klar. Und ich beschloss, etwas zu ändern.
Body Resonance: On the Neophenomenological Concept of Health. In contemporary philosophy, one can observe a trend of reorientation towards the (living) body (Leib), thereby declaring it a relevant topic of philosophical thinking. In this article, the so-called New Phenomenology will be discussed as an approach that aims to overcome the ignorance of health in Western philosophy. Following the ideas of Hermann Schmitz, the founder of New Phenomenology, the author introduces the concept of body resonance (Leibesgestimmtheit). In addition, some therapeutic tendencies within the neophenomenological scene are presented.