Definitions of medicine, disease and health are some of the most complex and philosophically intriguing discussions one can have in a medical context. There seems to be no universal truth that can be applied to these terms, as each of them can be viewed subjectively through the viewpoint of value-based arguments or through objective, factual definitions.
The definition of disease through theories such as the biostatistical theory of health, health as well-being, etc. show that the definition of medicine is not entirely scientific, nor is it entirely value based. However, it is a complex and ever-changing mixture of the two, depending on the individual circumstances of how this argument is applied.
Firstly, the definition of medicine as the “curing people of diseases” can be scrutinised, which is often mentioned as the key defining point of medicine. It can be argued that this is not entirely correct, as there are fields of medicine where the aim of the practitioners is not necessarily to cure the patent of disease but mitigate and reduce the symptoms of that disease. For example, according to the WHO, palliative medicine “improves the quality of life of patients and that of their families.”. Furthermore, any form of symptomatic treatment for diseases, some which may be terminal and so deemed ‘incurable’, is proof that the sole aim of medicine cannot simply be to cure disease. In fact, we can redefine medicine as aiming to improve the quality of life of people with disease, and thus the practice of medicine takes on a more holistic approach. Therefore, we have already deconstructed the first assumption which is commonly stated with regards to the definition of medicine.
However, we have yet to define exactly what is meant by disease. For that we must take a closer look at two different theories of the definition of disease.
Firstly, we take the biostatistical theory of health, as put forward by Christopher Boorse who stated that “a disease is a dysfunction of a subsystem of the body.” Put simply, this theory states that disease is a failure (or dysfunction) of the parts of the body, to carry out functions to statistically ‘normal’ levels, dependent on the age, species, gender, and so on. On the face of it, this theory does make sense; for example, the parameters we use to diagnose high potassium/bilirubin/white blood cell levels in the blood, etc. are based on calculated ranges that are known to be accurately reflective of the statistical normal. However, a key weakness in this theory is that for certain recognised illnesses, a patient may have statistically normal biological indicators of health, for example: mental illnesses or phantom back pain. Therefore, this theory cannot be applied as a universal truth and we cannot define what a biological dysfunction is through scientific or statistical methods alone; hence, this seemingly supports the value-based argument.
The second theory is that of “health as well-being”, which has been aptly defined as “[bringing] values back into the assessment of health, without leaving facts behind.”. Here, well-being is dependent on an individual being able to achieve their ‘vital goals’, which are personalised for every person and are the conditions that must be achieved for a person’s minimal happiness. Therefore this theory seems to suggest that disease must be based on the values of a person, because the vital goals of a person are dependent on his/her values. And so we can argue that the definition of medicine must be more value-based. However, a key point is that although this theory relies heavily on the patient’s subjective view of their own health, that view can be heavily influenced by science, and how scientific methods are applied in the context of that disease. For example, a doctor must use scientific methods to diagnose and understand the cause of disease and decide on the treatment/s needed for that patient. This in turn will affect the patient’s vital goals, and how they predict the outcome of their illness; whether they presume they have a good prognosis is based on the advice of the doctor, which is in turn based on science. So even though the vital goals of a patient are entirely subjective, the way in which those vital goals are seen and adjusted are heavily influenced by science. Therefore, science is still a fundamental part of medicine, and we cannot say that medicine is not entirely scientific and based on values.
In conclusion, we can see how medicine cannot be defined as either completely scientific or completely value based and if we take either of these theories as absolute and try to apply them to all contexts of medicine, then, we will uncover a rabbit-hole of contradictions to these arguments. The key here is to view both theories as complementary, and not mutually exclusive. This allows us to understand that the value-laden definition of disease does not diminish the scientific aspect but instead serves as a way to support and make practical use of its scientific methods.
Medicine is thus based on the beautiful harmony between science that enables doctors to diagnose and treat physical illnesses, and the experiences and values of the patients that receive treatment for their illness, which may not have any outwardly physical manifestations, but cause distress and discomfort to the patient either way. Therefore, through whichever way you define disease, it is a complementary blend of scientific and ‘non-scientific’ that ultimately best fits the definition of medicine.
Children Under 5 to get Covid-19 Vaccine by Next Week
- The FDA’s outside vaccine advisers finally approved Moderna’s two-shot vaccine for children under age 5. The panel is also set to vote on whether Pfizer’s three-shot series is suitable and safe for this age group.
- This is the last remaining group in the US to get vaccinated and many outside experts agree that the benefits of Moderna’s COVID-19 vaccine outweigh the risks for children under 5. If all the regulatory steps are cleared, vaccines can be available by next week.
- Dr. Joy Portnoy of Children’s Hospital in Kansas City, MO, also a panel member, stated “there are so many parents who are absolutely desperate to get this vaccine and I think we owe it to them to give them a choice to have the vaccine if they want to.”
- FDA reviewers stated that both brands appear to be effective and safe for children as young as 6 months, and the most common side effects, which are fever and fatigue, appear to be less common than seen in adults.
- Although the two vaccines use the same technology, the shots have not been tested against one another.
- Once the FDA approves the shots, the CDC will decide on a formal recommendation. Pfizer’s vaccine will be available to children 6 months to 4 years, while Moderna’s vaccine will be for 6 months to 5 years.
- Pfizer’s shots are 1/10 of the adult dose, while Moderna’s shots are ¼ of the adult dose.
- Moderna is also seeking regulatory approval outside the US for younger children as well. 12 countries already vaccinate children under 5 with other brands.
Monkeypox could be sexually transmitted disease – WHO
Monkeypox virus is caused by skin to skin contact and may be a sexually transmitted disease, warns the World Health Organisation.
The World Health Organisation (WHO) has started its research on the reports that the monkeypox virus is present in the semen of patients.
This presents a possibility that monkeypox could be sexually transmitted from one patient to their partners.
It is reported that most cases are in men who have sexual relations with men.
The WHO has said that the main transmission of the rare disease is through close interpersonal contact.
In Italy and Germany, scientists say that they have detected viral DNA in semen for a small number of monkeypox patients. The virus found in the semen was capable of infecting another person.
The WHO monkeypox incident manager in Europe, Catherine Smallwood said during a press briefing “this may have been something that we were unaware of in this disease before.”
“We really need to focus on the most frequent mode of transmission and we clearly see that to be associated with skin to skin contact,” she added.
The monkeypox outbreak is now considered a global outbreak. In more than 30 countries there have been more than 1,600 with over 500 cases in the UK.
A vaccine of monkeypox is available and the WHO has recommended that close contacts and healthcare workers should be vaccinated first.
WHO’s regional director for Europe, Hans Kluge said “Europe remains the epicentre of this escalating outbreak, with 25 countries reporting more than 1,500 cases, or 85% of the global total.”
Regarding the race to stockpile vaccines, he added “once again, a ‘me first’ approach could lead to damaging consequences down the road.”
“I beseech governments to tackle monkeypox without repeating the mistakes of the pandemic – and keeping equity at the heart of all we do.”
In the current outbreak, so far no deaths have been reported. But experts warn that every year monkeypox causes deaths in some countries, where the disease exists as endemic.
The WHO is also considering changing the name of the Monkeypox virus. Consideration came after 30 scientists wrote letters to the WHO that it is not correct but rather discriminatory to give the name of the rare disease as African.
Some of the Scientists has suggested hMPXV as new name of the virus to address the “urgent need” for a “non-discriminatory and non-stigmatising” name for the virus.
Monkeypox: Something To Be ‘Concerned About’ Says Biden
On Sunday, President Joe Biden, in his first public comments on the disease, said that recent cases of monkeypox that have been identified in Europe and the United States were something “to be concerned about. It is a concern in that if it were to spread it would be consequential.”
During the President’s first trip to Asia he was asked about the disease as he spoke to reporters at Osan Air Base in South Korea – “They haven’t told me the level of exposure yet but it is something that everybody should be concerned about,” Biden said. As for the vaccine, Jake Sullivan, Biden’s national security adviser, told reporters that the United States has a supply of “vaccine that is relevant to treating monkeypox. We have vaccines available to be deployed for that purpose,” he said.
Monkeypox is a virus that originates in wild animals like rodents and primates, and occasionally jumps to people. Most human cases have been in central and west Africa, where the disease is endemic.
According to CDC’s website, Centers for Disease Control and Prevention, Monkeypox was first discovered in 1958 when two outbreaks of a pox-like disease occurred in colonies of monkeys kept for research, hence the name ‘monkeypox.’ The first human case of monkeypox was recorded in 1970 in the Democratic Republic of Congo during a period of intensified effort to eliminate smallpox. Since then monkeypox has been reported in humans in other central and western African countries.
A detailed investigation of the outbreak in Europe, including determining who the first patients were, is now critical, says Shabir Mahdi, a professor of vaccinology at the University of Witwatersrand in Johannesburg.
“We need to really understand how this first started and why the virus is now gaining traction. In Africa, there have been very controlled and infrequent outbreaks of monkeypox. If that’s now changing, we really need to understand why.”
WHO reports about 3,000 monkeypox cases a year in Nigeria. Oyewale Tomori, a virologist who formerly headed the Nigerian Academy of Science, said that outbreaks are usually in rural areas when people have close contact with infected rats and squirrels.
Monkeypox typically causes fever, chills, rash and lesions on the face or genitals. Luckily, to date, no one has died in the outbreak. The estimation by WHO suggests that the disease is fatal for up to one in 10 people. The infection typically lasts two to four weeks and usually clears up on its own.
Britain’s Health Security Agency reported 11 new monkeypox cases on Friday, saying “a notable proportion” of the infections in the U.K. and Europe have been in young men with no history of travel to Africa and who were gay, bisexual or had sex with men.
Dr Susan Hopkins, the Chief Medical Adviser for the U.K.’s Health Security Agency stated that “the evidence suggests that there may be transmission of the monkeypox virus in the community, spread by close contact. We are particularly urging men who are gay and bisexual to be aware of any unusual rashes or lesions and to contact a sexual health service without delay.”
Monkeypox spreads when someone comes into close contact with another person, animal or material infected with the virus. The virus can enter the body through broken skin, the respiratory tract or through the eyes, nose and mouth. Monkeypox is not generally considered a sexually transmitted disease, though it can be passed on during sex. Health authorities stress that we are not on the brink of a serious outbreak and the risks to the general public remain very low.
Oklahoma’s Anti-Abortion Bill: The Newest Development in the United States’ Abortion Controversy
This Thursday, Oklahoma legislators passed what many have deemed as the most restrictive bill banning abortions in the U.S. The bill prohibits all abortions, except those that are required to save the mother’s life or are the result of rape/incest. The draft law is likely to be ratified by the state governor, Kevin Stitt, and further limit abortion access in the state.
Oklahoma’s measure has garnered national attention for a multitude of reasons. For one, the bill bans abortions immediately after fertilization; this is in stark contrast to pro-abortion laws across the U.S., which permit abortions up to 24 weeks of pregnancy. In September 2021, Texas passed a similarly restrictive abortion law, but even that measure enables abortions up to six weeks of pregnancy. Moreover, the Oklahoma measure comes right after the recent Supreme Court leak draft, which shows that the majority of the court is in favor of overturning the landmark Roe v. Wade ruling. If Roe v. Wade is overturned — which could happen as soon as late June or early July — many U.S. states (including Oklahoma) stand poised to immediately prohibit access to abortions.
Oklahoma’s bill, along with the SCOTUS leak, highlights how abortion rights in the U.S. are contingent upon the 1973 Roe v. Wade ruling and subject to change suddenly. Indeed, the recent discussions surrounding abortion shed light on the American judicial system and how volatile landmark rulings can be. Looking ahead, Americans must see whether or not the Supreme Court overturns Roe v. Wade. If so, abortion laws across the country will change drastically, and Americans will have to familiarize themselves with dozens of new laws and restrictions. If not, the legal systems of the U.S. will have been examined and questioned nonetheless.
A Monkeypox Outbreak has Been Detected in Europe, Canada, and Now the US
- There is a monkeypox outbreak in Europe and North America, with 8 reported cases in England, 20 in Portugal, a few in Canada, and one case in the US. What’s concerning is that the virus is possibly spreading throughout the community undetected and no one knows exactly where and how people are acquiring the infection.
- Monkeypox can cause fever, body aches, enlarged lymph nodes, and eventually painful and fluid-filled blisters called “pox” on the face and extremities. Although monkeypox can be deadly, the version of monkeypox currently in England is milder, with a fatality rate of 1%, and can usually resolve in 2-4 weeks.
- Person-to-person transmission is very uncommon, as it requires one to have close contact with bodily fluids, such as saliva or pus from lesions, and is more commonly transmitted from animals in Africa and then imported to other countries. However, 7 of the 8 cases in the UK did not involve recent travel to Africa, nor had they had contact with the 1 patient who had traveled to Nigeria. The one patient in Massachusetts hadn’t traveled to any countries that had an outbreak, but had traveled to Canada.
- Much evidence is suggesting that the disease is being transmitted through a new route, sexual contact, and particularly men who are gay or bisexual have been warned to be aware of any rashes or lesions, and to contact health service immediatley.
- Monkeypox is closely related to smallpox but isn’t as transmissible between people. The smallpox vaccine, which was approved in 2019 by the FDA, is about 85% effective, and after the world eradicated smallpox, countries stopped vaccinating children, and so now there’s a growing population of people who don’t have immunity to monkeypox, which means an outbreak could now involve dozens of people instead of just 1-2 cases. This virus can become more transmissible and there is a possible chance of a global threat, like COVID-19.
Baby Formula Shortage: White House Announces it Will Try to Increase the Supply of Formula, But No Quick Relief in Sight
After a voluntary recall of several lines of powdered formula in February, the country’s largest manufacturer of infant formula, Abbott Nutrition had to close its plant in Sturgis, Michigan, USA because of concerns about bacterial contamination after four infants became sick – of whom two died.
The shortage has the potential to impact many children across the country. Only about a quarter of infants born in the U.S. in 2017 were fed exclusively through breastfeeding in their first six months, the Centers for Disease Control and Prevention reported.
On Thursday, The White House said it had taken steps to address the shortage, “including working with other infant formula manufacturers to increase production, expediting the import of infant formula from abroad, and calling on both online and in-store retailers to establish purchasing limits to prevent the possibility of hoarding.”
The White House announced additional steps it will take to solve the issue of baby formula shortage. Listing Mexico, Chile, Ireland and the Netherlands as the key sources of such imports, the administration said that in the coming days, the Food and Drug Administration will announce that the United States will begin importing more formula from these countries.
The President said that had they been “better mind readers,” they could have acted on the shortage earlier. Margaret Brennan from CBS pressed Transportation Secretary Pete Buttigieg about the ongoing baby formula shortage on Sunday quoting President Biden’s comments from May 13 – “I know the president said more action is coming, but this has been ongoing for months. There were supply chain issues already, then you have issues with this one plant, Abbott. Whistleblower in September, February the recall. It’s May, why has it taken so long and why did the president on Friday seem to say it was new information to him?”
Buttegieg replied that America was a “capitalist country” and that “the government does not make baby formula, nor should it. Companies make formula.”
“This issue has been compounded by supply chain challenges, product recalls and historic inflation,” Datasembly CEO Ben Reich said in a statement.
White House says they’re unsure when parents could see relief. For the past three months, Chloe Banks and her husband have been struggling to buy formula for their 11-month-old son, Teddy. “It’s incredibly stressful,” she told NPR. “It’s endless, where you don’t know where your next can of formula is going to come from.”
Perhaps, the benefits of breastfeeding need to be encouraged – albeit it’s a mother’s personal choice to do so, and in many cases formula remains the only option to feed the baby, but the long-term health benefits must be emphasized for those that are capable. The government should incentivize breastfeeding, especially at the current moment whilst facing a national shortage crisis on baby formula.
“Breastfeeding provides unmatched health benefits for babies and mothers. It is the clinical gold standard for infant feeding and nutrition, with breast milk uniquely tailored to meet the health needs of a growing baby. We must do more to create supportive and safe environments for mothers who choose to breastfeed.”
Dr. Ruth Petersen, director of CDC’s Division of Nutrition, Physical Activity, and Obesity –
While Spain allows women medical leave who experience severe menstrual pain, in the United States women face a lot of stress returning back to work due to short-term maternity leave. The added burden on new mothers to go back into the workforce without fully bonding with their baby and the lack of healing from postpartum disorders, makes for a very regressive society – whereas European countries offer long-term maternity leave with medical benefits and mental health support. This shows how the American government is light years behind Europe’s maternity care. If a European country can progress into understanding the many challenges women face due to menstrual pain, then surely, the American government can perhaps get out of its capitalist mindset and start looking into more holistic approaches in bringing change to women’s health.
Alas, that might take another era to resolve as right now we’re unfortunately trying to retrieve baby formula to help our babies survive.
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