Acting as a health policymaker, expert in ethics, can you generate an ethical framework for health policies?


Prompt: Acting as a health policymaker, expert in ethics, can you create an ethical framework for health policies?

Attempt 1

https://chatgpt.com/share/6740a452-3340-800d-8e34-dfba82636492

Answer 1


Here’s an Ethical Framework for Health Policies designed for health policymakers to guide the creation, evaluation, and implementation of equitable and effective health policies:


Ethical Framework for Health Policies

1. Foundational Ethical Principles

  • Equity: Ensure fair access to health services, prioritizing the needs of marginalized and vulnerable populations.
  • Justice: Address social determinants of health and rectify systemic inequities in health systems.
  • Autonomy: Respect individual rights and cultural practices, enabling informed choices about health.
  • Beneficence: Aim to maximize health benefits for individuals and communities.
  • Non-Maleficence: Avoid causing harm, ensuring policies do not exacerbate inequalities or lead to unintended negative consequences.
  • Transparency: Maintain open and honest communication with stakeholders throughout policymaking and implementation processes.

2. Ethical Decision-Making Process

  • Stakeholder Engagement: Involve diverse groups (e.g., patients, healthcare professionals, community leaders) in the development and evaluation of policies.
  • Cultural Sensitivity: Integrate cultural values and Indigenous knowledge systems into policy design to ensure relevance and inclusivity.
  • Evidence-Based Practices: Base policies on reliable, up-to-date evidence while considering ethical implications of available data.
  • Impact Assessments: Analyze the potential ethical, social, and economic impacts of policies to minimize harm and maximize fairness.

3. Key Ethical Considerations

  • Health Equity Assessment: Evaluate who benefits and who is left behind; address disparities in health outcomes and resource distribution.
  • Accountability Mechanisms: Establish systems to monitor and evaluate the implementation and outcomes of policies, ensuring adherence to ethical standards.
  • Proportionality: Ensure the benefits of a policy justify any burdens or restrictions imposed.
  • Privacy and Data Protection: Safeguard personal health data and ensure its ethical use in decision-making.
  • Emergency Preparedness: Ensure policies account for ethical dilemmas in public health emergencies, such as resource allocation and mandatory interventions.

4. Implementation Guidelines

  • Inclusive Governance: Create advisory boards with representation from affected communities, ethical experts, and technical specialists.
  • Training and Education: Provide ethics training for policymakers and implementers to navigate complex ethical dilemmas.
  • Continuous Feedback: Establish channels for public feedback and policy adjustments to address unforeseen consequences.
  • Long-term Sustainability: Design policies to ensure sustainable health improvements while respecting environmental and economic constraints.

5. Monitoring and Evaluation

  • Develop metrics to measure:
    • Equity: Reduction in health disparities.
    • Effectiveness: Achievement of intended health outcomes.
    • Accountability: Adherence to ethical principles.
    • Stakeholder Satisfaction: Perceptions of fairness and inclusivity.
  • Regularly review and revise policies based on data, stakeholder input, and evolving ethical standards.

This framework integrates ethical rigor into the entire lifecycle of health policymaking, ensuring that policies not only improve health outcomes but also align with societal values and principles of justice.


Attempt 2

https://chatgpt.com/share/6740a452-3340-800d-8e34-dfba82636492

Answer 2

Here’s an Ethical Framework for Health Policies designed for health policymakers to guide the creation, evaluation, and implementation of equitable and effective health policies:


Ethical Framework for Health Policies

1. Foundational Ethical Principles

  • Equity: Ensure fair access to health services, prioritizing the needs of marginalized and vulnerable populations.
  • Justice: Address social determinants of health and rectify systemic inequities in health systems.
  • Autonomy: Respect individual rights and cultural practices, enabling informed choices about health.
  • Beneficence: Aim to maximize health benefits for individuals and communities.
  • Non-Maleficence: Avoid causing harm, ensuring policies do not exacerbate inequalities or lead to unintended negative consequences.
  • Transparency: Maintain open and honest communication with stakeholders throughout policymaking and implementation processes.

2. Ethical Decision-Making Process

  • Stakeholder Engagement: Involve diverse groups (e.g., patients, healthcare professionals, community leaders) in the development and evaluation of policies.
  • Cultural Sensitivity: Integrate cultural values and Indigenous knowledge systems into policy design to ensure relevance and inclusivity.
  • Evidence-Based Practices: Base policies on reliable, up-to-date evidence while considering ethical implications of available data.
  • Impact Assessments: Analyze the potential ethical, social, and economic impacts of policies to minimize harm and maximize fairness.

3. Key Ethical Considerations

  • Health Equity Assessment: Evaluate who benefits and who is left behind; address disparities in health outcomes and resource distribution.
  • Accountability Mechanisms: Establish systems to monitor and evaluate the implementation and outcomes of policies, ensuring adherence to ethical standards.
  • Proportionality: Ensure the benefits of a policy justify any burdens or restrictions imposed.
  • Privacy and Data Protection: Safeguard personal health data and ensure its ethical use in decision-making.
  • Emergency Preparedness: Ensure policies account for ethical dilemmas in public health emergencies, such as resource allocation and mandatory interventions.

4. Implementation Guidelines

  • Inclusive Governance: Create advisory boards with representation from affected communities, ethical experts, and technical specialists.
  • Training and Education: Provide ethics training for policymakers and implementers to navigate complex ethical dilemmas.
  • Continuous Feedback: Establish channels for public feedback and policy adjustments to address unforeseen consequences.
  • Long-term Sustainability: Design policies to ensure sustainable health improvements while respecting environmental and economic constraints.

5. Monitoring and Evaluation

  • Develop metrics to measure:
    • Equity: Reduction in health disparities.
    • Effectiveness: Achievement of intended health outcomes.
    • Accountability: Adherence to ethical principles.
    • Stakeholder Satisfaction: Perceptions of fairness and inclusivity.
  • Regularly review and revise policies based on data, stakeholder input, and evolving ethical standards.

This framework integrates ethical rigor into the entire lifecycle of health policymaking, ensuring that policies not only improve health outcomes but also align with societal values and principles of justice.

Attempt 3

https://chatgpt.com/share/6740a452-3340-800d-8e34-dfba82636492

Answer 3

Ethical Framework for Health Policies

This ethical framework is designed to guide health policymakers in creating, evaluating, and implementing health policies that are just, equitable, and culturally sensitive. It provides principles, indicators, and actionable strategies to ensure ethical integrity and public trust.


Core Principles

  1. Equity
    Ensure that health policies provide fair access to healthcare resources and address disparities among different population groups.
  2. Respect for Autonomy
    Acknowledge and respect individuals’ rights to make informed decisions about their health and well-being.
  3. Beneficence
    Promote actions that contribute to the well-being of individuals and communities.
  4. Non-Maleficence
    Avoid harm by ensuring policies do not unintentionally cause negative outcomes for any population.
  5. Cultural Sensitivity
    Incorporate the values, beliefs, and practices of diverse cultural groups, especially Indigenous and marginalized communities.
  6. Transparency and Accountability
    Foster open communication, stakeholder involvement, and mechanisms for holding policymakers accountable.
  7. Solidarity
    Encourage community collaboration and shared responsibility in health policymaking.
  8. Sustainability
    Create policies that consider long-term health outcomes and the responsible use of resources.

Key Components

  1. Stakeholder Engagement
    • Inclusion of diverse voices, particularly those of marginalized groups, in policy development and evaluation.
    • Establishment of advisory boards or councils with representatives from key communities.
  2. Evidence-Based Decision-Making
    • Use the best available data and research to inform policies.
    • Regularly update policies based on new findings and outcomes assessments.
  3. Ethical Deliberation
    • Conduct formal ethical assessments to identify and address potential dilemmas.
    • Incorporate frameworks such as the Four Principles of Biomedical Ethics or Virtue Ethics to analyze complex cases.
  4. Cultural Relevance
    • Engage with community leaders to understand traditional practices and integrate them appropriately.
    • Conduct cultural competency training for policymakers and implementers.
  5. Monitoring and Evaluation
    • Develop measurable indicators to assess the policy’s impact on health outcomes, equity, and public satisfaction.
    • Create mechanisms for continuous feedback and iterative improvement.

Indicators of Ethical Health Policy

  1. Equity
    • Reduction in health disparities across socioeconomic, geographic, and ethnic groups.
    • Proportional resource allocation based on need.
  2. Public Engagement
    • Percentage of policies developed with public consultation.
    • Representation of diverse stakeholders in decision-making processes.
  3. Outcomes
    • Improvement in health outcomes for vulnerable populations.
    • Satisfaction levels reported by beneficiaries.
  4. Transparency
    • Availability of clear, accessible information about policy goals, processes, and outcomes.
    • Mechanisms for public feedback and grievance redressal.
  5. Cultural Inclusion
    • Number of policies incorporating Indigenous and cultural health practices.
    • Surveys measuring cultural competence of policy implementation.

Implementation Strategies

  1. Develop Ethical Training Programs Train policymakers and healthcare professionals in ethics, cultural sensitivity, and stakeholder engagement.
  2. Build Inclusive Infrastructure Ensure policy development bodies are representative of the populations they serve.
  3. Establish Ethical Review Boards Create independent boards to evaluate policies for ethical compliance before implementation.
  4. Promote Community-Led Health Initiatives Empower local communities to lead health initiatives that align with their values and needs.
  5. Foster Global and Local Collaboration Partner with international organizations and local communities to align with global health standards while respecting local contexts.
  6. Ensure Accountability Mechanisms Implement clear, enforceable mechanisms for addressing ethical breaches and policy failures.

This ethical framework ensures that health policies are not only effective but also just and inclusive, contributing to better health outcomes and public trust.


Attempts 1, 2 and 3 condensed by ChatGPT

https://chatgpt.com/share/6740a452-3340-800d-8e34-dfba82636492

Unified Ethical Framework for Health Policies

Foundational Ethical Principles

  1. Equity
    • Ensure fair access to health services, prioritizing marginalized and vulnerable populations.
    • Address social determinants of health and rectify systemic inequities.
  2. Justice
    • Promote distributive, procedural, and restorative justice in health policy implementation.
    • Ensure fair resource allocation and inclusive participation in decision-making.
  3. Respect for Autonomy
    • Acknowledge individuals’ rights to make informed decisions about their health and well-being.
    • Ensure policies support informed consent, protecting against coercion and respecting cultural practices.
  4. Beneficence
    • Promote the well-being of individuals and communities through evidence-based and contextually relevant interventions.
    • Focus on maximizing health benefits and addressing broader social determinants of health.
  5. Non-Maleficence
    • Minimize harm by thoroughly assessing risks and implementing robust risk mitigation strategies.
    • Avoid policies that exacerbate health disparities or lead to unintended consequences.
  6. Transparency and Accountability
    • Foster open communication and maintain trust through transparent policymaking processes.
    • Implement accountability mechanisms such as audits, public reporting, and grievance redress systems.
  7. Solidarity
    • Recognize interdependence within communities and promote collective action to address shared health challenges.
    • Encourage community collaboration and shared responsibility in health policymaking.
  8. Cultural Sensitivity
    • Respect and integrate the values, beliefs, and practices of diverse cultural groups, especially Indigenous and marginalized communities.
    • Ensure health policies are linguistically and culturally accessible.
  9. Sustainability
    • Design policies with long-term health outcomes and responsible resource use in mind.
    • Develop scalable interventions adaptable to various regions and populations.

Core Components

1. Stakeholder Engagement

  • Actively involve diverse stakeholders, including patients, community representatives, health professionals, and policymakers, in all phases of health policy design and implementation.
  • Establish mechanisms for meaningful consultation with Indigenous communities and other marginalized groups to incorporate their knowledge and values.

2. Evidence-Based Decision-Making

  • Base policies on robust scientific evidence while considering local socio-cultural and economic contexts.
  • Regularly update policies based on emerging data and community feedback.

3. Cultural Relevance and Sensitivity

  • Engage with community leaders to understand traditional practices and integrate them into health policies.
  • Provide cultural competency training for policymakers and implementers to ensure relevance and inclusivity.

4. Transparency and Accountability

  • Share clear and accessible information about policy goals, processes, and outcomes with stakeholders.
  • Establish systems for public feedback, independent audits, and ethical review boards to ensure compliance and trust.

5. Sustainability and Scalability

  • Develop policies that prioritize long-term health improvements and sustainable resource use.
  • Design interventions that can be adapted and scaled across diverse populations and regions.

6. Ethical Impact Assessments

  • Conduct formal assessments to evaluate the ethical, social, and economic implications of proposed policies.
  • Use frameworks like the Four Principles of Biomedical Ethics or Virtue Ethics to address complex dilemmas.

Ethical Policy Development Process

1. Assessment

  • Identify and analyze health needs, disparities, and determinants within target populations.
  • Evaluate potential consequences of proposed policies through ethical impact assessments.

2. Policy Design

  • Develop policies aligned with foundational ethical principles and tailored to community needs.
  • Integrate equitable resource allocation mechanisms and prioritize the most vulnerable populations.

3. Implementation

  • Train health workers and policymakers on ethical standards, cultural competency, and stakeholder engagement.
  • Monitor policy rollout to ensure adherence to ethical principles and community expectations.

4. Evaluation

  • Use qualitative and quantitative methods to assess policy effectiveness, equity, and unintended consequences.
  • Incorporate continuous feedback from diverse stakeholders to refine and improve policies.

Indicators of Ethical Health Policy

  1. Equity
    • Reduction in health disparities across socioeconomic, geographic, and ethnic groups.
    • Proportional resource allocation based on identified community needs.
  2. Participation
    • Percentage of policies developed with public consultation and stakeholder involvement.
    • Representation of marginalized groups in decision-making processes.
  3. Transparency
    • Availability of accessible information about policy goals, processes, and outcomes.
    • Functioning mechanisms for public feedback and grievance resolution.
  4. Cultural Relevance
    • Number of policies incorporating Indigenous and cultural health practices.
    • Surveys measuring cultural competence in policy implementation.
  5. Outcome Effectiveness
    • Improvement in health outcomes, particularly for vulnerable populations.
    • Stakeholder satisfaction with health policies and their implementation.

Implementation Strategies

  1. Ethics Training Programs
    • Train policymakers and healthcare professionals in ethics, cultural sensitivity, and stakeholder engagement.
  2. Inclusive Governance
    • Establish advisory boards with representatives from affected communities, ethical experts, and technical specialists.
  3. Community-Led Health Initiatives
    • Empower local communities to design and lead health initiatives that align with their values and needs.
  4. Global and Local Collaboration
    • Partner with international organizations and local communities to align with global health standards while respecting local contexts.
  5. Accountability Mechanisms
    • Implement clear, enforceable systems to address ethical breaches and policy failures.
  6. Sustainable Practices
    • Incorporate environmental, economic, and social sustainability into policy development and implementation.

This unified ethical framework serves as a comprehensive guide to creating, implementing, and evaluating health policies that uphold justice, equity, and cultural sensitivity while promoting long-term health outcomes and public trust

On the Art of Peer-Editing

What constitutes a good peer review?

First impressions

As with many things in life, first impressions are always important. In peer editing, this is true in more ways than one. This does not mean that first impressions determine the value of the article, but they can give a first general idea of what might be found when reading the text. However, it is very important to know that, as in real life, first impressions can be misleading and not give a good picture of what is really happening in the text. I would say that feelings are not allowed at this stage because they can completely distort the final verdict for the article. So in that sense, first impressions are just a simple tool. This stage is the shortest. It’s just a first impression.

  1. The title. When the title is too broad or too vague, it could be expected to find objectives not very well defined. On the other hand, when the title is too complicated, it could be expected that the text will be complicated, because it could be a way of writing of the author.
  2. The structure of the article. With a quick look through the article we can understand a bit what the author is trying to do.
  3. Spelling. This may sound very trivial, but if there are big mistakes in the title, subtitles, or if it is obvious that there are many spelling mistakes that can be seen in a quick look, it means that the final version submitted for peer review has not been read carefully. This is not one of the most important things, but it gives the reviewer an idea that a very final revision was missing.

Abstract

The best way to understand what an article is about si reading the abstract. I think that reading the abstract gives you a very good idea of the article is about. However, it can happen that the author or authors were not able to summarize what they did. So it is important to continue reading and also avoid pre-judgements about the quality of the article.

Objective

If I had to choose where we find the core of the article is here, in the objective. I think we all have struggled with this in writing our final papers and all other pieces of writing. If the objective is not clear, then the whole text is just a mixture of good reflections, quotations and or citations, but not giving the reader that we hit the target.

From my experience in reviewing articles, if the article is not clear, then the whole structure of the text is not strong, the methods are too general, deal with too many things or are the wrong methods. Also, the discussion is a repetition of what other authors have said, and the conclusion is vague or too general. It could also be that the conclusion is again a citation of other authors’ work, but does not explain what this article really concludes. Sometimes conclusions are statements that could be applied to many other articles, that could be copied and pasted at the end of many other articles, and would fit perfectly.

So I think that being able to read, understand, and analyze objectives is the core of peer reviewing. And to do that, a good peer reviewer must also be a good writer, but a good writer who defines clear and concise objectives in his or her own papers. Otherwise, the task of peer reviewing would not be a good one.

Tips

I think that a peer reviewer can follow this tips to do good work:

  1. Have a first impression with a very quick look
  2. Read the abstract
  3. Go directly to the objective

At this stage it could be useful, before reading the whole paper, that the peer reviewer write down what they expect to find in that paper, based on the objective. This is a good way to see how the author could have developed the paper. It also helps the peer reviewer to be better trained on what objectives should look like.

4. Read the full article without making any written comments

Sometimes when I write comments during this first reading of the article, we question many things that are explained later, and usually I have to delete those initial comments. So it is better to have a general idea of the article and then make the written comments on the second and subsequent readings.

5. Be kind and respectful

Often we think we are right and that others are making mistakes. And sometimes peer review is seen as a judging task and not as a learning task. This does not mean that we cannot be as critical as we need to be and that the quality of the article is not being judged, but usually we think that we have a lot of power and therefore feel the right to be mean and make disrespectful comments to the authors.

The best thing for me is to make corrections to others as I would like others to do to me. Then we will find a balance between being a good reviewer and a good colleague who is also in a learning process. We’ll all be learning things until the last minute before we die!

6. Be concise

Our comments as peer reviewers should be as concise as possible. They should be fully understood. We cannot ask for clarity if we are not clear.

7. Be precise

It has to be clear where we are making the comment or the corrections in the text, and what we are correcting.

8. Be honest

I think that reviewers need to be honest with the editor of the journal and refuse to review articles that are beyond their expertise.


Finding the Collective Good: Public Health in Archaeology

Nobody wants to be sick, and we dedicate some time in our life to be healthy. However, even if we work on having good health or have healthy habits, there are also problems that affect us directly or indirectly. We had that experience during the COVID pandemic, some people were not as cautious as we were, or we were among those who were not so cautious on transmitting the virus to others. Well, these are problems of public health, because health-related problems from one person or a group of people can affect the whole population. In the case of COVID, it was not just in one country but worldwide.

Public health is made up of a set of policies that seek to guarantee the health of the population in an integrated manner through different actions directed to individuals and the community. The best way to guarantee people’s health is to work on prevention. However, this prevention goes in several directions, because health has been defined as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” (WHO, 1946). Every single person works, some much more than others, and takes actions to improve their health, but there are some things that cannot be improved if there is no cooperation with other members of the society.

This is why public health is so important and it is right now a discipline that is studied in many countries around the world and ministries of health spend large amounts of money and work on health policy making to prevent, manage and mitigate those problems, their causes, and their consequences. However, the most important thing in public health is work on prevention, because if we can prevent illnesses, then we do not have to work nor on management of the disease nor on dealing with the sequels and secondary effects.

The history of public health is interesting – it is the product of a community effort, and it usually requires some knowledge of the causative agent of disease to prevent its occurrence.  Therefore, it is important to be able to identify the emergence of the common good and public health activities, especially in the archaeological record, as the following case studies will demonstrate.

It is well known that public health began in the Middle Ages with the bubonic plague caused by Yersinia pestis, a bacterium commonly found in small mammals and their fleas. As European cities grew, rat populations flourished in the cities, harboring the disease, and ensuring the survival of the bacterium. From that moment on, two radical measures were created to prevent these diseases: quarantine and isolation (Shultz et al., 2024; Tognotti, 2013).

The spread of the Bubonic plague was directly related to the architecture of those cities where there was not proper sewage, and it was very easy to get contaminated with the disease. This is one example of how the study of architecture of the past can give us some clues on the public health of ancient societies (Gharipour et al., 2023).

Looking back further in the archeological record for evidence of public health is difficult, and findings are compounded by multiple factors.  Health treatments, especially those associated with traditional medicine, are associated with plants and animals, and this organic material is prone to rapid deterioration and may be absent in the archaeological record.  It can be difficult to assign changes in architecture to reasons of public health (did the community select a fast-moving waterway over a stale pond for health reasons, or because the specific waterway offered other advantages associated with its use?).  Assigning causality is especially difficult when considering cultures that were not aware of the causes of disease.  Finally, the traits of a site that are used to identify human habitation (size, concentration of people, the presence of specialized crafts and industries that may use toxic materials) may also indicate poor health conditions that must be balanced with public health measures to ensure survival and continuity of the site.  

As reported by Mitchell (2005), the earliest public sanitation dates from 2100 – 1600 BCE in Minoan civilization on Crete, and it was identified by the presence of toilet seats, sewage systems, and flushing using rainwater.  Later, Greek and Roman towns displayed public latrines with running water and ventilation.  Public health care practices appear to have emerged during the late Medieval period (1350-1550 CE) in Europe; for example, managing streets and gutters became more common (Coomans, 2021; Jorgensen, 2008), and these studies have provided clues on how to identify changes to architecture and urban planning as being associated with public health.

Addyman (1989) has examined these measures as applied at the town of York, England. The application of environmental archaeology to excavations at York have enabled studies to be made of the city’s layout, housing provision, food and water supply, effluent disposal, and environmental conditions over a span of some 2,000 years.  These factors have been compared to several thousand burials, allowing assessments of public health factors on longevity, stature, and the incidence of disease, stress, and trauma.  The results indicate that reasonably good public health at a Roman legionary fortress produced relatively fair-to-good- health levels, but did not alter longevity.  Different environmental conditions were present in Anglian York, and this was matched with poorer individual health.  The Viking time period was the worst from a public health perspective, and this was matched by overall poor health.  As York progressed into the Middle Ages, improvements in public health were matched by improvements to personal health.

Examining archaeological sites from the perspective of public health allows us to focus on the community’s response to disease.  The measures that were implemented to control specific diseases such as plague (isolated quarantine sites) and endemic levels of disease (latrines, sewage control, clean environmental conditions) demonstrate that even if people did not understand the specific causes of disease, they were willing to work towards a collective good, and that they recognized the impact of specific physical interventions towards public health.  Emergent technologies, especially molecular genetics that can more discreetly identify DNA and proteins from harmful organisms, may provide further evidence that even if people did not understand what, exactly, was causing disease, they possessed the knowledge and skills to work collectively to employ measures to protect public health.


As a collaborative approach, the two authors (R. Beggs and Carlos Rosas) first gathered information (recent reviews and publications) in the fields of environmental archaeology, health and public health history, and overviews of responses to the plague.  Information was reviewed, and used to create a possible outline for the blog posting.  When this was completed, the authors divided the blog in half, and each author wrote specifically to their part of the blog posting.  When this was completed, a “pause” of a day was made in order to provide a sense of “freshness” when reviewing and editing the text.  After the pause, the author’s reviewed each other’s writing.  In an iterative process, corrections and edits were made, and then the blog was posted.


References

Addyman, P. V. (1989). The Archaeology of Public Health at York, England. World Archaeology, 21(2), 244–264. http://www.jstor.org/stable/124911

Coomans, J. (2021). Community, urban health and environment in the late medieval Low Countries. Cambridge University Press.

Gharipour, M., Tchikine, A., & Inì, M. (2023). Architecture and Plague Prevention: The Development of Lazzaretti in Eighteenth-Century Mediterranean Cities. Salutogenic Urbanism, 83-123. https://doi.org/10.1007/978-981-19-7851-7_3

Jørgensen, D. (2008). Cooperative sanitation: Managing streets and gutters in late medieval England and Scandinavia. Technology and culture, 49(3), 547-567.

Shultz, J. M., Sullivan, L. M., & Galea, S. (2024). The Origins of Public Health. In J. M. Shultz, L. M. Sullivan, & S. Galea (Eds.), Public Health. An Introduction to the Science and Practice of Population Health (pp. 1-24). Springer Publishing Company, LLC.

Tognotti, E. (2013). Lessons from the History of Quarantine, from Plague to Influenza A. Emerging Infectious Diseases, 19(2), 254-259. https://doi.org/10.3201/eid1902.120312

World Health Organization (WHO). 1946. The Constitution of WHO. International Health Conference. New York, USA. 

When experience, preparation and fashion merge


The Speaker

Maggie Little is founder and Director of Ethics Lab, the Francis J. McNamara, Jr. Chair of Philosophy, and a Senior Research Scholar at the Kennedy Institute of Ethics, at Georgetown University. She is also a founding co-chair of the Tech and Society Initiative at Georgetown. Little oversees the growth of Ethics Lab’s work on campus, as well as among partners — from nonprofits to corporations to other academic institutions. She guides the focus of the Lab’s coursework on an annual basis, pushing her colleagues — and by extension, students — to examine the world’s most pressing, complex problems.


Experience

Giving a conference or a talk is always a challenge, but the more we are challenged, the more we have to practice. So after I do it many times, I’ll get experience in it. It is the same with many things in our lives. Speaking a foreign language is a matter of practice, practicing any sport, playing an instrument, making new friends, cooking, dancing, and so on.

What I see in this talk is that Dr. Little has a lot of experience in giving talks. I have seen many videos of her, and that is why I chose this video to talk about a good presentation. It’s true that this is similar to a TED talk, but what I find different is that it’s in a more academic setting.

He starts with an example of real life that grabs the attention of the students. Then, she develops the topic step by step. She starts giving simple arguments, but then she gives more elaborated ones.

I think she has a very good sense of movement on stage, she knows how to look at people – she even looks deep into the audience’s eyes – and she uses her hands and facial gestures to express herself.

I insist on the fact that she does not use any Power Point presentation. This is something that I really like. I think this is like 2000 years ago when people gathered in the “agoras” of Greek cities when people gathered to listen to speakers who had no visual aids and what attracted the audience was maybe their rhetoric and/or the topic they were talking about.


Preparation

Even if we can say that this talk was over-prepared, I think we can give Dr. Little credit for giving good talks.

She deals with very complicated topics in bioethics, and I think that her talks could be very controversial. But the way she talks motivates you to listen to everything she has to say to see how coherent she is. Even though I might not agree with some things, I think she makes very clear explanations of all the topics I have learned from her lectures. 

The first think that called my attention is that she does not need any visual aid. Well, the format of the talk could be like a TED talk where she does not need any visual aid, but all the speakers I’ve seen in TED talks use any kind of visual aid. So I think that in this case there is good management of time, space, movement, the content, the relation with the public, the use of the voice, sight, and hands movement.

Fashion

I’d like to say that today talks, especially TED talks, are part of a new way of making shows and presenting ourselves in society (“presentación en Sociedad” in Spanish). I remember my mother telling me that in Colombia, when girls reach their 15th birthday, they were “presented in society” in a very important party to which they invite the mayor of the town, the priest, the head doctor, the head of the military or the police, among other personalities. for some people their presentations at conferences are like their “presentación en Sociedad”. It is the time to show our new clothes, shoes, tattoos, jewelry, earrings, hats, hairstyle, hair color, socks, etc. This is not good not bad, just that it is the time of their show for many academics.

In this case, Dr. Little is very well dressed and also introduces a way of speaking, of giving presentations.

So, this point of fashion is very subjective, and we should be aware of that, because we can judge the speakers for any of those external things and forgetting to concentrate on what is essential (this could also be essential). Many academics could be even more concentrated on these external things that in the content of their talks.

In the end, I would say that in this case of Dr Little’s talk, fashion helped her to make her talk grab the attention of the public.



The good and the bad in writing


This paper asks whether there is a division between the local medicinal knowledge of the Indigenous Amazonian Tsimane ethnic group in Bolivia. This is the third largest ethnic group in the lowlands of the country. They conducted some interviews and surveys with a sample of this population to know how the Tsimane’ conceptualize and use local and Western forms of medicinal knowledge. They concluded that the two are complementary, not interchangeable. Both have value in their own right and need to be recognized as such, with equal weight given to each.

I think that this is a very good article for several reasons:

1.             The authors provided a very concise, detailed, and comprehensive background on the topic, citing relevant literature.

2.             The introduction is not too long.

3.             Due to the complexity of the work they have done, they added a section to describe their objectives.

4.             They gave a brief explanation of the ethnic group they worked with.

5.             They also gave details from that group about health, medical treatments, causes of illness, and use of medicine.

6.             They described the study site and sampling method, as well as the methods of data collection and how they were going to conduct the analysis of these data.

7.             They also mentioned the limitations of this methodology.

8.             They presented the results in a few subsections to separate them by topic.

9.             They made a not so long discussion, citing some relevant literature.

10.          They finished with a three-paragraph conclusion in your own words, citing only one other paper.

11. They used technical vocabulary, specific to their discipline, but simple enough to be understood by other people. For example, I am not an expert nor in Ethnobiology nor in Ethnomedicine, and I was able to understand the paper.

I cannot know what the authors where thinking about when they wrote this paper, but I would say that they could have had some of these criteria in mind:

  1. They thought about the reader. Their article should be readable, interesting, well explained, well organized and useful.
  2. They wanted that similar studies could be conducted following the same methodology.

This was not a discursive article, but a more scientific one. So there was a sequence of ideas in the sections that a standard article is written: introduction, objectives, methodology, results, discussion, and a conclusion. There was a smooth flow in the entire extension of the article.

Calvet-Mir, L., Reyes-García, V., & Tanner, S. (2008). Is there a divide between local medicinal knowledge and Western medicine? a case study among native Amazonians in Bolivia. Journal of Ethnobiology and Ethnomedicine, 4(1), 18. https://doi.org/10.1186/1746-4269-4-18


Second article

I cannot give a proper summary of this article because I do not understand well what the authors wanted to do. I think that their objective is very vague.

This was one article that I revised as a peer reviewer and my final verdict was that it should not be published. So, when I had to choose one bad article for our blog, I checked on my previous evaluations of the articles to see if this article was published. And it was! Therefore, I prefer not to give much detail about it. It has some improvements, from the version I made the revision, but it is still too vague and not adding much to the discussion about suffering.

In this paper the authors said that they defined “a space for reflection on the meaning of suffering, its correlate in clinical practice and a fundamental argument when proposing legislation related to the end of life”.

I would ask:

  1. What is a space for reflection.
  2. The meaning of suffering is a very complex topic. Therefore, defining a space for reflection, which is very vague, for the meaning of suffering, is something too broad.
  3. The correlation with clinical practice is also very vague.
  4. The “fundamental argument when proposing legislation related to the end of life” is not clear.

The authors included quotes from participants of research, but they do not mention if participants signed any informed consent or if they had approval from any research ethical committee.

Finally, the conclusion is very vague.

They just wrote that it was part of a PhD thesis, but I think that there is a lack of rigor of the journal for having accepted this article.

On the other hand, as reflection about suffering, it is a good one, I think. Then maybe I ask myself, if this journal publish scientific papers or good reflections about a particular topic or both.  

At this point, I raise the question of how many published articles are actually read in full. Academia is too focused on citations to evaluate researchers. This article may be cited many times because it has a very interesting quote, or one sentence might be very interesting and have many citations, but the paper itself does not add anything new and is not very well written. So I think our way of measuring the quality of researchers is flawed. We can just write papers with a few interesting sentences and reflections that might be widely quoted, but from an article that goes nowhere.

Knowing your audience


This study begins with the definition of health given by the World Health Organization (WHO) in 1946, which came into force in 1948 after the signature of an official document by 61 states. The WHO stated that “health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”. Having established this cornerstone of the definition of health, the author goes back to the so-called origins of Western medicine, traditionally attributed to Hippocrates and the school that continued to work on his thought and ideas of health and healing. He then describes the definitions or how health was conceived by some physicians in the Renaissance (XIV-XVIII centuries) and covering the XIX and XX centuries without much detail and ending with the definition of the WHO.

What I found in this article is that the topic described in the title “Historical evolution of the concept of health in Western medicine” is impossible to be covered in a single research paper. After reading the article, I think that the title does not give a clear objective. This is to me the most important thing that is lacking. Then, whatever the author states or explains could be interesting, but the reader does not know what the author wants by going through the history of the concept of health. I would say that he should have chosen only one aspect to analyze in this historical evolution and explain if there were changes or not.

The other problem I find is that since there was no clear objective, one can read some authors who gave definitions of health throughout history, but the readers can ask themselves: why did the author choose these authors and not others? Even more, it could be a bias because the author (with Italian surname) mentions two Italian doctors, two Germans, one French and all of them Europeans, but any American for example.

Since there is no clear objective, the conclusions are too general. But I also think it is a useful article for my final paper, because in a few pages I can have an overview of the concept of health, so I can learn from what the author describes, have more ideas on how to organize my paper, and continue to understand where I can contribute to the understanding of Western medicine when writing my paper.

The author is writing for an audience that could be interested in this topic and I think that publishing this article in this journal was a good choice.

Conti, A. A. (2018). Historical evolution of the concept of health in Western medicine. Acta Biomed, 89(3), 352-354.


In this article, the author describes what complementary and alternative medicine is. He gives a historical background, explaining that the adjectives complementary and alternative were used because there was an established or orthodox medicine that was a point of reference.  Then he gives the current definitions of complementary and alternative medicine and the debate that goes round this topic. He introduces the concepts “natural”, “soft”, and “holistic” as essential components of these two types of medicine. Having given this basis, he compares the two types of medicine with Western medicine.

I think that this research paper has a very solid structure, is readable and goes from a very clear objective to a conclusion that satisfies the reader (my personal opinion). However, one thing that I find quite confusing is that the author mentions in the title the term Western medicine but when he compares complementary and alternative medicine with “Western medicine” he uses the term “Evidence-based medicine”, but nowhere in the article he specifies that Evidence-based medicine is the same as Western medicine.

What I find interesting about this article is that the author assumes that the reader knows that evidence-based medicine and Western medicine are synonymous. However, this is one of my main arguments for the final paper. First, because sometimes we write papers assuming that readers know things that we are not sure about and can be very vague when writing. Second, because I think that in this case evidence-based medicine is a more appropriate term for what we know as western medicine than the term western medicine itself.

Having this in mind, I think that strictly I could not use this article to talk about Western medicine, but about evidence-based medicine.

This article is a chapter from the Handbook of the Philosophy of Medicine and in my opinion, the publication of this content in this book was very appropriate. This article gave the Handbook a broader perspective of what medicine could be.

Louhiala, P. (2017). Complementary and Alternative Medicine (CAM) and Its RelationshiptoWesternMedicine. In T. Schramme & S. Edwards (Eds.), Handbook of the Philosophy of Medicine. Springer.


This article is more the opinion of the author about what he thinks about Western medicine. He finds some literature to support the ideas he has and gives a detailed overview of what constitutes a chaos in Western medicine. The author is mainly worried about equity in healthcare around the world. He describes from his point of view how the medical profession and the system that qualifies doctors to be doctors acquired some kind of power in society and the effects of it.

My main critique to this article is that I think that this is another example of what I mentioned for the second article: one thing that I find quite confusing is that the author mentions in the title the term “Western medicine” but when he describes the chaos in “Western medicine” he uses the term “Orthodox medicine”, but nowhere in the article he specifies that “Orthodox medicine” is the same as “Western medicine”. At the beginning he mentioned “Western orthodox medicine”, but he did not explain that “Western orthodox medicine” is the same as “Orthodox medicine”.

What I also find difficult to understand in academia is when to take a more personal approach to a topic and when to write more academically. In this article, the author gives many of his personal thoughts without any quotes or evidence. He just mentions his thoughts. For example, he says: “It is often believed, from a background of religion, that a western doctor is a most important part of your life, as important as your religion”. But that is what he thinks. He does not cite any study to support this statement. The article was published in the Global Journal of Health Science, and it is assumed that the articles we can find in this journal are scientific. However, this article describes the author’s opinion rather than the results of scientific research.

What I find thought-provoking about these types of articles is that in this case the author is questioning the status quo of medicine and not many people will do that. I found this article very useful for my final paper and dissertation because in a way I am also questioning many things about how we take many things for granted and just act automatically without questioning them. The author is very concerned that there will be continued resistance to positive change to significantly improve global health status, and that scientific evidence will be very difficult to find.

After reading the scope of the journal, I think this article is in the right place. However, I would say again that it is a more scientific journal, and this article has more personal opinions than results obtained from research.

It does not mean that the article is not interesting, it is! And not useful, because it is! However, was it not supposed to give more scientific evidence to what he is saying in the article? I raise this question to the group.

Wilson, N. W. (2012). Chaos in Western Medicine: How Issues of Social-Professional Status are Undermining Our Health. Global Journal of Health Science, 4(6). https://doi.org/10.5539/gjhs.v4n6p1

Biomedicine and Anthropology

How they shake hands?

Brief summary

The authors present the relevance of the anthropological study of biomedicine. To do so, they describe some characteristics of biomedicine without going into much detail. What interests them is the anthropological analysis of biomedicine. They give several reasons to consider biomedicine as ethnomedicine and give some characteristics of biomedicine. They show that biomedicine has a very defined anthropological content, such as the division of labor as seen in medical specialties, the rules of practice, different roles, and means of socialization, to name a few. Among their conclusions, they insist that biomedicine is more than a pseudoscience than we can imagine.


“The central concern of Biomedicine is not general well-being, nor individual persons, nor simply their bodies, but their bodies in disease” (p. 312).

Overview

I would say that this is an article where the authors want to express their opinion on a particular topic and use the structure of a review to do so. This means that they justify each of their thoughts with background literature. This is one way of doing reviews, and I find it interesting. I have done it myself. I think there are some advantages, for example: you know what the authors think about a certain topic. Even if they quote or refer to previous publications, reading the article is a way of getting to know the author’s thinking. Another good thing is that in a very short article you can find an incredible amount of research, they referenced 197 articles, which I think is a lot. Another advantage is that the text is fluent and not difficult to read. It could be that these authors had the ability to write a good article, but I also think that this type of review is easy to read because you are following the authors’ thoughts and not just a summary of a review of 197 articles.

The main possible disadvantage is that the selection of articles is arbitrary, depending on what the authors want to say. They can talk about contrary opinions, that they could even choose the articles from the opposite argument as they wish. So, in that sense it is not a systematic review. But their aim was not to write a systematic review, and the reader has to be aware of that. Another disadvantage is that the reader can get lost in a sea of articles without having a clear idea of how the authors plan to proceed.

Structure

As mentioned before, in this kind of review you can understand what the authors think about a particular topic, but also how they organize their ideas. And I think this is a very well-structured article. They made a short introduction explaining what biomedicine is and immediately they described the importance of an anthropological analysis of biomedicine. In this analysis they covered several topics that were separated by subtitles. When they characterized biomedicine, they did it in two different ways, with their respective subtitles, and they always use numbers or letters to separate ideas or thoughts. So, I think in that sense the article is well structured. The conclusion is not so clear, but I think it was enough to understand her final thoughts on the subject. The lack of an abstract is something I really miss. This is an old article, from 1983, so abstracts were not very popular back then.

The authors’ approach

It was evident from the very beginning of the article that the authors did not want to go deep in the discussion of the misconceptions of biomedicine, something that I want to deal with in my final paper for our course. What they wanted to do is to show that anthropology has a lot to say about biomedicine and that biomedicine is more than just a technical discipline without any or just a little human component. It was clear that they wanted to be explicit about the value of medical anthropology and how the disciplines could be nurtured together.

Reviewers’ position

I think that the reviewers have a reconciling point of view. They mentioned the drawbacks of biomedicine and possible misconceptions or misunderstandings, but I did not have the feeling of rejecting biomedicine. The authors smoothly presented their point of view with abundant support of literature. It is evident that they have to choose a position and they strongly defend the role of anthropology and the value of an anthropological analysis. They mentioned several times some philosophical theories, such as Marxism or finalism. They could have mentioned others, but that was their position.

Strengths

The article shows the position of the authors. This position is very well documented. Their thoughts are recognizable. They added literal quotes when they found necessary and appropriate. They covered a topic that it is of great importance even today. They wrote their article with a critique position but not with criticism. They promoted the value of anthropology without making from the article an ode of anthropology.


“We propose that the development of anthropological ways of thought in Biomedical settings will enhance the science of Biomedicine and anthropology at the same time as it fosters a common humanity” (p. 327)


Reference

Hahn, R. A., & Kleinman, A. (1983). Biomedical Practice and Anthropological Theory: Frameworks and Directions. Annual review of anthropology., 12(1), 305-333. https://doi.org/10.1146/annurev.an.12.100183.001513

A war with many battles

My writing workflow

Writing about how we do things is not easy. We just do things in life and when we have to give account of them, it is a difficult task. Most of the time we do things almost automatically and because of that, we also make mistakes. Even though we learn a lot from our mistakes, I think that this exercise about our writing workflow is a good self-reflection activity.

I was thinking about how to write this post and the best way to explain to do it will be with an analogy. I had to go to the military service in Colombia for one year just after finishing high school. In some ways was a bad experience, but a final evaluation is very positive one. I think that describing an army and its duties will help me explain my writing workflow. As with many analogies, this is not perfect, and it could have negative connotations for some of you. So, I apologize in advance if anyone can feel uncomfortable with this analogy. I hope not.

An interesting experience in the Colombian National Army

  1. The big mission: I think that every army has a big mission, which could be defending its country. So, when I write, I think I always have a mission. It could be very general. For example, for the final assignment of this course, I thought about clarifying the concept of “Western medicine”. This is very broad, but after reading a lot of research papers and internet articles, I said: “This term is not precise, is equivocal, overgeneralizing”, I have to try to clarify it in its relation with Indigenous traditional medicine.
  • The army itself. Then, I ask myself: “Am I alone in doing this?” In some ways, “yes”, in other ways, “no”. I remember that when I was in the National Army, officers and soldiers were all the time saying: “You come alone to the Army, you leave alone the Army”. It was a very individualistic thought, but it was in part true, because it was very difficult to trust in anybody. Everyone acted according to their interests.

In writing, I sometimes have this feeling, “I come alone, I leave alone”. But the thing is that in the Army, you’re never alone, you’re always surround by people. And in writing is the same. I write for people. I’m not completely alone. Moreover, I also need help from other people to better develop my ideas, to discuss with someone about what I’m writing, and to accept corrections to improve the text. An Army works in some ways alone, but, in principle, fights for its country.

  • The weapons. I’d divide the weapons in two groups, internal and external. Internal weapons are personal skills, gifts, abilities, virtues: for example, intelligence, reflection capacity, amazement, curiosity, creativity, wisdom, will, discipline, order, commitment, responsibility, patience, resilience, flexibility, coherence, transparency, hope, etc. It doesn’t mean that I have 100% of all of these, but I think they are part of who we are and when we write, we can apply them, explicitly or implicitly.

The other group are external weapons. For example, time. If I do not have time, it will be impossible to write anything. A computer. I like writing on paper, but this is for my personal reflections at the end of the day or when I want to send someone a letter with a particular message. But for daily life, if I want to write a text, I need a computer, definitely! This could sound very simplistic, but it’s true. I also need a relatively comfortable chair and desk and a cup of coffee! As a typical Colombian, I like coffee. Besides, I’d say that I don’t need complete silence. Sometimes, a bit of noise of people chatting, help me write, for example at the Student Center at the university or in a not so crowded cafeteria.

  • The officers. Mentors and those who could take some time to read your work, are the equivalent of the officers in an army. I think I can start working on something without discussing it too much with someone, but I need some company and help during the process and especially when I have the drafts. I think I am open to comments from people. I am not very sensitive to those comments. What I think I need is that someone “destroys” your paper with a lot of comments, I would expect them to help me go the end of that. It’s like in a battle, if officers just tell you: “Solider, go to the battle and fight!” but they don’t go fighting, you have almost no motivation to go fighting. You can even die in the battlefield. Committed mentors are like high-ranked officers, like Generals, who go to fight with their soldiers.
  • My buddy or buddies. (In Spanish we say “mi lanza”, literally “my spear”. That was used t refer to your soldier partner). No soldier can survive if the soldier next to him is not keeping an eye on the other. This is hand rule in the Army. We need immediate support of one or two close people. In the writing workflow, it could be your boyfriend, girlfriend, partner, best friend. This is very important to me, because I need some kind of support especially when writing takes months. For short texts, I can survive alone. For small battles you can even go alone. However, for big battles, for long texts, I need so kind of external affective support. I need that.
  • The enemy. What blocks me in writing is when I think that I’m too different to people and that what I’m writing w0n’t be accepted.

  • The plan. When I write I do several things.
  1. The title. I write one possible title or several titles. This help me to see where I can go with that text. During the writing process, I can write 15 or more different titles.
  2. A mind map. I usually make a mind map on paper, trying to see where to put all the main concepts and ideas and how the are related.
  3. A table of contents. Then, I try to organize the order of the ideas in a table of contents at the beginning of the text. This helps me to see a logical order, to see the backbone of the text. I change the order several times until I have the best possible order and then I start working. But sometimes I just start working and, on the way, I change the order, because I see that I could better develop some ideas and not others.
  4. References. When I’m reading articles, I try to put quotations in each of the sections that I have created. I put them literally and during the writing process I can keep some of them literally, I paraphrase others, and others I keep just the general idea.
  5. Time to write. Even though I am not as those people who wait for the inspiration and perfect moment to write, I do look for at least 30 or 40 minutes to concentrate on writing. Then, I can have breaks to answer calls, messages or check emails, and then continue writing. I have found that I can have these breaks and I can deal with my daily life and commitments and have to for writing.
  6. Revision. I usually don’t wait to have the perfect draft to ask for feedback. Yesterday, I sent a third draft of my PhD research proposal to my supervisor, and I know it has a lot of work to be done, but then at least he knows what I’m working on and where I think I could get with my thesis. I think I was perfectionist before, but now I’m much more flexible.
  7. Final text. I think I’ve found a balance between perfectionism and academic production. I know that several drafts are needed to have a good product, but I also know that we have to define when to stop making changes. We’ll always find something to change.
  8. Publication. Many times I try to publish in a journal what I write. Since I have written mostly in Spanish, all the journals I have submitted articles to are from Latin America (LA) and Spain. I think that the experience of sending a paper for publication is a good one because you always have the feedback either from the editor and/or from the peer reviewers of the journal. So, you have at least one or two revisions of your text for free (at least in most of the journals in LA) and if things go well, your article is published.
  9. War and battles. The biggest war is my life and in this big war I have many battles to fight, and every battle is an article that I write. However, I also consider that every article is also a war, and the drafts are small battles.

The ideal thing would be to win the wars, to finish articles. Sometimes I lose some wars. I fight the war, that is, I write the text, but there is the possibility not to publish in the journal I want, for any reason. On other occasions, I win the war. I wrote an article, and it was published in the journal I wanted. However, there is always some gain, the reward of writing.

In conclusion, I feel that I’m fighting all the time, that I’m fighting many battles. Sometimes I lose the battle, but not the war. And even I lose the small wars I described, there is a big mission that pulls all this work up so that I can win the biggest war, which is my whole life.

Isn’t “Western” Medicine an overgeneralization?

Final work outline

“If we equip and empower communities to heal, to know and build their healing capacities, and to affirm communal obligations as part of the pursuit of good health -as Indigenous models suggest are possible- we would tap not only the strengths of a vibrant public health resource but also the potential healing and disease prevention that only strong communities can produce”
(Carolyn Smith-Morris, 2020)

For our course “Writing the Field” I want to work on a paper about the concept “Western medicine” as a problem of overgeneralization. The concept “Western medicine” has been used indistinctly and abundantly without considering how imprecise and equivocal is.

Is “Western” the most appropriate adjective to describe what the authors are trying to refer to? I think not. There are countries that follow the same patterns of “Western” thinking that she describes that are not in the West. These authors are overgeneralizing by using the adjective “Western.

Thus, one important point will be talking about the fallacy and cognitive distortion called overgeneralization. This distortion of thought consists of drawing a general conclusion from a single particular fact without sufficient basis. For example, a person who looks for a job and does not find it and concludes: “I will never get a job.” Another person who feels sad and thinks: “I will always be like this.”

It may even be unfair to say “Western” and imply that “Western” refers to non-indigenous thinking, because Western countries also include Guatemala and Bolivia, where indigenous people make up more than 40% of the population. I think the big conceptual gap is that the term “Western” is not very well defined.

Another problem is that by opposing “Western” one might conclude that “Eastern” is the solution to the problems authors describe. However, is that what researchers and academicians want to say when they use the concept “Western medicine”?

To contribute to a clarification of this concept I will write a paper that contains the following sections:

  1. What has been referred to as “Western” medicine?
  2. “Western medicine as opposed to “Eastern medicine” or what?
  3. Marginalization: unfair competition against Indigenous knowledge

To do this, I have set some deadlines:

Introduction                      :                 February 4

First section                        :                 February 13      

Second section                :                 February 27

Third section                     :                 March 12

Conclusion                          :                 March 19


My working abstract will be:

Abstract. Is “Western medicine” the most appropriate adjective to describe what contemporary researchers are trying to refer to? Perhaps not. What do researchers and academics mean when they use the term “Western medicine”? Is “Eastern medicine” the opposite? There are countries that follow the same patterns of “Western” thinking that they describe that are not in the West. It may even be unfair to say “Western medicine” and imply that “Western” refers to non-indigenous thinking. However, there are two countries in the West, Guatemala and Bolivia, where indigenous people make up more than 40% of the population. Therefore, the term “Western medicine” has been used vaguely and abundantly without considering how imprecise and ambiguous it is. There is a problem of overgeneralization, which is the fallacy and cognitive distortion called overgeneralization. This distortion of thought consists of drawing a general conclusion from a single particular fact without sufficient basis. For example, a person who looks for a job and does not find one and concludes: “I will never get a job. Another person who feels sad and thinks: “I will always be this way. A Google search for “Western medicine” shows 9,860,000 results (January 30, 2024), which shows how widespread this term is. So in this study we want to answer the question: What is the problem with the term “Western medicine”?  In this study we will not analyze the possible shortcomings of the practice of “Western medicine”, but the use of the term. To do so, we will examine what has been called “Western medicine,” describe the possible opposites of “Western medicine,” and explain how the use of this term has contributed to the marginalization of indigenous traditional medicine.

Keywords: Western medicine, Traditional Medicine, Indigenous, Biomedical medicine, Healing, Health

Who am I?

My name is Carlos Rosas. I’m originally from Colombia and I have done a lot of social work. My interest in vulnerable populations goes back to 2003 when I started working with people in very poor conditions in Bogotá, Colombia. These people were unemployed because they were working making artisanal bricks for construction, and their factories were closed by the government because the levels of pollution of this production were very high and extremely harmful for the families working there.

I started working as Social Project Manager and in the following years I had the opportunity to mission trips to develop different programs of health promotion and prevention and integral formation. For example, in 2007, I lived for one week in Usicayos, Puno, Perú at 3750 meters above sea level with a Quechua population. Then, between 2012 and 2017, I traveled to several rural places close to Cali, Colombia. Several years later, in 2017, I was allowed to stay for one week in the house of a family from the Embera-Chamí indigenous community in Antioquia, Colombia. Then, I stayed in Bogotá, Colombia, working for five years on the prevention of sexual abuse of children as a facilitator and consultant.

From the mission trips, the stays with Indigenous peoples, the work with people from rural areas in Colombia and Perú, I learned how to talk to them, ask questions, listen to them and be close to them. I think that having contact with people is very important to me and this has shaped my personal, academic, and professional life in several ways. I have always been amazed about the human beings in all their dimensions, physical, psychological, social, and even spiritual. That is what I have bachelors in biology, philosophy and theology. Then, my master and PhD are in global health because I am very interested to evidence how health in the global sphere should be understood as “holistic health” which includes all those dimensions of human life.

Regarding to writing, before starting my PhD I worked as an Assistant Editor and Journalist at an International charity in Germany. I published some articles with a more journalistic style, but before that, I published reflections and book reviews about many different topics, mainly in Spanish. Now, I want to start writing in English and improve it. I think that this process will lead me not only to write well in English, but also to improve my writing skills in general. Some issues I still struggle with are:

  1. To use a more rich and assertive vocabulary.
  2. To be able to use both, a scientific and a more informal way of writing to share scientific knowledge and deep reflections to the general public.
  3. To learn how to make my writing more attractive and clearer.
  4. To improve my peer reviewer and editor skills.
  5. To learn to take more risks in writing. 
  6. To be able to translate a whole course about the prevention of sexual abuse of children that I have in Spanish.