complexity – Causality, Complexity and Evidence in Health Sciences

Toward a just mental health service

by Rolf Sundet

Rolf is Specialist in clinical psychology and Professor Emeritus, University of South-Eastern Norway, Faculty of Health and Social Sciences, Department of Health, Social and Welfare Studies, Centre for Mental Health and Substance Abuse.

In June 1972 I got off the bus outside the village of Lier, Norway, slowly walking towards the regional mental hospital. I was 18 years old with both anxiety and tense expectation about this new experience; working as a nursing assistant in a mental hospital. I was received by the nursing principal who informed me that I was to work on Ward 23. I was sent on a round to get my nursing assistant uniform, keys and a place to stay. My living quarters was in a house named the House of Brothers.

WHAT NEXT? Reality-testing systemic resistance towards treating the whole person, the unique patient

Brian Broom, immunologist, psychotherapist and CauseHealth senior advisor

Most Western clinicians who pursue a person-centred approach to physical illness experience significant resistance from colleagues and health institutions. At first glance this may seem strange. Wouldn’t everybody want to be person-centred and oriented to the unique patient? Isn’t it obvious that the appearance and development of disease is commonly multi-causal and multidimensional? Surely anyone can see that disease is a manifestation or representation within, and of, the ‘whole’, whether that ‘whole’ is the presenting individual, or a bigger ‘whole’, such as family or culture. But life is not so simple. (This blog post is an extract. Read the long text here.)

Complexity; simplified – A video chat on the complex patient, causation, and manual therapy with Walt Fritz, Stephen King and Rani Lill Anjum

The video chat was recorded by Stephen King, co-founder of Vocal Health Education, and appears in the second tier qualification they offer; The Vocal Health Practitioner. Watch the video on physical therapist Walt Fritz‘s website, Foundations in Manual Therapy – Science Informed Manual Therapy Education, where he also offers a range of educational resources on patient centred manual care.

What’s in a word? It’s all Biopsychosocial, and a part of the complex human “ecosystem”

by David Poulter

There is still a lot of confusion regarding the word “biopsychosocial”. Yes it’s a compound word made up of three other words Biological (physical), Psychological (of the mind) and Social (of the environment). The trouble is that just like the word biopsychosocial is all one, so are humans.

Living with complexity and big data. Causal dispositionalim enters pharmacovigilance

Ralph Edwards on dispositionalism in pharmacovigilance

We have seen a lot of interest in the CauseHealth approach and issues during these last years, especially among clinicians who see a need for a more person centered healthcare. Can this be useful also outside the clinic? Yes, according to senior medical advisor at the WHO Uppsala Monitoring Center for Drug Safety, Ralph Edwards. In a recent perspectives article in the UMC report, he argues that dispositionalism can be useful for dealing with complexity, individual variation and the patient’s unique context. Continue reading “Living with complexity and big data. Causal dispositionalim enters pharmacovigilance”

Capturing the Colour: Classification and its Consequences

Author Eivind Hasvik
(#5 in the Whole Person reflections series)

Gazing through my window, I’m enriched by a muted but beautiful December twilight-palette. The remains of autumn covered by a thin layer of snow. It’s said that every culture has its own sense of the different hues. I’m reading a beautiful passage in White by Kenya Hara about the traditional Japanese way of naming colours. Contrary to the modern way of categorizing a given spectrum of light, such as greens, magentas or yellows, it’s said that red, blue, white and black were the only basic colour adjectives in 8^th century Japan. The tradition was not to classify, but to describe and texturize, capturing the seasons and surroundings. This narrative heritage is beautifully documented in the book The traditional colours of Japan.

I’m imagining a metaphorical link from all this to the difficulties of describing experience—sensations, emotions, pain or pleasure. Continue reading “Capturing the Colour: Classification and its Consequences”

Imagination and its Companions

Author Brian Broom
(#1 of the Whole Person reflections series)

How is it possible to be whole person-oriented and still feel that our work is manageable? Surely, we can’t be all things to all people? Continue reading “Imagination and its Companions”

Thinking about guidelines

clock-lion — National Geographic Wild, Trafalgar Square in London, January 28, 2016.

On October 24, 2016, the CauseHealth crowd met with a small group of other philosophers, healthcare practitioners, and members of the guidelines community. We had a rousing discussion that lasted the whole day, with few pauses and enthusiastic participation from all in attendance. We talked about several issues with how guidelines are developed and implemented and how we thought philosophy could be relevant in solving those issues.

It is difficult to summarize the discussion in a few words—the topics were wide-ranging and participants shared complex ideas from multiple perspectives. I’m going to highlight here some of the themes that came up more than once, and to give an idea of where the group thought the discussion should go next.

Reductionism isn’t enough for public health

humanmachine2 — Chinese medical poster, 1933 (ref US NLM; image source here)

By Håkon Boman Andresen

The overarching goal of the public health sciences is to increase the population’s health. Society spends a lot of money each year on health research, which again is used to develop public policies and guidelines. However, is this causing the population to have better health? Continue reading “Reductionism isn’t enough for public health”

You’re History (Hasta la Vista, baby)

By Neil Maltby — author of the becomingmorehuman blog, a physiotherapist in the UK, and a CauseHealth collaborator

She seemed straight forward enough on assessment. 45yrs old. Sudden pain onset from a seemingly innocuous movement many years ago. Episodic but progressive back pain since. Almost full range of movement. No significant neurological, inflammatory, vascular or other suspicious signs. One thing did sit in my mind though. It was as I asked her to reach down to the floor. Continue reading “You’re History (Hasta la Vista, baby)”