Have changes in the context of doctors' work altered the concept of the professional in medicine?

There is clearly current interest in the subject of doctors as professionals. Many other bodies look towards medicine for a definition of a professional. The term 'professional' is not easy to define but appears to include the concepts of a body of specialized knowledge and skill, autonomy, trust, responsibility and integrity, serving society, direct interaction with clients, duty to speak with authority and a licence to practise. This paper reflects on the changes in doctors' work, looking for any alteration in the concept of a professional. There have been significant recent changes in the context of medical work; medicine has suffered much bad publicity. In addition there have been major changes to the regulatory council and there have also been fundamental registration changes, including the revalidation of registration. The government has made substantial changes involving performance targets and management. In addition, patient power has been enhanced. This paper contends that there has been little change in the professional role of medical practitioners; this lack of change assists with defining the whole concept of a professional. The professional role appears to include elements of specialized knowledge, a service ethic and critical evaluation, but there are traits of personality within the concept. The paper concludes with the realization that a definition of a professional is both difficult and continually changing. There are important implications from this paper for other groups that seek to be professionals. Certainly, any such group needs to convince others that this title should indeed be used.     

Blood and expertise: the trials of the female medical expert in the ancien-régime courtroom

This article explores the obstacles faced by the female medical expert in the early modern courtroom through a close reading of three case studies: Marie Garnier, expert midwife tried for false testimony in 1665, and Angélique Perrotin and Barbe-Fran?oise D'Igard, accused of false accusation of rape and infant substitution, respectively, in the 1730s. The difficulties of determining the veracity of the corporeal signs of a crime were particularly acute with regard to the reproductive female body, which was perceived to be less reliable than its male counterpart. The ability of the female medical expert to accurately and truthfully interpret such signs was also questionable, and at times she seems to have been as much "on trial" as the bodies of those she examined.     

How strong is the case for the adoption of problem-based learning in physiotherapy education in the United Kingdom?

Despite its use in medical and health education in several countries, problem-based learning (PBL) has to date not been adopted in undergraduate physiotherapy education in the UK. Most of these physiotherapy curricula incorporate many of the educationally desirable features found in PBL. The question is whether the evidence for PBL is strong enough to justify the costs involved in adopting it on such programmes. The strength of the evidence for PBL was reviewed in relation to required graduate attributes and several aspects of learning theory. Overall the findings were equivocal. The evidence suggests that PBL is preferential to traditional curricular design, but does not seem to meet all the requirements of medical and health education. Adoption of PBL would be positive, but its processes and outcomes may be no more successful than those of other curricular designs that incorporate the same sound educational design features. Comparative research in this area is needed.     

Is Suffering the Enemy?

The relief of suffering is the great goal of medicine. That physicians give up on suffering when they can do nothing about the underlying condition is one of the contemporary criticisms of medicine. Yet even in irremediable suffering there is something noble, to which physicians should attend.     

Reassessing the Three Rs?

In recent years, the established paradigm of the three Rs of animal research—refinement, replacement, and reduction—has come under scrutiny. A crucial weakness in use of the three Rs is uncertainty about how they should be prioritized. Events like pandemics have the power to alter the research landscape, fast-tracking innovation and setting new precedents. Existential threats can raise perceptions of social benefit and can lower animal-welfare thresholds. The rush to develop new research models may also undermine progress in reducing or replacing animal models. By circumventing the barrier posed by animal models that are poorly matched to human conditions, new technologies like CRISPR can enhance the refinement component while undermining reduction and replacement. This pandemic has exposed the need for an urgent review of the efficacy of the three Rs, with the potential to establish a new set of protocols for animal research, both inside and beyond the context of an emergency.     

Beginning, formative power and intellect agent of Nicolò Leoniceno between the Arabic-Latin tradition and the rebirth of the Greek commentators

The treatise On Formative Power (Venice, 1506) of Ferrara's emblematic medical humanist, Nicolò Leoniceno (1428-1524), is the one of the first embryological monographs of the Renaissance. It shows, at the same time, the continuity of medieval Arabo-Latin tradition and the new elements brought by Renaissance medical humanism, namely through the use of the ancient Greek commentators of Aristotle like Simplicius. Thus this treatise stands at the crossroad of these two currents. The present study analyses the range of Leoniceno's philosophical discussion, determines its exact sources and brings to light premises for the early modern development of the concept of formative force, which will end up in the theory of "plastic nature" at the heart of the Scientific Revolution.     

Whither the Affordable Care Act?

The U.S. Supreme Court has likely already decided how much, if any, of President Obama's signature Affordable Care Act it is going to strike down as unconstitutional; its holding will be published this summer. No matter what the Court decides, though, it will send state and federal legislators scrambling—either to implement the law or to deal with the consequences of its alteration. There are various decisions the Court might make, but it is still most apt either to leave the ACA standing, or to selectively invalidate some of its mandate‐related provisions. In either case, there will be exchanges to design and manage, subsidies to allocate, transparency standards to design and enforce. The Court's decision will thus mark the beginning, not the end, of health reform.