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This article offers a revision of the history of Vincent de Gournay's neologism bureaucracy. The author shows that it was designed as a polemical tool against a tendency to multiply customs, tax-collecting and controlling bureaus, which "strangled commerce" in France. The origin of the term had more to do with the pre-physiocratic theory of liberal economy than with political philosophy.
View Article and Find Full Text PDFIs the NHS willing to help clinicians and patients reduce uncertainties about the effects of treatments?
Clin Med (Lond)
October 2005
Dermatology Centre, Hope Hospital, Salford, Manchester.
Uncertainty is an inevitable component of clinical practice. Clinicians have a responsibility to minimise it by keeping up-to-date with current knowledge: but what is the responsibility of individual clinicians in reducing collective uncertainty? In all fields of medicine there are important questions relevant to both patients and clinicians, which can be answered only by clinical research. Unfortunately, much of the clinical research that attracts funding does not address the questions that both patients and clinicians regard as important.
View Article and Find Full Text PDFThe challenge of palliative care.
Int J Clin Oncol
August 2002
Sir Michael Sobell House, Churchill Hospital, Oxford, OX3 7LJ, UK.
Palliative care is patient-centered, rather than disease-focused; accepts the inevitability of death while simultaneously is life-affirming; addresses psychological, social, and spiritual concerns as well as physical ones; and is best delivered by a multiprofessional team working in partnership with patients and their families. Palliative care stresses the importance of "appropriate treatment" and the need for doctors not to prescribe a lingering death. Even though there is no chance of cure, there is much scope for psychosocial and spiritual healing, and often some scope for physical rehabilitation.
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