The pertinence of an analysis like this is if you look at real-world registry-based data, you find a therapeutic nihilism
that's highly prevalent in CKD patients, where many patients who might benefit are not provided with revascularization therapy.
Lee Schwamm, a neurologist at Massachusetts General Hospital, recently said the controversy "underscores the continued therapeutic nihilism
that surrounds acute stroke."
If we think that P4's consequence is the refusal of any action in presence of doubt (in dubio abstine), or in the absence of evidence, we must also consider the risk of therapeutic nihilism
(9): to let the patient without support.
(4) This is not therapeutic nihilism
! Doing nothing, especially in the context of Primum non nocere, is an art form and takes courage.
Kenny's practice was, as Rogers points out, "optimistic, energetic and patient-centered"--in contrast to what many observers saw as the therapeutic nihilism
of the orthodox approach.
Organ Transplantation, Managed HealthCare, Rationing services within limited resources, Futility of treatment, Therapeutic Nihilism
, Care of the elderly and Quality of Life issues, Assisted life prolongation, End of life issues, DNR, Palliative care, Discreet euthanasia, Lessons drawn from Duae Makaram Al Akhlaq, Hippocratic oath and the Muslim Oath are all covered in detail.
Moreover, stigmatic beliefs of primary care physicians and therapeutic nihilism
lead them to avoid evaluating cognitive function until the illness is so apparent that it cannot be ignored."
The experiment was a major event in the history of psychiatry, demonstrating that organic or physical treatments could be of value for previously hopeless cases of "madness." While this type of treatment clearly violated the present-day first rule of medicine--to "do no harm"--one can argue, as did Edward Shorter in A History of Psychiatry: From the Era of the Asylum to the Age of Prozac, that it "broke the therapeutic nihilism
that had dominated psychiatry in previous generations," That is, it helped establish the mind-body connection and affirm the possibility of gaining relief through physical treatments.
While not a cure, the experiment was greatly beneficial, marking 'the end of therapeutic nihilism
' towards tinnitus, he said.
"There is a therapeutic nihilism
here, but drugs and help are available along with welfare support.
Seidman, "Sequential Single-Agent Chemotherapy for Metastatic Breast Cancer: Therapeutic Nihilism
or Realism?" Journal of Clinical Oncology 21 (2003): 577-79, at 578.
Moreover, a profound lack of awareness of AAT deficiency exists among both the medical community and affected individuals with respect to the condition itself and to testing for the disease.7 Finally, a number of obstacles exist in clinical practice that impede prompt diagnosis and effective management.7 These include time constraints, limited access to appropriate counseling, poor communication both within practices and with external specialists, and pessimistic physician attitudes (therapeutic nihilism
and/or the belief that the condition is too costly or complicated to manage).