IF 3.6 2区哲学

Medicine Health Care and Philosophy Pub Date : 2026-12-01 Epub Date: 2026-07-11 DOI: 10.1007/s11019-026-10380-0

Christopher Bobier, Daniel J Hurst

引用次数: 0

Cost-effectiveness, pharmaceutical pricing and the value flower - doing some gardening. 成本效益，药品定价和价值花-做一些园艺。

IF 3.6 2区哲学

Medicine Health Care and Philosophy Pub Date : 2026-12-01 Epub Date: 2026-07-07 DOI: 10.1007/s11019-026-10373-z

Lars Sandman, Martin Henriksson, Erik Gustavsson, David Lindqvist, Niklas Juth

{"title":"Cost-effectiveness, pharmaceutical pricing and the value flower - doing some gardening.","authors":"Lars Sandman, Martin Henriksson, Erik Gustavsson, David Lindqvist, Niklas Juth","doi":"10.1007/s11019-026-10373-z","DOIUrl":"10.1007/s11019-026-10373-z","url":null,"abstract":"During the recent years, ISPOR has proposed a number of values that could be taken into account in health technology assessments, for instance when doing an evaluation of what determines society's price for pharmaceutical treatments. These includes values that are not usually considered in health economic evaluation of pharmaceutical pricing, for instance option value, the value of hope and knowing, insurance value, the value of avoiding contagion, and scientific spillover. If these values were included in assessments of pricing of pharmaceutical, it would lead to broadening the cost-effectiveness analysis. We scrutinize the these suggested new value petals of the so-called value flower from two points of views: ethical value theory and the practical implications for a public healthcare system of a European kind, which factors in considerations of traditional cost-effectiveness (primarily in terms of net cost and quality-adjusted life years) and justice (primarily in terms of severity) from the outset. We argue that some of the suggested value petals should not be included in the health economic assessment for several reasons related to value theory or practical considerations in the welfare state: some are mutually conflicting, some do not point out unequivocally positive values, some entails double counting, some are already included in healthcare systems with universal coverage, or can be better handled by other means than by affecting pharmaceutical pricing. A few new petals have potential merit, for instance equity, but much work, both normative and empirical, is required if they should be included in the assessment of pharmaceuticals.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"979-994"},"PeriodicalIF":3.6,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148399548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The moral significance of moral distress. 道德困境的道德意义。

IF 3.6 2区哲学

Medicine Health Care and Philosophy Pub Date : 2026-12-01 Epub Date: 2026-06-22 DOI: 10.1007/s11019-026-10370-2

Cullin Brown, Jan Helge Solbakk

引用次数: 0

Suffering before it becomes Christian: non-Christian traditions of affliction and the goals of medicine. 成为基督教之前的苦难：非基督教的苦难传统和医学的目标。

IF 3.6 2区哲学

Medicine Health Care and Philosophy Pub Date : 2026-12-01 Epub Date: 2026-08-07 DOI: 10.1007/s11019-026-10387-7

Damian Sendrowski, Dariusz Kozłowski

{"title":"Suffering before it becomes Christian: non-Christian traditions of affliction and the goals of medicine.","authors":"Damian Sendrowski, Dariusz Kozłowski","doi":"10.1007/s11019-026-10387-7","DOIUrl":"10.1007/s11019-026-10387-7","url":null,"abstract":"Philosophy of medicine has drawn its richest account of suffering from a broadly Christian lineage, in which affliction can be borne with meaning and the sufferer retains an inviolable dignity. That lineage is not the only one, and it was not the first. This paper sets out the conceptions of suffering developed in the Stoic and Epicurean schools, in Buddhist thought, in Schopenhauer and Nietzsche, and in the phenomenological and existential reflection of Scheler, Weil, Levinas, Ricoeur, and Frankl, and asks what each contributes to the goals of medicine. The traditions disagree sharply. The Hellenistic schools locate suffering in judgment and counsel its dissolution through a discipline of the mind. Buddhist thought treats unsatisfactoriness as a structural feature of conditioned existence rather than a contingent defect. Schopenhauer reads suffering as the truth of the will, while Nietzsche makes it a condition of growth and meaning. The phenomenological tradition recovers suffering as the affliction of an embodied person and divides over whether it can be redeemed at all. Read together, these accounts test the assumption, common in clinical ethics, that suffering is either a problem to be solved or a meaning to be found. They suggest a medicine that can relieve what can be relieved, accompany what cannot, and decline to impose any single meaning on the person who suffers. The argument is illustrated through chronic pain, palliative care, and the care of the frail aged, where these traditions have already entered clinical practice through acceptance-based and meaning-centered interventions.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"1175-1182"},"PeriodicalIF":3.6,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148686381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A defense of empathy: Edith Stein, nursing, and prisoner/patients. 为同理心辩护：伊迪丝·斯坦，护理，囚犯/病人。

IF 3.6 2区哲学

Medicine Health Care and Philosophy Pub Date : 2026-12-01 Epub Date: 2026-06-17 DOI: 10.1007/s11019-026-10369-9

Micah Rojo, Farr Curlin

{"title":"A defense of empathy: Edith Stein, nursing, and prisoner/patients.","authors":"Micah Rojo, Farr Curlin","doi":"10.1007/s11019-026-10369-9","DOIUrl":"10.1007/s11019-026-10369-9","url":null,"abstract":"Many nurses fear empathizing too much with patients. They worry that empathy requires letting their guard down, which, when caring for a potentially violent patient, will make them vulnerable to the risk of assault. They worry that as empathy leads the nurse to reckon with who the other is, it will draw out prejudices the nurse might have toward some categories of persons. And nurses worry that empathy will cause them to experience and be burdened too much by the patient's suffering. These fears are perhaps most distilled in nurses' relationships with prisoner/patients, and situating our analysis within such relationships, this paper asks how philosopher Edith Stein's accounts of empathy and community address nurses' fears when caring for patients who may pose danger to them. We argue first that empathy for the prisoner/patient permits nurses to anticipate the patient's future actions, including violent ones. Second, what Stein calls reiterated empathy allows nurses to discern prisoner/patients' appraisal of the nurse's care and to self-correct, as needed, any stigmatizing care. Finally, though the suffering of patients is indeed too much for the nurse to bear alone, following Stein we suggest that through relationships of solidarity the nurse may meaningfully bear that suffering in community, and the community may meaningfully bear that suffering in the nurse. In Edith Stein, who, in addition to studying philosophy, had worked briefly as a nurse, we find resources to address nurses' misconceptions and fears of empathy and to enliven nurses' care.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"947-954"},"PeriodicalIF":3.6,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148266548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Ars Longa, Data Brevis: the science of disease and the art of care. Ars Longa，数据简介：疾病的科学和护理的艺术。

IF 3.6 2区哲学

Medicine Health Care and Philosophy Pub Date : 2026-12-01 Epub Date: 2026-07-06 DOI: 10.1007/s11019-026-10372-0

Hasan Erbay, Nader Ghotbi, Muhammad Shahid Shamim

{"title":"Ars Longa, Data Brevis: the science of disease and the art of care.","authors":"Hasan Erbay, Nader Ghotbi, Muhammad Shahid Shamim","doi":"10.1007/s11019-026-10372-0","DOIUrl":"10.1007/s11019-026-10372-0","url":null,"abstract":"The integration of Artificial Intelligence (AI) into modern medicine has revolutionised diagnostic accuracy, yet it generates a critical ethical dilemma: as healthcare becomes more data-driven, it risks eroding the high-touch essence of care. As algorithms increasingly shape clinical decision-making, patients risk being reduced to data points rather than persons with unique life stories. This paper examines the tension between AI's calculative logic and the narrative nature of illness, introducing the Processing-Witnessing Model. This framework distinguishes between algorithmic processing (speed, optimisation) and human witnessing (presence, interpretation, and narrative understanding). While AI excels at managing disease as biological dysfunction, it cannot address illness as the lived experience of suffering. This paper argues that the opacity of black-box systems creates a contextual void, enabling a form of epistemic violence that renders the patient's story invisible. Furthermore, the normalization of the screen gaze threatens the therapeutic alliance. Ironically, studies rating AI chatbots as 'more empathetic' are interpreted here not as evidence of machine moral agency, but as a symptom of systemic burnout. This makes narrative ethics a priority for medical education. The physician's role should evolve from data supervisor to cultural mediator, ensuring that while machines process the biological hardware, clinicians provide the interpretive software of meaning.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"877-885"},"PeriodicalIF":3.6,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148391990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Epistemic injustice in plain sight evidence from medical data. 医学数据中显而易见的认知不公。

IF 3.6 2区哲学

Medicine Health Care and Philosophy Pub Date : 2026-12-01 Epub Date: 2026-09-15 DOI: 10.1007/s11019-026-10393-9

Mara Floris

{"title":"Epistemic injustice in plain sight evidence from medical data.","authors":"Mara Floris","doi":"10.1007/s11019-026-10393-9","DOIUrl":"10.1007/s11019-026-10393-9","url":null,"abstract":"Recent debates on epistemic injustice in healthcare stress both the need for clearer criteria and measurement (Nielsen et al. 2025) and the importance of methodological pluralism (Færge et al. 2026). I argue that, in some domains, epistemic injustice can already be inferred from existing medical data, without waiting for new standardized metrics. Focusing on women's diagnostic delay, I argue that well-documented patterns - such as delayed diagnosis, symptom misattribution, and prolonged patient intervals - provide evidence of underlying epistemic injustice. The analysis distinguishes three dimensions - epistemic ignorance in knowledge production, testimonial injustice in clinical encounters, and hermeneutical injustice in patients' interpretive resources - and presents empirical indicators that allow these phenomena to be systematically identified and quantified. I argue that their convergence shows that epistemic injustice is already visible in medical track records and patients' diagnostic journeys. Although improved measurement remains important, the absence of standardized metrics should not prevent well-justified claims when the available evidence is already sufficiently robust.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"967-977"},"PeriodicalIF":3.6,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148978354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

ME/CFS and the emotional toll of persistent disbelief: from epistemic to affective injustice. ME/CFS和持续怀疑的情感代价：从认知到情感不公。

IF 3.6 2区哲学

Medicine Health Care and Philosophy Pub Date : 2026-12-01 Epub Date: 2026-08-14 DOI: 10.1007/s11019-026-10388-6

Sven Walter

{"title":"ME/CFS and the emotional toll of persistent disbelief: from epistemic to affective injustice.","authors":"Sven Walter","doi":"10.1007/s11019-026-10388-6","DOIUrl":"10.1007/s11019-026-10388-6","url":null,"abstract":"Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a debilitating chronic illness whose sufferers are frequently met with disbelief, stigmatization, and psychologization in both clinical and social contexts. Recent work has used the concept of \"epistemic injustice\" to illuminate important dimensions of this problem, especially the ways in which ME/CFS patients are discredited as knowers and denied adequate interpretive resources. This paper argues that the harms associated with persistent disbelief in ME/CFS are not exhausted by this epistemic dimension. Drawing on recent philosophical work on affective injustice, I argue that persistent disbelief can also impair patients' affective lives in distinctive and socially patterned ways. More specifically, I argue that individuals with ME/CFS are burdened by unjust affective expectations, pressured into norm-conforming forms of emotional self-presentation, exposed to pathologizing and gaslighting interpretations of their affective experience, denied uptake for apt emotional responses, and exploited through forms of emotional labor and affective appropriation. Conceptualizing these harms in terms of affective injustice, I argue, helps to capture dimensions of marginalization that a focus on testimony and understanding alone leaves obscure. The paper concludes by considering objections and drawing out implications for healthcare and philosophy of medicine.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"1049-1066"},"PeriodicalIF":3.6,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652865/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Fogarty-Funded Research Ethics Education in Latin America and the Caribbean: Progress Despite Ongoing Challenges. 福加蒂资助的拉丁美洲和加勒比地区的研究伦理教育：尽管面临持续挑战，但仍取得进展。

IF 1.7 4区哲学

Journal of Empirical Research on Human Research Ethics Pub Date : 2026-12-01 Epub Date: 2025-03-31 DOI: 10.1177/15562646251325621

Timothy Daly, Ignacio Mastroleo, Luis L García Valiña, Irene Melamed, María Florencia Santi, Theresa J Ochoa, Manuela Fernández Pinto, Paul J Cummins, Bernardo García Camino, Cheryl Macpherson, Elizabeth Heitman, Florencia Luna

引用次数: 0

Incidental findings in clinical imaging: should patient consent be obtained before disclosure? 临床影像学的意外发现：在披露前是否应征得患者同意？

IF 3.6 2区哲学

Medicine Health Care and Philosophy Pub Date : 2026-12-01 Epub Date: 2026-07-09 DOI: 10.1007/s11019-026-10375-x

Jasper Debrabander

{"title":"Incidental findings in clinical imaging: should patient consent be obtained before disclosure?","authors":"Jasper Debrabander","doi":"10.1007/s11019-026-10375-x","DOIUrl":"10.1007/s11019-026-10375-x","url":null,"abstract":"Seminal ethical guidelines regarding the management of incidental findings (IFs) in medicine recommend to obtain, in as far as practically possible, patients' informed consent regarding the disclosure of IFs arising from genetic tests or imaging procedures in clinical and research settings. In clinical genetics, genetics research and imaging research, patients' consent regarding the disclosure of IFs is standardly obtained. In clinical imaging, however, patients' consent regarding the disclosure of IFs is not systematically obtained. This raises the question whether there are theoretical and/or practical reasons for not obtaining patients' consent regarding the disclosure of IFs in clinical imaging. In this paper, I do two things. First, I offer a theoretical argument by analogy in favour of obtaining patients' informed consent regarding the disclosure of IFs in clinical imaging. Second, I develop a context-specific consent model, thereby mitigating important practical concerns regarding the feasibility of obtaining patients' consent in that context. However, the road towards implementation remains long and myriad practical difficulties remain. Therefore, my argument is not meant to show that obtaining patients' consent regarding the disclosure of IFs in clinical imaging is overall desirable, but that the burden of proof lies on those who wish to deny that obtaining patients' consent regarding the disclosure of IFs in clinical imaging is both theoretically desirable and practically feasible. I thereby strengthen previous calls for a more patient-centered radiology.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"1099-1110"},"PeriodicalIF":3.6,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

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