IF 3.6 2区哲学

Medicine Health Care and Philosophy Pub Date : 2026-12-01 Epub Date: 2026-08-01 DOI: 10.1007/s11019-026-10385-9

Hielke Bosma

{"title":"Inner strength in rehabilitation care: a philosophical framework of inner balance and inner posture.","authors":"Hielke Bosma","doi":"10.1007/s11019-026-10385-9","DOIUrl":"10.1007/s11019-026-10385-9","url":null,"abstract":"Rehabilitation care concerns not only the restoration of function but also how persons live through disruption. Injury and illness may bring loss, uncertainty, altered dependence, changed self-understanding, and a changed horizon of life. Concepts such as coping and resilience capture important aspects of adaptation but do not fully clarify the inner work involved in bearing and inhabiting such change. This paper argues that inner strength can provide a useful concept for clarifying that work. The paper develops a philosophical framework with a preparatory layer and two related dimensions. Inner base names foundational exercises of attention, breath, and body awareness. Inner balance names the centering work of recollection and steadier judgment, while inner posture names the orienting work of finding a viable relation to limitation, vulnerability, and a wider horizon of meaning. Drawing on Pierre Hadot's account of philosophy as a way of life, the paper interprets inner balance and inner posture through the complementary movements of concentration and expansion. It places this proposal in dialogue with rehabilitation research on inner posture and global meaning, and with literature on meaning-making, resilience, mindfulness, and existential care. The framework is conceptual rather than a validated intervention model. It offers a more differentiated vocabulary for grounding, centering, and orientation in rehabilitation care.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"1025-1034"},"PeriodicalIF":3.6,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148654976","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

Formative embodiment and early life: a comparative health humanities reading of development, meaning, and mental life. 形成的体现和早期生活：发展、意义和精神生活的比较健康人文阅读。

IF 3.6 2区哲学

Medicine Health Care and Philosophy Pub Date : 2026-12-01 Epub Date: 2026-07-31 DOI: 10.1007/s11019-026-10383-x

Christopher Fernandes

{"title":"Formative embodiment and early life: a comparative health humanities reading of development, meaning, and mental life.","authors":"Christopher Fernandes","doi":"10.1007/s11019-026-10383-x","DOIUrl":"10.1007/s11019-026-10383-x","url":null,"abstract":"This paper brings insights from classical Indic, Tantric, Daoist, and Hellenistic medical traditions into dialogue with contemporary developmental science to examine the metaphysical, relational, and moral status of the embryo during its formation. Modern embryology provides detailed scientific explanations of genetic, epigenetic, and physiological development. However, it pays comparatively less attention to how embodied life emerges and to the philosophical significance of early embryonic development. The study adopts a comparative health humanities approach to examine how concepts such as garbha, prāṇa, qì, pneuma, developmental plasticity, and maternal-fetal relationality reflects different cultural and philosophical understandings of embryological formation. Rather than treating classical traditions as precursors of modern biology, the analysis identifies both convergences and divergences in how these traditions conceptualize vitality, embodiment, temporality, and developmental continuity. Across these traditions, embryological development is understood not as the unfolding of a pre-existing essence but as the progressive organization of embodied life through interacting physiological, environmental, temporal, and relational conditions. The comparison reveals both shared insights and important differences among these traditions. Although concepts such as prāṇa, qì, and pneuma describe aspects of formative life, they should not be reduced to modern biological categories. By bringing these perspectives into dialogue, the paper shows how comparative health humanities can broaden contemporary understandings of development, embodiment, vulnerability, and care while respecting the historical context of each tradition.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"1005-1023"},"PeriodicalIF":3.6,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148632189","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

Inaudible and invisible: epistemic injustice and the failure of recognition as a single intersubjective relation. Pain as particularly illuminating case. 听不清和看不见：认识上的不公正和作为单一主体间关系的认识的失败。疼痛是一个特别有启发性的例子。

IF 3.6 2区哲学

Medicine Health Care and Philosophy Pub Date : 2026-12-01 Epub Date: 2026-07-14 DOI: 10.1007/s11019-026-10371-1

Helmar Bornemann-Cimenti

{"title":"Inaudible and invisible: epistemic injustice and the failure of recognition as a single intersubjective relation. Pain as particularly illuminating case.","authors":"Helmar Bornemann-Cimenti","doi":"10.1007/s11019-026-10371-1","DOIUrl":"10.1007/s11019-026-10371-1","url":null,"abstract":"Miranda Fricker's concept of epistemic injustice and Axel Honneth's theory of recognition have each been applied, separately, to chronic pain. The relationship between them is usually construed as sequential: epistemic injustice is thought to produce failures of recognition, or prior misrecognition to ground later epistemic marginalisation. This article rejects that reading. It argues that, in the clinical encounter with a person in pain, the relation between the two is not exhausted by causal succession. They are analytically separable dimensions of a single intersubjective relation, dimensions that cannot, in that encounter, be treated apart without descriptive and practical loss. The act by which a clinician withholds credibility from a patient's testimony is the same act by which recognition is refused to that patient as a suffering subject. The claim is offered as a heuristic rather than an ontological thesis. Pain is presented not as uniquely paradigmatic but as a particularly illuminating case within a broader class of testimonially dependent suffering, since its privacy, its dependence on testimony, and the mediating role of diagnostic language converge in it with unusual clarity. The argument bears on recognition theory; on medical ethics, where remedies addressed to one dimension alone prove insufficient; and on clinical practice, where diagnostic classification operates as a technology of recognition.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"955-965"},"PeriodicalIF":3.6,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148438417","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

Choosing how to decide: empowering patients for shared decision-making in end-of-life care. 选择如何决定：在临终关怀中赋予患者共同决策的权力。

IF 3.6 2区哲学

Medicine Health Care and Philosophy Pub Date : 2026-12-01 Epub Date: 2026-08-18 DOI: 10.1007/s11019-026-10389-5

Nicholas Abernethy

{"title":"Choosing how to decide: empowering patients for shared decision-making in end-of-life care.","authors":"Nicholas Abernethy","doi":"10.1007/s11019-026-10389-5","DOIUrl":"10.1007/s11019-026-10389-5","url":null,"abstract":"Shared Decision-Making (SDM) is a process wherein patients and clinicians make healthcare decisions collaboratively. There are two main versions of SDM. The first is narrow SDM, wherein the clinician's role is limited to things like providing information and eliciting (without challenging) the patient's preferences. The second is broad SDM, wherein the clinician participates in the decision-making in various additional ways (e.g., by providing recommendations). In this paper, I argue that there are cases where a patient would not be wronged by a clinician letting them choose from a range of versions of SDM - including narrow SDM and types of broad SDM - for an end-of-life treatment decision. This paper's structure is as follows. First, I explain my proposal. Second, I provide a brief rationale for it. Third, I thoroughly defend it from the likeliest objection, which holds that clinicians in the relevant cases should offer only narrow SDM because broad SDM would unduly influence patients. This paper's originality comes from (i) presenting a new and uniquely detailed proposal for when and how to offer versions of SDM and (ii) exploring the ethical implications of a patient's choice of a version, understood as an act of consent. The main purpose of my proposal's many details is to maximize how much the SDM would advance patient autonomy (and, secondarily, patient wellbeing).","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"931-945"},"PeriodicalIF":3.6,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799567","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

Ontological deskilling: clinical expertise and the changing disease object in precision medicine. 本体论去技能化：精准医学中临床专业知识与疾病对象的变化。

IF 3.6 2区哲学

Medicine Health Care and Philosophy Pub Date : 2026-12-01 Epub Date: 2026-07-08 DOI: 10.1007/s11019-026-10377-9

Anastasios E Germenis

{"title":"Ontological deskilling: clinical expertise and the changing disease object in precision medicine.","authors":"Anastasios E Germenis","doi":"10.1007/s11019-026-10377-9","DOIUrl":"10.1007/s11019-026-10377-9","url":null,"abstract":"Concerns about physician deskilling in AI-enabled medicine usually ask how automated systems substitute for, attenuate, or distort clinical capacities. This article argues that precision medicine introduces a distinct object-side problem. Its dominant classificatory operation is not simply finer nosological classification but stratification for action: patients are grouped and regrouped for treatment selection, risk allocation, surveillance, trial eligibility, and prediction. In doing so, precision medicine fragments established disease categories, connects conditions across former boundaries, temporalizes disease into trajectories and thresholds, and produces actionable risk states and algorithmic subgroups. If clinical expertise is acquired through relatively stable nosological categories, then preserved skills may become insufficient when those categories no longer organize the clinical object in the same way. I call this failure of fit ontological deskilling. The article distinguishes it from technological deskilling, diagnostic uncertainty, overdiagnosis, medicalization, plastic diagnostics, and ordinary adaptive-learning demands. Drawing on Canguilhem, Mol, phenomenological intentionality, and accounts of expertise, it argues that ontological deskilling changes the conditions of clinical judgment, uncertainty, and responsibility. The appropriate response is critical nosological awareness: the ability to use disease categories competently while recognizing their contingency, plurality of functions, and susceptibility to transformation.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"903-921"},"PeriodicalIF":3.6,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652772/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148406353","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 dis-economy of precision medicine: how stratification multiplies social tension in healthcare systems. 精准医疗的不经济：分层如何加剧医疗系统中的社会紧张。

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/s11019-026-10381-z

Raef Kozman, Fabrice Jotterand

{"title":"The dis-economy of precision medicine: how stratification multiplies social tension in healthcare systems.","authors":"Raef Kozman, Fabrice Jotterand","doi":"10.1007/s11019-026-10381-z","DOIUrl":"10.1007/s11019-026-10381-z","url":null,"abstract":"Precision medicine (PM) promises better outcomes by aligning prevention and treatment with molecular and phenotypic profiles. But precision is not merely a clinical refinement; it is an epistemic shift in how health systems classify risk, allocate eligibility and define value. In this study, we argue that broad adoption of PM creates structural tension within solidarity-based health systems and exposes limits in conventional cost-effectiveness evaluation. Ethically, PM converts pooled probabilistic uncertainty into individualized biological prediction, making access increasingly conditional on measurement, interpretation and pathway completion. Economically, PM fragments evaluable populations, destabilizes counterfactual comparison and shifts value from discrete products to information-dependent care pathways. As a result, standard metrics such as the incremental cost-effectiveness ratio (ICER) often become sensitive not only to biological effect, but also to governance: who is tested, how results are interpreted, which downstream services are funded and who can complete the pathway. We suggest that the instability observed in PM appraisal is not simply a technical problem of modeling, but a sign that the object of evaluation has changed. Recognizing this structural shift is essential if PM is to be integrated into health systems committed to both equity and evaluability.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"923-930"},"PeriodicalIF":3.6,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652759/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148424984","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

Caring for the lonely: an ethical case for social prescribing against loneliness. 照顾孤独者：社会处方对抗孤独的伦理案例。

IF 3.6 2区哲学

Medicine Health Care and Philosophy Pub Date : 2026-12-01 Epub Date: 2026-08-21 DOI: 10.1007/s11019-026-10386-8

Zohar Lederman

引用次数: 0

Beyond Anxiety: The Role of Writing Enjoyment in Predicting L2 Writing Procrastination 超越焦虑：写作乐趣在预测二语写作拖延中的作用

IF 4.2 1区文学

Language Teaching Research Pub Date : 2026-10-21 DOI: 10.1177/13621688261479325

Mohadeseh Harasani,Zahraossadat Mirsanjari

引用次数: 0

Spirited Away: Childhood, Transatlantic Transportation, and the Politics of Religious Instruction in Civil War England 《千与千寻：童年、跨大西洋运输和英国内战时期的宗教教育政治》