Journal of Medical Ethics and History of Medicine最新文献

{"title":"The ethics of science journalism in medicine: a science and technology studies approach.","authors":"Rahman Sharifzadeh","doi":"10.18502/jmehm.v18i10.19948","DOIUrl":"https://doi.org/10.18502/jmehm.v18i10.19948","url":null,"abstract":"<p><p>Reexamining science journalism through the constructivist lens of Science and Technology Studies (STS), the present paper argues that this perspective promotes a more responsible approach to reporting scientific discoveries in medicine. The dominant anti-constructivist, realist approach often results in what we term \"dramatic modalization,\" which attributes greater facticity and universality to scientific findings than they actually possess at the time of publication, leading to significant moral consequences. To illustrate this, we will first explore the STS perspective as a framework for understanding the construction of facts in practice. Next, through a discourse analysis of two historical cases in medical journalism-the MMR-autism link and the depression-serotonin connection-we will demonstrate that the realist media coverage of these cases engaged in dramatic modalization, resulting in tangible moral repercussions. We hereby propose an alternative STS model for science journalism in medicine, arguing that it offers a more morally responsible approach.</p>","PeriodicalId":45276,"journal":{"name":"Journal of Medical Ethics and History of Medicine","volume":"18 ","pages":"10"},"PeriodicalIF":0.8,"publicationDate":"2025-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13106634/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Narrative medicine in ethics education: from theory to practice.","authors":"Hasan Erbay","doi":"10.18502/jmehm.v18i9.19658","DOIUrl":"https://doi.org/10.18502/jmehm.v18i9.19658","url":null,"abstract":"<p><p>Historically, medicine has been grounded in storytelling; however, contemporary practice has shifted toward expertise and empirical data, often neglecting the patient's narrative. This shift has created a gap in understanding the complexity of human suffering. Narrative medicine bridges this gap by prioritizing empathy, ethical sensitivity, and patient-centred care. It integrates patients' life experiences and cultural backgrounds into clinical practice and aims to harmonize empirical methodologies with phenomenological insights. This review examines the theoretical foundations and practical applications of narrative medicine, particularly within medical ethics education. It highlights how narrative approaches improve moral reasoning, empathy, and cultural competence in healthcare professionals. Pedagogical methods such as reflective writing, attentive reading, and group discussions enhance ethical awareness and improve practitioners' capacity to manage complex clinical situations. Narrative medicine promotes a comprehensive understanding of illness and care by bridging the gap between evidence-based medicine and narrative approaches; it can also be integrated into education to address challenges such as cultural diversity, health inequalities, and ethical dilemmas arising from technological developments. However, ethical issues like power dynamics, privacy, and representation in patient narratives require careful management. Despite the existing challenges, narrative medicine offers a transformative framework for rethinking medical education and practice, ensuring that healthcare remains empathetic, equitable, and ethical.</p>","PeriodicalId":45276,"journal":{"name":"Journal of Medical Ethics and History of Medicine","volume":"18 ","pages":"9"},"PeriodicalIF":0.8,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13106661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anti-epidemic campaigns in Macao during the war and post-war reconstruction period (1937 - 1949): a procedural grounded theory analysis of news reports from overseas Chinese news.","authors":"Baoling Wu, Hanxiang Gong, Xi Wang","doi":"10.18502/jmehm.v18i8.19563","DOIUrl":"https://doi.org/10.18502/jmehm.v18i8.19563","url":null,"abstract":"<p><p>This study explores how Macao, a semi-autonomous colonial territory under Portuguese neutrality, governed epidemic crises between 1937 and 1949 through a civic-driven, multi-actor approach. It examines how local responses to epidemics were formulated and sustained amid institutional fragility, political isolation, mass refugee inflows, and in the absence of strong centralized authority. Drawing on 1036 contemporaneous reports from <i>Overseas Chinese News</i>, the study employs procedural grounded theory to inductively reconstruct Macao's epidemic governance logic. The findings reveal six interrelated strategies: real-time epidemiological monitoring and disclosure, universal compulsory vaccination, cross-institutional and transregional collaboration, grassroots hygiene education, institutionalized civil society participation, and strict quarantine and sanitation enforcement. The study proposes a \"Civic-Driven Epidemic Governance Framework under Neutrality\", illustrating how decentralized collaboration, institutional improvisation, and social capital compensated for limited state control. The Macao case offers a historically grounded alternative to state-centric public health models by underscoring the role of civic engagement and cross-border cooperationFinally, it highlights the media's dual role as a platform for public communication and a driver of social mobilization. These findings contribute to broader debates on resilient, inclusive and adaptive governance in politically fragmented or fragile contexts.</p>","PeriodicalId":45276,"journal":{"name":"Journal of Medical Ethics and History of Medicine","volume":"18 ","pages":"8"},"PeriodicalIF":0.8,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13106702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From concept to practice: integrating ethical spirituality into philosophical counseling training.","authors":"Mahdi Ganjvar","doi":"10.18502/jmehm.v18i7.19421","DOIUrl":"https://doi.org/10.18502/jmehm.v18i7.19421","url":null,"abstract":"<p><p>Philosophical counseling increasingly recognizes the role of spirituality and ethics within multicultural contexts. This paper aims to address a gap in counselor education regarding clear guidelines for integration of moral and spiritual concepts into counseling and proposes a conceptual-practical model. Methodologically, this study undertakes a comprehensive literature review, synthesizing professional publications on philosophical counseling, spirituality, and ethical principles from institutions such as the American Counseling Association (ACA) and the Psychology and Counseling Organization of Iran (PCOI). The paper conceptualizes an ethical framework for spirituality in philosophical counseling and advocates for the incorporation of competency, values, open-mindedness, client welfare, confidentiality, and moral rehabilitation into the curricula. This theoretical model, requiring future empirical validation, aims to enhance practitioners' spiritual literacy and ethical abilities. The study outcomes underscore the imperative for philosophical counselors to synchronize their approaches meticulously with the distinct values, requirements, priorities, and anticipations articulated by their clients. This alignment intrinsically validates the client's inherent autonomy and their capacity for self-determination in decision-making processes. Consequently, it is paramount that philosophical counselors exercise judicious caution to circumvent the inadvertent imposition of their personal values or religious convictions, as such actions would fundamentally contravene the ethical principle of client autonomy. This alignment intrinsically validates the client's inherent autonomy and their capacity for self-determination in decision-making processes. Consequently, it is paramount that philosophical counselors exercise judicious caution to circumvent the inadvertent imposition of their personal values or religious convictions, as such actions would fundamentally contravene the ethical principle of client autonomy.</p>","PeriodicalId":45276,"journal":{"name":"Journal of Medical Ethics and History of Medicine","volume":"18 ","pages":"7"},"PeriodicalIF":0.8,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13105388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Compassionate care and moral distress in nursing: the mediating role of organizational citizenship behavior.","authors":"Somayeh Mohammadi, Mahnaz Rakhshan, Mostafa Roshanzadeh, Parvin Ghaemmaghami, Hamid Reza Hamidian","doi":"10.18502/jmehm.v18i6.19212","DOIUrl":"10.18502/jmehm.v18i6.19212","url":null,"abstract":"<p><p>Decline in compassionate care is potentially linked to moral distress and fostering different aspects of organizational citizenship behavior can reduce the outcome of moral distress. This study aimed to determine the mediating role of organizational citizenship behavior in the relationship between compassionate care and moral distress among nurses. For this purpose, a correlational study design using structural equation modeling was employed. Between December 2023 and March 2024, 300 nurses were selected through convenience sampling from hospitals in Fars Province, southern Iran. Data were collected using the Organizational Citizenship Behavior Questionnaire, the Compassionate Care Questionnaire for Nurses, and the Moral Distress Questionnaire. Data analysis was conducted using SPSS version 22 and Smart-PLS software. Our findings showed that compassionate care, combined with the mediating role of organizational citizenship behavior, significantly impacted moral distress (t = 2.442, <i>P</i> < 0.015, β = -0.071). Pearson's correlation coefficients showed that compassionate care had a positive and significant relationship with organizational citizenship behavior (r = 0.444, <i>P</i> < 0.001) and a negative and significant relationship with moral distress (r = -0.353, <i>P</i> < 0.001). It is therefore recommended that managers in clinical systems focus on training nurses who exhibit appropriate organizational citizenship behavior in health-care settings.</p>","PeriodicalId":45276,"journal":{"name":"Journal of Medical Ethics and History of Medicine","volume":"18 ","pages":"6"},"PeriodicalIF":0.8,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12474521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond appearance: patient perspectives on the role of physician attire in trust.","authors":"Mohammad Kazem Sarpoolaki, Hanieh Tavasoli, Amirali Sohrabpoor, Fariba Asghari","doi":"10.18502/jmehm.v18i5.19209","DOIUrl":"10.18502/jmehm.v18i5.19209","url":null,"abstract":"<p><p>This study examines the role of physician attire in building patient trust compared to other professional behaviors, identifying key attire-related factors that influence this trust. The study consisted of two parts. In the first part, patients and their companions participated in in-depth interviews to identify factors affecting their trust in doctors, including appearance. The findings from these interviews were used to create a survey questionnaire. In the second part of the study, 120 patients and their companions from two teaching hospitals were surveyed about the importance of doctors' attire and professional behaviors identified earlier. Qualitative interviews revealed three trust-building themes: general behavior (honesty and kindness), providing information (about diseases and necessary measures), and appearance (white coat and cleanliness). Quantitatively, 120 participants rated providing information (81%) and honesty (74.2%) as the most important factors in building trust, with appearance rated as very important (40%) but less critical (<i>P</i> < 0.001). White coats were prioritized over hygiene and clothing cleanliness (<i>P</i> < 0.0001), while 37.5% noted that tattoos or bright clothing reduced trust. The findings show that several factors are more important than the type of a doctor's attire in maintaining the patient's trust, and the dress code should prioritize safety and infection prevention.</p>","PeriodicalId":45276,"journal":{"name":"Journal of Medical Ethics and History of Medicine","volume":"18 ","pages":"5"},"PeriodicalIF":0.8,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12474522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clearing the confusion about conflict of interest, conflict management and conflict resolution in educational settings.","authors":"Fatemeh Mohseni, Mahboobeh Khabaz Mafinejad, Larry Gruppen","doi":"10.18502/jmehm.v18i4.19231","DOIUrl":"10.18502/jmehm.v18i4.19231","url":null,"abstract":"","PeriodicalId":45276,"journal":{"name":"Journal of Medical Ethics and History of Medicine","volume":"18 ","pages":"4"},"PeriodicalIF":0.8,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12474518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between moral resilience, moral distress, and second victim syndrome among Iranian ICU nurses: a cross-sectional correlational study.","authors":"Zahra Asadi, Alun C Jackson, Azam Jahangirimehr, Fatemeh Bahramnezhad","doi":"10.18502/jmehm.v18i3.18879","DOIUrl":"10.18502/jmehm.v18i3.18879","url":null,"abstract":"<p><p>This cross-sectional study, conducted in 2023 on 386 ICU nurses from hospitals affiliated with Tehran University of Medical Sciences, investigated the relationships between moral resilience, moral distress, and second victim syndrome. Participants were selected through simple random sampling, and data were collected using Rushton's Moral Resilience Scale, Hamric's Moral Distress Questionnaire, and Burlison's Second Victim Scale. Analysis was performed using descriptive statistics and Pearson's correlation in SPSS v24. The results showed a significant positive correlation between second victim syndrome and moral distress, indicating that increased second victim experiences were associated with higher moral distress. There was also a significant negative correlation between moral resilience and second victim syndrome, confirmed by regression and structural equation modeling. However, no significant correlation was found between moral resilience and moral distress. Overall, the study highlights that second victim syndrome contributes to moral distress, while moral resilience acts as a protective factor. It is recommended that targeted interventions - such as resilience training, peer support groups, professional debriefing, and organizational mental health initiatives be imple- mented to mitigate these psychological challenges in high-stress ICU environments.</p>","PeriodicalId":45276,"journal":{"name":"Journal of Medical Ethics and History of Medicine","volume":"18 ","pages":"3"},"PeriodicalIF":0.8,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12474523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Philosophy of medicine meets AI hallucination and AI drift: moving toward a more gentle medicine.","authors":"Hamidreza Namazi, Mohammad Mahdi Radfar","doi":"10.18502/jmehm.v18i2.18812","DOIUrl":"10.18502/jmehm.v18i2.18812","url":null,"abstract":"<p><p>The contemporary world is profoundly shaped by technological progress. Among the advancements of our era is the proliferation of artificial intelligence (AI). AI has permeated every facet of human knowledge, including medicine. One domain of AI development is the application of large language models (LLMs) in health-care settings. While these applications hold immense promise, they are not without challenges. Two notable phenomena, AI hallucination and AI drift, pose setbacks. AI hallucination refers to the generation of erroneous information by AI systems, while AI drift is the production of multiple responses to a single query. The emergence of these challenges underscores the crucial role of the philosophy of medicine. By reminding practitioners of the inherent uncertainty that underpins medical interventions, the philosophy of medicine fosters a more receptive stance toward these technological advancements. Furthermore, by acknowledging the inherent fallibility of these technologies, the philosophy of medicine reinforces the importance of gentle medicine and humility in clinical practice. Physicians must not shy away from embracing AI tools due to their imperfections. Acknowledgment of uncertainty fosters a more accepting attitude toward AI tools among physicians, and by constantly highlighting the imperfections, the philosophy of medicine cultivates a deeper sense of humility among practitioners. It is imperative that experts in the philosophy of medicine engage in thoughtful deliberation to ensure that these powerful technologies are harnessed responsibly and ethically, preventing the reins of medical decision-making from falling into the hands of those without the requisite expertise and ethical grounding.</p>","PeriodicalId":45276,"journal":{"name":"Journal of Medical Ethics and History of Medicine","volume":"18 ","pages":"2"},"PeriodicalIF":0.8,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12474519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Why is the idea of AI completely replacing physicians a pseudo-problem? a philosophical analysis.","authors":"Alireza Monajemi","doi":"10.18502/jmehm.v18i1.18814","DOIUrl":"10.18502/jmehm.v18i1.18814","url":null,"abstract":"<p><p>Artificial intelligence (AI) has the potential to revolutionize healthcare, but is unlikely to fully replace human doctors. This paper explores the limitations of AI in healthcare, focusing on three key areas: lack of embodiment, limited understanding of meaning in everyday language, and the inability to exercise judgment and clinical reasoning. Recognizing these limitations enables us to use AI to enhance our capabilities rather than allowing it to substitute humans. Following this philosophical examination of AI's limitations, I will argue that the question of whether AI will replace doctors is a misleading one. Instead, this framework advocates for synergistic human-AI collaboration in health-care settings. It necessitates the development of hybrid entities: a physician-AI partnership and a patient-AI interface. The overarching objective is to effectively address the core mission of medicine, which is providing optimal treatment and compassionate care for all patients. This hybrid model must proactively mitigate the risks of AI integration, such as exacerbation of existing health-care challenges and potential dehumanization of patient care. Within this framework, key objectives include: reducing medical errors, fostering humane doctor-patient relationships, mitigating the trend of medicalization, and ultimately improving overall public health outcomes.</p>","PeriodicalId":45276,"journal":{"name":"Journal of Medical Ethics and History of Medicine","volume":"18 ","pages":"1"},"PeriodicalIF":0.8,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12474520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}