Theoretical Medicine and Bioethics最新文献

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The concept of disease in the time of COVID-19. COVID-19时代的疾病概念。
IF 1.4 3区 哲学
Theoretical Medicine and Bioethics Pub Date : 2020-12-01 Epub Date: 2021-02-16 DOI: 10.1007/s11017-021-09540-5
Maria Cristina Amoretti, Elisabetta Lalumera
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引用次数: 2
The right to assistive technology. 使用辅助技术的权利。
IF 1.4 3区 哲学
Theoretical Medicine and Bioethics Pub Date : 2020-12-01 Epub Date: 2020-10-06 DOI: 10.1007/s11017-020-09527-8
Joseph A Stramondo
{"title":"The right to assistive technology.","authors":"Joseph A Stramondo","doi":"10.1007/s11017-020-09527-8","DOIUrl":"https://doi.org/10.1007/s11017-020-09527-8","url":null,"abstract":"<p><p>In this paper, I argue that disabled people have a right to assistive technology (AT), but this right cannot be grounded simply in a broader right to health care or in a more comprehensive view like the capabilities approach to justice. Both of these options are plagued by issues that I refer to as the problem of constriction, where the theory does not justify enough of the AT that disabled people should have access to, and the problem of overextension, where the theory cannot adequately identify an upper limit on the AT that people have a right to. As an alternative to these justificatory frameworks, I argue that disabled people are owed access to AT at the expense of nondisabled people as a matter of compensatory justice. That is, I defend the position that disabled people are owed AT as part of due compensation for the harms they experience from being disadvantaged by society's dominant cooperative scheme and the violation of their right to equality of opportunity that such disadvantage entails. I also propose a method for identifying an upper limit to what this right to AT requires. In this way, I argue that compensatory justice avoids both the problem of constriction and the problem of overextension.</p>","PeriodicalId":46703,"journal":{"name":"Theoretical Medicine and Bioethics","volume":"41 5-6","pages":"247-271"},"PeriodicalIF":1.4,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s11017-020-09527-8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38461789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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: 5
Gregory L. Eastwood: Finishing our story: preparing for the end of life 格雷戈里·l·伊斯特伍德:结束我们的故事:为生命的终结做准备
IF 1.4 3区 哲学
Theoretical Medicine and Bioethics Pub Date : 2020-09-20 DOI: 10.1007/s11017-020-09528-7
M. Daverio
{"title":"Gregory L. Eastwood: Finishing our story: preparing for the end of life","authors":"M. Daverio","doi":"10.1007/s11017-020-09528-7","DOIUrl":"https://doi.org/10.1007/s11017-020-09528-7","url":null,"abstract":"","PeriodicalId":46703,"journal":{"name":"Theoretical Medicine and Bioethics","volume":"41 1","pages":"279 - 280"},"PeriodicalIF":1.4,"publicationDate":"2020-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s11017-020-09528-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44600425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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: 1
Our suffering and the suffering of our time. 我们的苦难和我们这个时代的苦难。
IF 1.4 3区 哲学
Theoretical Medicine and Bioethics Pub Date : 2020-08-01 DOI: 10.1007/s11017-020-09529-6
John D Lantos
{"title":"Our suffering and the suffering of our time.","authors":"John D Lantos","doi":"10.1007/s11017-020-09529-6","DOIUrl":"https://doi.org/10.1007/s11017-020-09529-6","url":null,"abstract":"","PeriodicalId":46703,"journal":{"name":"Theoretical Medicine and Bioethics","volume":"41 4","pages":"197-201"},"PeriodicalIF":1.4,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s11017-020-09529-6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38682676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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: 1
Valuing life and evaluating suffering in infants with life-limiting illness. 重视生命并评估患有限制生命疾病的婴儿的痛苦。
IF 1.4 3区 哲学
Theoretical Medicine and Bioethics Pub Date : 2020-08-01 Epub Date: 2020-12-17 DOI: 10.1007/s11017-020-09532-x
Dominic Wilkinson, Amir Zayegh
{"title":"Valuing life and evaluating suffering in infants with life-limiting illness.","authors":"Dominic Wilkinson,&nbsp;Amir Zayegh","doi":"10.1007/s11017-020-09532-x","DOIUrl":"https://doi.org/10.1007/s11017-020-09532-x","url":null,"abstract":"<p><p>In this paper, we explore three separate questions that are relevant to assessing the prudential value of life in infants with severe life-limiting illness. First, what is the value or disvalue of a short life? Is it in the interests of a child to save her life if she will nevertheless die in infancy or very early childhood? Second, how does profound cognitive impairment affect the balance of positives and negatives in a child's future life? Third, if the life of a child with life-limiting illness is prolonged, how much suffering will she experience and can any of it be alleviated? Is there a risk that negative experiences for such a child (suffering) will remain despite the provision of palliative care? We argue that both the subjective and objective components of well-being for children could be greatly reduced if they are anticipated to have a short life that is affected by profound cognitive impairment. This does not mean that their overall well-being will be negative, but rather that there may be a higher risk of negative overall well-being if they are expected to experience pain, discomfort, or distress. Furthermore, we point to some of the practical limitations of therapies aimed at relieving suffering, such that there is a risk that suffering will go partially or completely unrelieved. Taken together, these considerations imply that some life-prolonging treatments are not in the best interests of infants with severe life-limiting illness.</p>","PeriodicalId":46703,"journal":{"name":"Theoretical Medicine and Bioethics","volume":"41 4","pages":"179-196"},"PeriodicalIF":1.4,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s11017-020-09532-x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38383692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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: 5
Philosophical investigations into the essence of pediatric suffering. 对儿童痛苦本质的哲学研究。
IF 1.4 3区 哲学
Theoretical Medicine and Bioethics Pub Date : 2020-08-01 Epub Date: 2020-12-17 DOI: 10.1007/s11017-020-09531-y
Tyler Tate
{"title":"Philosophical investigations into the essence of pediatric suffering.","authors":"Tyler Tate","doi":"10.1007/s11017-020-09531-y","DOIUrl":"https://doi.org/10.1007/s11017-020-09531-y","url":null,"abstract":"","PeriodicalId":46703,"journal":{"name":"Theoretical Medicine and Bioethics","volume":"41 4","pages":"137-142"},"PeriodicalIF":1.4,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s11017-020-09531-y","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38383691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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: 4
Relational suffering and the moral authority of love and care. 关系苦难和道德权威的爱和关怀。
IF 1.4 3区 哲学
Theoretical Medicine and Bioethics Pub Date : 2020-08-01 DOI: 10.1007/s11017-020-09530-z
Georgina D Campelia, Jennifer C Kett, Aaron Wightman
{"title":"Relational suffering and the moral authority of love and care.","authors":"Georgina D Campelia,&nbsp;Jennifer C Kett,&nbsp;Aaron Wightman","doi":"10.1007/s11017-020-09530-z","DOIUrl":"https://doi.org/10.1007/s11017-020-09530-z","url":null,"abstract":"<p><p>Suffering is a ubiquitous yet elusive concept in health care. In a field devoted to the pursuit of objective data, suffering is a phenomenon with deep ties to subjective experience, moral values, and cultural norms. Suffering's tie to subjective experience makes it challenging to discern and respond to the suffering of others. In particular, the question of whether a child with profound neurocognitive disabilities can suffer has generated a robust discourse, rooted in philosophical conceptualizations of personhood as well as the academic and experiential expertise of practiced health-care professionals. The issue remains unresolved because it is difficult, perhaps impossible, to ever truly know an infant's lived experience. But what if this is not the best question? What if instead of asking \"can this infant suffer?\" the discourse is broadened to ask \"is there suffering here?\" This latter question demands attention to patients' subjective experiences of suffering, but also to the web of relationships that envelop them. Without losing sight of the importance of patients' experiences, consideration of their relationships may elucidate the presence of suffering when the patients themselves are unable to provide the same clarity. In this essay, care ethics frames an examination of how suffering manifests in the loving and caring relationships that surround an infant with profound neurocognitive disabilities, changing those relationships and affecting the individuals within them. Exploring suffering through these relationships may offer clarity on the presence and content of suffering for infants with profound cognitive disabilities, in turn offering moral guidance for responding to suffering and supporting flourishing in this context.</p>","PeriodicalId":46703,"journal":{"name":"Theoretical Medicine and Bioethics","volume":"41 4","pages":"165-178"},"PeriodicalIF":1.4,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s11017-020-09530-z","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38682677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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: 7
What we talk about when we talk about pediatric suffering. 当我们谈论儿童的痛苦时。
IF 1.4 3区 哲学
Theoretical Medicine and Bioethics Pub Date : 2020-08-01 Epub Date: 2021-01-05 DOI: 10.1007/s11017-020-09535-8
Tyler Tate
{"title":"What we talk about when we talk about pediatric suffering.","authors":"Tyler Tate","doi":"10.1007/s11017-020-09535-8","DOIUrl":"https://doi.org/10.1007/s11017-020-09535-8","url":null,"abstract":"<p><p>In this paper I aim to show why pediatric suffering must be understood as a judgment or evaluation, rather than a mental state. To accomplish this task, first I analyze the various ways that the label of suffering is used in pediatric practice. Out of this analysis emerge what I call the twin poles of pediatric suffering. At one pole sits the belief that infants and children with severe cognitive impairment cannot suffer because they are nonverbal or lack subjective life experience. At the other pole exists the idea that once child suffering reaches some threshold it is ethical to eliminate the sufferer. Concerningly, at both poles, any particular child vanishes from view. Second, in an attempt to identify a theory of suffering inclusive of children, I examine two prominent so-called experiential accounts of suffering. I find them both wanting on account of their absurd entailments and their flawed assumptions regarding the subjective experiences of people who cannot communicate expressively. Finally, I extend arguments found in Alastair MacIntyre's Dependent Rational Animals to argue that child suffering can be understood only as a set of absences-absences of conditions such as love, warmth, and freedom from pain. An evaluation of these absences reveals the exquisite dependency of children. It also discloses why pediatric suffering is necessarily a social and political event. Unlike adults, children will never be either the authors or the mitigators of their own suffering. Rather, children must rely wholly on others in order to resist suffering, grow, and flourish.</p>","PeriodicalId":46703,"journal":{"name":"Theoretical Medicine and Bioethics","volume":"41 4","pages":"143-163"},"PeriodicalIF":1.4,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s11017-020-09535-8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38782355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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: 1
A naturalist response to Kingma's critique of naturalist accounts of disease. 一个自然主义者对金玛对自然主义者疾病描述的批判的回应。
IF 1.4 3区 哲学
Theoretical Medicine and Bioethics Pub Date : 2020-06-01 DOI: 10.1007/s11017-020-09526-9
David B Hershenov
{"title":"A naturalist response to Kingma's critique of naturalist accounts of disease.","authors":"David B Hershenov","doi":"10.1007/s11017-020-09526-9","DOIUrl":"https://doi.org/10.1007/s11017-020-09526-9","url":null,"abstract":"<p><p>Elselijn Kingma maintains that Christopher Boorse and other naturalists in the philosophy of medicine cannot deliver the value-free account of disease that they promise. Even if disease is understood as dysfunction and that notion can be applied in a value-free manner, values still manifest themselves in the justification for picking one particular operationalization of dysfunction over a number of competing alternatives. Disease determinations depend upon comparisons within a reference class vis-à-vis reaching organism goals. Boorse considers reference classes for a species to consist in the properties of age and sex and organism goals to comprise survival and reproduction. Kingma suggests that naturalists are influenced by value judgments and may rely upon implicit assumptions about disease in their choice of reference classes and goals to determine which conditions are diseased. I argue that she is wrong to claim that these choices cannot be defended without arguing in a circular manner or making certain arbitrary or value-driven judgments.</p>","PeriodicalId":46703,"journal":{"name":"Theoretical Medicine and Bioethics","volume":"41 2-3","pages":"83-97"},"PeriodicalIF":1.4,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s11017-020-09526-9","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38327085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Addressing complex hospital discharge by cultivating the virtues of acknowledged dependence. 通过培养承认依赖的美德来解决复杂的出院问题。
IF 1.4 3区 哲学
Theoretical Medicine and Bioethics Pub Date : 2020-06-01 DOI: 10.1007/s11017-020-09525-w
Annie B Friedrich
{"title":"Addressing complex hospital discharge by cultivating the virtues of acknowledged dependence.","authors":"Annie B Friedrich","doi":"10.1007/s11017-020-09525-w","DOIUrl":"https://doi.org/10.1007/s11017-020-09525-w","url":null,"abstract":"<p><p>Every day around the country, patients are discharged from hospitals without difficulty, as the interests of the hospital and the patient tend to align: both the hospital and the patient want the patient to leave and go to a setting that will promote the patient's continued recovery. In some cases, however, this usually routine process does not go quite as smoothly. Patients may not want to leave the hospital, or they may insist on an unsafe discharge plan. In other cases, there may simply be no good place for the patient to go. These complex hospital discharge situations often involve ethical, legal, financial, and practical considerations, but the ethical issues inherent in these dilemmas have received only sporadic attention from clinical ethicists at best, leaving patients, providers, administrators, and caregivers unsure about what to do. When the ethical issues are in fact brought to light, analysis usually proceeds based on a consideration of the principles of autonomy, beneficence, nonmaleficence, and justice. However, principled analysis often fails to present patients and providers with a satisfactory solution, as the principles inevitably conflict (for example, when the patient's autonomous desire to remain in the hospital conflicts with the principles of beneficence and justice). In this paper, I argue that difficult discharges are ethical dilemmas worthy of scholarly attention that goes beyond principlism, and I argue that providers and those involved in discharge planning ought to cultivate what philosopher Alasdair MacIntyre calls \"virtues of acknowledged dependence\" in order to care for these patients and their families. I first trace the current conversation about difficult discharge and show that the principled approach to resolving discharge dilemmas is not sufficient. I then argue that a new approach is needed, and to that end, I offer practical ways in which MacIntyre's account of the virtues of acknowledged dependence may help patients, providers, and family members to navigate issues of difficult discharge.</p>","PeriodicalId":46703,"journal":{"name":"Theoretical Medicine and Bioethics","volume":"41 2-3","pages":"99-114"},"PeriodicalIF":1.4,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s11017-020-09525-w","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38232234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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: 2
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