Theoretical Medicine and Bioethics最新文献_第8页

The prospects of precision psychiatry. 精准精神病学的前景。

IF 1.4 3区哲学

Theoretical Medicine and Bioethics Pub Date : 2021-12-01 Epub Date: 2022-02-01 DOI: 10.1007/s11017-022-09558-3

Kathryn Tabb, Maël Lemoine

{"title":"The prospects of precision psychiatry.","authors":"Kathryn Tabb, Maël Lemoine","doi":"10.1007/s11017-022-09558-3","DOIUrl":"https://doi.org/10.1007/s11017-022-09558-3","url":null,"abstract":"Since the turn of the twenty-first century, biomedical psychiatry around the globe has embraced the so-called precision medicine paradigm, a model for medical research that uses innovative techniques for data collection and analysis to reevaluate traditional theories of disease. The goal of precision medicine is to improve diagnostics by restratifying the patient population on the basis of a deeper understanding of disease processes. This paper argues that precision is ill-fitting for psychiatry for two reasons. First, in psychiatry, unlike in fields like oncology, precision medicine has been understood as an attempt to improve medicine by casting out, rather than merely revising, traditional taxonomic tools. Second, in psychiatry the term \"biomarker\" is often used in reference to signs or symptoms that allow patients to be classified and then matched with treatments; however, in oncology \"biomarker\" usually refers to a disease mechanism that is useful not only for diagnostics, but also for discovering causal pathways that drug therapies can target. Given these differences between how the precision medicine paradigm operates in psychiatry and in other medical fields like oncology, while precision psychiatry may offer successful rhetoric, it is not a promising paradigm.","PeriodicalId":46703,"journal":{"name":"Theoretical Medicine and Bioethics","volume":"42 5-6","pages":"193-210"},"PeriodicalIF":1.4,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39578621","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: 6

Is the replication crisis a base-rate fallacy? 复制危机是基本率谬论吗?

IF 1.4 3区哲学

Theoretical Medicine and Bioethics Pub Date : 2021-12-01 DOI: 10.1007/s11017-022-09561-8

B. Autzen

引用次数: 4

What is morally at stake when using algorithms to make medical diagnoses? Expanding the discussion beyond risks and harms. 使用算法进行医疗诊断在道德上有何利害关系？将讨论扩展到风险和危害之外。

IF 1.1 3区哲学

Theoretical Medicine and Bioethics Pub Date : 2021-12-01 Epub Date: 2022-01-01 DOI: 10.1007/s11017-021-09553-0

Bas de Boer, Olya Kudina

{"title":"What is morally at stake when using algorithms to make medical diagnoses? Expanding the discussion beyond risks and harms.","authors":"Bas de Boer, Olya Kudina","doi":"10.1007/s11017-021-09553-0","DOIUrl":"10.1007/s11017-021-09553-0","url":null,"abstract":"In this paper, we examine the qualitative moral impact of machine learning-based clinical decision support systems in the process of medical diagnosis. To date, discussions about machine learning in this context have focused on problems that can be measured and assessed quantitatively, such as by estimating the extent of potential harm or calculating incurred risks. We maintain that such discussions neglect the qualitative moral impact of these technologies. Drawing on the philosophical approaches of technomoral change and technological mediation theory, which explore the interplay between technologies and morality, we present an analysis of concerns related to the adoption of machine learning-aided medical diagnosis. We analyze anticipated moral issues that machine learning systems pose for different stakeholders, such as bias and opacity in the way that models are trained to produce diagnoses, changes to how health care providers, patients, and developers understand their roles and professions, and challenges to existing forms of medical legislation. Albeit preliminary in nature, the insights offered by the technomoral change and the technological mediation approaches expand and enrich the current discussion about machine learning in diagnostic practices, bringing distinct and currently underexplored areas of concern to the forefront. These insights can contribute to a more encompassing and better informed decision-making process when adapting machine learning techniques to medical diagnosis, while acknowledging the interests of multiple stakeholders and the active role that technologies play in generating, perpetuating, and modifying ethical concerns in health care.","PeriodicalId":46703,"journal":{"name":"Theoretical Medicine and Bioethics","volume":"42 5-6","pages":"245-266"},"PeriodicalIF":1.1,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8907081/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39781766","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: 0

Wakefield's harmful dysfunction analysis of disorder and the problem of defining harm to nonsentient organisms. 韦克菲尔德的有害功能障碍分析以及定义对无知觉生物的伤害的问题。

IF 1.4 3区哲学

Theoretical Medicine and Bioethics Pub Date : 2021-12-01 Epub Date: 2022-02-24 DOI: 10.1007/s11017-022-09559-2

Antoine C Dussault

{"title":"Wakefield's harmful dysfunction analysis of disorder and the problem of defining harm to nonsentient organisms.","authors":"Antoine C Dussault","doi":"10.1007/s11017-022-09559-2","DOIUrl":"https://doi.org/10.1007/s11017-022-09559-2","url":null,"abstract":"This paper criticizes Jerome Wakefield's harmful dysfunction analysis (HDA) of disorder by arguing that the conceptual linkage it establishes between the medical concepts of health and disorder and the prudential notions of well-being and harm makes the account inapplicable to nonsentient organisms, such as plants, fungi, and many invertebrate animals. Drawing on a previous formulation of this criticism by Christopher Boorse, and noting that Wakefield could avoid it if he adopted a partly biofunction-based account of interests like that often advocated in the field of environmental ethics, I argue that integrating such an account of interests into the HDA would generate serious concerns. Specifically, it would make dysfunction sufficient for disorder and so reestablish between dysfunction and disorder precisely the kind of sufficiency relation that harm-requiring accounts of disorder strive to avoid; blur the line between the HDA's dysfunction and harm components and, in so doing, deprive the HDA of its alleged main advantage over monistic dysfunction-based accounts of disorders like Boorse's; and tie the HDA to an understanding of harm that is in itself problematic. I argue that these three concerns, and the dilemmas they generate, rob the HDA of much of its prima facie appeal, ultimately indicating that a satisfactory account of disorder should most likely eschew all references to prudential notions of well-being and harm.","PeriodicalId":46703,"journal":{"name":"Theoretical Medicine and Bioethics","volume":"42 5-6","pages":"211-231"},"PeriodicalIF":1.4,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39662259","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

Why bother the public? A critique of Leslie Cannold's empirical research on ectogenesis. 为什么要打扰公众?对莱斯利·坎诺德关于胚胎发生的实证研究的批判。

IF 1.4 3区哲学

Theoretical Medicine and Bioethics Pub Date : 2021-08-01 Epub Date: 2021-11-30 DOI: 10.1007/s11017-021-09549-w

Anna Smajdor

{"title":"Why bother the public? A critique of Leslie Cannold's empirical research on ectogenesis.","authors":"Anna Smajdor","doi":"10.1007/s11017-021-09549-w","DOIUrl":"https://doi.org/10.1007/s11017-021-09549-w","url":null,"abstract":"Can discussion with members of the public show philosophers where they have gone wrong? Leslie Cannold argues that it can in her 1995 paper 'Women, Ectogenesis and Ethical Theory', which investigates the ways in which women reason about abortion and ectogenesis (the gestation of foetuses in artificial wombs). In her study, Cannold interviewed female non-philosophers. She divided her participants into separate 'pro-life' and 'pro-choice' groups and asked them to consider whether the availability of ectogenesis would change their views about the morality of dealing with an unwanted pregnancy. The women in Cannold's study gave responses that did not map onto the dominant tropes in the philosophical literature. Yet Cannold did not attempt to reason with her participants, and her engagement with the philosophical literature is oddly limited, focussing only on the pro-choice perspective. In this paper, I explore the question of whether Cannold is correct that philosophers' reasoning about abortion is lacking in some way. I suggest that there are alternative conclusions to be drawn from the data she gathered and that a critical approach is necessary when attempting to undertake philosophy informed by empirical data.","PeriodicalId":46703,"journal":{"name":"Theoretical Medicine and Bioethics","volume":"42 3-4","pages":"155-168"},"PeriodicalIF":1.4,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8695417/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39678697","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

Experimental philosophy of medicine and the concepts of health and disease. 医学的实验哲学以及健康和疾病的概念。

IF 1.4 3区哲学

Theoretical Medicine and Bioethics Pub Date : 2021-08-01 Epub Date: 2021-12-01 DOI: 10.1007/s11017-021-09550-3

Walter Veit

引用次数: 14

Transposon dynamics and the epigenetic switch hypothesis. 转座子动力学和表观遗传开关假说。

IF 1.4 3区哲学

Theoretical Medicine and Bioethics Pub Date : 2021-08-01 Epub Date: 2021-12-17 DOI: 10.1007/s11017-021-09548-x

Stefan Linquist, Brady Fullerton

{"title":"Transposon dynamics and the epigenetic switch hypothesis.","authors":"Stefan Linquist, Brady Fullerton","doi":"10.1007/s11017-021-09548-x","DOIUrl":"https://doi.org/10.1007/s11017-021-09548-x","url":null,"abstract":"The recent explosion of interest in epigenetics is often portrayed as the dawning of a scientific revolution that promises to transform biomedical science along with developmental and evolutionary biology. Much of this enthusiasm surrounds what we call the epigenetic switch hypothesis, which regards certain examples of epigenetic inheritance as an adaptive organismal response to environmental change. This interpretation overlooks an alternative explanation in terms of coevolutionary dynamics between parasitic transposons and the host genome. This raises a question about whether epigenetics researchers tend to overlook transposon dynamics more generally. To address this question, we surveyed a large sample of scientific publications on the topics of epigenetics and transposons over the past fifty years. We found that enthusiasm for epigenetics is often inversely related to interest in transposon dynamics across the four disciplines we examined. Most surprising was a declining interest in transposons within biomedical science and cellular and molecular biology over the past two decades. Also notable was a delayed and relatively muted enthusiasm for epigenetics within evolutionary biology. An analysis of scientific abstracts from the past twenty-five years further reveals systematic differences among disciplines in their uses of the term epigenetic, especially with respect to heritability commitments and functional interpretations. Taken together, these results paint a nuanced picture of the rise of epigenetics and the possible neglect of transposon dynamics, especially among biomedical scientists.","PeriodicalId":46703,"journal":{"name":"Theoretical Medicine and Bioethics","volume":"42 3-4","pages":"137-154"},"PeriodicalIF":1.4,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8938347/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39734514","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: 3

A plea for an experimental philosophy of medicine. 对医学实验哲学的请求。

IF 1.4 3区哲学

Theoretical Medicine and Bioethics Pub Date : 2021-08-01 Epub Date: 2021-12-17 DOI: 10.1007/s11017-021-09551-2

Andreas De Block, Kristien Hens

引用次数: 4

Pain priors, polyeidism, and predictive power: a preliminary investigation into individual differences in ordinary thought about pain. 疼痛先验、多义性和预测力：关于疼痛的普通思维中个体差异的初步调查。

IF 1.1 3区哲学

Theoretical Medicine and Bioethics Pub Date : 2021-08-01 Epub Date: 2021-12-17 DOI: 10.1007/s11017-021-09552-1

Emma Borg, Sarah A Fisher, Nat Hansen, Richard Harrison, Deepak Ravindran, Tim V Salomons, Harriet Wilkinson

{"title":"Pain priors, polyeidism, and predictive power: a preliminary investigation into individual differences in ordinary thought about pain.","authors":"Emma Borg, Sarah A Fisher, Nat Hansen, Richard Harrison, Deepak Ravindran, Tim V Salomons, Harriet Wilkinson","doi":"10.1007/s11017-021-09552-1","DOIUrl":"10.1007/s11017-021-09552-1","url":null,"abstract":"According to standard philosophical and clinical understandings, pain is an essentially mental phenomenon (typically, a kind of conscious experience). In a challenge to this standard conception, a recent burst of empirical work in experimental philosophy, such as that by Justin Sytsma and Kevin Reuter, purports to show that people ordinarily conceive of pain as an essentially bodily phenomenon-specifically, a quality of bodily disturbance. In response to this bodily view, other recent experimental studies have provided evidence that the ordinary ('folk') concept of pain is more complex than previously assumed: rather than tracking only bodily or only mental aspects of pain, the ordinary concept of pain can actually track either of these aspects. The polyeidic (or 'many ideas') analysis of the folk concept of pain, as proposed by Emma Borg et al., captures this complexity. Whereas previous empirical support for the polyeidic view has focused on the context-sensitivity of the folk concept of pain, here we discuss individual differences in people's 'pain priors'-namely, their standing tendencies to think of pain in relatively mind-centric or body-centric ways. We describe a preliminary empirical study and present a small number of findings, which will be explored further in future work. The results we discuss are part of a larger programme of work which seeks to integrate philosophical pain research into clinical practice. For example, we hypothesise that variations in how patients with chronic pain are thinking about pain could help predict their responses to treatment.","PeriodicalId":46703,"journal":{"name":"Theoretical Medicine and Bioethics","volume":"42 3-4","pages":"113-135"},"PeriodicalIF":1.1,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8938353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39734904","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: 0

Experimental philosophical bioethics and normative inference. 实验哲学生命伦理学与规范推理。

IF 1.4 3区哲学

Theoretical Medicine and Bioethics Pub Date : 2021-08-01 Epub Date: 2021-11-17 DOI: 10.1007/s11017-021-09546-z

Brian D Earp, Jonathan Lewis, Vilius Dranseika, Ivar R Hannikainen

引用次数: 18