Health Care Analysis最新文献_第10页

From 'Consent or Anonymise' to 'Share and Protect': Facilitating Access to Surplus Tissue for Research Whilst Safeguarding Donor Interests. 从“同意或匿名”到“分享和保护”:促进获取多余组织用于研究，同时维护捐赠者的利益。

IF 1.9 3区哲学

Health Care Analysis Pub Date : 2021-09-01 Epub Date: 2021-07-14 DOI: 10.1007/s10728-021-00435-z

Catherine Blewett

{"title":"From 'Consent or Anonymise' to 'Share and Protect': Facilitating Access to Surplus Tissue for Research Whilst Safeguarding Donor Interests.","authors":"Catherine Blewett","doi":"10.1007/s10728-021-00435-z","DOIUrl":"https://doi.org/10.1007/s10728-021-00435-z","url":null,"abstract":"There is significant research value in the secondary use of surplus human tissue which has been removed during clinical care and is stored in diagnostic archives. However, this value is limited without access to information about the person from whom the tissue was removed. As the research value of surplus tissue is often not realised until after the patient's episode of care, it is often the case that no consent has been given for any surplus tissue to be used for research purposes. The Human Tissue Act 2004 does permit research use of surplus tissue without consent, but the researcher must not be in possession of information which could identify the person from whom the tissue was removed. Due to the commonly applied 'consent or anonymise' approach, linking tissue and data is challenging and full anonymisation would likely render much research on surplus tissue ineffectual. This article suggests that in recognising the value in surplus tissue linked with information about the person, a 'share and protect' approach which considers safeguards other than anonymisation, where obtaining consent for research use would not be feasible, would better balance the public benefit of health research with the protection of individual rights and interests than a requirement for either consent or anonymisation.","PeriodicalId":46740,"journal":{"name":"Health Care Analysis","volume":"29 3","pages":"213-230"},"PeriodicalIF":1.9,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8321992/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39186302","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

'We Should View Him as an Individual': The Role of the Child's Future Autonomy in Shared Decision-Making About Unsolicited Findings in Pediatric Exome Sequencing. “我们应该把他视为一个个体”:儿童未来自主决策在儿童外显子组测序中主动发现的作用。

IF 1.9 3区哲学

Health Care Analysis Pub Date : 2021-09-01 Epub Date: 2021-01-02 DOI: 10.1007/s10728-020-00425-7

W Dondorp, I Bolt, A Tibben, G De Wert, M Van Summeren

{"title":"'We Should View Him as an Individual': The Role of the Child's Future Autonomy in Shared Decision-Making About Unsolicited Findings in Pediatric Exome Sequencing.","authors":"W Dondorp, I Bolt, A Tibben, G De Wert, M Van Summeren","doi":"10.1007/s10728-020-00425-7","DOIUrl":"https://doi.org/10.1007/s10728-020-00425-7","url":null,"abstract":"In debates about genetic testing of children, as well as about disclosing unsolicited findings (UFs) of pediatric exome sequencing, respect for future autonomy should be regarded as a prima facie consideration for not taking steps that would entail denying the future adult the opportunity to decide for herself about what to know about her own genome. While the argument can be overridden when other, morally more weighty considerations are at stake, whether this is the case can only be determined in concrete cases. Importantly, when children grow into adolescents, respect for future autonomy will have to give way to respecting their emerging autonomy. When pediatric exome sequencing is done for complex conditions not involving developmental delay, respect for the child's future or emerging autonomy should be a primary consideration for those charged with deciding on behalf of the child. Building on what Emanuel and Emanuel have termed the 'deliberative model' of shared decision making, we argue that if parents fail to give these considerations their due, professionals should actively invite them to do so. Taking a directive stance may be needed in order to make sure that the future or emerging autonomy of the child are duly considered in the decision-making process, but also to help the parents and themselves to shape their respective roles as responsible care-givers.","PeriodicalId":46740,"journal":{"name":"Health Care Analysis","volume":"29 3","pages":"249-261"},"PeriodicalIF":1.9,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s10728-020-00425-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38773275","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

A New Argument for No-Fault Compensation in Health Care: The Introduction of Artificial Intelligence Systems. 医疗保健无过错赔偿的新论点:人工智能系统的引入。

IF 1.9 3区哲学

Health Care Analysis Pub Date : 2021-09-01 Epub Date: 2021-03-21 DOI: 10.1007/s10728-021-00430-4

Søren Holm, Catherine Stanton, Benjamin Bartlett

引用次数: 10

The Doctor as Parent, Partner, Provider… or Comrade? Distribution of Power in Past and Present Models of the Doctor-Patient Relationship. 医生是父母、伙伴、提供者还是同志?过去和现在的医患关系模型中的权力分配。

IF 1.9 3区哲学

Health Care Analysis Pub Date : 2021-09-01 Epub Date: 2021-04-27 DOI: 10.1007/s10728-021-00432-2

Mani Shutzberg

{"title":"The Doctor as Parent, Partner, Provider… or Comrade? Distribution of Power in Past and Present Models of the Doctor-Patient Relationship.","authors":"Mani Shutzberg","doi":"10.1007/s10728-021-00432-2","DOIUrl":"https://doi.org/10.1007/s10728-021-00432-2","url":null,"abstract":"The commonly occurring metaphors and models of the doctor-patient relationship can be divided into three clusters, depending on what distribution of power they represent: in the paternalist cluster, power resides with the physician; in the consumer model, power resides with the patient; in the partnership model, power is distributed equally between doctor and patient. Often, this tripartite division is accepted as an exhaustive typology of doctor-patient relationships. The main objective of this paper is to challenge this idea by introducing a fourth possibility and distribution of power, namely, the distribution in which power resides with neither doctor nor patient. This equality in powerlessness-the hallmark of \"the age of bureaucratic parsimony\"-is the point of departure for a qualitatively new doctor-patient relationship, which is best described in terms of solidarity between comrades. This paper specifies the characteristics of this specific type of solidarity and illustrates it with a case study of how Swedish doctors and patients interrelate in the sickness certification practice.","PeriodicalId":46740,"journal":{"name":"Health Care Analysis","volume":"29 3","pages":"231-248"},"PeriodicalIF":1.9,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s10728-021-00432-2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38913002","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

Prospective Intention-Based Lifestyle Contracts: mHealth Technology and Responsibility in Healthcare. 基于意向的前瞻性生活方式契约：移动医疗技术与医疗保健中的责任。

IF 1.8 3区哲学

Health Care Analysis Pub Date : 2021-09-01 Epub Date: 2021-01-11 DOI: 10.1007/s10728-020-00424-8

Emily Feng-Gu, Jim Everett, Rebecca C H Brown, Hannah Maslen, Justin Oakley, Julian Savulescu

{"title":"Prospective Intention-Based Lifestyle Contracts: mHealth Technology and Responsibility in Healthcare.","authors":"Emily Feng-Gu, Jim Everett, Rebecca C H Brown, Hannah Maslen, Justin Oakley, Julian Savulescu","doi":"10.1007/s10728-020-00424-8","DOIUrl":"10.1007/s10728-020-00424-8","url":null,"abstract":"As the rising costs of lifestyle-related diseases place increasing strain on public healthcare systems, the individual's role in disease may be proposed as a healthcare rationing criterion. Literature thus far has largely focused on retrospective responsibility in healthcare. The concept of prospective responsibility, in the form of a lifestyle contract, warrants further investigation. The responsibilisation in healthcare debate also needs to take into account innovative developments in mobile health technology, such as wearable biometric devices and mobile apps, which may change how we hold others accountable for their lifestyles. Little is known about public attitudes towards lifestyle contracts and the use of mobile health technology to hold people responsible in the context of healthcare. This paper has two components. Firstly, it details empirical findings from a survey of 81 members of the United Kingdom general public on public attitudes towards individual responsibility and rationing healthcare, prospective and retrospective responsibility, and the acceptability of lifestyle contracts in the context of mobile health technology. Secondly, we draw on the empirical findings and propose a model of prospective intention-based lifestyle contracts, which is both more aligned with public intuitions and less ethically objectionable than more traditional, retrospective models of responsibility in healthcare.","PeriodicalId":46740,"journal":{"name":"Health Care Analysis","volume":"29 3","pages":"189-212"},"PeriodicalIF":1.8,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8321967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38805683","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

Here comes trouble. 麻烦来了。

IF 1.9 3区哲学

Health Care Analysis Pub Date : 2021-07-15 DOI: 10.1142/9789811239564_0014

L. Repchull

引用次数: 0

Foucault's Concept of Clinical Gaze Today. 福柯今天的临床凝视概念。

IF 1.9 3区哲学

Health Care Analysis Pub Date : 2021-06-01 DOI: 10.1007/s10728-020-00402-0

Aleksandar J Ristić, Adriana Zaharijević, Nenad Miličić

引用次数: 3

How to Draw the Line Between Health and Disease? Start with Suffering. 如何在健康和疾病之间划清界限?从痛苦开始。

IF 1.9 3区哲学

Health Care Analysis Pub Date : 2021-06-01 Epub Date: 2021-04-29 DOI: 10.1007/s10728-021-00434-0

Bjørn Hofmann

{"title":"How to Draw the Line Between Health and Disease? Start with Suffering.","authors":"Bjørn Hofmann","doi":"10.1007/s10728-021-00434-0","DOIUrl":"https://doi.org/10.1007/s10728-021-00434-0","url":null,"abstract":"How can we draw the line between health and disease? This crucial question of demarcation has immense practical implications and has troubled scholars for ages. The question will be addressed in three steps. First, I will present an important contribution by Rogers and Walker who argue forcefully that no line can be drawn between health and disease. However, a closer analysis of their argument reveals that a line-drawing problem for disease-related features does not necessarily imply a line-drawing problem for disease as such. The second step analyzes some alternative approaches to drawing the line between health and disease. While these approaches do not provide full answers to the question, they indicate that the line-drawing question should not be dismissed too hastily. The third step investigates whether the line-drawing problem can find its solution in the concept of suffering. In particular, I investigate whether returning to the origin of medicine, with the primary and ultimate goal of reducing suffering, may provide sources of demarcation between health and disease. In fact, the reason why we pay attention to particular phenomena as characteristics of disease, consider certain processes to be relevant, and specific functions are classified as dys-functions, is that they are related to suffering. Accordingly, using suffering as a criterion of demarcation between health and disease may hinder a wide range of challenges with modern medicine, such as unwarranted expansion of disease, overdiagnosis, overtreatment, and medicalization.","PeriodicalId":46740,"journal":{"name":"Health Care Analysis","volume":"29 2","pages":"127-143"},"PeriodicalIF":1.9,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s10728-021-00434-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38932749","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

The Teaching of Ethics and the Moral Competence of Medical and Nursing Students. 伦理学教学与医护生道德素质。

IF 1.9 3区哲学

Health Care Analysis Pub Date : 2021-06-01 Epub Date: 2020-09-17 DOI: 10.1007/s10728-020-00401-1

Vera Sílvia Meireles Martins, Cristina Maria Nogueira Costa Santos, Patrícia Unger Raphael Bataglia, Ivone Maria Resende Figueiredo Duarte

{"title":"The Teaching of Ethics and the Moral Competence of Medical and Nursing Students.","authors":"Vera Sílvia Meireles Martins, Cristina Maria Nogueira Costa Santos, Patrícia Unger Raphael Bataglia, Ivone Maria Resende Figueiredo Duarte","doi":"10.1007/s10728-020-00401-1","DOIUrl":"https://doi.org/10.1007/s10728-020-00401-1","url":null,"abstract":"In a time marked by the development of innovative treatments in healthcare and the need for health professionals to deal with resulting ethical dilemmas in clinical practice, this study was developed to determine the influence of the bioethics teaching on the moral competence of medical and nursing students. The authors conduct a longitudinal study using the Moral Competence Test extended version before and after attending the ethics curricular unit, in three nursing schools and three medical schools of Portugal. In this questionnaire the participant is confronted with three ethical dilemmas (related to theft, euthanasia and the torture of a terrorist) and asked to evaluate arguments for and against the attitude of the main character (Worker, doctor and judge). For both nursing and medical students, C-score was lower after the attendance of the ethics curricular units, with a statistically significant decrease in the total score (from 21 to 19.5 on average; p = 0.046) for nursing students and a decrease not statistically significant for medical students (from 23.2 to 22 on average; p = 0.358). A multivariate analysis did not find any association between this decrease and gender, course, or age. The phenomenon of moral segmentation was observed, with better performance in the worker and judge dilemma, than in the doctor dilemma. These results highlight the need to reflect on the curricular strategies that can be implemented for health professionals to better develop moral competence and decision-making, allowing for the provision of humanized health care.","PeriodicalId":46740,"journal":{"name":"Health Care Analysis","volume":"29 2","pages":"113-126"},"PeriodicalIF":1.9,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s10728-020-00401-1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38395005","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: 17

Witnessing Quality of Life of Persons with Profound Intellectual and Multiple Disabilities. A practical-Philosophical Approach. 见证重度智力残疾者和多重残疾者的生活质量。实用哲学方法。

IF 1.9 3区哲学

Health Care Analysis Pub Date : 2021-06-01 Epub Date: 2021-03-17 DOI: 10.1007/s10728-021-00428-y

Erik Olsman, Appolonia M Nieuwenhuijse, Dick L Willems

{"title":"Witnessing Quality of Life of Persons with Profound Intellectual and Multiple Disabilities. A practical-Philosophical Approach.","authors":"Erik Olsman, Appolonia M Nieuwenhuijse, Dick L Willems","doi":"10.1007/s10728-021-00428-y","DOIUrl":"https://doi.org/10.1007/s10728-021-00428-y","url":null,"abstract":"Persons with profound intellectual and multiple disabilities (PIMD) cannot speak about their Quality of Life (QoL), which makes it necessary to involve others. In current approaches, these 'others' are seen as assessors trying to describe QoL as objectively as possible, which involves a reduction of their experiences, through which they develop knowledge on the QoL of the person with PIMD. The objective of this paper is to give caregivers' knowledge on the QoL of a person with PIMD a theoretical basis that values these experiences. We will argue that caregivers should be seen as witnesses, not assessors, and their statements on QoL as testimonies, not assessments. Audiences judge the trustworthiness of these witnesses intersubjectively, which implies a relationship characterized by trust and suspicion. Trust supports the witness to tell in her own words about the QoL of the person with PIMD; it demands receptivity, indicating that both the witness and the audience are willing to reconsider their perspective on QoL. Suspicion is necessary too, which helps the witness to critically approach her own interpretations and supports her to create more trustworthy testimonies. We conclude that the concept of witnessing helps to acknowledge caregivers' experiential knowledge of QoL of a person with PIMD, which may also apply to other persons who cannot speak about their own QoL. We hope that our study will empower caregivers to give testimonies on QoL of a person with PIMD, which is crucial when complex decisions about the life of this person have to be made.","PeriodicalId":46740,"journal":{"name":"Health Care Analysis","volume":"29 2","pages":"144-153"},"PeriodicalIF":1.9,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s10728-021-00428-y","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25488915","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