Health Care Analysis最新文献_第10页

Hospitalizations at Home in Israel, a Retrospective Observational Study. 以色列家庭住院：一项回顾性观察研究

IF 1.4 3区哲学

Health Care Analysis Pub Date : 2025-12-01 Epub Date: 2025-09-27 DOI: 10.1007/s10728-025-00544-z

Hanna Schroeder, Yitzhak Ben Menachem, Netta Bentur, Dina Cherno, Lior Barak, Ayelet Grinbaum Arizon

{"title":"Hospitalizations at Home in Israel, a Retrospective Observational Study.","authors":"Hanna Schroeder, Yitzhak Ben Menachem, Netta Bentur, Dina Cherno, Lior Barak, Ayelet Grinbaum Arizon","doi":"10.1007/s10728-025-00544-z","DOIUrl":"10.1007/s10728-025-00544-z","url":null,"abstract":"Israel's aging population and demographic growth have driven a surge in hospitalizations, prompting the Ministry of Health to expand community-based care. In 2019, a financial incentive was introduced, special payments to health maintenance organizations (HMOs) for Hospital at Home (HaH) services, implemented in 2020. This study examines changes in the volume and geographic distribution of HaH following this policy. We analyzed retrospective Ministry of Health data on all HaH admissions from 2017-2023, excluding COVID-19 cases. Data included length of stay, referral source (hospital vs. community), patient age, and residence. HMOs reported 70,203 HaH admissions during the study period, increasing from only 8 in 2017 to 33,141 in 2023. Growth was most rapid after the payment policy was introduced. The mean monthly HaH days rose sharply, reaching 2762 in 2023. Over time, the proportion of HaH admissions from central Israel increased, while peripheral areas saw a relative decline. Readmission rates to HaH were low-3% within 1 week, and 8%, 15%, and 23% within 1, 3, and 6 months, respectively. HaH could play a significant role in meeting Israel's growing demand for inpatient care. To maximize its impact, policy efforts should address barriers to expansion, particularly in peripheral regions, and promote more equitable geographic access.","PeriodicalId":46740,"journal":{"name":"Health Care Analysis","volume":" ","pages":"401-412"},"PeriodicalIF":1.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179410","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

History of the Autism Diagnosis- How the Perspectives Have Changed. 自闭症诊断的历史-观点是如何改变的。

IF 1.4 3区哲学

Health Care Analysis Pub Date : 2025-12-01 Epub Date: 2025-05-29 DOI: 10.1007/s10728-025-00527-0

Heldi Marleen Lang

{"title":"History of the Autism Diagnosis- How the Perspectives Have Changed.","authors":"Heldi Marleen Lang","doi":"10.1007/s10728-025-00527-0","DOIUrl":"10.1007/s10728-025-00527-0","url":null,"abstract":"The diagnosis and perception of autism have undergone significant transformations throughout history. Initially conceptualised as a symptom of schizophrenia, autism later emerged as a distinct diagnosis, evolving into the broader classification of autism spectrum disorder (ASD). This essay explores the main shifts in the understanding of autism throughout its history and different approaches to its treatment. While the traditional psychiatric perspective aligns with a naturalist view of disease, the Neurodiversity Movement advocates for a normative approach, emphasising societal adaptation over medical intervention. The study examines historical milestones, including the contributions of Eugen Bleuler, Grunya Sukhareva, Leo Kanner, and Hans Asperger, alongside the conceptual transition from low- and high-functioning autism to the spectrum model. It also discusses the implications of language in shaping autism discourse, highlighting the shift from person-first to identity-first terminology. The essay ultimately argues that the expansion of the autism diagnosis supports the neurodiversity paradigm, which fosters greater inclusion and empowerment of neurodivergent individuals. However, considerations of severity and linguistic framing remain crucial in advancing this perspective.","PeriodicalId":46740,"journal":{"name":"Health Care Analysis","volume":" ","pages":"337-348"},"PeriodicalIF":1.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175331","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

Collaboration During Crisis: New Graduates' Experiences of Interprofessional Practice During the COVID-19 Pandemic. 危机中的协作：新冠肺炎大流行期间应届毕业生的跨专业实践经验。

IF 1.4 3区哲学

Health Care Analysis Pub Date : 2025-12-01 Epub Date: 2025-09-18 DOI: 10.1007/s10728-025-00540-3

Lindsay Van Dam, Sheri L Price, Hossein Khalili, John H V Gilbert

{"title":"Collaboration During Crisis: New Graduates' Experiences of Interprofessional Practice During the COVID-19 Pandemic.","authors":"Lindsay Van Dam, Sheri L Price, Hossein Khalili, John H V Gilbert","doi":"10.1007/s10728-025-00540-3","DOIUrl":"10.1007/s10728-025-00540-3","url":null,"abstract":"The COVID-19 pandemic presented unprecedented challenges for health and social care practice worldwide. Ensuring effective collaboration between health and social care is essential to meet population health needs- especially during crisis. Interprofessional education for collaborative practice (IPECP) during students' pre-licensure education is an important primer for collaboration in practice. Within IPECP, students are provided opportunities to learn about, with, and from each other, lending to professional and interprofessional socialization and processes of developing an interprofessional identity. Few studies have followed health professions graduates longitudinally from pre-licensure into professional practice to understand how IPECP supports new professionals' readiness for collaborative practice. The COVID-19 pandemic coincided with the timing of this longitudinal study of students' experiences of IPECP and collaboration upon entry to practice. This interpretive, narrative analysis provides novel insights to how collaboration was experienced during the pandemic and implications for interprofessional identity development. The participant narratives provide insight into the contexts, settings, and experiences that were critical catalysts for connection and collaboration between professionals. Findings support a need for IPECP throughout pre-licensure and into practice and provides important direction for innovative curricula, policy and practice development to prepare future collaborative practitioners and interprofessional teams.","PeriodicalId":46740,"journal":{"name":"Health Care Analysis","volume":" ","pages":"349-367"},"PeriodicalIF":1.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082003","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

Impact of Mindfulness, Emotional Intelligence, and Employee Well-being on Mental Healthcare of Workers' Affectiveness: The Mediating Role of Employee Satisfaction and the Moderating Effect of Digital Leadership. 正念、情绪智力和员工幸福感对员工情感心理健康的影响：员工满意度的中介作用和数字领导的调节作用

IF 1.4 3区哲学

Health Care Analysis Pub Date : 2025-12-01 Epub Date: 2025-05-28 DOI: 10.1007/s10728-025-00523-4

Junjian Zheng, Hao Hong, Nan Wang, JiuJian Sun, Xiaowei Xu

{"title":"Impact of Mindfulness, Emotional Intelligence, and Employee Well-being on Mental Healthcare of Workers' Affectiveness: The Mediating Role of Employee Satisfaction and the Moderating Effect of Digital Leadership.","authors":"Junjian Zheng, Hao Hong, Nan Wang, JiuJian Sun, Xiaowei Xu","doi":"10.1007/s10728-025-00523-4","DOIUrl":"10.1007/s10728-025-00523-4","url":null,"abstract":"Recently, the most critical psychological challenges have compelled healthcare professionals to confront their mental health issues. Consequently, many employees experiencing elevated levels of psychological stress have reported disengagement and dissatisfaction across various aspects of their work. Given the strong association between individual well-being and job satisfaction, how healthcare employees regulate their emotions and psychological health to attain job satisfaction remains largely unexplored. To address this issue, the present study investigates the effects of mindfulness, emotional intelligence, and employee well-being on healthcare workers' emotional and mental health while considering the mediating role of employee satisfaction and the moderating role of digital leadership. Data were collected through a structured questionnaire distributed to 633 healthcare employees in China. We employed SPSS and Smart PLS for reliability, discriminant validity, and structural equation modeling analyses. The findings reveal that mindfulness (MFN), emotional intelligence (EI), and employee well-being (EWB) significantly and positively influence both emotional health (EH) and mental health (MH). Furthermore, employee satisfaction (ES) mediated the relationship between mindfulness, emotional intelligence, and employee well-being to emotional and mental health. The moderating role of digital leadership (DL) was also examined, demonstrating its influence on emotional and mental health. These findings hold important implications for healthcare professionals, managers, policymakers, practitioners, and other stakeholders seeking to enhance employee well-being and job satisfaction in healthcare settings.","PeriodicalId":46740,"journal":{"name":"Health Care Analysis","volume":" ","pages":"368-400"},"PeriodicalIF":1.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144162830","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

Analysing the Suitability of Artificial Intelligence in Healthcare and the Role of AI Governance. 分析人工智能在医疗保健中的适用性和人工智能治理的作用。

IF 1.4 3区哲学

Health Care Analysis Pub Date : 2025-12-01 Epub Date: 2025-03-06 DOI: 10.1007/s10728-025-00514-5

Zhenwei You, Yahui Wang, Yineng Xiao

{"title":"Analysing the Suitability of Artificial Intelligence in Healthcare and the Role of AI Governance.","authors":"Zhenwei You, Yahui Wang, Yineng Xiao","doi":"10.1007/s10728-025-00514-5","DOIUrl":"10.1007/s10728-025-00514-5","url":null,"abstract":"In recent years, artificial intelligence (AI) has become more important in healthcare. It has the ability to completely change how patients are diagnosed, treated, and cared for. To make sure AI is properly supervised in healthcare, many problems need to be solved. This calls for a broad approach that includes policy, technology, and involving important people. This study investigates the governance of AI within healthcare, highlighting the importance of policy, technology, and stakeholder engagement. Adopting a mixed-methods research design, the study encompasses surveys, interviews, and document analysis to comprehensively explore diverse perspectives on AI governance. Purposive sampling techniques were employed to gather 897 valid samples, ensuring diversity across stakeholder groups. Surveys gathered quantitative data on demographic characteristics and attitudes toward AI governance, while interviews provided deeper insights into stakeholders' experiences and recommendations. Document analysis supplemented data collection by reviewing policy documents, guidelines, and academic literature related to AI governance. This study merges quantitative and qualitative data to thoroughly investigate AI governance, enabling the identification of policy implications and actionable recommendations. This study contributes novel insights by adopting a comprehensive approach to AI governance in healthcare, integrating policy, technology, and stakeholder engagement perspectives. Unlike previous studies focusing solely on individual aspects of AI governance, this research provides a holistic understanding of the complex dynamics involved. This research offers important insights into AI governance by investigating the impact of stakeholder engagement, ethical considerations, digital health disparities, governance structures, and health communication strategies on AI integration in healthcare, ultimately aiding in policy development and implementation.","PeriodicalId":46740,"journal":{"name":"Health Care Analysis","volume":" ","pages":"413-445"},"PeriodicalIF":1.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568197","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

Consanguineous Marriage: Law and Public Health. 近亲婚姻：法律与公共卫生。

IF 1.6 3区哲学

Health Care Analysis Pub Date : 2025-12-01 Epub Date: 2025-10-10 DOI: 10.1007/s10728-025-00541-2

Nicola Glover-Thomas

{"title":"Consanguineous Marriage: Law and Public Health.","authors":"Nicola Glover-Thomas","doi":"10.1007/s10728-025-00541-2","DOIUrl":"10.1007/s10728-025-00541-2","url":null,"abstract":"This article examines the complex interplay of cultural practices, genetic health risks, and evolving legal frameworks surrounding consanguineous marriage, with a focus on England and Wales. Consanguineous unions, increase offspring's risk of autosomal recessive genetic disorders and congenital anomalies due to heightened homozygosity. The 'Born in Bradford' study revealed that 37% of babies in the cohort were born to related parents, with over 60% of marriages in the Pakistani-origin population being consanguineous. This was associated with a near doubling of the congenital anomaly risk (3% to 6%) and accounted for an estimated 30% of all congenital anomalies and 25% of infant mortality in Bradford. While Norway and Sweden have recently banned or are set to ban first-cousin marriages, citing public health and forced marriage concerns, England and Wales maintain a permissive stance. Proposed legislation, like the Marriage (Prohibited Degrees of Relationship) Bill 2025, aims to prohibit these unions and is argued to mitigate NHS strain. However, such proposals face significant human rights challenges (right to marry, privacy, non-discrimination) and concerns about driving the practice underground. The paper concludes by advocating for nuanced, culturally sensitive public health strategies-including enhanced genetic counselling, targeted education, and proactive screening-to empower informed choice and improve health outcomes without legal coercion, aiming to balance state responsibility with individual and cultural freedoms.","PeriodicalId":46740,"journal":{"name":"Health Care Analysis","volume":" ","pages":"321-336"},"PeriodicalIF":1.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12634778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276201","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

Professional Practice of Ukrainian Doctors in Germany and Poland-Legal and Ethical Considerations. 乌克兰医生在德国和波兰的专业实践——法律和伦理考虑。

IF 1.6 3区哲学

Health Care Analysis Pub Date : 2025-09-01 Epub Date: 2025-06-07 DOI: 10.1007/s10728-025-00526-1

Helena Hointza, Nikola Biller-Andorno, Michael Leitzmann, Julian Werner März

{"title":"Professional Practice of Ukrainian Doctors in Germany and Poland-Legal and Ethical Considerations.","authors":"Helena Hointza, Nikola Biller-Andorno, Michael Leitzmann, Julian Werner März","doi":"10.1007/s10728-025-00526-1","DOIUrl":"10.1007/s10728-025-00526-1","url":null,"abstract":"The ongoing war in Ukraine, which began in 2022, has displaced millions of people, creating immense challenges for healthcare systems in refugee-receiving countries. While temporary protection aims to grant refugees access to medical care, significant structural barriers and ethical shortcomings exist in refugee healthcare. To meet this challenge, the authors propose considering the integration of displaced physicians into the medical care systems of host countries. This solution not only meets the immediate healthcare demands but also leverages the expertise of Ukrainian doctors. The implementation in Germany and Poland exemplifies the current heterogeneity of regulations governing the professional practice of Ukrainian physicians, with individual workarounds such as the possibility of treating fellow Ukrainians while waiting for the approval of the license. From an ethical perspective, the dilemma between the urgent need for additional physicians and ensuring patient safety by thoroughly assessing all doctors' qualifications is a critical concern. Considering all the analyzed aspects, the authors advocate for harmonizing the regulations across the EU and removing barriers that limit healthcare access for refugees. They further stress the importance of developing comprehensive long-term strategies to ensure sustained healthcare access for Ukrainian refugees.","PeriodicalId":46740,"journal":{"name":"Health Care Analysis","volume":" ","pages":"297-319"},"PeriodicalIF":1.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12361323/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250243","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

Healthcare Workforce Analytics: Computational Analysis of Despotic Leadership on Workplace Deviance, Emotional Exhaustion and Neuroticism's as a Mediation-Moderation. 医疗保健劳动力分析：专制领导对工作场所偏差、情绪耗竭和神经质的计算分析作为中介-调节。

IF 1.6 3区哲学

Health Care Analysis Pub Date : 2025-09-01 Epub Date: 2025-05-05 DOI: 10.1007/s10728-025-00520-7

Hasib Shamshad, Sadaf Shamshad, Amina Tariq, Fasee Ullah

{"title":"Healthcare Workforce Analytics: Computational Analysis of Despotic Leadership on Workplace Deviance, Emotional Exhaustion and Neuroticism's as a Mediation-Moderation.","authors":"Hasib Shamshad, Sadaf Shamshad, Amina Tariq, Fasee Ullah","doi":"10.1007/s10728-025-00520-7","DOIUrl":"10.1007/s10728-025-00520-7","url":null,"abstract":"Despotic leadership harms both employee motivation and well-being. It has been studied using several theories, including social exchange and social learning theory, the latter suggesting learning stems from imitation. This study explores dark side of leadership, particularly in current healthcare reforms in Pakistan, such as Medical Teaching Institute (MTI). The need to review changing structural hierarchies is emphasized, as unilateral decisions often lead to defensive silence rather than workplace aggression and bullying. This study investigated the moderating role of neuroticism in the relationship between despotic leader- ship and workplace deviance, with emotional exhaustion mediating factor among healthcare sector employees. This study involved 294 professionals from public healthcare centres in Pakistan, achieving a 73% response rate. Five hypotheses were tested using Smart PLS for model testing and structural measurement along with SPSS and Preacher Hayes process models for moderated-mediation analysis. Results of linear regression analysis revealed that despotic leadership, mediated by emotional exhaustion, significantly impacts interpersonal and organizational deviance. Interestingly, neuroticism does not moderate this relationship, challenging previous literature. This study sheds light on despotic leadership's broader influence beyond personality attributes, offering new theoretical and practical implications and guiding future research directions.","PeriodicalId":46740,"journal":{"name":"Health Care Analysis","volume":" ","pages":"279-296"},"PeriodicalIF":1.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053834","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

The "Newborn Gang" Scandal in Türkiye: Ethics in a Neoliberal Health System. <s:1>基耶的“新生儿帮”丑闻：新自由主义医疗体系中的伦理。

IF 1.6 3区哲学

Health Care Analysis Pub Date : 2025-09-01 Epub Date: 2025-05-28 DOI: 10.1007/s10728-025-00522-5

Maide Barış, Gürkan Sert, M İnanç Özekmekçi

{"title":"The \"Newborn Gang\" Scandal in Türkiye: Ethics in a Neoliberal Health System.","authors":"Maide Barış, Gürkan Sert, M İnanç Özekmekçi","doi":"10.1007/s10728-025-00522-5","DOIUrl":"10.1007/s10728-025-00522-5","url":null,"abstract":"In October 2024, Türkiye was shocked by the \"Newborn Gang\" scandal, in which a network of healthcare professionals allegedly exploited newborns for financial gain in private hospitals. The accused are charged with intentionally neglecting, mistreating or even killing of healthy infants in neonatal intensive care units to prolong their stays and maximize government reimbursements. This paper critically examines the structural and ethical failures exposed by the 2024 \"Newborn Gang\" scandal in Türkiye, in which healthcare professionals in private hospitals allegedly allowed or caused the deaths of newborns to profit from the state's healthcare reimbursement system. Drawing on the frameworks of neoliberal critique and medical humanities, the study argues that such extreme violations are not isolated incidents of individual misconduct, but manifestations of deeper systemic vulnerabilities fostered by the neoliberalization of healthcare. It explores how deregulation, market incentives, and the erosion of ethical values-exacerbated by Türkiye's Health Transformation Program-have created an environment where financial gain is prioritized over patient welfare. Comparative case studies are employed to contextualize these findings within broader global patterns of ethical collapse in healthcare systems influenced by market logic. The paper contends that merely strengthening oversight is insufficient; rather, a structural reorientation is needed. As a potential alternative, the study introduces Value-Based Healthcare as a model that aligns clinical outcomes with ethical imperatives. Ultimately, the paper calls for a fundamental moral recalibration of healthcare-one that affirms care, integrity, and justice as core values over profit and efficiency.","PeriodicalId":46740,"journal":{"name":"Health Care Analysis","volume":" ","pages":"215-231"},"PeriodicalIF":1.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12360970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175309","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

10 Limits to Forgiveness in Health Care. 医疗领域宽恕的10个限度。

IF 1.6 3区哲学

Health Care Analysis Pub Date : 2025-09-01 Epub Date: 2025-04-28 DOI: 10.1007/s10728-025-00518-1

Stephen Buetow

{"title":"10 Limits to Forgiveness in Health Care.","authors":"Stephen Buetow","doi":"10.1007/s10728-025-00518-1","DOIUrl":"10.1007/s10728-025-00518-1","url":null,"abstract":"Compliance and regulatory bodies often encourage health care providers' disclosure of and apologies for wrongdoing. Patients may perceive that forgiveness is expected and feel pressure to grant it. However, forgiveness carries consequences, which can bring limits to forgiveness. Understanding these limits is crucial for understanding when forgiveness can either heal or add to trauma. This paper explores 10 context-dependent limits to forgiveness across four categories. The first category outlines conceptual limits: not all harm requires forgiveness, some evil acts may be beyond human forgiveness, and blame can be incompatible with forgiveness. Secondly, moral and ethical limits result from how accountability strains forgiveness, how moral absolutism can hinder it, and how proxy forgiveness may lack moral legitimacy. The third category identifies relational and social limits. Forced reconciliation can undermine forgiveness. System negligence diffuses culpability, hindering individual forgiveness, and requires prioritizing the victim's healing and benefit despite the diluted accountability. Finally, the fourth category highlights temporal and process-related limits. It emphasizes that ongoing or unaddressed harm can obstruct forgiveness, while variations in healing trajectories may delay or complicate it. Updating current understanding, this framework adds insight into when forgiveness may be inappropriate. It offers providers ethical guidance in navigating this terrain through a person-centred approach balancing empathy and accountability. The framework aims to facilitate healing for the patient and provider, regardless of whether forgiveness occurs.","PeriodicalId":46740,"journal":{"name":"Health Care Analysis","volume":" ","pages":"261-278"},"PeriodicalIF":1.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12360977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144034874","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