Health Care Analysis最新文献_第6页

Medical Termination of Pregnancy and the Persistent Challenges in India. 印度的医疗终止妊娠和持续挑战。

IF 1.4 3区哲学

Health Care Analysis Pub Date : 2026-07-31 DOI: 10.1007/s10728-026-00592-z

Ranjit Immanuel James, Senthil Kumar R, Jagadeesh Narayanareddy

{"title":"Medical Termination of Pregnancy and the Persistent Challenges in India.","authors":"Ranjit Immanuel James, Senthil Kumar R, Jagadeesh Narayanareddy","doi":"10.1007/s10728-026-00592-z","DOIUrl":"https://doi.org/10.1007/s10728-026-00592-z","url":null,"abstract":"The global discourse on reproductive rights has increasingly centred on securing safe and legal abortion access, with India emerging as a significant site of legal and medical deliberation aimed at curbing the harms associated with clandestine pregnancy terminations. Unsafe abortion remains a critical public health concern worldwide, contributing significantly to maternal mortality, particularly in nations with stringent anti-abortion legislation. Abortion laws vary considerably across different countries and are subject to change in response to the socio-political viewpoints of respective regions. In a noteworthy ruling, the Supreme Court of India reaffirmed that the right to reproductive autonomy, which includes the authority to terminate a pregnancy, is encompassed within the right to privacy and personal liberty as delineated in Article 21 of the Indian Constitution. The Court's interpretation of the Medical Termination of Pregnancy Act and associated regulations reflects a recognition that legal frameworks must evolve in accordance with changing social realities. However, the verdict creates an unresolved tension between protecting the reproductive privacy of minor survivors and the investigative requirements of criminal law under the Protection of Children from Sexual offences Act. This article will critically examine the landmark judgement delineating reproductive autonomy in India, arguing that while the judgement is neoteric, it does not go far enough to address the practical challenges associated with medical termination of pregnancy.","PeriodicalId":46740,"journal":{"name":"Health Care Analysis","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148632216","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

Constructing a Conceptual Model for Measuring Physician-Patient Trust: Integrating Theory and Research. 构建衡量医患信任的概念模型：理论与研究的整合。

IF 1.4 3区哲学

Health Care Analysis Pub Date : 2026-07-31 DOI: 10.1007/s10728-026-00593-y

Linda Weber

{"title":"Constructing a Conceptual Model for Measuring Physician-Patient Trust: Integrating Theory and Research.","authors":"Linda Weber","doi":"10.1007/s10728-026-00593-y","DOIUrl":"https://doi.org/10.1007/s10728-026-00593-y","url":null,"abstract":"Trust is a critical dynamic in the physician-patient relationship, essential for achieving positive health outcomes. Drawing on Luhmann's systemic account of trust, Seligman's notion of familiarity as a bridging mechanism, and Weber and Carter's interactional-constructivist approach, this study proposes a theoretically grounded model of patient trust in physicians, one that aligns with existing empirical measures. Seven dimensions of trust were identified through theoretical-empirical mapping of the indicators in existing measurement tools: self-disclosure, communication competence, interpersonal competence, perspective-taking, fidelity, technical competence, and fairness. While self-disclosure and perspective-taking are present in the interactional model of trust, they are absent from the primary empirical measures of trust, highlighting important areas for further measurement development. This study draws on the established distinction between trust as a way of relating to a known autonomous moral agent and confidence in systems, with familiarity serving as a conceptual bridge through which system confidence can become interpersonal trust. By integrating foundational sociological theories with empirical dimensions using an abductive analytical approach, this study proposes a conceptual framework that is intended to guide future measurement development in the study of physician trust.","PeriodicalId":46740,"journal":{"name":"Health Care Analysis","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148632254","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

A Pathway from Law to Care: How the Artificial Intelligence Act, the Medical Device Regulation, and the Public Procurement Directive Can Contribute to Ensuring Quality in Healthcare. 从法律到医疗的途径：人工智能法案、医疗器械法规和公共采购指令如何有助于确保医疗质量。

IF 1.4 3区哲学

Health Care Analysis Pub Date : 2026-07-24 DOI: 10.1007/s10728-026-00588-9

Jennifer Viberg Johansson, Santa Slokenberga

{"title":"A Pathway from Law to Care: How the Artificial Intelligence Act, the Medical Device Regulation, and the Public Procurement Directive Can Contribute to Ensuring Quality in Healthcare.","authors":"Jennifer Viberg Johansson, Santa Slokenberga","doi":"10.1007/s10728-026-00588-9","DOIUrl":"https://doi.org/10.1007/s10728-026-00588-9","url":null,"abstract":"Artificial intelligence (AI) is increasingly embedded in healthcare delivery, and when systems are scaled across clinical workflows, errors may have system-wide consequences. The Artificial Intelligence Act (AIA) and the Medical Device Regulation (MDR) establish important safety requirements for AI-based medical devices placed on the EU market, but they do not, in themselves, guarantee that AI tools deliver quality care for patients in real-world clinical settings. This article examines how the EU Public Procurement Directive (PPD) can complement the AIA and MDR to strengthen quality assurance when AI tools are adopted in healthcare systems across EU Member States. The article proposes specific procurement mechanisms as a prerequisite for adoption, thereby translating regulatory safeguards into practice. The article also argues that healthcare providers play a critical role in shaping the quality of AI. Beyond CE-marking, procurement should require evidence of clinical relevance, context-specific documentation, transparency in system design, and clearly defined quality criteria, including diagnostic accuracy and patient outcomes. Embedding legal and ethical requirements in procurement provides a pathway from law to care, ensuring that AI supports safe, equitable, and high-quality healthcare.","PeriodicalId":46740,"journal":{"name":"Health Care Analysis","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148580062","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 Disposition Decision: A Qualitative Study of Swedish Emergency Physicians' Objectives Through a Value-Focused Thinking Analysis. 处置决策：以价值为中心的思维分析对瑞典急诊医师目标的定性研究。

IF 1.4 3区哲学

Health Care Analysis Pub Date : 2026-07-22 DOI: 10.1007/s10728-026-00582-1

Katrin Hruska, Lisa Kurland, Magnus Hjelmblom, Ulla Ahonen-Jonnarth

{"title":"The Disposition Decision: A Qualitative Study of Swedish Emergency Physicians' Objectives Through a Value-Focused Thinking Analysis.","authors":"Katrin Hruska, Lisa Kurland, Magnus Hjelmblom, Ulla Ahonen-Jonnarth","doi":"10.1007/s10728-026-00582-1","DOIUrl":"https://doi.org/10.1007/s10728-026-00582-1","url":null,"abstract":"Objectives: Disposition decisions in emergency departments involve multiple, often conflicting objectives. This study aimed to develop avalue assessment framework, expressed as a hierarchy of objectives, based on emergency physicians' values.Methods: We used value-focused thinking to analyze the disposition decision through semi-structured interviews with thirteen emergency physicians in Sweden. A hierarchy of objectives was developed through content analysis and refined through iterative group interviews with the participants.Results: Three fundamental objectives were identified: maximizing patient health, maximizing alignment with patient preferences, and maximizing healthcare equity. Maximizing patient healthencompassed minimizing morbidity and mortality risk while maximizing wellbeing. Maximizing healthcare equity required balancing individual patient needs against those of other patients in the ED, hospital, and broader healthcare system.Conclusions: This study conceptualizes the disposition decision as a value-based decision about subsequent care after an ED visit. The hierarchy of objectives provides a transparent framework for analyzing value conflicts, supporting stakeholder communication, and facilitating the development and evaluation of disposition alternatives.","PeriodicalId":46740,"journal":{"name":"Health Care Analysis","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148551089","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

From Authorization to Access: A Synthesis of Implementation Barriers and Strategies for Pharmacist-Prescribed Contraception. 从授权到获取：药剂师处方避孕的实施障碍和策略的综合。

IF 1.4 3区哲学

Health Care Analysis Pub Date : 2026-07-22 DOI: 10.1007/s10728-026-00590-1

Muhammad Tayyub Kazam, Saba Bashir, Hamid Saeed

{"title":"From Authorization to Access: A Synthesis of Implementation Barriers and Strategies for Pharmacist-Prescribed Contraception.","authors":"Muhammad Tayyub Kazam, Saba Bashir, Hamid Saeed","doi":"10.1007/s10728-026-00590-1","DOIUrl":"https://doi.org/10.1007/s10728-026-00590-1","url":null,"abstract":"Reasonable access to contraceptive services is essential for reproductive autonomy, allowing individuals to decide when to become pregnant. However, 19 million women of reproductive age in the United States live in a pharmacy desert, having no reasonable access to a health center that can provide the full range of contraceptive services. Pharmacists are increasingly positioned to fill the service gap through direct prescribing. To synthesize the available literature on pharmacist-prescribed contraceptive services, exploring implementation, barriers, facilitators, and outcomes to inform pharmacists considering implementation. A literature search was conducted on PubMed for articles between 2015 and 2025 on pharmacist-prescribed contraceptive services. The synthesis of the evidence confirms that, while pharmacist prescribing of contraception services has been shown to attain high degrees of patient satisfaction, one study found that 97% of respondents reported being satisfied or very satisfied, implementation of these services is variable. Case study indicates that implementation of these services is contingent upon integrated service, financial, and staff training models. However, the literature identifies critical barriers to implementation, including the lack of sustainable reimbursement for cognitive services, staffing issues, and regulatory complexities. This gap between state authorization and the presence of these barriers constitutes the critical implementation chasm. Pharmacist-prescribed contraception has shown its effectiveness; however, its public health potential is hindered by modifiable implementation barriers. Closing the gap between authorization and access is dependent upon innovations in payment policy, regulatory harmonization, and implementation of effective strategies.","PeriodicalId":46740,"journal":{"name":"Health Care Analysis","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148551155","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

Physician Brain Drain from Turkey: Push-Pull Dynamics, Return Intentions, and the Normative Challenge for Health Policy. 土耳其医生人才外流：推挽动态、回归意图和卫生政策的规范性挑战。

IF 1.4 3区哲学

Health Care Analysis Pub Date : 2026-07-17 DOI: 10.1007/s10728-026-00587-w

Dilaver Tengilimoğlu, Elif Eşiyok Barut, Alper Güzel, Büşra Kavasoğlu, Oktay Karaca, Faruk Guven

{"title":"Physician Brain Drain from Turkey: Push-Pull Dynamics, Return Intentions, and the Normative Challenge for Health Policy.","authors":"Dilaver Tengilimoğlu, Elif Eşiyok Barut, Alper Güzel, Büşra Kavasoğlu, Oktay Karaca, Faruk Guven","doi":"10.1007/s10728-026-00587-w","DOIUrl":"https://doi.org/10.1007/s10728-026-00587-w","url":null,"abstract":"This mixed-methods study examines the push-pull factors influencing physician emigration from Turkey and assesses the feasibility of reverse brain drain, framing physician migration as a challenge for health governance rather than merely an individual career choice. Quantitative data from 1331 physicians (700 specialists, 631 interns) across 19 provinces and qualitative interviews with 32 emigrated physicians in four destination countries reveal that violence against healthcare workers (81.6%), low salary (74.3%), and challenging working conditions (59.8%) constitute the primary push factors. A statistically significant negative correlation between job satisfaction and brain drain attitudes (r = - 0.132, p < 0.01) confirms an association but explains only limited variance, indicating that structural and systemic conditions matter beyond individual satisfaction alone in shaping migration orientations. The qualitative findings identify professional burnout, performance system dysfunction, and sociopolitical instability as additional drivers. Only 2 of 32 emigrated physicians were considering return, and no female participant expressed return intention. Drawing on the ethics of health workforce governance, the study argues that when the state fails to protect physicians from violence and provide sustainable professional conditions, the normative responsibility for brain drain shifts from the emigrating individual to the institutional structures that render emigration rational. Policy interventions targeting salary alone are insufficient; comprehensive reforms in professional safety, meritocratic career pathways, workload standards, and sociopolitical stability are required.","PeriodicalId":46740,"journal":{"name":"Health Care Analysis","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148473463","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 Ulysses Framework: A Navigational Approach to Complexity in Forensic Psychiatric Practice. 尤利西斯框架：法医精神病学实践中复杂性的导航方法。

IF 1.4 3区哲学

Health Care Analysis Pub Date : 2026-06-26 DOI: 10.1007/s10728-026-00577-y

Rebeca Hidalgo Borrajo, Pilar de Castro-Manglano

{"title":"The Ulysses Framework: A Navigational Approach to Complexity in Forensic Psychiatric Practice.","authors":"Rebeca Hidalgo Borrajo, Pilar de Castro-Manglano","doi":"10.1007/s10728-026-00577-y","DOIUrl":"https://doi.org/10.1007/s10728-026-00577-y","url":null,"abstract":"This paper presents the Ulysses Framework, a navigational approach to forensic psychiatric practice developed through clinical work with gender violence survivors in Spain's specialised legal system. I argue that forensic psychiatry at the intersection of law, culture, and clinical care requires navigation between incommensurable frameworks rather than synthesis. Like Odysseus choosing between Scylla and Charybdis, the forensic psychiatrist must make strategic, conscious choices about what to sacrifice while maintaining orientation toward healing and justice even when these conflict. The framework draws on criminal law theory, phenomenological psychiatry, cultural psychiatry, and feminist epistemology-particularly Fricker's account of testimonial and hermeneutical injustice and Beauvoir's ethics of ambiguity. A composite clinical case shows how conventional diagnostic approaches fail to capture the entanglement of trauma, cultural meaning, legal demands, and contested credibility characterising gender violence cases. Three principles structure the framework: primacy of movement, framework plurality, and conscious sacrifice. The concept of métis-cunning practical wisdom that operates in ambiguous situations-is the central competence for forensic practice, distinct from cultural competence, evidence-based practice, and clinical intuition. The framework's distinctive contribution is its refusal of consoling syntheses: it provides tools for navigating conflicts between perspectives while acknowledging the costs. For gender violence survivors, it holds simultaneously trauma and agency, injury and resilience; for forensic clinicians, it makes explicit the navigation occurring, often implicitly, in complex clinical-legal encounters.","PeriodicalId":46740,"journal":{"name":"Health Care Analysis","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148340530","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

From Static Risk Estimates to Dynamic Clinical Trajectories: A Conceptual Analysis of Perioperative Medicine. 从静态风险估计到动态临床轨迹：围手术期医学的概念分析。

IF 1.4 3区哲学

Health Care Analysis Pub Date : 2026-06-23 DOI: 10.1007/s10728-026-00584-z

Michele Danilo Pierri

{"title":"From Static Risk Estimates to Dynamic Clinical Trajectories: A Conceptual Analysis of Perioperative Medicine.","authors":"Michele Danilo Pierri","doi":"10.1007/s10728-026-00584-z","DOIUrl":"https://doi.org/10.1007/s10728-026-00584-z","url":null,"abstract":"Perioperative risk assessment still relies largely on models that estimate outcomes from variables measured at a single time point. These tools remain useful for cohort stratification, communication of baseline risk, and perioperative planning, but they often underrepresent the temporal dynamics that shape individual postoperative trajectories. That mismatch may reflect more than ordinary clinical variability. At least in part, it may point to a limitation in how perioperative risk itself is conceptualized. This paper offers a conceptual analysis drawing on physiology, critical care medicine, and dynamic systems theory. Its central claim is simple: perioperative risk may be better understood as a trajectory through physiological state space than as a fixed probability assigned before surgery. Surgical interventions can then be viewed as structured perturbations imposed on already reconfigured biological systems, with responses shaped by prior states, adaptive capacity, and physiological resilience. From this perspective, postoperative complications are not merely isolated adverse events. They may instead mark transitions between physiological regimes. Processes such as sterile inflammation, microcirculatory dysfunction, organ crosstalk, and loss of physiological complexity may help explain why postoperative trajectories diverge so sharply. Cardiac surgery provides a particularly clear setting in which these dynamics become visible, although the broader argument likely extends beyond it. The analysis has practical implications for clinical reasoning in high-risk settings. Rather than displacing static prediction, it highlights dimensions of perioperative risk, such as state dependence, irreversibility, and loss of resilience, that static models represent only incompletely. That shift does not solve the problem of perioperative uncertainty. It does, however, describe it more faithfully.","PeriodicalId":46740,"journal":{"name":"Health Care Analysis","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148303320","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

Access, Equity and Ethical Challenges in Assisted Reproductive Technologies in India: An Empirical Bioethics Analysis. 印度辅助生殖技术的获取、公平和伦理挑战：经验生物伦理学分析。

IF 1.4 3区哲学

Health Care Analysis Pub Date : 2026-06-23 DOI: 10.1007/s10728-026-00583-0

Aiswarya Acharya, Rubi Talukdar, Pramit Chandra Rout, Susanta Kumar Pradhan

{"title":"Access, Equity and Ethical Challenges in Assisted Reproductive Technologies in India: An Empirical Bioethics Analysis.","authors":"Aiswarya Acharya, Rubi Talukdar, Pramit Chandra Rout, Susanta Kumar Pradhan","doi":"10.1007/s10728-026-00583-0","DOIUrl":"https://doi.org/10.1007/s10728-026-00583-0","url":null,"abstract":"Assisted reproductive technologies (ART) have expanded rapidly in India, raising significant ethical and distributive justice concerns relating to accessibility, affordability and reproductive healthcare governance. Despite growing scholarly attention to ART regulation, empirical evidence examining public perceptions of access, perceived equity barriers and ethical governance within the Indian context remains limited. This study addresses this gap through an empirical bioethics analysis of public perceptions regarding ART accessibility and governance in India. A cross-sectional survey of 560 respondents from urban, semi-urban and rural settings was conducted using a structured questionnaire. Data were analysed using descriptive statistics, reliability analysis, correlation analysis and one-way ANOVA with Tukey post hoc comparisons. The findings reveal significant geographic disparities in access to ART services, with urban respondents reporting substantially greater access than semi-urban and rural respondents (F = 35.040, p < 0.001). Descriptive findings further indicate moderate levels of awareness and regulatory trust alongside lower perceptions of access and greater perceived equity barriers. The study highlights the continuing influence of structural inequality on reproductive healthcare accessibility in India and underscores the need for policy interventions aimed at improving equitable access, institutional accountability and inclusive reproductive healthcare governance.","PeriodicalId":46740,"journal":{"name":"Health Care Analysis","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148303391","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

Holostasis: Health as Personal Orientation in an Anthropological Framework. 整体平衡：健康作为人类学框架中的个人取向。

IF 1.4 3区哲学

Health Care Analysis Pub Date : 2026-06-18 DOI: 10.1007/s10728-026-00581-2

Ramon Cases-Solé

{"title":"Holostasis: Health as Personal Orientation in an Anthropological Framework.","authors":"Ramon Cases-Solé","doi":"10.1007/s10728-026-00581-2","DOIUrl":"https://doi.org/10.1007/s10728-026-00581-2","url":null,"abstract":"Contemporary health care discourse increasingly recognises the need to move beyond purely functional and optimisation-based models of health. Yet prevailing approaches often fragment the human person into biological, psychological, and-when included-spiritual domains, without a coherent anthropological basis capable of integrating them. This article introduces Holostasis as an anthropological framework in which health is understood as personal orientation sustained through change-a stability-in-change proper to personal existence, distinct from equilibrium-based or functional conceptions. Rather than proposing a physiological mechanism or an operative clinical model, Holostasis is articulated at a pre-clinical and epistemological level, offering a conceptual criterion for rethinking health and illness from the unity of the person. Drawing on philosophical anthropology and the philosophy of medicine, the paper distinguishes Holostasis from regulatory notions such as homeostasis and allostasis, as well as from additive holistic and integrative approaches. It develops an account of health as continuity of meaning, orientation toward truth, and relational integrity, including conditions of vulnerability, illness, and functional limitation. By foregrounding the therapeutic relationship and the limits of optimisation paradigms, Holostasis is proposed as an open interpretative contribution to contemporary debates on personhood, health, and person-centred care.","PeriodicalId":46740,"journal":{"name":"Health Care Analysis","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148273346","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