Health Care Analysis最新文献_第9页

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

Quotas: Enabling Conscientious Objection to Coexist with Abortion Access. 配额:使良心反对与堕胎并存。

IF 1.9 3区哲学

Health Care Analysis Pub Date : 2021-06-01 Epub Date: 2020-11-19 DOI: 10.1007/s10728-020-00419-5

Daniel Rodger, Bruce P Blackshaw

{"title":"Quotas: Enabling Conscientious Objection to Coexist with Abortion Access.","authors":"Daniel Rodger, Bruce P Blackshaw","doi":"10.1007/s10728-020-00419-5","DOIUrl":"https://doi.org/10.1007/s10728-020-00419-5","url":null,"abstract":"The debate regarding the role of conscientious objection in healthcare has been protracted, with increasing demands for curbs on conscientious objection. There is a growing body of evidence that indicates that in some cases, high rates of conscientious objection can affect access to legal medical services such as abortion-a major concern of critics of conscientious objection. Moreover, few solutions have been put forward that aim to satisfy both this concern and that of defenders of conscientious objection-being expected to participate in the provision of services that compromise their moral integrity. Here we attempt to bring some resolution to the debate by proposing a pragmatic, long-term solution offering what we believe to be an acceptable compromise-a quota system for medical trainees in specialties where a conscientious objection can be exercised, and is known to cause conflict. We envisage two main objectives of the quota system we propose. First, as a means to introduce conscientious objection into countries where this is not presently permitted. Second, to minimise or eliminate the effects of high rates of conscientious objection in countries such as Italy, where access to legal abortion provision can be negatively affected.","PeriodicalId":46740,"journal":{"name":"Health Care Analysis","volume":"29 2","pages":"154-169"},"PeriodicalIF":1.9,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s10728-020-00419-5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38726778","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

Made to Measure: The Ethics of Routine Measurement for Healthcare Improvement. 量身定制：医疗保健改善的常规测量伦理。

IF 1.9 3区哲学

Health Care Analysis Pub Date : 2021-03-01 Epub Date: 2020-12-20 DOI: 10.1007/s10728-020-00421-x

Polly Mitchell, Alan Cribb, Vikki Entwistle

{"title":"Made to Measure: The Ethics of Routine Measurement for Healthcare Improvement.","authors":"Polly Mitchell, Alan Cribb, Vikki Entwistle","doi":"10.1007/s10728-020-00421-x","DOIUrl":"10.1007/s10728-020-00421-x","url":null,"abstract":"This paper analyses the ethics of routine measurement for healthcare improvement. Routine measurement is an increasingly central part of healthcare system design and is taken to be necessary for successful healthcare improvement efforts. It is widely recognised that the effectiveness of routine measurement in bringing about improvement is limited-it often produces only modest effects or fails to generate anticipated improvements at all. We seek to show that these concerns do not exhaust the ethics of routine measurement. Even if routine measurement does lead to healthcare improvements, it has associated ethical costs which are not necessarily justified by its benefits. We argue that the practice of routine measurement changes the function of the healthcare system, resulting in an unintended and ethically significant transformation of the sector. It is difficult to determine whether such changes are justified or offset by the benefits of routine measurement because there may be no shared understanding of what is 'good' in healthcare by which to compare the benefits of routine measurement with the goods that are precluded by it. We counsel that the practice of routine measurement should proceed with caution and should be recognised to be an ethically significant choice, rather than an inevitability.","PeriodicalId":46740,"journal":{"name":"Health Care Analysis","volume":"29 1","pages":"39-58"},"PeriodicalIF":1.9,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7870769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10655470","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

Correction to: Complicity in Harm Reduction. 更正:减少危害的共犯。

IF 1.9 3区哲学

Health Care Analysis Pub Date : 2020-12-01 Epub Date: 2020-11-03 DOI: 10.1007/s10728-020-00414-w

Timothy Kirschenheiter, John Corvino

引用次数: 0

Harm Reduction: A Misnomer. 减少伤害:用词不当。

IF 1.9 3区哲学

Health Care Analysis Pub Date : 2020-12-01 Epub Date: 2020-11-05 DOI: 10.1007/s10728-020-00413-x

Nicholas B King

引用次数: 1

Toward a Philosophy of Harm Reduction. 走向减少伤害的哲学。

IF 1.9 3区哲学

Health Care Analysis Pub Date : 2020-12-01 Epub Date: 2020-10-29 DOI: 10.1007/s10728-020-00405-x

Shannon Dea

引用次数: 7

Collateral Paternalism and Liberal Critiques of Public Health Policy: Diminishing Theoretical Demandingness and Accommodating the Devil in the Detail. 附带的家长作风和公共卫生政策的自由主义批评:减少理论要求和适应细节中的魔鬼。

IF 1.9 3区哲学

Health Care Analysis Pub Date : 2020-12-01 Epub Date: 2020-11-04 DOI: 10.1007/s10728-020-00417-7

John Coggon, A M Viens

引用次数: 2