Health Care Analysis最新文献_第9页

Pharmaceutical Sales Representatives in the United States and China: The Need for Professional Public Space. 美国和中国的医药销售代表:专业公共空间的需求。

IF 1.9 3区哲学

Health Care Analysis Pub Date : 2022-03-01 Epub Date: 2021-11-11 DOI: 10.1007/s10728-021-00438-w

Xiaoying Chen

{"title":"Pharmaceutical Sales Representatives in the United States and China: The Need for Professional Public Space.","authors":"Xiaoying Chen","doi":"10.1007/s10728-021-00438-w","DOIUrl":"https://doi.org/10.1007/s10728-021-00438-w","url":null,"abstract":"Pharmaceutical sales representatives (PSRs) are one of the most frequently used drug information sources for physicians in both the United States and China. During face-to-face interactions, PSRs use various promotional strategies to impact the prescribing behavior. In the United States, PSRs provide physicians small gifts, free drug samples, and \"sincere friendships\", whereas in China, they played an indispensable role in medical corruption over the past three decades. To cope with the undue influence of PSRs, both these countries have taken positive but insufficient measures to eliminate the effect thus far. By comparing the strategies of American and Chinese PSRs, it was found that building a friendly personal relationship with physicians in a relatively closed private environment (such as physician's office) is a key factor to exert an individualized influence on physicians, even in different social backgrounds and healthcare contexts. Therefore, this essay suggests that it is necessary to limit the establishment of personal relationships and maintain a more professional interaction to reduce the personalized psychological and emotional influences on physicians' professional judgment. To achieve this goal, it is proposed to transfer the physician-PSR interaction to a professional public space as a supplement to current countermeasures and suggestions. The presence of others and the possibility of third party participation will stimulate more ethical and reputational concerns. It is hoped that the increased transparency of the interaction will promote participants to consider more professional norms and mitigate the undue influence of PSRs' individualized strategies.","PeriodicalId":46740,"journal":{"name":"Health Care Analysis","volume":"30 1","pages":"35-56"},"PeriodicalIF":1.9,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8580741/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39717400","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

The Case for Telemedical Early Medical Abortion in England: Dispelling Adult Safeguarding Concerns. 英国远程医疗早期药物流产的案例:消除成人保护的担忧。

IF 1.9 3区哲学

Health Care Analysis Pub Date : 2022-03-01 Epub Date: 2021-10-23 DOI: 10.1007/s10728-021-00439-9

Jordan A Parsons, Elizabeth Chloe Romanis

{"title":"The Case for Telemedical Early Medical Abortion in England: Dispelling Adult Safeguarding Concerns.","authors":"Jordan A Parsons, Elizabeth Chloe Romanis","doi":"10.1007/s10728-021-00439-9","DOIUrl":"https://doi.org/10.1007/s10728-021-00439-9","url":null,"abstract":"Access to abortion care has been hugely affected by the COVID-19 pandemic. This has prompted several governments to permit the use of telemedicine for fully remote care pathways, thereby ensuring pregnant people are still able to access services. One such government is that of England, where these new care pathways have been publicly scrutinised. Those opposed to telemedical early medical abortion care have raised myriad concerns, though they largely centre on matters of patient safeguarding. It is argued that healthcare professionals cannot adequately carry out their safeguarding duties if the patient is not in the room with them. These concerns lack empirical support. Emerging evidence suggests that safeguarding processes may, in fact, be more effective within telemedical abortion care pathways. In this article, we address two specific safeguarding concerns: (1) that a remote consultation prevents a healthcare professional from identifying instances of abuse, and (2) that healthcare professionals cannot reliably confirm the absence of coercion during a remote consultation. We demonstrate that such concerns are misplaced, and that safeguarding may actually be improved in telemedical care pathways as victims of abuse may find it easier to engage with services. It is inevitable that some individuals will fall through the net, but this is unavoidable even with in-person care and thus does not constitute a strong critique of the use of telemedicine in abortion care. These safeguarding concerns set aside, then, we argue that the current approval that enables telemedical early medical abortion should be afforded permanence.","PeriodicalId":46740,"journal":{"name":"Health Care Analysis","volume":"30 1","pages":"73-96"},"PeriodicalIF":1.9,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8540868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39551808","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

Three Harm-Based Arguments for a Moral Obligation to Vaccinate. 接种疫苗的道德义务的三个基于伤害的论据。

IF 1.9 3区哲学

Health Care Analysis Pub Date : 2022-03-01 Epub Date: 2021-11-05 DOI: 10.1007/s10728-021-00437-x

Viktor Ivanković, Lovro Savić

{"title":"Three Harm-Based Arguments for a Moral Obligation to Vaccinate.","authors":"Viktor Ivanković, Lovro Savić","doi":"10.1007/s10728-021-00437-x","DOIUrl":"https://doi.org/10.1007/s10728-021-00437-x","url":null,"abstract":"A particularly strong reason to vaccinate against transmittable diseases, based on considerations of harm, is to contribute to the realization of population-level herd immunity. We argue, however, that herd immunity alone is insufficient for deriving a strong harm-based moral obligation to vaccinate in all circumstances, since the obligation significantly weakens well above and well below the herd immunity threshold. The paper offers two additional harm-based arguments that, together with the herd immunity argument, consolidates our moral obligation. First, we argue that individuals should themselves aim not to expose others to risk of harm, and that this consideration becomes stronger the more non-vaccinated people there are, i.e., the further we are below herd immunity. Second, we elaborate on two pragmatic reasons to vaccinate beyond the realization of herd immunity, pertaining to instability of vaccination rates and population heterogeneity, and argue that vaccinating above the threshold should serve as a precautionary measure for buttressing herd immunity. We also show that considerations of harm have normative primacy in establishing this obligation over considerations of fairness. Although perfectly sound, considerations of fairness are, at worst secondary, or at best complementary to considerations of harm.","PeriodicalId":46740,"journal":{"name":"Health Care Analysis","volume":"30 1","pages":"18-34"},"PeriodicalIF":1.9,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8569289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39593304","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: 2

Trust and The Acquisition and Use of Public Health Information. 信任与公共卫生信息的获取和使用。

IF 1.9 3区哲学

Health Care Analysis Pub Date : 2022-03-01 Epub Date: 2021-11-09 DOI: 10.1007/s10728-021-00436-y

Stephen Holland, Jamie Cawthra, Tamara Schloemer, Peter Schröder-Bäck

{"title":"Trust and The Acquisition and Use of Public Health Information.","authors":"Stephen Holland, Jamie Cawthra, Tamara Schloemer, Peter Schröder-Bäck","doi":"10.1007/s10728-021-00436-y","DOIUrl":"https://doi.org/10.1007/s10728-021-00436-y","url":null,"abstract":"Information is clearly vital to public health, but the acquisition and use of public health data elicit serious privacy concerns. One strategy for navigating this dilemma is to build 'trust' in institutions responsible for health information, thereby reducing privacy concerns and increasing willingness to contribute personal data. This strategy, as currently presented in public health literature, has serious shortcomings. But it can be augmented by appealing to the philosophical analysis of the concept of trust. Philosophers distinguish trust and trustworthiness from cognate attitudes, such as confident reliance. Central to this is value congruence: trust is grounded in the perception of shared values. So, the way to build trust in institutions responsible for health data is for those institutions to develop and display values shared by the public. We defend this approach from objections, such as that trust is an interpersonal attitude inappropriate to the way people relate to organisations. The paper then moves on to the practical application of our strategy. Trust and trustworthiness can reduce privacy concerns and increase willingness to share health data, notably, in the context of internal and external threats to data privacy. We end by appealing for the sort of empirical work our proposal requires.","PeriodicalId":46740,"journal":{"name":"Health Care Analysis","volume":"30 1","pages":"1-17"},"PeriodicalIF":1.9,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8576798/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39856472","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: 2

Editorial Acknowledgement 社论承认

IF 1.9 3区哲学

Health Care Analysis Pub Date : 2022-02-09 DOI: 10.1023/A:1017270824131

N. Daniels

引用次数: 0

Maternal-Fetal Surgery: Does Recognising Fetal Patienthood Pose a Threat to Pregnant Women's Autonomy? 母胎手术:承认胎儿的耐心会对孕妇的自主权构成威胁吗?

IF 1.9 3区哲学

Health Care Analysis Pub Date : 2021-12-01 Epub Date: 2021-10-21 DOI: 10.1007/s10728-021-00440-2

Dunja Begović

{"title":"Maternal-Fetal Surgery: Does Recognising Fetal Patienthood Pose a Threat to Pregnant Women's Autonomy?","authors":"Dunja Begović","doi":"10.1007/s10728-021-00440-2","DOIUrl":"https://doi.org/10.1007/s10728-021-00440-2","url":null,"abstract":"Maternal-fetal surgery (MFS) encompasses a range of innovative procedures aiming to treat fetal illnesses and anomalies during pregnancy. Their development and gradual introduction into healthcare raise important ethical issues concerning respect for pregnant women's bodily integrity and autonomy. This paper asks what kind of ethical framework should be employed to best regulate the practice of MFS without eroding the hard-won rights of pregnant women. I examine some existing models conceptualising the relationship between a pregnant woman and the fetus to determine what kind of framework is the most adequate for MFS, and conclude that an ecosystem or maternal-fetal dyad model is best suited for upholding women's autonomy. However, I suggest that an appropriate framework needs to incorporate some notion of fetal patienthood, albeit a very limited one, in order to be consistent with the views of healthcare providers and their pregnant patients. I argue that such an ethical framework is both theoretically sound and fundamentally respectful of women's autonomy, and is thus best suited to protect women from coercion or undue paternalism when deciding whether to undergo MFS.","PeriodicalId":46740,"journal":{"name":"Health Care Analysis","volume":"29 4","pages":"301-318"},"PeriodicalIF":1.9,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8529227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39537168","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

Engaging Tomorrow's Doctors in Clinical Ethics: Implications for Healthcare Organisations. 参与未来医生的临床伦理学:对医疗机构的影响。

IF 1.9 3区哲学

Health Care Analysis Pub Date : 2021-12-01 DOI: 10.1007/s10728-020-00403-z

Laura L Machin, Robin D Proctor

{"title":"Engaging Tomorrow's Doctors in Clinical Ethics: Implications for Healthcare Organisations.","authors":"Laura L Machin, Robin D Proctor","doi":"10.1007/s10728-020-00403-z","DOIUrl":"https://doi.org/10.1007/s10728-020-00403-z","url":null,"abstract":"Clinical ethics can be viewed as a practical discipline that provides a structured approach to assist healthcare practitioners in identifying, analysing and resolving ethical issues that arise in practice. Clinical ethics can therefore promote ethically sound clinical and organisational practices and decision-making, thereby contributing to health organisation and system quality improvement. In order to develop students' decision-making skills, as well as prepare them for practice, we decided to introduce a clinical ethics strand within an undergraduate medical curriculum. We designed a programme of clinical ethics activities for teaching and assessment purposes that involved using ethical frameworks to analyse hypothetical and real-life cases in uni- and inter- professional groups. In this paper, we draw on medical student feedback collected over 6 years to illustrate the appeal to students of learning clinical ethics. We also outline the range of benefits for students, healthcare organisations, and the field of clinical ethics arising from tomorrow's doctors experiencing clinical ethics early in their training. We conclude by briefly reflecting on how including clinical ethics within tomorrow's doctors curricular can secure and continue future engagement in clinical ethics support services in the UK, alongside the dangers of preparing students for organisational cultures that might not (yet) exist. We anticipate the findings presented in the paper will contribute to wider debates examining the impact of ethics teaching, and its ability to inform future doctors' practice.","PeriodicalId":46740,"journal":{"name":"Health Care Analysis","volume":"29 4","pages":"319-342"},"PeriodicalIF":1.9,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s10728-020-00403-z","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38448215","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: 2

Ethico-Political Aspects of Conceptualizing Screening: The Case of Dementia. 将筛查概念化的伦理-政治方面：痴呆症案例。

IF 1.9 3区哲学

Health Care Analysis Pub Date : 2021-12-01 Epub Date: 2021-03-16 DOI: 10.1007/s10728-021-00431-3

Martin Gunnarson, Alexandra Kapeller, Kristin Zeiler

{"title":"Ethico-Political Aspects of Conceptualizing Screening: The Case of Dementia.","authors":"Martin Gunnarson, Alexandra Kapeller, Kristin Zeiler","doi":"10.1007/s10728-021-00431-3","DOIUrl":"10.1007/s10728-021-00431-3","url":null,"abstract":"While the value of early detection of dementia is largely agreed upon, population-based screening as a means of early detection is controversial. This controversial status means that such screening is not recommended in most national dementia plans. Some current practices, however, resemble screening but are labelled \"case-finding\" or \"detection of cognitive impairment\". Labelled as such, they may avoid the ethical scrutiny that population-based screening may be subject to. This article examines conceptualizations of screening and case-finding. It shows how the definitions and delimitations of the concepts (the what of screening) are drawn into the ethical, political, and practical dimensions that screening assessment criteria or principles are intended to clarify and control (the how of screening, how it is and how it should be performed). As a result, different conceptualizations of screening provide the opportunity to rethink what ethical assessments should take place: the conceptualizations have different ethico-political implications. The article argues that population-based systematic screening, population-based opportunistic screening, and case-finding should be clearly distinguished.","PeriodicalId":46740,"journal":{"name":"Health Care Analysis","volume":"29 4","pages":"343-359"},"PeriodicalIF":1.9,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8560671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25484357","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

Gender Transition: Is There a Right to Be Forgotten? 性别转换:有被遗忘的权利吗?

IF 1.9 3区哲学

Health Care Analysis Pub Date : 2021-12-01 Epub Date: 2021-05-02 DOI: 10.1007/s10728-021-00433-1

Mónica Correia, Guilhermina Rêgo, Rui Nunes

{"title":"Gender Transition: Is There a Right to Be Forgotten?","authors":"Mónica Correia, Guilhermina Rêgo, Rui Nunes","doi":"10.1007/s10728-021-00433-1","DOIUrl":"https://doi.org/10.1007/s10728-021-00433-1","url":null,"abstract":"The European Union (EU) faced high risks from personal data proliferation to individuals' privacy. Legislation has emerged that seeks to articulate all interests at stake, balancing the need for data flow from EU countries with protecting personal data: the General Data Protection Regulation. One of the mechanisms established by this new law to strengthen the individual's control over their data is the so-called \"right to be forgotten\", the right to obtain from the controller the erasure of records. In gender transition, this right represents a powerful form of control over personal data, especially health data that may reveal a gender with which they do not identify and reject. Therefore, it is pertinent to discern whether the right to have personal data deleted-in particular, health data-is ethically acceptable in gender transition. Towards addressing the ethical dimensions of the right to be forgotten in this case, this study presents relevant concepts, briefly outlines history, ethics and law of records considering the evolution from paper to electronic format, the main aspects of identity construction and gender identity, and explores the relationship between privacy, data protection/information control and identity projection. Also, it discusses in gender transition the relation between \"the right to self-determination\", \"the right to delete\", and \"the right to identity and individuality\". Conclusions on the ethical admissibility of the 'right to be forgotten' to control gender-affirming information are presented.","PeriodicalId":46740,"journal":{"name":"Health Care Analysis","volume":"29 4","pages":"283-300"},"PeriodicalIF":1.9,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s10728-021-00433-1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38941775","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

Beyond Individual Triage: Regional Allocation of Life-Saving Resources such as Ventilators in Public Health Emergencies. 超越个人分类:突发公共卫生事件中呼吸机等救生资源的区域分配。

IF 1.9 3区哲学

Health Care Analysis Pub Date : 2021-12-01 Epub Date: 2021-02-06 DOI: 10.1007/s10728-020-00427-5

Jonathan Pugh, Dominic Wilkinson, Cesar Palacios-Gonzalez, Julian Savulescu

{"title":"Beyond Individual Triage: Regional Allocation of Life-Saving Resources such as Ventilators in Public Health Emergencies.","authors":"Jonathan Pugh, Dominic Wilkinson, Cesar Palacios-Gonzalez, Julian Savulescu","doi":"10.1007/s10728-020-00427-5","DOIUrl":"https://doi.org/10.1007/s10728-020-00427-5","url":null,"abstract":"In the first wave of the COVID-19 pandemic, healthcare workers in some countries were forced to make distressing triaging decisions about which individual patients should receive potentially life-saving treatment. Much of the ethical discussion prompted by the pandemic has concerned which moral principles should ground our response to these individual triage questions. In this paper we aim to broaden the scope of this discussion by considering the ethics of broader structural allocation decisions raised by the COVID-19 pandemic. More specifically, we consider how nations ought to distribute a scarce life-saving resource across healthcare regions in a public health emergency, particularly in view of regional differences in projected need and existing capacity. We call this the regional triage question. Using the case study of ventilators in the COVID-19 pandemic, we show how the moral frameworks that we might adopt in response to individual triage decisions do not translate straightforwardly to this regional-level triage question. Having outlined what we take to be a plausible egalitarian approach to the regional triage question, we go on to propose a novel way of operationalising the 'save the most lives' principle in this context. We claim that the latter principle ought to take some precedence in the regional triage question, but also note important limitations to the extent of the influence that it should have in regional allocation decisions.","PeriodicalId":46740,"journal":{"name":"Health Care Analysis","volume":"29 4","pages":"263-282"},"PeriodicalIF":1.9,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s10728-020-00427-5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25339780","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