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Towards Excellence: Virtue and the Principle of Autonomy in Informed Consent for Clinical Trials. 走向卓越：美德与临床试验知情同意的自主原则。
IF 1.3 3区 哲学
Journal of Medicine and Philosophy Pub Date : 2025-07-21 DOI: 10.1093/jmp/jhaf002
Alexander Montes
{"title":"Towards Excellence: Virtue and the Principle of Autonomy in Informed Consent for Clinical Trials.","authors":"Alexander Montes","doi":"10.1093/jmp/jhaf002","DOIUrl":"10.1093/jmp/jhaf002","url":null,"abstract":"<p><p>In this article, I argue that approximating virtues such as care and respectfulness are necessary to conduct an informed consent discussion for clinical trials adequately. I argue against Beauchamp and Childress' principlism insofar as it claims that virtues do not have \"advantages\" over the principle of respecting autonomy. When we elaborate what it means to facilitate autonomy in a consent discussion adequately, we find we are describing the virtues. This is because virtues do have an advantage over principles insofar as virtues provide us with rich descriptions of not only what we should do (respect autonomy), but how to do so (with the virtues of respectfulness, care, etc.). Thus, the principle of respecting autonomy points back to the virtues. I conclude by showing how cultivation of these virtues can help rectify well-known shortcomings in the informed consent process.</p>","PeriodicalId":47377,"journal":{"name":"Journal of Medicine and Philosophy","volume":" ","pages":"295-307"},"PeriodicalIF":1.3,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765407","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
Boundaries of Disease: Vagueness and Overdiagnosis. 疾病的界限：模糊和过度诊断。
IF 1.3 3区 哲学
Journal of Medicine and Philosophy Pub Date : 2025-07-21 DOI: 10.1093/jmp/jhaf001
Christopher Boorse
{"title":"Boundaries of Disease: Vagueness and Overdiagnosis.","authors":"Christopher Boorse","doi":"10.1093/jmp/jhaf001","DOIUrl":"10.1093/jmp/jhaf001","url":null,"abstract":"<p><p>In five related essays, Mary Jean Walker and Wendy Rogers, joined in one essay by Jenny Doust, defend various theses about the concept of disease. First, they argue \"disease\" is a cluster concept, not a \"classically structured\" one definable by necessary and sufficient conditions. Second, \"disease\" is vague, in the standard philosophical sense of having borderline cases. In fascinating detail, they argue that this vagueness shows up almost everywhere one looks among ordinary diseases, even if disease is taken to require dysfunction. Still, they conclude, vagueness per se need not be a problem because logicians and philosophers know several ways to handle it. Third, Rogers and Walker believe that the vagueness of \"disease\" is a clue to how to reduce the much-discussed medical problem of \"overdiagnosis\": the diagnosis of permanently harmless disease. Finally, they find my analysis of disease-the \"biostatistical theory\" (BST)-defective and dangerous in four different ways: it offers insufficient guidance on how to draw disease boundaries; it does not fit actual medical practice in doing so; it is ambiguous as to reference class; and it facilitates overdiagnosis. In this article, I freely concede the vagueness of disease, but argue that it is considerably less than Rogers and Walker suppose, and no threat to the BST in any case. I also rebut all their other charges of deficiency in my analysis.</p>","PeriodicalId":47377,"journal":{"name":"Journal of Medicine and Philosophy","volume":" ","pages":"231-247"},"PeriodicalIF":1.3,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040767","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
Depression and Autonomy in Physician-Assisted Suicide. 医生协助自杀中的抑郁和自主。
IF 1.3 3区 哲学
Journal of Medicine and Philosophy Pub Date : 2025-07-21 DOI: 10.1093/jmp/jhaf005
Rina Tzinman
{"title":"Depression and Autonomy in Physician-Assisted Suicide.","authors":"Rina Tzinman","doi":"10.1093/jmp/jhaf005","DOIUrl":"10.1093/jmp/jhaf005","url":null,"abstract":"<p><p>The standard view in medical practice is that patients have to be in an appropriate state of mind to count as autonomous. For example, according to the Macarthur Competency Assessment Tool for Treatment patients need to be able to: (1) communicate a choice; (2) factually understand the issues; (3) appreciate their situation; and (4) rationally manipulate information. These capacities are normally taken to be compromised by factors that may diminish one's capacity to properly assess one's situation. One of these diminishing factors is depression, which is especially relevant to decisions about assisted suicide or termination of treatment, since depression might contribute to the patient's leaning towards an action resulting in her death. I argue, however, that in certain circumstances, depression and the accompanying desires can be appropriate. Specifically, I demonstrate that even when depression is a factor in the patient's decision, it does not automatically undermine autonomy.</p>","PeriodicalId":47377,"journal":{"name":"Journal of Medicine and Philosophy","volume":" ","pages":"285-294"},"PeriodicalIF":1.3,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796831","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 Morality of Assisted Dying. 协助死亡的道德。
IF 1.3 3区 哲学
Journal of Medicine and Philosophy Pub Date : 2025-07-21 DOI: 10.1093/jmp/jhaf003
Stephen Richards
{"title":"The Morality of Assisted Dying.","authors":"Stephen Richards","doi":"10.1093/jmp/jhaf003","DOIUrl":"10.1093/jmp/jhaf003","url":null,"abstract":"<p><p>This essay analyzes the morality of assisted dying. To do this, it is necessary to recognize that assisted dying is the outworking of a larger process. This process unavoidably begins with the key moral conception of human dignity. Emphasis upon individualism in society has caused a restructuring of the dignity concept, changing what is most highly valued. This altered concept of dignity gives rise to assisted dying, yet is morally flawed. This is because it is an understanding of dignity that minimizes people's vulnerability, dismisses coercive forces that are brought into effect, encourages undue confidence in safeguards, and removes any sustained basis for respect of the individual. Autonomy, as the primary justification for assisted dying in contemporary society, is an abbreviated understanding of the restructured concept of dignity and therefore subject to the same criticisms. Assisted dying arises from a deficient and self-defeating foundation that mark it as immoral.</p>","PeriodicalId":47377,"journal":{"name":"Journal of Medicine and Philosophy","volume":" ","pages":"262-284"},"PeriodicalIF":1.3,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12279015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796835","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
The Contradictions in the Criteria for Diagnosing Hypermobile Ehlers-Danlos Syndrome as Reflecting Some of the Philosophical Debates about the Threshold between the Normal and the Pathological. 超动性埃勒-丹洛斯综合征诊断标准的矛盾反映了一些关于正常与病理界限的哲学争论。
IF 1.3 3区 哲学
Journal of Medicine and Philosophy Pub Date : 2025-07-21 DOI: 10.1093/jmp/jhaf004
Mar Rosàs Tosas
{"title":"The Contradictions in the Criteria for Diagnosing Hypermobile Ehlers-Danlos Syndrome as Reflecting Some of the Philosophical Debates about the Threshold between the Normal and the Pathological.","authors":"Mar Rosàs Tosas","doi":"10.1093/jmp/jhaf004","DOIUrl":"10.1093/jmp/jhaf004","url":null,"abstract":"<p><p>The arrival of some diagnoses tends to bring about relief because it validates suffering and grants access to social legitimization, medical resources, and economic aid. This is the case of the Ehlers-Danlos Syndrome (EDS), a pathology with multisystemic involvement characterized by general laxity. Patients find it difficult to secure a diagnosis of one of its types-hypermobile EDS-due to a lack of awareness among physicians, the multiple changes that the diagnostic criteria undergo, and their increasing restrictivity. Consequently, several patients are intermittently let in and out of the diagnostic label, which leads some members of family, friends, administration, working environment, and healthcare professionals to view these patients with a skeptical gaze. This article argues that the ambiguity and contradictions surrounding the diagnosis of hEDS partially result from and reflect two philosophical controversies on the nature of disease. First, the debate between naturalists and normativists. Second, the discussion on the line-drawing problem. It concludes by urging healthcare practitioners to tell patients the implications of these contradictions-mainly, that medicine can work, and does work, without definitive diagnostic criteria.</p>","PeriodicalId":47377,"journal":{"name":"Journal of Medicine and Philosophy","volume":" ","pages":"248-261"},"PeriodicalIF":1.3,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12279013/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991435","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
Do Non-Compensating Plasma Centers Exploit Donors? 非补偿性血浆中心剥削献血者吗？
IF 1.3 3区 哲学
Journal of Medicine and Philosophy Pub Date : 2025-05-19 DOI: 10.1093/jmp/jhaf014
D Robert MacDougall
{"title":"Do Non-Compensating Plasma Centers Exploit Donors?","authors":"D Robert MacDougall","doi":"10.1093/jmp/jhaf014","DOIUrl":"https://doi.org/10.1093/jmp/jhaf014","url":null,"abstract":"<p><p>Some authors defend prohibiting compensation for blood plasma on the grounds that compensating donors exploits them. James Taylor has recently argued against this view. According to Taylor, not only does compensation not exploit donors but also accepting uncompensated donations in jurisdictions requiring this exploits donors. In this article, I evaluate Taylor's novel market-based account of exploitation and the conclusions about plasma donations he draws from it. I accept and offer further support for his account of exploitation but argue that (contra Taylor) the market-based account suggests that it is only in cases of capped compensation or legal monopsonies that centers can exploit donors. Uncompensated donations required by prohibitions are unlikely to exploit donors because a system of uncompensated donations does not actually benefit plasma centers, assuming a reasonable understanding of \"benefits\" for these nonprofit organizations. Finally, I discuss whether centers that can increase benefits to everyone by making exploitative offers should.</p>","PeriodicalId":47377,"journal":{"name":"Journal of Medicine and Philosophy","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144102645","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
Illness Experience and Social Suffering: Synthesizing Medical Phenomenology and Critical Theory. 疾病经验与社会苦难：医学现象学与批判理论的综合。
IF 1.3 3区 哲学
Journal of Medicine and Philosophy Pub Date : 2025-05-19 DOI: 10.1093/jmp/jhaf015
Domonkos Sik
{"title":"Illness Experience and Social Suffering: Synthesizing Medical Phenomenology and Critical Theory.","authors":"Domonkos Sik","doi":"10.1093/jmp/jhaf015","DOIUrl":"https://doi.org/10.1093/jmp/jhaf015","url":null,"abstract":"<p><p>Medical phenomenology describes the illness experience while providing an alternative to the reductionist biomedical discourse. Phenomenologically oriented critical theories focus on the experiences of structural paradoxes manifesting as social suffering. While both approaches elaborate different patterns of suffering, so far, their parallelisms and interactions have not been adequately analyzed. This task is all the more important because illness experience is never only about the disabled body or the distressed mind, it is also inseparable from a distorted intersubjectivity; and vice versa, untreated social suffering also has the potential of turning into illness. After overviewing various experiences characterizing illness and those disrupted intersubjectivities, which can produce a homologous phenomenological pattern, four idealtypical patterns are analyzed. The parallel occurrence of illness and social suffering represents extreme existential disembedding; illness without social suffering represents a chance for countering the bodily disembedding by intersubjective re-embedding; social suffering without illness is a constellation, wherein the chance of medicalizing structural distortions is high; the lack of illness and social suffering represents a carefree, yet unreflective potential. Differentiating between these patterns opens new horizons for medical phenomenology and critical theories as well, both on the theoretical and the practical level.</p>","PeriodicalId":47377,"journal":{"name":"Journal of Medicine and Philosophy","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144102730","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
Skewed Transgender Narratives in Western Media. 西方媒体中扭曲的跨性别叙事。
IF 1.3 3区 哲学
Journal of Medicine and Philosophy Pub Date : 2025-05-19 DOI: 10.1093/jmp/jhaf016
Hans-Georg Moeller, Jorge Ponseti
{"title":"Skewed Transgender Narratives in Western Media.","authors":"Hans-Georg Moeller, Jorge Ponseti","doi":"10.1093/jmp/jhaf016","DOIUrl":"https://doi.org/10.1093/jmp/jhaf016","url":null,"abstract":"<p><p>This essay compares representations of transgender people in Western mass and social media with data drawn from studies on transgender individuals. Three differences between the surveyed data and the media representations stand out: (1) while Western media focus on male-to-female (M-F) individuals, most transgender people in Western societies today are female-to-male (F-M). (2) Western media representations of transgender individuals highlight glamorous, successful people. Empirical data show that the socioeconomic status of transgender individuals in Western societies tends to be lower than that of nontransgender people. (3) In Western media, the transitioning process of transgender people is often portrayed as a successful soteriological journey of becoming one's \"true self.\" Medical surveys show that transgender people suffer from psychological and physical problems both before and after transitioning. It is concluded that the disparity between the empirical data and the media narratives on transgender people is due to the persistence of neoliberal narratives in Western media.</p>","PeriodicalId":47377,"journal":{"name":"Journal of Medicine and Philosophy","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144102844","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
Justification and Limitations of the Duty to Treat. 处理义务的正当性与局限性。
IF 1.3 3区 哲学
Journal of Medicine and Philosophy Pub Date : 2025-05-14 DOI: 10.1093/jmp/jhaf017
Gustavo Ortiz-Millán
{"title":"Justification and Limitations of the Duty to Treat.","authors":"Gustavo Ortiz-Millán","doi":"10.1093/jmp/jhaf017","DOIUrl":"https://doi.org/10.1093/jmp/jhaf017","url":null,"abstract":"<p><p>Do healthcare workers have a duty to treat contagious patients, even when it poses risks to their own health and lives during a pandemic? This article explores various justifications proposed in the literature to support such a duty. However, it contends that none of these provides a strong enough basis for establishing an absolute duty to treat-although it acknowledges that the bar of justification may be raised when working on more clear and explicit conditions in contracts and codes of ethics, among others. Furthermore, even if such a duty were acknowledged, it must be weighed against healthcare workers' other duties toward their families, co-workers, and personal well-being. Moreover, the duty to treat is argued to be contingent on the circumstances in which healthcare professionals operate, including access to adequate personal protective equipment provided by their institutions. It would have to be balanced against their right to safe working conditions. Within this context, the duty to treat is inherently tied to the preparedness of the State, healthcare systems, or institutions to effectively respond to emergencies.</p>","PeriodicalId":47377,"journal":{"name":"Journal of Medicine and Philosophy","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081385","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
Rethinking Phenomenology of Health and Illness: An Alternative Interpretation. 重新思考健康与疾病的现象学：另一种解释。
IF 1.3 3区 哲学
Journal of Medicine and Philosophy Pub Date : 2025-05-05 DOI: 10.1093/jmp/jhaf013
Junguo Zhang
{"title":"Rethinking Phenomenology of Health and Illness: An Alternative Interpretation.","authors":"Junguo Zhang","doi":"10.1093/jmp/jhaf013","DOIUrl":"https://doi.org/10.1093/jmp/jhaf013","url":null,"abstract":"<p><p>This paper critically evaluates Matthew Burch's interpretations and critiques of the phenomenological account of health and illness, which are predominantly situated within the realm of static phenomenology within Husserl's framework, thereby neglecting the potential insights offered by genetic phenomenology. The primary focus of this paper is to explore genetic phenomenology in order to present an alternative interpretation of PHI. It argues that illness experience involves subjectivity, intersubjectivity, and objectivity, unified within a structural interdependence. Additionally, normality comprises subjective, intersubjective, and objective dimensions, reflecting its multifaceted nature. It encompasses both a pregiven aspect and a constitutive process. Moreover, the distinction between the lived body and the physical body is a result of first-person subjectification and third-person objectification perspectives. These perspectives mutually complement and intertwine, where bodily transparency and bodily conspicuousness do not necessarily conflict.</p>","PeriodicalId":47377,"journal":{"name":"Journal of Medicine and Philosophy","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054097","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
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