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The Social Epistemology of Clinical Placebos. 临床安慰剂的社会认识论》。
IF 1.6 3区 哲学
Journal of Medicine and Philosophy Pub Date : 2024-04-20 DOI: 10.1093/jmp/jhae010
Melissa Rees
{"title":"The Social Epistemology of Clinical Placebos.","authors":"Melissa Rees","doi":"10.1093/jmp/jhae010","DOIUrl":"10.1093/jmp/jhae010","url":null,"abstract":"<p><p>Many extant theories of placebo focus on their causal structure wherein placebo effects are those that originate from select features of the therapy (e.g., client expectations or \"incidental\" features like size and shape). Although such accounts can distinguish placebos from standard medical treatments, they cannot distinguish placebos from everyday occurrences, for example, when positive feedback improves our performance on a task. Providing a social-epistemological account of a treatment context can rule out such occurrences, and furthermore reveal a new way to distinguish clinical placebos from standard medical treatments.</p>","PeriodicalId":47377,"journal":{"name":"Journal of Medicine and Philosophy","volume":" ","pages":"233-245"},"PeriodicalIF":1.6,"publicationDate":"2024-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140294954","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 Fictionalist Account of Open-Label Placebo. 关于开放标签安慰剂的虚构故事
IF 1.6 3区 哲学
Journal of Medicine and Philosophy Pub Date : 2024-04-20 DOI: 10.1093/jmp/jhae008
Doug Hardman
{"title":"A Fictionalist Account of Open-Label Placebo.","authors":"Doug Hardman","doi":"10.1093/jmp/jhae008","DOIUrl":"10.1093/jmp/jhae008","url":null,"abstract":"<p><p>The placebo effect is now generally defined widely as an individual's response to the psychosocial context of a clinical treatment, as distinct from the treatment's characteristic physiological effects. Some researchers, however, argue that such a wide definition leads to confusion and misleading implications. In response, they propose a narrow definition restricted to the therapeutic effects of deliberate placebo treatments. Within the framework of modern medicine, such a scope currently leaves one viable placebo treatment paradigm: the non-deceptive and non-concealed administration of \"placebo pills\" or open-label placebo (OLP) treatment. In this paper, I consider how the placebo effect occurs in OLP. I argue that a traditional, belief-based account of OLP is paradoxical. Instead, I propose an account based on the non-doxastic attitude of pretence, understood within a fictionalist framework.</p>","PeriodicalId":47377,"journal":{"name":"Journal of Medicine and Philosophy","volume":" ","pages":"246-256"},"PeriodicalIF":1.6,"publicationDate":"2024-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140294951","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
Three Arguments Against Institutional Conscientious Objection, and Why They Are (Metaphysically) Unconvincing. 反对制度性良心反对的三个论点，以及为什么它们（从形而上学角度）无法令人信服。
IF 1.6 3区 哲学
Journal of Medicine and Philosophy Pub Date : 2024-04-20 DOI: 10.1093/jmp/jhae012
Xavier Symons, Reginald Mary Chua
{"title":"Three Arguments Against Institutional Conscientious Objection, and Why They Are (Metaphysically) Unconvincing.","authors":"Xavier Symons, Reginald Mary Chua","doi":"10.1093/jmp/jhae012","DOIUrl":"10.1093/jmp/jhae012","url":null,"abstract":"<p><p>The past decade has seen a burgeoning of scholarly interest in conscientious objection in healthcare. While the literature to date has focused primarily on individual healthcare practitioners who object to participation in morally controversial procedures, in this article we consider a different albeit related issue, namely, whether publicly funded healthcare institutions should be required to provide morally controversial services such as abortions, emergency contraception, voluntary sterilizations, and voluntary euthanasia. Substantive debates about institutional responsibility have remained largely at the level of first-order ethical debate over medical practices which institutions have refused to offer; in this article, we argue that more fundamental questions about the metaphysics of institutions provide a neglected avenue for understanding the basis of institutional conscientious objection. To do so, we articulate a metaphysical model of institutional conscience, and consider three well-known arguments for undermining institutional conscientious objection in light of this model. We show how our metaphysical analysis of institutions creates difficulties for justifying sanctions on institutions that conscientiously object. Thus, we argue, questions about the metaphysics of institutions are deserving of serious attention from both critics and defenders of institutional conscientious objection.</p>","PeriodicalId":47377,"journal":{"name":"Journal of Medicine and Philosophy","volume":" ","pages":"298-312"},"PeriodicalIF":1.6,"publicationDate":"2024-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11032102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140337213","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
Psychopathology and Metaphysics: Can One Be a Realist About Mental Disorder? 精神病理学与形而上学：能否成为精神障碍的现实主义者？
IF 1.6 3区 哲学
Journal of Medicine and Philosophy Pub Date : 2024-04-20 DOI: 10.1093/jmp/jhae013
Simoni Iliadi
{"title":"Psychopathology and Metaphysics: Can One Be a Realist About Mental Disorder?","authors":"Simoni Iliadi","doi":"10.1093/jmp/jhae013","DOIUrl":"10.1093/jmp/jhae013","url":null,"abstract":"<p><p>Metaphysical realism about mental disorder is the thesis that mental disorder exists mind-independently. There are two ways to challenge metaphysical realism about mental disorder. The first is by denying that mental disorder exists. The second is by denying that mental disorder exists mind-independently. Or, differently put, by arguing that mental disorder is mind-dependent. The aim of this paper is three-fold: (a) to examine three ways in which mental disorder can be said to be mind-dependent (namely, by being causally dependent on the human mind, by being weakly dependent on human attitudes, and by being strongly dependent on human attitudes), (b) to clarify their differences, and (c) to discuss their implications regarding metaphysical realism about mental disorder. I argue that mental disorder being mind-dependent in the first two senses is compatible with metaphysical realism about mental disorder, whereas mental disorder being mind-dependent in the third sense is not.</p>","PeriodicalId":47377,"journal":{"name":"Journal of Medicine and Philosophy","volume":" ","pages":"283-297"},"PeriodicalIF":1.6,"publicationDate":"2024-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11032104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140294952","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 Altruism Requirement as Moral Fiction. 作为道德虚构的利他要求。
IF 1.6 3区 哲学
Journal of Medicine and Philosophy Pub Date : 2024-04-20 DOI: 10.1093/jmp/jhae011
Luke Semrau
{"title":"The Altruism Requirement as Moral Fiction.","authors":"Luke Semrau","doi":"10.1093/jmp/jhae011","DOIUrl":"10.1093/jmp/jhae011","url":null,"abstract":"<p><p>It is widely agreed that living kidney donation is permitted but living kidney sales are not. Call this the Received View. One way to support the Received View is to appeal to a particular understanding of the conditions under which living kidney transplantation is permissible. It is often claimed that donors must act altruistically, without the expectation of payment and for the sake of another. Call this the Altruism Requirement. On the conventional interpretation, the Altruism Requirement is a moral fact. It states a legitimate constraint on permissible transplantation and is accepted on the basis of cogent argument. The present paper offers an alternative interpretation. I suggest the Altruism Requirement is a moral fiction-a kind of motivated falsehood. It is false that transplantation requires altruism. But the Requirement serves a purpose. Accepting it allows kidney donation but not kidney sale. It, in short, rationalizes the Received View.</p>","PeriodicalId":47377,"journal":{"name":"Journal of Medicine and Philosophy","volume":" ","pages":"257-270"},"PeriodicalIF":1.6,"publicationDate":"2024-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140294953","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
Expanding the Use of Continuous Sedation Until Death and Physician-Assisted Suicide. 扩大使用持续镇静至死和医生协助自杀。
IF 1.6 3区 哲学
Journal of Medicine and Philosophy Pub Date : 2024-04-20 DOI: 10.1093/jmp/jhae009
Samuel H LiPuma, Joseph P Demarco
{"title":"Expanding the Use of Continuous Sedation Until Death and Physician-Assisted Suicide.","authors":"Samuel H LiPuma, Joseph P Demarco","doi":"10.1093/jmp/jhae009","DOIUrl":"10.1093/jmp/jhae009","url":null,"abstract":"<p><p>The controversy over the equivalence of continuous sedation until death (CSD) and physician-assisted suicide/euthanasia (PAS/E) provides an opportunity to focus on a significant extended use of CSD. This extension, suggested by the equivalence of PAS/E and CSD, is designed to promote additional patient autonomy at the end-of-life. Samuel LiPuma, in his article, \"Continuous Sedation Until Death as Physician-Assisted Suicide/Euthanasia: A Conceptual Analysis\" claims equivalence between CSD and death; his paper is seminal in the equivalency debate. Critics contend that sedation follows proportionality protocols for which LiPuma's thesis does not adequately account. Furthermore, sedation may not eliminate consciousness, and as such LiPuma's contention that CSD is equivalent to neocortical death is suspect. We not only defend the equivalence thesis, but also expand it to include additional moral considerations. First, we explain the equivalence thesis. This is followed by a defense of the thesis against five criticisms. The third section critiques the current use of CSD. Finally, we offer two proposals that, if adopted, would broaden the use of PAS/E and CSD and thereby expand options at the end-of-life.</p>","PeriodicalId":47377,"journal":{"name":"Journal of Medicine and Philosophy","volume":" ","pages":"313-323"},"PeriodicalIF":1.6,"publicationDate":"2024-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140307392","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
Reference-Class Problems Are Real: Health-Adjusted Reference Classes and Low Bone Mineral Density. 参考类问题是真实存在的：健康调整参考类与低骨质密度。
IF 1.6 3区 哲学
Journal of Medicine and Philosophy Pub Date : 2024-03-14 DOI: 10.1093/jmp/jhae005
Nicholas Binney
{"title":"Reference-Class Problems Are Real: Health-Adjusted Reference Classes and Low Bone Mineral Density.","authors":"Nicholas Binney","doi":"10.1093/jmp/jhae005","DOIUrl":"10.1093/jmp/jhae005","url":null,"abstract":"<p><p>Elselijn Kingma argues that Christopher Boorse's biostatistical theory (the BST) does not show how the reference classes it uses are objective and naturalistic. Recently, philosophers of medicine have attempted to rebut Kingma's concerns. I argue that these rebuttals are theoretically unconvincing, and that there are clear examples of physicians adjusting their reference classes according to their prior knowledge of health and disease. I focus on the use of age-adjusted reference classes to diagnose low bone mineral density in children. In addition to using the BST's age, sex, and species, physicians also choose to use other factors to define reference classes, such as pubertal status, bone age, body size, and muscle mass. I show that physicians calibrate the reference classes they use according to their prior knowledge of health and disease. Reference classes are also chosen for pragmatic reasons, such as to predict fragility fractures.</p>","PeriodicalId":47377,"journal":{"name":"Journal of Medicine and Philosophy","volume":" ","pages":"128-146"},"PeriodicalIF":1.6,"publicationDate":"2024-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10938540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139991472","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
Interventionism and Intelligibility: Why Depression Is Not (Always) a Brain Disease. 干预主义与可理解性：为什么抑郁症不是（总是）一种脑部疾病？
IF 1.6 3区 哲学
Journal of Medicine and Philosophy Pub Date : 2024-03-14 DOI: 10.1093/jmp/jhae004
Quinn Hiroshi Gibson
{"title":"Interventionism and Intelligibility: Why Depression Is Not (Always) a Brain Disease.","authors":"Quinn Hiroshi Gibson","doi":"10.1093/jmp/jhae004","DOIUrl":"10.1093/jmp/jhae004","url":null,"abstract":"<p><p>Major depressive disorder (MDD) is a serious condition with a large disease burden. It is often claimed that MDD is a \"brain disease.\" What would it mean for MDD to be a brain disease? I argue that the best interpretation of this claim is as offering a substantive empirical hypothesis about the causes of the syndrome of depression. This syndrome-causal conception of disease, combined with the idea that MDD is a disease of the brain, commits the brain disease conception of MDD to the claim that brain dysfunction causes the symptoms of MDD. I argue that this consequence of the brain disease conception of MDD is false. It incorrectly rules out genuine instances of content-sensitive causation between adverse conditions in the world and the characteristic symptoms of MDD. Empirical evidence shows that the major causes of depression are genuinely psychological causes of the symptoms of MDD. This rules out, in many cases, the \"brute\" causation required by the brain disease conception. The existence of cases of MDD with non-brute causes supports the reinstatement of the old nosological distinction between endogenous and exogenous depression.</p>","PeriodicalId":47377,"journal":{"name":"Journal of Medicine and Philosophy","volume":" ","pages":"160-177"},"PeriodicalIF":1.6,"publicationDate":"2024-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139991471","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 Phenomenology of the Face-to-Facetime: A Levinasian Critique of the Virtual Clinic. 面对面的现象学：勒维纳斯虚拟诊所批判》。
IF 1.6 3区 哲学
Journal of Medicine and Philosophy Pub Date : 2024-03-14 DOI: 10.1093/jmp/jhae003
Daniel C O'Brien
{"title":"The Phenomenology of the Face-to-Facetime: A Levinasian Critique of the Virtual Clinic.","authors":"Daniel C O'Brien","doi":"10.1093/jmp/jhae003","DOIUrl":"10.1093/jmp/jhae003","url":null,"abstract":"<p><p>In order to promote social distancing during the recent COVID-19 pandemic, physicians and healthcare systems have made efforts to replace in-person with virtual clinic visits when feasible. While these efforts have been well received and seem compatible with sound clinical practice, they do not perfectly replicate the experience of a face-to-face exchange between doctor and patient. This essay attempts to describe features of the virtual visit that distinguish it from its face-to-face analog and considers the phenomenological work of Emmanuel Levinas in arguing that these differences may limit the force of the ethical summons a provider would otherwise experience before the face of a patient. The diminishment of this signal therapeutic experience may engender vocational as well as clinical consequences, which should be weighed against the practical benefits of the virtual visit as we consider whether our enthusiasm for this mode of practice should continue.</p>","PeriodicalId":47377,"journal":{"name":"Journal of Medicine and Philosophy","volume":" ","pages":"207-219"},"PeriodicalIF":1.6,"publicationDate":"2024-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139991474","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
Unfreedom or Mere Inability? The Case of Biomedical Enhancement. 不自由还是仅仅无能？生物医学增强案例。
IF 1.6 3区 哲学
Journal of Medicine and Philosophy Pub Date : 2024-03-14 DOI: 10.1093/jmp/jhae007
Ji Young Lee
{"title":"Unfreedom or Mere Inability? The Case of Biomedical Enhancement.","authors":"Ji Young Lee","doi":"10.1093/jmp/jhae007","DOIUrl":"10.1093/jmp/jhae007","url":null,"abstract":"<p><p>Mere inability, which refers to what persons are naturally unable to do, is traditionally thought to be distinct from unfreedom, which is a social type of constraint. The advent of biomedical enhancement, however, challenges the idea that there is a clear division between mere inability and unfreedom. This is because bioenhancement makes it possible for some people's mere inabilities to become matters of unfreedom. In this paper, I discuss several ways that this might occur: first, bioenhancement can exacerbate social pressures to enhance one's abilities; second, people may face discrimination for not enhancing; third, the new abilities made possible due to bioenhancement may be accompanied by new inabilities for the enhanced and unenhanced; and finally, shifting values around abilities and inabilities due to bioenhancement may reinforce a pre-existing ableism about human abilities. As such, we must give careful consideration to these potential unfreedom-generating outcomes when it comes to our moral evaluations of bioenhancement.</p>","PeriodicalId":47377,"journal":{"name":"Journal of Medicine and Philosophy","volume":" ","pages":"195-206"},"PeriodicalIF":1.6,"publicationDate":"2024-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139991422","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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