Journal of Medicine and Philosophy最新文献_第7页

The "Risks of Routine Tests" and Analogical Reasoning in Assessments of Minimal Risk. “常规测试的风险”和最小风险评估中的类比推理。

IF 1.3 3区哲学

Journal of Medicine and Philosophy Pub Date : 2024-01-13 DOI: 10.1093/jmp/jhad042

Adrian Kwek

引用次数: 0

Intentions at the End of Life: Continuous Deep Sedation and France's Claeys-Leonetti law. 生命尽头的意图：持续的深度镇静和法国的克莱斯·莱昂内蒂定律。

IF 1.3 3区哲学

Journal of Medicine and Philosophy Pub Date : 2024-01-13 DOI: 10.1093/jmp/jhad040

Steven Farrelly-Jackson

引用次数: 0

How to Exercise Integrity in Medical Billing: Don't Distort Prices, Don't Free-Ride on Other Physicians. 如何在医疗账单中保持诚信：不要扭曲价格，不要搭其他医生的便车。

IF 1.3 3区哲学

Journal of Medicine and Philosophy Pub Date : 2024-01-13 DOI: 10.1093/jmp/jhad043

Christopher Langston

{"title":"How to Exercise Integrity in Medical Billing: Don't Distort Prices, Don't Free-Ride on Other Physicians.","authors":"Christopher Langston","doi":"10.1093/jmp/jhad043","DOIUrl":"10.1093/jmp/jhad043","url":null,"abstract":"This paper proposes that billing gamesmanship occurs when physicians free-ride on the billing practices of other physicians. Gamesmanship is non-universalizable and does not exercise a competitive advantage; consequently, it distorts prices and allocates resources inefficiently. This explains why gamesmanship is wrong. This explanation differs from the recent proposal of Heath (2020. Ethical issues in physician billing under fee-for-service plans. J. Med. Philos. 45(1):86-104) that gamesmanship is wrong because of specific features of health care and of health insurance. These features are aggravating factors but do not explain gamesmanship's primary wrong-making feature, which is to cause diffuse harm not traceable to any particular patient or insurer. This conclusion has important consequences for how medical schools and professional organizations encourage integrity in billing. To avoid free-riding, physicians should ask themselves, \"could all physicians bill this way?\" and if not, \"does the patient benefit from the distinctive service I am providing under this code?\" If both answers are \"no,\" physicians should refrain from the billing practice in question.","PeriodicalId":47377,"journal":{"name":"Journal of Medicine and Philosophy","volume":" ","pages":"72-84"},"PeriodicalIF":1.3,"publicationDate":"2024-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10787110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41152031","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

Phenomenological Interview and Gender Dysphoria: A Third Pathway for Diagnosis and Treatment. 现象学访谈与性别障碍：诊断和治疗的第三条途径。

IF 1.3 3区哲学

Journal of Medicine and Philosophy Pub Date : 2024-01-13 DOI: 10.1093/jmp/jhad039

Geoffrey Dierckxsens, Teresa R Baron

{"title":"Phenomenological Interview and Gender Dysphoria: A Third Pathway for Diagnosis and Treatment.","authors":"Geoffrey Dierckxsens, Teresa R Baron","doi":"10.1093/jmp/jhad039","DOIUrl":"10.1093/jmp/jhad039","url":null,"abstract":"Gender dysphoria (GD) is marked by an incongruence between a person's biological sex at birth, and their felt gender (or gender identity). There is continuing debate regarding the benefits and drawbacks of physiological treatment of GD in children, a pathway, beginning with endocrine treatment to suppress puberty. Currently, the main alternative to physiological treatment consists of the so-called \"wait-and-see\" approach, which often includes counseling or other psychotherapeutic treatment. In this paper, we argue in favor of a \"third pathway\" for the diagnosis and treatment of GD in youths. To make our case, we draw on a recent development in bioethics: the phenomenological approach. Scholars such as Slatman and Svenaeus have argued that the extent to which the body can (or should be) manipulated or reconstructed through medical intervention is not only determined by consideration of ethical frameworks and social and legal norms. Rather, we must also take account of patients' personal experience of their body, the personal and social values associated with it, and their understanding of its situation in their life: their narrative identities. We apply this phenomenological approach to medicine and nursing to the diagnosis and treatment of GD in youth. In particular, we discuss Zahavi and Martiny's conception of the phenomenological interview, in order to show that narrative techniques can assist in the process of gender identification and in the treatment of youth presenting with GD. We focus on two case studies that highlight the relevance of a narrative-based interview in relations between patients, HCPs, and family, to expose the influence of social ideologies on how young people presenting with GD experience their bodies and gender.","PeriodicalId":47377,"journal":{"name":"Journal of Medicine and Philosophy","volume":" ","pages":"28-42"},"PeriodicalIF":1.3,"publicationDate":"2024-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41152032","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

Moral Distress, Conscientious Practice, and the Endurance of Ethics in Health Care through Times of Crisis and Calm. 危机与平静时期的道德困境、良心实践与医疗伦理的持久性。

IF 1.3 3区哲学

Journal of Medicine and Philosophy Pub Date : 2024-01-13 DOI: 10.1093/jmp/jhad041

Lauris Christopher Kaldjian

{"title":"Moral Distress, Conscientious Practice, and the Endurance of Ethics in Health Care through Times of Crisis and Calm.","authors":"Lauris Christopher Kaldjian","doi":"10.1093/jmp/jhad041","DOIUrl":"10.1093/jmp/jhad041","url":null,"abstract":"When health professionals experience moral distress during routine clinical practice, they are challenged to maintain integrity through conscientious practice guided by ethical principles and virtues that promote the dignity of all human beings who need care. Their integrity also needs preservation during a crisis like the COVID-19 pandemic, especially when faced with triage protocols that allocate scarce resources. Although a crisis may change our ability to provide life-saving treatment to all who need it, a crisis should not change the ethical values that should always be guiding clinical care. Enduring ethical commitments should encourage clinicians to base treatment decisions on the medical needs of individual patients. This approach contrasts with utilitarian attempts to maximize selected aggregate outcomes by using scoring systems that use short-term and possibly long-term prognostic estimates to discriminate between patients and thereby treat them unequally in terms of their eligibility for life-sustaining treatment. During times of crisis and calm, moral communication allows clinicians to exercise moral agency and advocate for their individual patients, thereby demonstrating conscientious practice and resisting influences that may contribute to compartmentalization, moral injury, and burnout.","PeriodicalId":47377,"journal":{"name":"Journal of Medicine and Philosophy","volume":" ","pages":"11-27"},"PeriodicalIF":1.3,"publicationDate":"2024-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41155038","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

On The Problem of Defending Basic Equality: Natural Law and The Substance View. 论维护基本平等的问题:自然法与实体观。

IF 1.6 3区哲学

Journal of Medicine and Philosophy Pub Date : 2023-11-03 DOI: 10.1093/jmp/jhad030

Henrik Friberg-Fernros

引用次数: 1

What's the Harm in Cardiopulmonary Resuscitation? 心肺复苏的危害是什么?

IF 1.6 3区哲学

Journal of Medicine and Philosophy Pub Date : 2023-11-03 DOI: 10.1093/jmp/jhad033

Peter M Koch

{"title":"What's the Harm in Cardiopulmonary Resuscitation?","authors":"Peter M Koch","doi":"10.1093/jmp/jhad033","DOIUrl":"10.1093/jmp/jhad033","url":null,"abstract":"In clinical ethics, there remains a great deal of uncertainty regarding the appropriateness of attempting cardiopulmonary resuscitation (CPR) for certain patients. Although the issue continues to receive ample attention and various frameworks have been proposed for navigating such cases, most discussions draw heavily on the notion of harm as a central consideration. In the following, I use emerging philosophical literature on the notion of harm to argue that the ambiguities and disagreement about harm create important and oft-overlooked challenges for the ethics of CPR. I begin by elucidating the standard account of harm, called the Counterfactual Comparative Account (CCA). I then show that three challenges to the CCA-preemptive harms, the harm of death, and non-experiential harms-are particularly salient when assessing potential harms for candidates of CPR and likely impact-related decision-making and communication. I extend this argument to explore how the ambiguities of harm might extend to other realms of clinical decision-making, such as the use and limitations of life-sustaining treatments. To address these challenges, I propose two strategies for identifying and minimizing the impact of such uncertainty: first, clinicians and ethicists ought to promote pluralistic conversations that account for different understandings of harm; second, they ought to invoke harm-independent considerations when discussing the ethics of CPR in order to reflect the nuances of such conversations. These strategies, coupled with a richer philosophical understanding of harm, promise to help clinicians and ethicists navigate the prevalent and difficult cases involving patient resuscitation and many other harm-based decisions in the clinical setting.","PeriodicalId":47377,"journal":{"name":"Journal of Medicine and Philosophy","volume":" ","pages":"603-612"},"PeriodicalIF":1.6,"publicationDate":"2023-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10099600","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: 1

Disability, Transition Costs, and the Things That Really Matter. 残疾、过渡成本和真正重要的事情。

IF 1.6 3区哲学

Journal of Medicine and Philosophy Pub Date : 2023-11-03 DOI: 10.1093/jmp/jhad034

Tommy Ness, Linda Barclay

引用次数: 1

On Drugs. 在药物。

IF 1.6 3区哲学

Journal of Medicine and Philosophy Pub Date : 2023-11-03 DOI: 10.1093/jmp/jhad035

Sam Baron, Sara Linton, Maureen A O'Malley

引用次数: 0

Abortion, Impairment, and Well-Being. 堕胎、损害和幸福。