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Democratic Justifications for Patient Public Involvement and Engagement in Health Research: An Exploration of the Theoretical Debates and Practical Challenges. 病人公众参与和参与健康研究的民主理由:理论辩论和实践挑战的探索。
IF 1.6 3区 哲学
Journal of Medicine and Philosophy Pub Date : 2023-06-20 DOI: 10.1093/jmp/jhad024
Lucy Frith
{"title":"Democratic Justifications for Patient Public Involvement and Engagement in Health Research: An Exploration of the Theoretical Debates and Practical Challenges.","authors":"Lucy Frith","doi":"10.1093/jmp/jhad024","DOIUrl":"https://doi.org/10.1093/jmp/jhad024","url":null,"abstract":"<p><p>The literature on patient public involvement and engagement (PPIE) in health research has grown significantly in the last decade, with a diverse range of definitions and topologies promulgated. This has led to disputes over what the central functions and purpose of PPIE in health research is, and this in turn makes it difficult to assess and evaluate PPIE in practice. This paper argues that the most important function of PPIE is the attempt to make health research more democratic. Bringing this function to the fore and locating PPIE in the wider context of changes in contemporary forms of democratic engagement provides greater conceptual clarity over what PPIE in research should be trying to achieve. Conceptualizing PPIE as a form of democratization has a number of benefits. First, theories of what are appropriate, normatively justifiable and workable criteria for PPIE practices can be developed, and this can provide tools to address the legitimacy and accountability questions that have troubled the PPIE community. Second, this work can be used to form the basis of a research agenda to investigate how PPIE in health research operates, and how it can facilitate and/or improve democratic processes in health research.</p>","PeriodicalId":47377,"journal":{"name":"Journal of Medicine and Philosophy","volume":"48 4","pages":"400-412"},"PeriodicalIF":1.6,"publicationDate":"2023-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10281369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9710410","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
On the Anatomy of Health-related Actions for Which People Could Reasonably be Held Responsible: A Framework. 剖析人们可合理承担责任的与健康有关的行为:一个框架。
IF 1.6 3区 哲学
Journal of Medicine and Philosophy Pub Date : 2023-06-20 DOI: 10.1093/jmp/jhad025
Kristine Bærøe, Andreas Albertsen, Cornelius Cappelen
{"title":"On the Anatomy of Health-related Actions for Which People Could Reasonably be Held Responsible: A Framework.","authors":"Kristine Bærøe,&nbsp;Andreas Albertsen,&nbsp;Cornelius Cappelen","doi":"10.1093/jmp/jhad025","DOIUrl":"https://doi.org/10.1093/jmp/jhad025","url":null,"abstract":"<p><p>Should we let personal responsibility for health-related behavior influence the allocation of healthcare resources? In this paper, we clarify what it means to be responsible for an action. We rely on a crucial conceptual distinction between being responsible and holding someone responsible, and show that even though we might be considered responsible and blameworthy for our health-related actions, there could still be well-justified reasons for not considering it reasonable to hold us responsible by giving us lower priority. We transform these philosophical considerations into analytical use first by assessing the general features of health-related actions and the corresponding healthcare needs. Then, we identify clusters of structural features that even adversely affected people cannot reasonably deny constitute actions for which they should be held responsible. We summarize the results in an analytical framework that can be used by decision-makers when considering personal responsibility for health as a criterion for setting priorities.</p>","PeriodicalId":47377,"journal":{"name":"Journal of Medicine and Philosophy","volume":"48 4","pages":"384-399"},"PeriodicalIF":1.6,"publicationDate":"2023-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10281374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9761834","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
Toward a Hybrid Theory of How to Allocate Health-related Resources. 健康相关资源配置的混合理论研究
IF 1.6 3区 哲学
Journal of Medicine and Philosophy Pub Date : 2023-06-20 DOI: 10.1093/jmp/jhad022
Anders Herlitz
{"title":"Toward a Hybrid Theory of How to Allocate Health-related Resources.","authors":"Anders Herlitz","doi":"10.1093/jmp/jhad022","DOIUrl":"https://doi.org/10.1093/jmp/jhad022","url":null,"abstract":"<p><p>How should scarce health-related resources be allocated? This paper argues that values that apply to these decisions fail to always fully determine what we should do. Health maximization and allocation-according-to-need are suggested as two values that should be part of a general theory of how to allocate health-related resources. The \"small improvement argument\" is used to argue that it is implausible that one alternative is always better, worse, or equal to another alternative with respect to these values. Approaches that rely on these values are thus incomplete. To deal with this, it is suggested that we ought to use incomplete theories in a two-step process. Such a process first discards ineligible alternatives, and, second, uses reasons grounded in collective commitments to identify a unique, best alternative in the remaining set.</p>","PeriodicalId":47377,"journal":{"name":"Journal of Medicine and Philosophy","volume":"48 4","pages":"373-383"},"PeriodicalIF":1.6,"publicationDate":"2023-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10281386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10083851","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
Preclinical Disease or Risk Factor? Alzheimer's Disease as a Case Study of Changing Conceptualizations of Disease. 临床前疾病还是危险因素?阿尔茨海默病:疾病概念变化的个案研究。
IF 1.6 3区 哲学
Journal of Medicine and Philosophy Pub Date : 2023-06-20 DOI: 10.1093/jmp/jhad009
Maartje H N Schermer
{"title":"Preclinical Disease or Risk Factor? Alzheimer's Disease as a Case Study of Changing Conceptualizations of Disease.","authors":"Maartje H N Schermer","doi":"10.1093/jmp/jhad009","DOIUrl":"https://doi.org/10.1093/jmp/jhad009","url":null,"abstract":"<p><p>Alzheimer's Disease (AD) provides an excellent case study to investigate emerging conceptions of health, disease, pre-disease, and risk. Two scientific working groups have recently reconceptualized AD and created a new category of asymptomatic biomarker positive persons, who are either said to have preclinical AD, or to be at risk for AD. This article examines how prominent theories of health and disease would classify this condition: healthy or diseased? Next, the notion of being \"at risk\"-a state somewhere in-between health and disease-is considered from various angles. It is concluded that medical-scientific developments urge us to let go of dichotomous ways of understanding disease, that the notion of \"risk,\" conceptualized as an increased chance of getting a symptomatic disease, might be a useful addition to our conceptual framework, and that we should pay more attention to the practical usefulness and implications of the ways in which we draw lines and define concepts.</p>","PeriodicalId":47377,"journal":{"name":"Journal of Medicine and Philosophy","volume":"48 4","pages":"322-334"},"PeriodicalIF":1.6,"publicationDate":"2023-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10281385/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9698398","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
Priority for Organ Donors in the Allocation of Organs: Priority Rules from the Perspective of Equality of Opportunity. 器官分配中的器官捐赠者优先:机会平等视角下的优先规则。
IF 1.6 3区 哲学
Journal of Medicine and Philosophy Pub Date : 2023-06-20 DOI: 10.1093/jmp/jhad023
Andreas Albertsen
{"title":"Priority for Organ Donors in the Allocation of Organs: Priority Rules from the Perspective of Equality of Opportunity.","authors":"Andreas Albertsen","doi":"10.1093/jmp/jhad023","DOIUrl":"https://doi.org/10.1093/jmp/jhad023","url":null,"abstract":"<p><p>Should priority in the allocation of organs be given to those who have previously donated or declared their willingness to do so? This article examines the Israeli priority rule in light of two prominent critiques of priority rules, pertaining to failure to reciprocate and unfairness. The scope and content of these critiques are interpreted from the perspective of equality of opportunity. Because the Israeli priority rule may be reasonably criticized for unfairness and failing to reward certain behaviors, the article develops an adjusted priority rule, which removes and adjust the elements in the Israeli priority rule deemed problematic. However, such a priority rule is complex to the extent that it may fail to increase donation rates and furthermore introduce new concerns of fairness, as the better off may be better able to navigate the complex adjusted priority rule.</p>","PeriodicalId":47377,"journal":{"name":"Journal of Medicine and Philosophy","volume":"48 4","pages":"359-372"},"PeriodicalIF":1.6,"publicationDate":"2023-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10049655","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: 2
Prevention of Disease and the Absent Body: A Phenomenological Approach to Periodontitis. 疾病预防与缺失体:牙周炎的现象学研究。
IF 1.6 3区 哲学
Journal of Medicine and Philosophy Pub Date : 2023-05-16 DOI: 10.1093/jmp/jhad015
Dylan Rakhra, Māra Grīnfelde
{"title":"Prevention of Disease and the Absent Body: A Phenomenological Approach to Periodontitis.","authors":"Dylan Rakhra,&nbsp;Māra Grīnfelde","doi":"10.1093/jmp/jhad015","DOIUrl":"https://doi.org/10.1093/jmp/jhad015","url":null,"abstract":"A large part of the contemporary phenomenology of medicine has been devoted to accounts of health and illness, arguing that they contribute to the improvement of health care. Less focus has been paid to the issue of prevention of disease and the associated difficulty of adhering to health-promoting behaviours, which is arguably of equal importance. This article offers a phenomenological account of this disease prevention, focusing on how we-as embodied beings-engage with health-promoting behaviours. It specifically considers how we engage with oral hygiene regimens to prevent periodontitis and why we are not good at it. The article suggests that poor adherence to health-promoting behaviours can be explained with reference to the concept of the absent body, because prevention of disease is generally concerned with pre-symptomatic illness experience. The final section contains a discussion of some strategies for the improvement of disease prevention based on this viewpoint.","PeriodicalId":47377,"journal":{"name":"Journal of Medicine and Philosophy","volume":"48 3","pages":"299-311"},"PeriodicalIF":1.6,"publicationDate":"2023-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9500302","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
Anti-abortionist Action Theory and the Asymmetry between Spontaneous and Induced Abortions. 反堕胎行动理论与自然流产与人工流产的不对称。
IF 1.6 3区 哲学
Journal of Medicine and Philosophy Pub Date : 2023-05-16 DOI: 10.1093/jmp/jhad011
Matthew Lee Anderson
{"title":"Anti-abortionist Action Theory and the Asymmetry between Spontaneous and Induced Abortions.","authors":"Matthew Lee Anderson","doi":"10.1093/jmp/jhad011","DOIUrl":"https://doi.org/10.1093/jmp/jhad011","url":null,"abstract":"<p><p>This essay defends the asymmetry between the badness of spontaneous and induced abortions in order to explain why anti-abortionists prioritize stopping induced abortions over preventing spontaneous abortions. Specifically, it argues (1) the distinction between killing and letting-die is of more limited use in explaining the asymmetry than has sometimes been presumed, and (2) that accounting for intentions in moral agency does not render performances morally inert. Instead, anti-abortionists adopt a pluralist, nonreductive account of moral analysis which is situated against a backdrop that sees the limits of our ability to control the process of fertility as themselves valuable. Although this view is complex, the paper concludes by arguing that it has the advantage of explaining features of the anti-abortion outlook that have sometimes been overlooked. First, it accounts for why the pre-Roe regime of abortion restrictions primarily imposed penalties on doctors who induced abortions rather than the women who seek them. Second, it explains why the advent of ectogestation will not prompt anti-abortionists to compromise on 'disconnect abortions,' which putatively let the embryo die by extracting it from the mother's womb.</p>","PeriodicalId":47377,"journal":{"name":"Journal of Medicine and Philosophy","volume":"48 3","pages":"209-224"},"PeriodicalIF":1.6,"publicationDate":"2023-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9488059","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
Miscarriage, Abortion, and Disease. 流产、流产和疾病。
IF 1.6 3区 哲学
Journal of Medicine and Philosophy Pub Date : 2023-05-16 DOI: 10.1093/jmp/jhad012
Tom Waters
{"title":"Miscarriage, Abortion, and Disease.","authors":"Tom Waters","doi":"10.1093/jmp/jhad012","DOIUrl":"https://doi.org/10.1093/jmp/jhad012","url":null,"abstract":"<p><p>The frequency of death from miscarriage is very high, greater than the number of deaths from induced abortion or major diseases. Berg (2017 , Philosophical Studies 174:1217-26) argues that, given this, those who contend that personhood begins at conception (PAC) are obliged to reorient their resources accordingly-towards stopping miscarriage, in preference to stopping abortion or diseases. This argument depends on there being a basic moral similarity between these deaths. I argue that, for those that hold to PAC, there are good reasons to think that there is no such similarity. There is a morally relevant difference between preventing killing and letting die, giving PAC supporters reasons to prioritize reducing abortion over reducing miscarriage. And the time-relative interest account provides a morally relevant difference in the badness of death of miscarriages and deaths of born adults, justifying attempts to combat major diseases over attempts to combat miscarriage. I consider recent developments in the literature and contend that these new arguments are unsuccessful in establishing moral similarities between deaths from miscarriage and abortion, and deaths from miscarriage and disease.</p>","PeriodicalId":47377,"journal":{"name":"Journal of Medicine and Philosophy","volume":"48 3","pages":"243-251"},"PeriodicalIF":1.6,"publicationDate":"2023-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9493878","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
Embryo Loss and Moral Status. 胚胎丧失与道德地位。
IF 1.6 3区 哲学
Journal of Medicine and Philosophy Pub Date : 2023-05-16 DOI: 10.1093/jmp/jhad010
James Delaney
{"title":"Embryo Loss and Moral Status.","authors":"James Delaney","doi":"10.1093/jmp/jhad010","DOIUrl":"https://doi.org/10.1093/jmp/jhad010","url":null,"abstract":"<p><p>There is a significant debate over the moral status of human embryos. This debate has important implications for practices like abortion and IVF. Some argue that embryos have the same moral status as infants, children, and adults. However, critics claim that the frequency of pregnancy loss/miscarriage/spontaneous abortion shows a moral inconsistency in this view. One line of criticism is that those who know the facts about pregnancy loss and nevertheless attempt to conceive children are willing to sacrifice embryos lost for the healthy children they ultimately have. I respond to this criticism and argue that on the most plausible accounts of well-being, these embryos are not made worse off and thus not \"sacrifices.\" I then make some more general remarks about what people's typical views about pregnancy loss show about their views toward the moral status of embryos.</p>","PeriodicalId":47377,"journal":{"name":"Journal of Medicine and Philosophy","volume":"48 3","pages":"252-264"},"PeriodicalIF":1.6,"publicationDate":"2023-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9849675","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
The Scourges: Why Abortion Is Even More Morally Serious than Miscarriage. 《祸患:为什么堕胎在道德上比流产更严重》
IF 1.6 3区 哲学
Journal of Medicine and Philosophy Pub Date : 2023-05-16 DOI: 10.1093/jmp/jhad014
Calum Miller
{"title":"The Scourges: Why Abortion Is Even More Morally Serious than Miscarriage.","authors":"Calum Miller","doi":"10.1093/jmp/jhad014","DOIUrl":"https://doi.org/10.1093/jmp/jhad014","url":null,"abstract":"<p><p>Several recent papers have suggested that the pro-life view entails a radical, implausible thesis: that miscarriage is the biggest public health crisis in the history of our species and requires radical diversion of funds to combat. In this paper, I clarify the extent of the problem, showing that the number of miscarriages about which we can do anything morally significant is plausibly much lower than previously thought, then describing some of the work already being done on this topic. I then briefly survey a range of reasons why abortion might be thought more serious and more worthy of prevention than miscarriage. Finally, I lay out my central argument: that reflection on the wrongness of killing reveals that the norms for ending life and failing to save life are different, in such a way that could justify the prioritization of anti-abortion advocacy over anti-miscarriage efforts. Such an account can also respond to similar problems posed to the pro-lifer, such as the question of whom to save in a \"burning lab\" type scenario.</p>","PeriodicalId":47377,"journal":{"name":"Journal of Medicine and Philosophy","volume":"48 3","pages":"225-242"},"PeriodicalIF":1.6,"publicationDate":"2023-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10185666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9849676","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
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