Medicine Health Care and Philosophy最新文献

Menstrual pain and epistemic injustice. 经期疼痛和认知不公。

IF 2.3 2区哲学

Medicine Health Care and Philosophy Pub Date : 2025-04-05 DOI: 10.1007/s11019-025-10266-7

Adriana Joanna Mickiewicz

引用次数: 0

"The significance of clinical foetal autopsy for reproductive health care: an ethical analysis in the German context". "临床胎儿解剖对生殖保健的意义：德国的伦理分析"。

IF 2.3 2区哲学

Medicine Health Care and Philosophy Pub Date : 2025-04-03 DOI: 10.1007/s11019-025-10265-8

Elisa Groff, Marta C Cohen, Florian Steger

{"title":"\"The significance of clinical foetal autopsy for reproductive health care: an ethical analysis in the German context\".","authors":"Elisa Groff, Marta C Cohen, Florian Steger","doi":"10.1007/s11019-025-10265-8","DOIUrl":"https://doi.org/10.1007/s11019-025-10265-8","url":null,"abstract":"The clinical autopsy of foetuses, stillborn babies, or neonates and the examination of the placenta help to inform the mother's decision-making and her medical care for subsequent pregnancies. Indeed, these post-mortem examinations can identify unexpected congenital malformations or the cause of repeated miscarriage or stillbirth. However, the use of clinical pathology for diagnostic purposes in the context of family planning for bereaved parents with an unfulfilled desire to have a child, and IVF couples has received little attention to date. This article applies Beauchamp and Childress' bioethical framework to identify, assess and systematically discuss ethical issues associated with the use of clinical foetal autopsy in reproductive healthcare within the German legal context. In the format of a clinical ethics consultation, the article examines the current policy on perinatal post-mortem examinations in Germany, and asks whether the clinical foetal autopsy for reproductive health purposes should be part of standard clinical examinations offered to bereaved parents. The conclusion of our research recommends clinical foetal autopsy as ethically acceptable, provided that the necessary resources are available. This recommendation is based on the ethical obligation towards the mother as the patient, which is grounded in the bioethical principles of autonomy and beneficence.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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

Having a chronic disease and being chronically ill. 患有慢性疾病和长期患病。

IF 2.3 2区哲学

Medicine Health Care and Philosophy Pub Date : 2025-04-02 DOI: 10.1007/s11019-025-10267-6

Henk Ten Have, Bert Gordijn

引用次数: 0

Chronic illness as transformative activity. 慢性病是一种变革性的活动。

IF 2.3 2区哲学

Medicine Health Care and Philosophy Pub Date : 2025-03-17 DOI: 10.1007/s11019-025-10260-z

Victoria Paul

引用次数: 0

The need for epistemic humility in AI-assisted pain assessment. 人工智能辅助疼痛评估需要认识上的谦逊。

IF 2.3 2区哲学

Medicine Health Care and Philosophy Pub Date : 2025-03-15 DOI: 10.1007/s11019-025-10264-9

Rachel A Katz, S Scott Graham, Daniel Z Buchman

{"title":"The need for epistemic humility in AI-assisted pain assessment.","authors":"Rachel A Katz, S Scott Graham, Daniel Z Buchman","doi":"10.1007/s11019-025-10264-9","DOIUrl":"https://doi.org/10.1007/s11019-025-10264-9","url":null,"abstract":"It has been difficult historically for physicians, patients, and philosophers alike to quantify pain given that pain is commonly understood as an individual and subjective experience. The process of measuring and diagnosing pain is often a fraught and complicated process. New developments in diagnostic technologies assisted by artificial intelligence promise more accurate and efficient diagnosis for patients, but these tools are known to reproduce and further entrench existing issues within the healthcare system, such as poor patient treatment and the replication of systemic biases. In this paper we present the argument that there are several ethical-epistemic issues with the potential implementation of these technologies in pain management settings. We draw on literature about self-trust and epistemic and testimonial injustice to make these claims. We conclude with a proposal that the adoption of epistemic humility on the part of both AI tool developers and clinicians can contribute to a climate of trust in and beyond the pain management context and lead to a more just approach to the implementation of AI in pain diagnosis and management.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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

Who decides who goes first? Taking democracy seriously in micro-allocative healthcare decisions. 谁决定谁先走？在微观配置医疗决策中认真对待民主。

IF 2.3 2区哲学

Medicine Health Care and Philosophy Pub Date : 2025-03-15 DOI: 10.1007/s11019-025-10263-w

Davide Battisti, Chiara Mannelli

{"title":"Who decides who goes first? Taking democracy seriously in micro-allocative healthcare decisions.","authors":"Davide Battisti, Chiara Mannelli","doi":"10.1007/s11019-025-10263-w","DOIUrl":"https://doi.org/10.1007/s11019-025-10263-w","url":null,"abstract":"The structural scarcity of healthcare resources has deeply challenged their fair distribution, prompting the need for allocation criteria. Long under the spotlight of the bioethical debate with an extraordinary peak during the recent COVID-19 pandemic, micro-allocation of healthcare has been extensively discussed in the literature with regard to issues of substantive and formal justice. This paper addresses a relatively underdiscussed question within the field of formal justice: who should define micro-allocation criteria in healthcare? To explore this issue, we first establish formal requirements that must be met for allocation criteria to be considered fair and legitimate. Then, we introduce three possible answers to the research question: the attending physician, the team of physicians, and the team of experts. We discuss and then reject all of them, arguing that the task of defining allocation criteria should be assigned to a political representative, supported by a cross-disciplinary team of experts. This proposal is based on the need to take democracy seriously as a tool for making substantive allocative decisions in light of the inevitable disagreement on such matters within a community. To support this claim, we present two key arguments-the democracy argument and the consistency argument. We also pre-emptively respond to two significant critiques: the too-specificity of the decision critique and the catastrophic outcomes critique. In conclusion, we argue that our proposal offers the fairest and most legitimate decision-making process for healthcare micro-allocation.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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

Why a responsibility sensitive healthcare system is not disrespectful. 为什么一个责任敏感的医疗系统不是不尊重。

IF 2.3 2区哲学

Medicine Health Care and Philosophy Pub Date : 2025-03-14 DOI: 10.1007/s11019-025-10262-x

Lydia Tsiakiri

{"title":"Why a responsibility sensitive healthcare system is not disrespectful.","authors":"Lydia Tsiakiri","doi":"10.1007/s11019-025-10262-x","DOIUrl":"https://doi.org/10.1007/s11019-025-10262-x","url":null,"abstract":"The prevalence of non-communicable diseases, the related increased medical costs, and the recent public health emergency bring out more forcefully pre-existing dilemmas of distributive justice in the healthcare context. Under this reality, would it be justified to hold people responsible for their taken lifestyle decisions, or would it constitute an instance of unjustified disrespectful treatment? From a respect-based standpoint, one could argue that a responsibility-sensitive healthcare system morally disrespects the imprudent ones engaging in disadvantageous differential treatment to their detriment. In contrast, however, we might also have luck egalitarian reasons that explain why this differential treatment is not unjust. Luck egalitarianism is a responsibility-sensitive theory of distributive justice, which argues that it is bad if some people are worse off than others through no voluntary fault of their own. In this paper, I clarify the concerns about disrespect raised against the luck egalitarian viewpoint and offer possible respect-based reasons for why this might not be the case grounded in deontological concepts. First, I employ a revised Double-effect case to support responsibility-sensitive rationing. In the last part of the paper, these are further supported through the Kantian Formula of Humanity supplemented by the concept of duties.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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 value compatibility: reflections on the ethical framework for pandemic healthcare distribution. 论价值相容性：对大流行卫生保健分配伦理框架的思考。

IF 2.3 2区哲学

Medicine Health Care and Philosophy Pub Date : 2025-03-07 DOI: 10.1007/s11019-025-10261-y

Yijie Wang

{"title":"On value compatibility: reflections on the ethical framework for pandemic healthcare distribution.","authors":"Yijie Wang","doi":"10.1007/s11019-025-10261-y","DOIUrl":"https://doi.org/10.1007/s11019-025-10261-y","url":null,"abstract":"An ethical framework for pandemic healthcare distribution typically encompasses multiple ethical values. However, integrating various ethical values and distributive principles into a single framework raises concerns about their compatibility and the overall coherence of the framework. This issue of value compatibility could lead to moral inconsistencies within the ethical framework, leading to practical indetermination when facing conflicting implications. This paper offers a methodological resolution to the compatibility problem, serving as an effective tool to mitigate the impact of value conflicts where possible. It proposes four pathways: specifying values rather than balancing them, incorporating values rather than weighing them, reinforcing values rather than aggregating them, and seeking scientific evidence. By developing coherent ethical frameworks where values do not contradict each other, this approach also enhances practical ethical decision-making. Using the COVID-19 vaccine distribution as a case study, this approach demonstrates how conflicting values can yield practical prioritization strategies, such as allocating vaccines to healthcare and essential workers, addressing multiple layers of disadvantage, and assessing age-related prioritization. Reflecting on the compatibility of values within ethical frameworks offers crucial insights beyond COVID-19, contributing to the development of robust ethical frameworks for future public health crises.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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

Fundamental issues in epistemic injustice in healthcare. 在医疗保健认识不公正的基本问题。

IF 2.3 2区哲学

Medicine Health Care and Philosophy Pub Date : 2025-03-07 DOI: 10.1007/s11019-025-10259-6

Kasper Møller Nielsen, Julie Nordgaard, Mads Gram Henriksen

{"title":"Fundamental issues in epistemic injustice in healthcare.","authors":"Kasper Møller Nielsen, Julie Nordgaard, Mads Gram Henriksen","doi":"10.1007/s11019-025-10259-6","DOIUrl":"https://doi.org/10.1007/s11019-025-10259-6","url":null,"abstract":"The research field of epistemic justice in healthcare has gained traction in the last decade. However, the importation of Miranda Fricker's original philosophical framework to medicine raises several interrelated issues that have largely escaped attention. Instead of pushing forward, crafting new concepts or exploring other medical conditions, we suggest that it is time to take stock, reconsider, and articulate some fundamental issues that confront the field of epistemic injustice in healthcare. This paper articulates such fundamental issues, which we divide into scientific, conceptual, and theoretical issues. Scientifically, the research field is confronted by a lack of empirical evidence. It relies on cases, making generalizations impossible and the field vulnerable to bias. Conceptually, many of the claims advanced in the literature are presented as facts but are merely hypotheses to be tested. Moreover, a criterion for applying the concept of testimonial injustice in medicine is lacking, impeding the development of a construct to empirically measure said injustices. Theoretically, many of the cases discussed in the literature do not prima facie qualify as cases of testimonial injustice, since they lack necessary components of testimonial injustice in Fricker's framework, i.e., being unintentional and caused by identity prejudices in the hearers. If epistemic injustice is as pervasive as it is claimed in this literature, it should be of concern to us all. Addressing the issues raised here may strengthen the conceptualization of epistemic injustice in healthcare and lead to development of constructs that finally can explore its empirical basis.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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

Why we should talk about institutional (dis)trustworthiness and medical machine learning. 我们为什么要讨论机构（不）可信度和医学机器学习？

IF 2.3 2区哲学

Medicine Health Care and Philosophy Pub Date : 2025-03-01 Epub Date: 2024-11-13 DOI: 10.1007/s11019-024-10235-6

Michiel De Proost, Giorgia Pozzi

引用次数: 0