Medicine Health Care and Philosophy最新文献

Reclaiming human dignity: a critical review of contemporary theories in light of ontological foundations. 重拾人的尊严：当代理论在本体论基础下的批判回顾。

IF 3.1 2区哲学

Medicine Health Care and Philosophy Pub Date : 2025-08-02 DOI: 10.1007/s11019-025-10290-7

Francisca Rego, Stela Barbas, Patrícia Frantz

{"title":"Reclaiming human dignity: a critical review of contemporary theories in light of ontological foundations.","authors":"Francisca Rego, Stela Barbas, Patrícia Frantz","doi":"10.1007/s11019-025-10290-7","DOIUrl":"https://doi.org/10.1007/s11019-025-10290-7","url":null,"abstract":"Contemporary healthcare ethics often invokes the concept of human dignity as a normative cornerstone. Yet beneath this apparent consensus lies a fragmentation of meaning: dignity is variably interpreted as autonomy, capacity, recognition, or social construction-with little agreement on its essential content or justification. This conceptual disarray weakens the ethical coherence of bioethical decision-making and obscures the true nature of the human person. This article offers a critical review of the predominant contemporary theories of human dignity, including recognition-based approaches, capabilities theory, procedural pragmatism, and postmodern critiques. We expose the internal tensions and philosophical fragilities of each, especially when applied to medical practice. In contrast, we defend an ontologically grounded understanding of dignity-one that recognizes the human being as a unified, rational, embodied substance possessing intrinsic worth by virtue of being. By recovering this ontological foundation, we argue for a more coherent, universal, and morally resilient framework for healthcare ethics-one capable of upholding the inviolability of the person beyond shifting cultural, legal, or utilitarian paradigms.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769187","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

Addressing the overuse-underuse paradox in healthcare. 解决医疗保健领域过度使用和使用不足的矛盾。

IF 3.1 2区哲学

Medicine Health Care and Philosophy Pub Date : 2025-07-31 DOI: 10.1007/s11019-025-10287-2

Bjørn Hofmann

引用次数: 0

Integrating ethics in digital mental healthcare technologies: a principle-based empirically grounded roadmap approach. 整合伦理在数字精神卫生保健技术：基于原则的经验为基础的路线图方法。

IF 3.1 2区哲学

Medicine Health Care and Philosophy Pub Date : 2025-07-30 DOI: 10.1007/s11019-025-10283-6

Wanda Spahl, Giovanni Rubeis

{"title":"Integrating ethics in digital mental healthcare technologies: a principle-based empirically grounded roadmap approach.","authors":"Wanda Spahl, Giovanni Rubeis","doi":"10.1007/s11019-025-10283-6","DOIUrl":"https://doi.org/10.1007/s11019-025-10283-6","url":null,"abstract":"Digital mental healthcare technologies increasingly incorporate gamification, yet relevant ethical considerations remain underexamined. This paper introduces the Principle-Based Empirically Grounded Roadmap Approach (PERA), a methodological contribution to empirical bioethics. It has evolved from ethics research within the Horizon Europe project ASPbelong, which designs a collaboratively played augmented reality intervention for adolescents. PERA refines existing integrated empirical bioethics methodologies by responding to three key characteristics of the use case: a largely predetermined technology with a relatively low degree of openness in technological design, embedded co-development practices led by facilitators from within the project team, and planned future iterations beyond the ethics team's involvement. PERA integrates mapping of principles from the ethics literature, a scoping review of the moral intuitions of developers of comparable technologies, and the collection of original empirical data on the use case. Using abductive reasoning, these insights are synthesized into a tangible output: an ethics roadmap designed to guide and be adapted in future use case iterations. By advancing a methodology of combining normative reasoning with empirical insights on a concrete use case, this paper provides both practical tools for ethics researchers in technology projects and a means to generate empirically grounded conceptual contributions. Its outcomes, when brought into dialogue with findings from other integrated empirical bioethics research, can support the critical examination of broader assumptions and implications of gamified mental healthcare, including questions of good care and the broader social implications of such technologies.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745479","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

Rethinking reversibility. 反思可逆性。

IF 3.1 2区哲学

Medicine Health Care and Philosophy Pub Date : 2025-07-29 DOI: 10.1007/s11019-025-10286-3

Bert Gordijn, Henk Ten Have

引用次数: 0

Epistemic injustice suffered by patients with rare diseases, poorly understood diseases, and underdiagnosed diseases, and the epistemic advantage granted by these diseases. 罕见病、不了解疾病、诊断不足疾病患者的认知不公，以及这些疾病带来的认知优势。

IF 3.1 2区哲学

Medicine Health Care and Philosophy Pub Date : 2025-07-29 DOI: 10.1007/s11019-025-10285-4

Mar Rosàs Tosas

{"title":"Epistemic injustice suffered by patients with rare diseases, poorly understood diseases, and underdiagnosed diseases, and the epistemic advantage granted by these diseases.","authors":"Mar Rosàs Tosas","doi":"10.1007/s11019-025-10285-4","DOIUrl":"https://doi.org/10.1007/s11019-025-10285-4","url":null,"abstract":"Fricker (Epistemic Injustice. Power and the Ethics of Knowing, Oxford University Press, Oxford, 2007) coined the term epistemic injustice to refer to the downgrading of credibility of speakers provoked either by prejudices-which she labeled testimonial injustice-or by a gap in interpretative resources that account for a given phenomenon-which she referred to as hermeneutical injustice. This paper reviews the existing literature on how patients with rare diseases, poorly understood diseases, and underdiagnosed diseases are questioned by the healthcare practitioners who assist them in order to explore how they suffer from both these types of epistemic injustice. At the same time, the paper argues that the very epistemic marginalization suffered by these patients actually grants them some epistemic advantages over patients with better-known diseases, and even some meta-epistemic advantages-that is, a deeper understanding of how the very taxonomy that marginalizes or excludes them is, to some extent, a sociocultural construction. The paper therefore applies the notion of \"epistemic advantage\", coined by contemporary standpoint theorists, to the field of healthcare.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733955","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

Consent and its discontents: the case of UK Biobank. 同意及其不满：英国生物银行案例。

IF 2.3 2区哲学

Medicine Health Care and Philosophy Pub Date : 2025-07-17 DOI: 10.1007/s11019-025-10276-5

Gulzaar Barn

{"title":"Consent and its discontents: the case of UK Biobank.","authors":"Gulzaar Barn","doi":"10.1007/s11019-025-10276-5","DOIUrl":"10.1007/s11019-025-10276-5","url":null,"abstract":"UK Biobank is a major biomedical database and research resource, holding the genetic, health, and lifestyle information of half a million adult volunteers. Its datasets are accessible to approved researchers from academic, charity, government, and commercial organisations for health-related research in the public interest. Drawing upon a range of approved projects and the downstream applications of this research, I suggest that UK Biobank datasets have been processed towards ends that are inimical to its stated aims, breaking the terms of consent under which its participants entered the study. First, I provide an overview of the broad consent model employed by UK Biobank in recruiting participants and using their data. The consent documents and participant information leaflets used exhibit information failures in their framing of health-research in terms of disease and treatment, obscuring the full range of lawful uses of participants' data. Beyond this, certain approved uses of UK Biobank data, including studies by insurance companies and direct-to-consumer genetic testing companies, arguably fall outside UK Biobank's stated aims altogether. Moreover, UK Biobank has not adequately safeguarded against \"dual use\" issues. Tracking the trajectory of research outputs that used biobank data, I suggest that approved uses of biobank datasets have gone on to have objectionable further applications that are not in the public interest. Such applications include the development of polygenic scores that seek to predict \"intelligence\" for use in commercial embryo screening services. Such tools are rife with risk of harm and are being deployed without sufficient public deliberation or oversight.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660777","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

Burnout as breakdown of one's existence in the world. 倦怠是一个人在这个世界上生存的崩溃。

IF 2.3 2区哲学

Medicine Health Care and Philosophy Pub Date : 2025-07-07 DOI: 10.1007/s11019-025-10281-8

Lisa IJzerman, Annemie Halsema

{"title":"Burnout as breakdown of one's existence in the world.","authors":"Lisa IJzerman, Annemie Halsema","doi":"10.1007/s11019-025-10281-8","DOIUrl":"https://doi.org/10.1007/s11019-025-10281-8","url":null,"abstract":"Burnout is generally conceived as a condition resulting from external stressors in one's work environment, but its precise definition is contested. In line with recent empirical studies, we suggest an existential-phenomenological approach to avoid the dualisms that characterize the present understanding of burnout. Drawing on Merleau-Ponty's phenomenology, we do not consider burnout in terms of a psychological syndrome with physiological aspects, but rather suggest that these syndromes are expressions of the same problem. Burnout is not caused by an individual's inability to cope with external demands, nor by a too demanding work environment, but it is a mismatch between the two. Furthermore, we conceive of 'world' in Arendtian terms and situate burnout within the social context of vita activa. We argue that burnout can be understood in terms of 'world alienation,' and discuss the extent to which Arendt's diagnosis of the shifts in human activity in modernity from 'work' to 'labor' may provide a social context for the existential breakdown that burnout entails. We conclude the paper by outlining some implications for diagnosis and treatment based on our definition of burnout.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576675","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

REC review of deceptive studies: diversifying guidance for diverse review needs. 欺骗性研究的REC综述：针对不同综述需求的多样化指导。

IF 2.3 2区哲学

Medicine Health Care and Philosophy Pub Date : 2025-06-26 DOI: 10.1007/s11019-025-10280-9

Kamiel Verbeke, Dieter Baeyens, Tomasz Krawczyk, Jan Piasecki, Pascal Borry

{"title":"REC review of deceptive studies: diversifying guidance for diverse review needs.","authors":"Kamiel Verbeke, Dieter Baeyens, Tomasz Krawczyk, Jan Piasecki, Pascal Borry","doi":"10.1007/s11019-025-10280-9","DOIUrl":"https://doi.org/10.1007/s11019-025-10280-9","url":null,"abstract":"Deceiving participants is an ethically complicated research practice which remains an important challenge for research ethics committees (RECs) and researchers, despite the availability of abundant research ethics guidance. Exploring this persistent policy-practice divide, we develop a framework for assessing the needs of the REC review of deceptive studies in a context-sensitive way. Different guidance formats are evaluated in light of their potential contribution to the frequently recurring REC review need for consistent and representative rules that set a perimeter for precise, coherent and representative discretionary review to take place. Research ethics guidelines and a new format of \"descriptive living documents\" are argued to respectively provide perimeter-setting rules and support discretionary decision-making about the justifiability of deceptive studies. REC review coordination is argued to benefit from analogous guidance formats to ensure conditions that facilitate successful REC review. As the needs of REC review may differ depending on the context, different mixes of these and possibly other guidance formats may support the REC review of deceptive studies and offer a way out of the policy-practice divide.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498376","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

Reversibility of neurotechnological interventions: conceptual and ethical issues. 神经技术干预的可逆性：概念和伦理问题。

IF 2.3 2区哲学

Medicine Health Care and Philosophy Pub Date : 2025-06-26 DOI: 10.1007/s11019-025-10282-7

Junjie Yang

{"title":"Reversibility of neurotechnological interventions: conceptual and ethical issues.","authors":"Junjie Yang","doi":"10.1007/s11019-025-10282-7","DOIUrl":"https://doi.org/10.1007/s11019-025-10282-7","url":null,"abstract":"Currently, we have developed a range of neurotechnologies to intervene in neurological and psychiatric disorders, with some of these interventions considered reversible. However, the term \"reversibility,\" although widely used in clinical and research contexts, remains ambiguously defined, and is often applied inconsistently in different contexts, which may pose ethical risks for patients. In fact, reversibility can be classified into three categories: ontological reversibility (including structural, functional, and psychological reversibility), methodological reversibility (including current and future methodological reversibility), and ethical reversibility (including autonomy, well-being, and harm reversibility). However, each of these forms of reversibility has inherent problems when applied in clinical settings. To ensure that patients are fully informed about the reversibility of neurotechnological interventions, we should adopt a perspective of practical reversibility to address this issue, improving the informed consent procedures for neurotechnological interventions, and clarifying the actual needs of patients regarding reversibility in terms of individual conditions, technological consequences, and value assessments.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498377","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 misempowerment & mobile health. 关于不当授权和移动医疗。

IF 2.3 2区哲学

Medicine Health Care and Philosophy Pub Date : 2025-06-09 DOI: 10.1007/s11019-025-10277-4

Jesse Gray, Heidi Mertes

{"title":"On misempowerment & mobile health.","authors":"Jesse Gray, Heidi Mertes","doi":"10.1007/s11019-025-10277-4","DOIUrl":"https://doi.org/10.1007/s11019-025-10277-4","url":null,"abstract":"Mobile health tools often claim to empower their users by giving them the knowledge they need to take control of their health. However, this notion of empowerment, what we refer to as the knowledge-control paradigm, only superficially engages with the concept and leaves out the different ways in which people come to be empowered. We first identify two distinct elements of empowerment: psychological empowerment, which pertains to beliefs about one's power and control over their health, and relational empowerment, which is connected with one's actual power to control their health, as well as the ability to hold those in positions of power (the empowered) accountable. The knowledge-control paradigm is incapable of creating empowered individuals in the relational sense, and it is only when knowledge is coupled with both the means and the motivations to control health and/or hold the empowered to account, that one can be considered empowered. Mobile health tools that overemphasize knowledge as the empowering mechanism often misempower their users, that is, they create a belief in users about their power to control their health that does not align with their actual capacity to do so. This mismatch between beliefs and reality can have far reaching consequences as with knowledge, ability, control, and power comes responsibility. We worry not only that the misempowered will be viewed as more responsible for their health than the circumstances permit, but also, that these individuals will lose the ability to hold those in positions of power accountable..","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250285","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