Medicine Health Care and Philosophy最新文献

Correction: Conceptual scaffolding for the philosophy of medicine.

IF 2.3 2区哲学

Medicine Health Care and Philosophy Pub Date : 2024-12-20 DOI: 10.1007/s11019-024-10242-7

Yael Friedman

引用次数: 0

Endometriosis in later life: an intersectional analysis from the perspective of epistemic injustice. 晚年子宫内膜异位症：从认识不公正的角度进行交叉分析。

IF 2.3 2区哲学

Medicine Health Care and Philosophy Pub Date : 2024-12-20 DOI: 10.1007/s11019-024-10245-4

Elisabeth Langmann, Anna-Christina Kainradl, Merle Weßel, Alekszandra Rokvity

{"title":"Endometriosis in later life: an intersectional analysis from the perspective of epistemic injustice.","authors":"Elisabeth Langmann, Anna-Christina Kainradl, Merle Weßel, Alekszandra Rokvity","doi":"10.1007/s11019-024-10245-4","DOIUrl":"https://doi.org/10.1007/s11019-024-10245-4","url":null,"abstract":"Endometriosis, a chronic inflammatory condition affecting 10% of biological women, is widely understudied and particularly overlooked in later life. Discussions surrounding endometriosis predominantly centre on medical gender bias during reproductive years, with limited attention to intersecting factors of discrimination and the impact of ageism on affected individuals. As endometriosis is framed as a disease of reproductive age, research is lacking when it comes to the effects of the illness on the older population. Symptoms in (post)menopausal individuals are frequently misattributed to other ailments due to ageist and sexist preconceptions, leading to prolonged diagnoses and mistreatment. This is a social justice issue in which age and sex contribute to the discrimination of a certain population - namely older biological women living with endometriosis. In this paper, we approach this issue from the perspective of epistemic justice. The experiences of the affected persons are shaped by a lack of knowledge about endometriosis among both the healthcare personal and the affected person, as well as a lack of acknowledgement and consideration of the persons experiences. Using the lens of epistemic justice, we develop an analytical model to understand the intersection of age and gender in the experiences of endometriosis patients. This article contributes to ongoing debates on epistemic injustice and intersectionality within medicine and healthcare, offering an analytical model that connects the critical approaches of epistemic injustice and intersectionality to address health injustice. Ultimately, this work advocates for a comprehensive, lifespan approach to endometriosis that acknowledges and addresses intersecting forms of discrimination.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865824","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

Clouds on the horizon: clinical decision support systems, the control problem, and physician-patient dialogue.

IF 2.3 2区哲学

Medicine Health Care and Philosophy Pub Date : 2024-12-07 DOI: 10.1007/s11019-024-10241-8

Mahmut Alpertunga Kara

{"title":"Clouds on the horizon: clinical decision support systems, the control problem, and physician-patient dialogue.","authors":"Mahmut Alpertunga Kara","doi":"10.1007/s11019-024-10241-8","DOIUrl":"https://doi.org/10.1007/s11019-024-10241-8","url":null,"abstract":"Artificial intelligence-based clinical decision support systems have a potential to improve clinical practice, but they may have a negative impact on the physician-patient dialogue, because of the control problem. Physician-patient dialogue depends on human qualities such as compassion, trust, and empathy, which are shared by both parties. These qualities are necessary for the parties to reach a shared understanding -the merging of horizons- about clinical decisions. The patient attends the clinical encounter not only with a malfunctioning body, but also with an 'unhomelike' experience of illness that is related to a world of values and meanings, a life-world. Making wise individual decisions in accordance with the patient's life-world requires not only scientific analysis of causal relationships, but also listening with empathy to the patient's concerns. For a decision to be made, clinical information should be interpreted considering the patient's life-world. This side of clinical practice is not a job for computers, and they cannot be final decision-makers. On the other hand, in the control problem users blindly accept system output because of over-reliance, rather than evaluating it with their own judgement. This means over-reliant parties leave their place in the dialogue to the system. In this case, the dialogue may be disrupted and mutual trust may be lost. Therefore, it is necessary to design decision support systems to avoid the control problem and to limit their use when this is not possible, in order to protect the physician-patient dialogue.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792181","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

One R or the other - an experimental bioethics approach to 3R dilemmas in animal research. 非此即彼--以实验生物伦理学方法解决动物研究中的 3R 困境。

IF 2.3 2区哲学

Medicine Health Care and Philosophy Pub Date : 2024-12-01 Epub Date: 2024-08-17 DOI: 10.1007/s11019-024-10221-y

Christian Rodriguez Perez, David M Shaw, Brian D Earp, Bernice S Elger, Kirsten Persson

{"title":"One R or the other - an experimental bioethics approach to 3R dilemmas in animal research.","authors":"Christian Rodriguez Perez, David M Shaw, Brian D Earp, Bernice S Elger, Kirsten Persson","doi":"10.1007/s11019-024-10221-y","DOIUrl":"10.1007/s11019-024-10221-y","url":null,"abstract":"Sacrificial dilemmas such as the trolley problem play an important role in experimental philosophy (x-phi). But it is increasingly argued that, since we are not likely to encounter runaway trolleys in our daily life, the usefulness of such thought experiments for understanding moral judgments in more ecologically valid contexts may be limited. However, similar sacrificial dilemmas are experienced in real life by animal research decision makers. As part of their job, they must make decisions about the suffering, and often the death, of many non-human animals. For this reason, a context-specific investigation of so-called \"3R dilemmas\" (i.e., dilemmas where there is a conflict between the principles of replacement, reduction, and refinement of the use of animals in research) is essential to improve the situation of both non-human animals and human stakeholders. An approach well suited for such investigation is experimental philosophical bioethics (\"bioxphi\"), which draws on methods similar to x-phi to probe more realistic, practical scenarios with an eye to informing normative debates and ethical policy. In this article, we argue for a need to investigate 3R dilemmas among professional decision-makers using the tools of bioxphi. In a first step, we define 3R dilemmas and discuss previous investigations of professionals' attitudes in such cases. In a second step, we show how bioxphi is a promising method to investigate the whys and hows of professional decision-making in 3R dilemmas. In a last step, we provide a bioxphi template for 3R dilemmas, give recommendations on its use, explore the normative relevance of data collected by such means, and discuss important limitations.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"497-512"},"PeriodicalIF":2.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11519301/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141996645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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

Genetic enhancement from the perspective of transhumanism: exploring a new paradigm of transhuman evolution. 从超人主义的角度看基因强化：探索超人进化的新范式。

IF 2.3 2区哲学

Medicine Health Care and Philosophy Pub Date : 2024-12-01 Epub Date: 2024-08-28 DOI: 10.1007/s11019-024-10224-9

Yawen Zou

{"title":"Genetic enhancement from the perspective of transhumanism: exploring a new paradigm of transhuman evolution.","authors":"Yawen Zou","doi":"10.1007/s11019-024-10224-9","DOIUrl":"10.1007/s11019-024-10224-9","url":null,"abstract":"Transhumanism is a movement that advocates for the enhancement of human capabilities through the use of advanced technologies such as genetic enhancement. This article explores the definition, history, and development of transhumanism. Then, it compares the stance on genetic enhancement from the perspectives of bio-conservatism, bio-liberalism, and transhumanism. This article posits that transhuman evolution has twofold implications, allowing for the integration of transhumanist research and evolutionary biology. First, it offers a compelling scientific framework for understanding genetic enhancement, avoiding technological progressivism, and incorporating concepts of evolutionary biology. Second, it represents a new evolutionary paradigm distinct from traditional Lamarckism and Darwinism. It marks the third synthesis of evolutionary biology, offering fresh perspectives on established concepts such as artificial selection and gene-culture co-evolution. In recent decades, human enhancement has captivated not only evolutionary biologists, neurobiologists, psychologists, and philosophers, but also those in fields such as cybernetics and artificial intelligence. In addition to genetic enhancement, other human enhancement technologies, including brain-computer interfaces and brain uploading, are currently under development, which the paradigm of transhuman evolution can better integrate into its framework.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"529-544"},"PeriodicalIF":2.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142082183","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

What is a cure through gene therapy? An analysis and evaluation of the use of "cure". 什么是通过基因疗法治愈疾病？对使用 "治愈 "一词的分析和评价。

IF 2.3 2区哲学

Medicine Health Care and Philosophy Pub Date : 2024-12-01 Epub Date: 2024-08-22 DOI: 10.1007/s11019-024-10223-w

Lieke Baas, Karina Meijer, Annelien L Bredenoord, Rieke van der Graaf

{"title":"What is a cure through gene therapy? An analysis and evaluation of the use of \"cure\".","authors":"Lieke Baas, Karina Meijer, Annelien L Bredenoord, Rieke van der Graaf","doi":"10.1007/s11019-024-10223-w","DOIUrl":"10.1007/s11019-024-10223-w","url":null,"abstract":"The development of gene therapy has always come with the expectation that it will offer a cure for various disorders, of which hemophilia is a paradigm example. However, although the term is used regularly, it is unclear what exactly is meant with \"cure\". Therefore, the aim of this paper is to analyse how the concept of cure is used in practice and evaluate which of the interpretations is most suitable in discussions surrounding gene therapy. We analysed how cure is used in four different medical fields where the concept raises discussion. We show that cure can be used in three different ways: cure as normalization of the body, cure as obtaining a normal life, or cure as a change in identity. We argue that since cure is a practical term, its interpretation should be context-specific and the various uses can exist simultaneously, as long as their use is suitable to the function the notion of cure plays in each of the settings. We end by highlighting three different settings in the domain of hemophilia gene therapy in which the term cure is used and explore the function(s) it serves in each setting. We conclude that in the clinical application of gene therapy, it could be better to abandon the term cure, whereas more modest and specified definitions of cure are required in the context of health resource allocation decisions and decisions on research funding.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"489-496"},"PeriodicalIF":2.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11519194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142019160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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 role of conscience and virtue: contrasting two models of medicine. 良知与美德的作用：两种医学模式的对比。

IF 2.3 2区哲学

Medicine Health Care and Philosophy Pub Date : 2024-12-01 Epub Date: 2024-10-01 DOI: 10.1007/s11019-024-10229-4

Jaime Hernandez-Ojeda, Xavier Symons

引用次数: 0

Biobank consent under the GDPR: are potential sample donors informed about all lawful uses of biobank data? GDPR 下的生物库同意：潜在样本捐献者是否被告知生物库数据的所有合法用途？

IF 2.3 2区哲学

Medicine Health Care and Philosophy Pub Date : 2024-12-01 Epub Date: 2024-10-08 DOI: 10.1007/s11019-024-10227-6

Emmi Kaaya

{"title":"Biobank consent under the GDPR: are potential sample donors informed about all lawful uses of biobank data?","authors":"Emmi Kaaya","doi":"10.1007/s11019-024-10227-6","DOIUrl":"10.1007/s11019-024-10227-6","url":null,"abstract":"This paper analyses the information disclosures in two biobank consent documents used by biobanks operating under the General Data Protection Regulation (GDPR). The aim of the analysis is to investigate how these documents inform potential sample donors about possible future uses of biobank data. The findings suggest that the consent documents provide potentially misleading information regarding the range of possible future uses of biobank data. Based on these information disclosures, potential sample donors may reasonably believe that the data can only be used for a narrowly defined range of research purposes. However, the range of lawful uses of the data is much broader and less clearly defined. Consent provided based on misleading information is not morally transformative, even if it were legally valid. To facilitate morally transformative biobank consent, this paper provides two recommendations for information disclosure to potential sample donors regarding future uses of biobank data: first, potential sample donors should be informed about the legal scope of consent; and second, they should be informed about the full range of lawful uses of biobank data.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"567-577"},"PeriodicalIF":2.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394230","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

Healthcare providers' advocacy approaches and ethical challenges in delivering healthcare to undocumented migrants: a scoping review. 医疗服务提供者向无证移民提供医疗服务的宣传方法和伦理挑战：范围界定综述。

IF 2.3 2区哲学

Medicine Health Care and Philosophy Pub Date : 2024-12-01 Epub Date: 2024-10-07 DOI: 10.1007/s11019-024-10225-8

Fayez Abdulrazeq, Julian März, Nikola Biller-Andorno, Chris Gastmans

{"title":"Healthcare providers' advocacy approaches and ethical challenges in delivering healthcare to undocumented migrants: a scoping review.","authors":"Fayez Abdulrazeq, Julian März, Nikola Biller-Andorno, Chris Gastmans","doi":"10.1007/s11019-024-10225-8","DOIUrl":"10.1007/s11019-024-10225-8","url":null,"abstract":"Delivering healthcare to undocumented migrants presents a complex challenge for healthcare providers. Integrating advocacy efforts into their daily practices can be ambiguous in practical terms, stemming from the intricate task of addressing the health needs of this population while simultaneously advocating for their health rights within the constraints imposed on them. This study seeks to consolidate findings from literature regarding the advocacy approaches employed by healthcare providers and the correlated ethical challenges. We conducted a scoping review of qualitative literature by systematically searching four databases-PubMed/Medline, Embase, Cinahl, and Cochrane Library. For developing our search strategy, we employed the PICO (Population, Intervention, Comparison, Outcome) scheme. Our analysis followed the qualitative content analysis approach proposed by Graneheim and Lundman. 30 studies were included, revealing a cumulative total of 915 healthcare providers who were interviewed. A total of 30 themes emerged comprising 14 advocacy approaches and 16 ethical challenges. Healthcare providers made a deliberate choice to engage in advocacy, responding to injustices experienced by undocumented migrants. The spectrum of advocacy initiatives varied, encompassing voluntary participation in healthcare provision, empathetic understanding, and healthcare-focused strategies. We also identified numerous correlated ethical challenges, necessitating healthcare providers to strike a balance between their eagerness to assist and their professional competence, respect the autonomy of undocumented migrants, and establish trust with them. These findings not only offer practical guidance for healthcare providers to enhance accessibility to healthcare services for undocumented migrant patients but also foster awareness of the ethical challenges that may arise in their advocacy roles.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"579-606"},"PeriodicalIF":2.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11519158/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142382030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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

Non-empirical methods for ethics research on digital technologies in medicine, health care and public health: a systematic journal review. 医学、医疗保健和公共卫生领域数字技术伦理研究的非实证方法：系统性期刊综述。

IF 2.3 2区哲学

Medicine Health Care and Philosophy Pub Date : 2024-12-01 Epub Date: 2024-08-09 DOI: 10.1007/s11019-024-10222-x

Frank Ursin, Regina Müller, Florian Funer, Wenke Liedtke, David Renz, Svenja Wiertz, Robert Ranisch

{"title":"Non-empirical methods for ethics research on digital technologies in medicine, health care and public health: a systematic journal review.","authors":"Frank Ursin, Regina Müller, Florian Funer, Wenke Liedtke, David Renz, Svenja Wiertz, Robert Ranisch","doi":"10.1007/s11019-024-10222-x","DOIUrl":"10.1007/s11019-024-10222-x","url":null,"abstract":"Bioethics has developed approaches to address ethical issues in health care, similar to how technology ethics provides guidelines for ethical research on artificial intelligence, big data, and robotic applications. As these digital technologies are increasingly used in medicine, health care and public health, thus, it is plausible that the approaches of technology ethics have influenced bioethical research. Similar to the \"empirical turn\" in bioethics, which led to intense debates about appropriate moral theories, ethical frameworks and meta-ethics due to the increased use of empirical methodologies from social sciences, the proliferation of health-related subtypes of technology ethics might have a comparable impact on current bioethical research. This systematic journal review analyses the reporting of ethical frameworks and non-empirical methods in argument-based research articles on digital technologies in medicine, health care and public health that have been published in high-impact bioethics journals. We focus on articles reporting non-empirical research in original contributions. Our aim is to describe currently used methods for the ethical analysis of ethical issues regarding the application of digital technologies in medicine, health care and public health. We confine our analysis to non-empirical methods because empirical methods have been well-researched elsewhere. Finally, we discuss our findings against the background of established methods for health technology assessment, the lack of a typology for non-empirical methods as well as conceptual and methodical change in bioethics. Our descriptive results may serve as a starting point for reflecting on whether current ethical frameworks and non-empirical methods are appropriate to research ethical issues deriving from the application of digital technologies in medicine, health care and public health.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"513-528"},"PeriodicalIF":2.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11519279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141908010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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