Medicine Health Care and Philosophy最新文献

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

Embracing ambivalence and hesitation: a Ricoeurian perspective on anticipatory choice processes at the end of life. 拥抱矛盾与犹豫：从李可染的视角看生命终结时的预期选择过程。

IF 2.3 2区哲学

Medicine Health Care and Philosophy Pub Date : 2024-12-01 Epub Date: 2024-10-05 DOI: 10.1007/s11019-024-10228-5

Els van Wijngaarden

{"title":"Embracing ambivalence and hesitation: a Ricoeurian perspective on anticipatory choice processes at the end of life.","authors":"Els van Wijngaarden","doi":"10.1007/s11019-024-10228-5","DOIUrl":"10.1007/s11019-024-10228-5","url":null,"abstract":"Especially older adults are increasingly stimulated to think about, talk about and record their preferences with regard to future (health)care decisions, preferably in a pro-active manner. In this paper, I analyse these anticipatory choice processes. My goal is twofold: Firstly, to provide a deeper understanding of what it actually means to decide in advance about end-of-life treatments or options. Secondly, to make a theoretical contribution to bioethics and ACP-theories by rethinking the concept of end-of-life choices from a phenomenological viewpoint. To achieve this, I start by presenting a case narrative that elucidates how these anticipatory choices are lived. Secondly, I map out a theoretical framework about choice based on the phenomenology of the will of Paul Ricoeur. Finally, guided by this Ricoeurian framework, I investigate the potential meaning of choice in the context of contemporary advance care planning trajectories. The analysis demonstrates that choice and agency always imply notions of passivity and uncontrollability. It also indicates the significant value of hesitation and ambivalence. Moreover, it highlights the importance of the notion of co-responsibility in the context of anticipated end-of-life choices, and the relevant distinction between a (willed) choice and a wish. To improve care and support regarding end-of-life trajectories and to promote meaningful conversations, it is imperative to integrate these underrated elements more substantially in our theories, language and practical approaches. I conclude by suggesting that, in order to do justice to the real-life complexities, we might even need to revise the notion of advance 'directives'.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"555-566"},"PeriodicalIF":2.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11519185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142378431","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 focus account of false hope. 虚假希望的焦点账户。

IF 2.3 2区哲学

Medicine Health Care and Philosophy Pub Date : 2024-11-16 DOI: 10.1007/s11019-024-10236-5

Christopher Bobier

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 : 2024-11-13 DOI: 10.1007/s11019-024-10235-6

Michiel De Proost, Giorgia Pozzi

引用次数: 0