Medicine Health Care and Philosophy最新文献_第10页

Pandemics and the precautionary principle: an analysis taking the Swedish Corona Commission's report as a point of departure. 流行病与预防原则:以瑞典冠状病毒委员会的报告为出发点的分析。

IF 2.1 2区哲学

Medicine Health Care and Philosophy Pub Date : 2023-06-01 DOI: 10.1007/s11019-023-10139-x

Anders Nordgren

{"title":"Pandemics and the precautionary principle: an analysis taking the Swedish Corona Commission's report as a point of departure.","authors":"Anders Nordgren","doi":"10.1007/s11019-023-10139-x","DOIUrl":"https://doi.org/10.1007/s11019-023-10139-x","url":null,"abstract":"In the initial phase of the COVID-19 pandemic, Sweden's response stood out as an exception. For example, Sweden did not introduce any lockdowns, while many other countries did. In this paper I take the Swedish Corona Commission's critique of the initial Swedish response as a point of departure for a general analysis of precaution in relation to pandemics. The Commission points out that in contrast to many other countries Sweden did not follow 'the precautionary principle'. Based on this critique, the Commission proposes that the precautionary principle should be included among Sweden's guiding principles for crisis management. However, as the debate on this principle during the last 30 years indicates, the principle is loaded with problems. I discuss one of these problems, namely its lack of clarity. I argue, however, that this problem is not unsurmountable. A principle is lacking clarity precisely by being a principle and not a rule with a well-defined meaning. As a principle it indicates a direction but does not prescribe a specific action. However, to be action-guiding its content needs to be specified by rational deliberation. With this in mind, I propose a framework for specification of the precautionary principle as applied to pandemics. The framework focuses on the principle's four key elements: threat, uncertainty, action and responsibility. I also suggest certain general ethical restrictions on specification.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":"26 2","pages":"163-173"},"PeriodicalIF":2.1,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9924198/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9476589","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: 2

Precaution. 预防措施。

IF 2.1 2区哲学

Medicine Health Care and Philosophy Pub Date : 2023-06-01 DOI: 10.1007/s11019-023-10156-w

Henk Ten Have, Bert Gordijn

引用次数: 4

Ethical challenges of clinical trials with a repurposed drug in outbreaks. 在疫情爆发时使用改变用途的药物进行临床试验的伦理挑战。

IF 2.3 2区哲学

Medicine Health Care and Philosophy Pub Date : 2023-06-01 Epub Date: 2023-03-07 DOI: 10.1007/s11019-023-10140-4

Katarzyna Klas, Karolina Strzebonska, Marcin Waligora

{"title":"Ethical challenges of clinical trials with a repurposed drug in outbreaks.","authors":"Katarzyna Klas, Karolina Strzebonska, Marcin Waligora","doi":"10.1007/s11019-023-10140-4","DOIUrl":"10.1007/s11019-023-10140-4","url":null,"abstract":"Drug repurposing is a strategy of identifying new potential uses for already existing drugs. Many researchers adopted this method to identify treatment or prevention during the COVID-19 pandemic. However, despite the considerable number of repurposed drugs that were evaluated, only some of them were labeled for new indications. In this article, we present the case of amantadine, a drug commonly used in neurology that attracted new attention during the COVID-19 outbreak. This example illustrates some of the ethical challenges associated with the launch of clinical trials to evaluate already approved drugs. In our discussion, we follow the ethics framework for prioritization of COVID-19 clinical trials proposed by Michelle N Meyer and colleagues (2021). We focus on four criteria: social value, scientific validity, feasibility, and consolidation/collaboration. We claim that launching amantadine trials was ethically justified. Although the scientific value was anticipated to be low, unusually, the social value was expected to be high. This was because of significant social interest in the drug. In our view, this strongly supports the need for evidence to justify why the drug should not be prescribed or privately accessed by interested parties. Otherwise, a lack of evidence-based argument could enhance its uncontrolled use. With this paper, we join the discussion on the lessons learned from the pandemic. Our findings will help to improve future efforts to decide on the launch of clinical trials on approved drugs when dealing with the widespread off-label use of the drug.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":"26 2","pages":"233-241"},"PeriodicalIF":2.3,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9989564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9457706","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 impairment argument, ethics of abortion, and nature of impairing to the n + 1 degree. 损害论，堕胎的伦理，损害到n + 1度的本质。

IF 2.1 2区哲学

Medicine Health Care and Philosophy Pub Date : 2023-06-01 DOI: 10.1007/s11019-023-10137-z

Alex R Gillham

{"title":"The impairment argument, ethics of abortion, and nature of impairing to the n + 1 degree.","authors":"Alex R Gillham","doi":"10.1007/s11019-023-10137-z","DOIUrl":"https://doi.org/10.1007/s11019-023-10137-z","url":null,"abstract":"I argue here that the impairment principle requires clarification. It needs to explain what makes one impairment greater than another, otherwise we will be unable to make the comparisons it requires, the ones that enable us to determine whether b really is a greater impairment than a, and as a result, whether causing b is immoral because causing a is. I then develop two of what I think are the most natural accounts of what might make one impairment greater than another. The quantitative understanding of greater impairment is problematic because it leaves the impairment principle vulnerable to counterexamples; just because impairment b impairs a larger number of abilities or the same number of abilities but for a longer period or to a higher degree does not mean that b is a greater impairment than a. The qualitative understanding of greater impairment is problematic because it does not explain examples of greater impairment used in the literature, means that an abortion is always a qualitatively more severe impairment than causing fetal alcohol syndrome regardless of how the organism is affected, and/or entails that lethal impairment is always greater than nonlethal impairment.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":"26 2","pages":"215-224"},"PeriodicalIF":2.1,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9460693","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: 1

How to derive ethically appropriate recommendations for action? A methodology for applied ethics. 如何得出合乎道德的行动建议?应用伦理学的方法论。

IF 2.1 2区哲学

Medicine Health Care and Philosophy Pub Date : 2023-06-01 DOI: 10.1007/s11019-022-10133-9

Sebastian Schleidgen, Alexander Kremling, Marcel Mertz, Katja Kuehlmeyer, Julia Inthorn, Joschka Haltaufderheide

{"title":"How to derive ethically appropriate recommendations for action? A methodology for applied ethics.","authors":"Sebastian Schleidgen, Alexander Kremling, Marcel Mertz, Katja Kuehlmeyer, Julia Inthorn, Joschka Haltaufderheide","doi":"10.1007/s11019-022-10133-9","DOIUrl":"https://doi.org/10.1007/s11019-022-10133-9","url":null,"abstract":"Researchers in applied ethics, and some areas of bioethics particularly, aim to develop concrete and appropriate recommendations for action in morally relevant real-world situations. When proceeding from more abstract levels of ethical reasoning to such concrete recommendations, however, even with regard to the very same normative principle or norm, it seems possible to develop divergent or even contradictory recommendations for action regarding a certain situation. This may give the impression that such recommendations would be arbitrary and, hence, not well justified. Against this background, we, first, aim at showing that ethical recommendations for action, although being contingent in some sense, are not arbitrary if developed appropriately. For this purpose, we examine two types of contingencies arising in applied ethics reasoning based on recent examples of recommendations for action in the context of the COVID-19 pandemic. In doing so, we refer to a three-step model of ethical reasoning towards recommendations for actions. This, however, leaves open the question of how applied ethics may cope with contingent recommendations for action. Therefore, in a second step, we analyze the role of bridge principles for developing ethically appropriate recommendations for action, i.e., principles which connect normative claims with relevant empirical information to justify certain recommendations for action in a given morally relevant situation. Finally, we discuss some implications for reasoning and reporting in empirically informed ethics.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":"26 2","pages":"175-184"},"PeriodicalIF":2.1,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9754304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9454566","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: 3

"Ruptured selves: moral injury and wounded identity". "破碎的自我:道德伤害和身份受伤"

IF 2.1 2区哲学

Medicine Health Care and Philosophy Pub Date : 2023-06-01 DOI: 10.1007/s11019-023-10138-y

Jonathan M Cahill, Ashley J Moyse, Lydia S Dugdale

引用次数: 1

Social inclusion revisited: sheltered living institutions for people with intellectual disabilities as communities of difference. 重新审视社会包容:作为差异社区的智障人士庇护生活机构。

IF 2.1 2区哲学

Medicine Health Care and Philosophy Pub Date : 2023-06-01 DOI: 10.1007/s11019-022-10135-7

Femmianne Bredewold, Simon van der Weele

{"title":"Social inclusion revisited: sheltered living institutions for people with intellectual disabilities as communities of difference.","authors":"Femmianne Bredewold, Simon van der Weele","doi":"10.1007/s11019-022-10135-7","DOIUrl":"https://doi.org/10.1007/s11019-022-10135-7","url":null,"abstract":"The dominant idea in debates on social inclusion of people with intellectual disabilities is that social inclusion requires recognition of their 'sameness'. As a result, most care providers try to enable people with intellectual disabilities to live and participate in 'normal' society, 'in the community'. In this paper, we draw on (Pols, Medicine Health Care and Philosophy 18:81-90, 2015) empirical ethics of care approach to give an in-depth picture of places that have a radically different take on what social inclusion for people with intellectual disabilities looks like: places known as 'sheltered living institutions'. We argue these places can be seen as 'communities of difference' catered to the specific needs and capacities of the residents. We then contend that these communities raise questions about what a good life for people with intellectual disabilities looks like and where and how it ought to be realised; questions not posed very often, as they get muzzled by the dominant rhetoric of normalisation and the emphasis on sameness.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":"26 2","pages":"201-213"},"PeriodicalIF":2.1,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10175347/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9825597","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

Should responsibility be used as a tiebreaker in allocation of deceased donor organs for patients suffering from alcohol-related end-stage liver disease? 在为患有酒精相关性终末期肝病的患者分配已故供体器官时，责任是否应作为决定性因素?

IF 2.1 2区哲学

Medicine Health Care and Philosophy Pub Date : 2023-06-01 DOI: 10.1007/s11019-023-10141-3

Diehua Hu, Nadia Primc

{"title":"Should responsibility be used as a tiebreaker in allocation of deceased donor organs for patients suffering from alcohol-related end-stage liver disease?","authors":"Diehua Hu, Nadia Primc","doi":"10.1007/s11019-023-10141-3","DOIUrl":"https://doi.org/10.1007/s11019-023-10141-3","url":null,"abstract":"There is a long-standing debate concerning the eligibility of patients suffering from alcohol-related end-stage liver disease (ARESLD) for deceased donor liver transplantation. The question of retrospective and/or prospective responsibility has been at the center of the ethical discussion. Several authors argue that these patients should at least be regarded as partly responsible for their ARESLD. At the same time, the arguments for retrospective and/or prospective responsibility have been strongly criticized, such that no consensus has been reached. A third option was proposed as a form of compromise, namely that responsibility should only be used as a tiebreaker in liver allocation. The present study provides an ethical investigation of this third option. First, we will provide an overview of the main arguments that have been offered for and against the use of responsibility as an allocation criterion. Second, we will explore the concept of responsibility as a tiebreaker in detail and discuss several types of situations, in which responsibility could be used as a tiebreaker, as well as the main ethical challenges associated with them. As we will show, an ethical justified use of responsibility as a tiebreaker is limited to a very restricted number of cases and is associated with a number of ethical concerns. For this reason, waiting time should be preferred as a tiebreaker in liver allocation, even though the criterion of waiting time, too, raises a number of equity-related concerns.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":"26 2","pages":"243-255"},"PeriodicalIF":2.1,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10175331/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9510317","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

Paternalistic persuasion: are doctors paternalistic when persuading patients, and how does persuasion differ from convincing and recommending? 家长式说服:医生在说服病人时是否家长式?劝说与说服和推荐有何不同?

IF 2.1 2区哲学

Medicine Health Care and Philosophy Pub Date : 2023-06-01 DOI: 10.1007/s11019-023-10142-2

Anniken Fleisje

{"title":"Paternalistic persuasion: are doctors paternalistic when persuading patients, and how does persuasion differ from convincing and recommending?","authors":"Anniken Fleisje","doi":"10.1007/s11019-023-10142-2","DOIUrl":"https://doi.org/10.1007/s11019-023-10142-2","url":null,"abstract":"In contemporary paternalism literature, persuasion is commonly not considered paternalistic. Moreover, paternalism is typically understood to be problematic either because it is seen as coercive, or because of the insult of the paternalist considering herself superior. In this paper, I argue that doctors who persuade patients act paternalistically. Specifically, I argue that trying to persuade a patient (here understood as aiming for the patient to consent to a certain treatment, although he prefers not to) should be differentiated from trying to convince him (here understood as aiming for the patient to want the treatment) and recommending (the doctor merely providing her professional opinion). These three forms of influence are illustrated by summaries of video-recorded hospital encounters. While convincing and recommending are generally not paternalistic, I argue that persuasion is what I call communicative paternalism and that it is problematic for two reasons. First, the patient's preferences are dismissed as unimportant. Second, the patient might wind up undergoing treatment against his preferences. This does not mean that persuasion always should be avoided, but it should not be undertaken lightly, and doctors should be aware of the fine line between non-paternalism and paternalism. The fact that my analysis of paternalism differs from traditional accounts does not imply that I deem these to be wrong, but rather that paternalism should be considered as a more multi-faceted concept than previous accounts allow for.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":"26 2","pages":"257-269"},"PeriodicalIF":2.1,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10175395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9455975","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

Empathy is not so perfect! -For a descriptive and wide conception of empathy. 同理心并不是那么完美!-对移情的描述和广泛的概念。

IF 2.1 2区哲学

Medicine Health Care and Philosophy Pub Date : 2023-03-01 DOI: 10.1007/s11019-022-10124-w

Elodie Malbois, S Hurst-Majno

引用次数: 2