Medicine Health Care and Philosophy最新文献_第2页

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

Ethical and epistemological considerations in applying moral injury (MI) concepts to refugee populations.

IF 2.3 2区哲学

Medicine Health Care and Philosophy Pub Date : 2024-11-30 DOI: 10.1007/s11019-024-10237-4

Roghieh Dehghan

引用次数: 0

The impact of digital health technologies on moral responsibility: a scoping review.

IF 2.3 2区哲学

Medicine Health Care and Philosophy Pub Date : 2024-11-30 DOI: 10.1007/s11019-024-10238-3

E Meier, T Rigter, M P Schijven, M van den Hoven, M A R Bak

{"title":"The impact of digital health technologies on moral responsibility: a scoping review.","authors":"E Meier, T Rigter, M P Schijven, M van den Hoven, M A R Bak","doi":"10.1007/s11019-024-10238-3","DOIUrl":"https://doi.org/10.1007/s11019-024-10238-3","url":null,"abstract":"Recent publications on digital health technologies highlight the importance of 'responsible' use. References to the concept of responsibility are, however, frequently made without providing clear definitions of responsibility, thus leaving room for ambiguities. Addressing these uncertainties is critical since they might lead to misunderstandings, impacting the quality and safety of healthcare delivery. Therefore, this study investigates how responsibility is interpreted in the context of using digital health technologies, including artificial intelligence (AI), telemonitoring, wearables and mobile apps. We conducted a scoping review with a systematic search in PubMed, Web of Science, Embase, CINAHL and Philosopher's Index. A total of 34 articles were included and categorized using a theoretical framework of responsibility aspects, and revealed two main findings. First, we found that digital health technologies can expand and shift existing 'role responsibilities' among caregivers, patients and technology. Second, moral responsibility is often equated with liability or accountability, without clear justification. Articles describe new ways in which physicians can be held accountable, particularly in the context of AI, and discuss the emergence of a 'responsibility gap' where no-one can be fully responsible for AI-generated outcomes. The literature also shows that m-Health technologies can increase patients' accountability for their own health. However, there was limited discussion in the reviewed literature on whether these attributions of accountability are appropriate. We conclude with implications for practice and suggestions for expanding the theoretical framework of moral responsibility, recommending further study on responsibility of collectives and artificial entities, and on the role of virtue in digital health.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142755647","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

Applied humanities as the antidote for the malaise of bioethics.

IF 2.3 2区哲学

Medicine Health Care and Philosophy Pub Date : 2024-11-29 DOI: 10.1007/s11019-024-10240-9

Consolandi Monica, Pegoraro Renzo

{"title":"Applied humanities as the antidote for the malaise of bioethics.","authors":"Consolandi Monica, Pegoraro Renzo","doi":"10.1007/s11019-024-10240-9","DOIUrl":"https://doi.org/10.1007/s11019-024-10240-9","url":null,"abstract":"The present paper highlights the urgency for a revitalization of the field of bioethics. The authors have identified the \"malaise\" present in contemporary bioethics, and they claim that it has become a boring way to approach medicine and life sciences instead of challenging them. Starting from a brief explanation of the origin of bioethics, this paper analyzes the main issues at the core of its malaise, i.e., its depersonalization and extreme specialization which exclude of a holistic view of the patient. Clinical ethics, an applied branch of bioethics, provides a prime example of a bioethical discipline that operates in real-world contexts, and it contrasts with the more theoretical nature of traditional bioethical frameworks. Thus, the inherent multidisciplinary nature of clinical ethics offers an opportunity to a way of connecting the hard and soft sciences, and, ultimately, of transcending this distinction in the medical humanities. The cure of the malaise of bioethics proposed in this article comes from the medical humanities, specifically from the applied humanities perspective, which offers a comprehensive approach to current world issues, including the fast evolution of technologies with applications to the health field.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142752007","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

Ontology of doctor and patient relationship and bioethics: from Aristotle's teleology to Pellegrino's philosophy of medicine. 医患关系本体论与生命伦理学：从亚里士多德的目的论到佩列格里诺的医学哲学。

IF 2.3 2区哲学

Medicine Health Care and Philosophy Pub Date : 2024-11-27 DOI: 10.1007/s11019-024-10239-2

Nuno Ribeiro Ferreira, Américo Pereira, Rui Nunes

引用次数: 0

The role of social justice in triage revisited: a threshold conception. 重新审视社会公正在分流中的作用：阈值概念。

IF 2.3 2区哲学

Medicine Health Care and Philosophy Pub Date : 2024-11-23 DOI: 10.1007/s11019-024-10232-9

Felicitas Holzer, Nikola Biller-Andorno, Holger Baumann

{"title":"The role of social justice in triage revisited: a threshold conception.","authors":"Felicitas Holzer, Nikola Biller-Andorno, Holger Baumann","doi":"10.1007/s11019-024-10232-9","DOIUrl":"https://doi.org/10.1007/s11019-024-10232-9","url":null,"abstract":"Saving as many lives as possible while ensuring equity for vulnerable groups through access to triage resources has been the dominant position since the onset of the COVID-19 pandemic in 2020. However, the exact relationship between the principles of social justice and efficiency remains a controversial and unresolved issue. In this paper, we aim to systematically distinguish between different models of this relationship and show that conceptualizing social justice as a 'moral side-constraint' or adopting a 'balancing approach' that attempt to reconcile social justice with efficiency inevitably lead to significant moral costs that require further justification. Based on this discussion, we propose a novel \"threshold model\" for trading-off moral costs. According to this model, the structural impact of triage must be considered in order to determine whether one opts for triage with the primary aim of efficiency or social justice. This contextualization further explains why, in some societies and circumstances, social justice can rightly be seen as the primary concern, while in other societies and circumstances, efficiency can be defended as the primary concern.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142696005","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

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

Mental health pluralism. 心理健康多元化。

IF 2.3 2区哲学

Medicine Health Care and Philosophy Pub Date : 2024-11-13 DOI: 10.1007/s11019-024-10233-8

Craig French

引用次数: 0

Correction: Tracking ambivalence: an existential critique of datafication in the context of chronic pain. 更正：追踪矛盾心理：对慢性疼痛数据化的存在主义批判。

IF 2.3 2区哲学

Medicine Health Care and Philosophy Pub Date : 2024-11-04 DOI: 10.1007/s11019-024-10234-7

Michelle Charette

引用次数: 0