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

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 3.1 2区哲学

Medicine Health Care and Philosophy Pub Date : 2025-09-01 Epub 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":"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":"577-594"},"PeriodicalIF":3.1,"publicationDate":"2025-09-01","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

The obscured face in video consultations. A Levinasian analysis. 视频咨询中模糊的脸。列文式分析。

IF 3.1 2区哲学

Medicine Health Care and Philosophy Pub Date : 2025-09-01 Epub Date: 2025-04-26 DOI: 10.1007/s11019-025-10271-w

Elisabeth Assing Hvidt, Frida Greek Kofod, Johannes van den Heuvel, Michael Scheffmann-Petersen

{"title":"The obscured face in video consultations. A Levinasian analysis.","authors":"Elisabeth Assing Hvidt, Frida Greek Kofod, Johannes van den Heuvel, Michael Scheffmann-Petersen","doi":"10.1007/s11019-025-10271-w","DOIUrl":"10.1007/s11019-025-10271-w","url":null,"abstract":"Video consultations represent a relatively new way of delivering face-to-face consultation in the context of general practice. The aim of the present analysis is to examine how video consultations influence patients' experiences of their ability to communicate their emotions, needs, and vulnerabilities, as well as their experiences with their general practitioner's ability to respond to these. The empirical base consists of 43 semi-structured interviews with patients (23 women and 20 men), aged between 17 and 81 years old, who have used video consultation as part of their treatment for various health issues in general practice. Emmanuel Levinas' theory of the face was used as an analytical and interpretative tool. The analysis showed that in video consultations, patients experience a digital obscuring of the face, i.e., of their emotions, needs and vulnerabilities. This complicates the GP's ability to perceive their vulnerability, making it challenging to recognize the patients' needs. Moreover, this obscuration hinders the patients' capacity to connect to their own vulnerabilities, which can lead to a diminished awareness of their own suffering. However, this mechanism might help patients who wish to obtain shielding from their face and from difficult emotions. Overall, we argue that significant relational and ethical dimensions of care within the doctor-patient relationship in general practice may be challenged in video consultations. We propose integrating Buber's dialogical principles with the present Levinasian analysis as it may offer a promising approach to enhancing relational and ethical dynamics in video consultations.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"461-472"},"PeriodicalIF":3.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12380976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056281","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

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 3.1 2区哲学

Medicine Health Care and Philosophy Pub Date : 2025-09-01 Epub 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":"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":"375-392"},"PeriodicalIF":3.1,"publicationDate":"2025-09-01","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

"The significance of clinical foetal autopsy for reproductive health care: an ethical analysis in the German context". "临床胎儿解剖对生殖保健的意义：德国的伦理分析"。

IF 3.1 2区哲学

Medicine Health Care and Philosophy Pub Date : 2025-09-01 Epub Date: 2025-04-03 DOI: 10.1007/s11019-025-10265-8

Elisa Groff, Marta C Cohen, Florian Steger

{"title":"\"The significance of clinical foetal autopsy for reproductive health care: an ethical analysis in the German context\".","authors":"Elisa Groff, Marta C Cohen, Florian Steger","doi":"10.1007/s11019-025-10265-8","DOIUrl":"10.1007/s11019-025-10265-8","url":null,"abstract":"The clinical autopsy of foetuses, stillborn babies, or neonates and the examination of the placenta help to inform the mother's decision-making and her medical care for subsequent pregnancies. Indeed, these post-mortem examinations can identify unexpected congenital malformations or the cause of repeated miscarriage or stillbirth. However, the use of clinical pathology for diagnostic purposes in the context of family planning for bereaved parents with an unfulfilled desire to have a child, and IVF couples has received little attention to date. This article applies Beauchamp and Childress' bioethical framework to identify, assess and systematically discuss ethical issues associated with the use of clinical foetal autopsy in reproductive healthcare within the German legal context. In the format of a clinical ethics consultation, the article examines the current policy on perinatal post-mortem examinations in Germany, and asks whether the clinical foetal autopsy for reproductive health purposes should be part of standard clinical examinations offered to bereaved parents. The conclusion of our research recommends clinical foetal autopsy as ethically acceptable, provided that the necessary resources are available. This recommendation is based on the ethical obligation towards the mother as the patient, which is grounded in the bioethical principles of autonomy and beneficence.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"393-400"},"PeriodicalIF":3.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12380977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774352","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

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 3.1 2区哲学

Medicine Health Care and Philosophy Pub Date : 2025-09-01 Epub 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":"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":"595-606"},"PeriodicalIF":3.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12380938/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Giving as repaying: towards an embodied ethics of living donor liver transplantation. 给予即回报：论活体肝移植的体现伦理。

IF 3.1 2区哲学

Medicine Health Care and Philosophy Pub Date : 2025-09-01 Epub Date: 2025-06-05 DOI: 10.1007/s11019-025-10275-6

Ya-Ping Lin, Huei-Ya Chen

{"title":"Giving as repaying: towards an embodied ethics of living donor liver transplantation.","authors":"Ya-Ping Lin, Huei-Ya Chen","doi":"10.1007/s11019-025-10275-6","DOIUrl":"10.1007/s11019-025-10275-6","url":null,"abstract":"This article explores the lived experiences and ethical complexities of the decision- and meaning-making journey involved in living donor liver transplantation (LDLT) through a case study of a young adult who donated part of his liver to his father. Utilising embodied phenomenology and narrative analysis, we present an in-depth exploration of personal stories and interconnected narratives that reveal the intricate layers and nuances inherent in child-to-parent LDLT within the Taiwanese sociocultural milieu. This study examines the embodied, relational, temporal and normative dimensions through a dynamic, iterative process of careful reading and analysis, from which four plotlines emerged [(1) indebtedness, (2) thrownness, (3) struggle for selfhood and (4) family seniority] along with a postscript. The findings illuminate the complex interplay of body, self, family, intergenerational dynamics and sociocultural norms throughout the decision-making process. The analysis aims to lay the groundwork for a refined framework for understanding concepts such as giving, relationality, agency, temporality and normativity within bioethical discourses on organ transplantation. Furthermore, the study offers insights for healthcare professionals to develop culturally sensitive approaches in LDLT care ethics and practice, with particular attention to vulnerability, relational autonomy and embodied intersubjectivity as normative foundations.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"517-531"},"PeriodicalIF":3.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12380939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227228","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

Differences in the EU regulations for biomedical research on humans and animals: an ethical analysis. 欧盟对人类和动物生物医学研究规定的差异：伦理分析。

IF 3.1 2区哲学

Medicine Health Care and Philosophy Pub Date : 2025-09-01 Epub Date: 2025-05-08 DOI: 10.1007/s11019-025-10270-x

Katarzyna Żebrowska

{"title":"Differences in the EU regulations for biomedical research on humans and animals: an ethical analysis.","authors":"Katarzyna Żebrowska","doi":"10.1007/s11019-025-10270-x","DOIUrl":"10.1007/s11019-025-10270-x","url":null,"abstract":"The European Union regulations for research on human and nonhuman participants differ significantly. This study aims to present a thorough analysis of these differences in the field of biomedical research. The study consists of a review of regulations issued by the European Union and Council of Europe institutions, supported by two UNESCO documents. The regulations are compared between three types of research: on humans, on nonhuman animals, and research using human embryos, within five categories: (1) Justification and scope of the regulations; (2) Inclusion criteria; (3) Consent procedures; (4) Participants' welfare; and (5) Values in research. In each category, significant differences between regulations for humans and animals are presented. These differences can be ethically analyzed in terms of values pursued in the protection of participants (intrinsic value of humans vs. value of animal welfare) and hierarchies of values in regulations (priority of participant-centered values in research on humans vs. priority of research-centered values in research on animals). Since the current protection of animals in biomedical research based on the '3Rs' principles seems not adequate, two possible ways forward are analyzed: replacement of all animals in research with other methods and a shift to research on companion animals.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"447-460"},"PeriodicalIF":3.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041273","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 3.1 2区哲学

Medicine Health Care and Philosophy Pub Date : 2025-09-01 Epub 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":"533-547"},"PeriodicalIF":3.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12380962/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Menstrual pain and epistemic injustice. 经期疼痛和认知不公。

IF 3.1 2区哲学

Medicine Health Care and Philosophy Pub Date : 2025-09-01 Epub Date: 2025-04-05 DOI: 10.1007/s11019-025-10266-7

Adriana Joanna Mickiewicz

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 : 2025-09-01 Epub 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":"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":"411-424"},"PeriodicalIF":3.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12380974/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0