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

The moral significance of moral distress. 道德困境的道德意义。

IF 3.6 2区哲学

Medicine Health Care and Philosophy Pub Date : 2026-12-01 Epub Date: 2026-06-22 DOI: 10.1007/s11019-026-10370-2

Cullin Brown, Jan Helge Solbakk

引用次数: 0

Suffering before it becomes Christian: non-Christian traditions of affliction and the goals of medicine. 成为基督教之前的苦难：非基督教的苦难传统和医学的目标。

IF 3.6 2区哲学

Medicine Health Care and Philosophy Pub Date : 2026-12-01 Epub Date: 2026-08-07 DOI: 10.1007/s11019-026-10387-7

Damian Sendrowski, Dariusz Kozłowski

{"title":"Suffering before it becomes Christian: non-Christian traditions of affliction and the goals of medicine.","authors":"Damian Sendrowski, Dariusz Kozłowski","doi":"10.1007/s11019-026-10387-7","DOIUrl":"10.1007/s11019-026-10387-7","url":null,"abstract":"Philosophy of medicine has drawn its richest account of suffering from a broadly Christian lineage, in which affliction can be borne with meaning and the sufferer retains an inviolable dignity. That lineage is not the only one, and it was not the first. This paper sets out the conceptions of suffering developed in the Stoic and Epicurean schools, in Buddhist thought, in Schopenhauer and Nietzsche, and in the phenomenological and existential reflection of Scheler, Weil, Levinas, Ricoeur, and Frankl, and asks what each contributes to the goals of medicine. The traditions disagree sharply. The Hellenistic schools locate suffering in judgment and counsel its dissolution through a discipline of the mind. Buddhist thought treats unsatisfactoriness as a structural feature of conditioned existence rather than a contingent defect. Schopenhauer reads suffering as the truth of the will, while Nietzsche makes it a condition of growth and meaning. The phenomenological tradition recovers suffering as the affliction of an embodied person and divides over whether it can be redeemed at all. Read together, these accounts test the assumption, common in clinical ethics, that suffering is either a problem to be solved or a meaning to be found. They suggest a medicine that can relieve what can be relieved, accompany what cannot, and decline to impose any single meaning on the person who suffers. The argument is illustrated through chronic pain, palliative care, and the care of the frail aged, where these traditions have already entered clinical practice through acceptance-based and meaning-centered interventions.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"1175-1182"},"PeriodicalIF":3.6,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148686381","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

Epistemic injustice in plain sight evidence from medical data. 医学数据中显而易见的认知不公。

IF 3.6 2区哲学

Medicine Health Care and Philosophy Pub Date : 2026-12-01 Epub Date: 2026-09-15 DOI: 10.1007/s11019-026-10393-9

Mara Floris

{"title":"Epistemic injustice in plain sight evidence from medical data.","authors":"Mara Floris","doi":"10.1007/s11019-026-10393-9","DOIUrl":"10.1007/s11019-026-10393-9","url":null,"abstract":"Recent debates on epistemic injustice in healthcare stress both the need for clearer criteria and measurement (Nielsen et al. 2025) and the importance of methodological pluralism (Færge et al. 2026). I argue that, in some domains, epistemic injustice can already be inferred from existing medical data, without waiting for new standardized metrics. Focusing on women's diagnostic delay, I argue that well-documented patterns - such as delayed diagnosis, symptom misattribution, and prolonged patient intervals - provide evidence of underlying epistemic injustice. The analysis distinguishes three dimensions - epistemic ignorance in knowledge production, testimonial injustice in clinical encounters, and hermeneutical injustice in patients' interpretive resources - and presents empirical indicators that allow these phenomena to be systematically identified and quantified. I argue that their convergence shows that epistemic injustice is already visible in medical track records and patients' diagnostic journeys. Although improved measurement remains important, the absence of standardized metrics should not prevent well-justified claims when the available evidence is already sufficiently robust.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"967-977"},"PeriodicalIF":3.6,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148978354","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

Ars Longa, Data Brevis: the science of disease and the art of care. Ars Longa，数据简介：疾病的科学和护理的艺术。

IF 3.6 2区哲学

Medicine Health Care and Philosophy Pub Date : 2026-12-01 Epub Date: 2026-07-06 DOI: 10.1007/s11019-026-10372-0

Hasan Erbay, Nader Ghotbi, Muhammad Shahid Shamim

{"title":"Ars Longa, Data Brevis: the science of disease and the art of care.","authors":"Hasan Erbay, Nader Ghotbi, Muhammad Shahid Shamim","doi":"10.1007/s11019-026-10372-0","DOIUrl":"10.1007/s11019-026-10372-0","url":null,"abstract":"The integration of Artificial Intelligence (AI) into modern medicine has revolutionised diagnostic accuracy, yet it generates a critical ethical dilemma: as healthcare becomes more data-driven, it risks eroding the high-touch essence of care. As algorithms increasingly shape clinical decision-making, patients risk being reduced to data points rather than persons with unique life stories. This paper examines the tension between AI's calculative logic and the narrative nature of illness, introducing the Processing-Witnessing Model. This framework distinguishes between algorithmic processing (speed, optimisation) and human witnessing (presence, interpretation, and narrative understanding). While AI excels at managing disease as biological dysfunction, it cannot address illness as the lived experience of suffering. This paper argues that the opacity of black-box systems creates a contextual void, enabling a form of epistemic violence that renders the patient's story invisible. Furthermore, the normalization of the screen gaze threatens the therapeutic alliance. Ironically, studies rating AI chatbots as 'more empathetic' are interpreted here not as evidence of machine moral agency, but as a symptom of systemic burnout. This makes narrative ethics a priority for medical education. The physician's role should evolve from data supervisor to cultural mediator, ensuring that while machines process the biological hardware, clinicians provide the interpretive software of meaning.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"877-885"},"PeriodicalIF":3.6,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148391990","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

Incidental findings in clinical imaging: should patient consent be obtained before disclosure? 临床影像学的意外发现：在披露前是否应征得患者同意？

IF 3.6 2区哲学

Medicine Health Care and Philosophy Pub Date : 2026-12-01 Epub Date: 2026-07-09 DOI: 10.1007/s11019-026-10375-x

Jasper Debrabander

{"title":"Incidental findings in clinical imaging: should patient consent be obtained before disclosure?","authors":"Jasper Debrabander","doi":"10.1007/s11019-026-10375-x","DOIUrl":"10.1007/s11019-026-10375-x","url":null,"abstract":"Seminal ethical guidelines regarding the management of incidental findings (IFs) in medicine recommend to obtain, in as far as practically possible, patients' informed consent regarding the disclosure of IFs arising from genetic tests or imaging procedures in clinical and research settings. In clinical genetics, genetics research and imaging research, patients' consent regarding the disclosure of IFs is standardly obtained. In clinical imaging, however, patients' consent regarding the disclosure of IFs is not systematically obtained. This raises the question whether there are theoretical and/or practical reasons for not obtaining patients' consent regarding the disclosure of IFs in clinical imaging. In this paper, I do two things. First, I offer a theoretical argument by analogy in favour of obtaining patients' informed consent regarding the disclosure of IFs in clinical imaging. Second, I develop a context-specific consent model, thereby mitigating important practical concerns regarding the feasibility of obtaining patients' consent in that context. However, the road towards implementation remains long and myriad practical difficulties remain. Therefore, my argument is not meant to show that obtaining patients' consent regarding the disclosure of IFs in clinical imaging is overall desirable, but that the burden of proof lies on those who wish to deny that obtaining patients' consent regarding the disclosure of IFs in clinical imaging is both theoretically desirable and practically feasible. I thereby strengthen previous calls for a more patient-centered radiology.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"1099-1110"},"PeriodicalIF":3.6,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413284","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

ME/CFS and the emotional toll of persistent disbelief: from epistemic to affective injustice. ME/CFS和持续怀疑的情感代价：从认知到情感不公。

IF 3.6 2区哲学

Medicine Health Care and Philosophy Pub Date : 2026-12-01 Epub Date: 2026-08-14 DOI: 10.1007/s11019-026-10388-6

Sven Walter

{"title":"ME/CFS and the emotional toll of persistent disbelief: from epistemic to affective injustice.","authors":"Sven Walter","doi":"10.1007/s11019-026-10388-6","DOIUrl":"10.1007/s11019-026-10388-6","url":null,"abstract":"Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a debilitating chronic illness whose sufferers are frequently met with disbelief, stigmatization, and psychologization in both clinical and social contexts. Recent work has used the concept of \"epistemic injustice\" to illuminate important dimensions of this problem, especially the ways in which ME/CFS patients are discredited as knowers and denied adequate interpretive resources. This paper argues that the harms associated with persistent disbelief in ME/CFS are not exhausted by this epistemic dimension. Drawing on recent philosophical work on affective injustice, I argue that persistent disbelief can also impair patients' affective lives in distinctive and socially patterned ways. More specifically, I argue that individuals with ME/CFS are burdened by unjust affective expectations, pressured into norm-conforming forms of emotional self-presentation, exposed to pathologizing and gaslighting interpretations of their affective experience, denied uptake for apt emotional responses, and exploited through forms of emotional labor and affective appropriation. Conceptualizing these harms in terms of affective injustice, I argue, helps to capture dimensions of marginalization that a focus on testimony and understanding alone leaves obscure. The paper concludes by considering objections and drawing out implications for healthcare and philosophy of medicine.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"1049-1066"},"PeriodicalIF":3.6,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652865/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762237","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 academic theatre of shadows: epistemological and ethical erosion in the era of marketing-based medicine. 学术剧场的阴影：认识论和伦理侵蚀的时代，以市场为基础的医学。

IF 3.6 2区哲学

Medicine Health Care and Philosophy Pub Date : 2026-12-01 Epub Date: 2026-09-09 DOI: 10.1007/s11019-026-10395-7

Piotr Bramora, Wiesław Pilis

{"title":"The academic theatre of shadows: epistemological and ethical erosion in the era of marketing-based medicine.","authors":"Piotr Bramora, Wiesław Pilis","doi":"10.1007/s11019-026-10395-7","DOIUrl":"10.1007/s11019-026-10395-7","url":null,"abstract":"This paper analyzes the systemic crisis within contemporary medical academia, characterized by the authors as the \"Academic Theatre of Shadows.\" This phenomenon occurs when the epistemological rigor of Evidence-Based Medicine (EBM) is superseded by Evidence-Based Marketing (EBM-m). The study examines how modern academic institutions consciously or unconsciously facilitate an environment where charismatic med-influencers prioritize digital metrics, public relations, and commercial viability over physiological accuracy, patient safety, and methodological validation. By deconstructing the mechanism of \"commodity diagnostics\"-specifically analyzing the misinterpretation of Cross-reactive Carbohydrate Determinants (CCDs) as a prime case study-the article highlights how analytical errors are deliberately rebranded as scientific discoveries. This process creates an ethical hazard by pathologizing healthy populations for commercial gain, transforming citizens into \"phantom patients.\" Furthermore, the paper explores the sociological \"Inversion of Hierarchy,\" drawing parallels with the Theranos scandal, to demonstrate how administrative support for marketing-driven agendas marginalizes expert epistemic authority. The article concludes by utilizing the frameworks of agnotology and communicative action to analyze institutional complicity, ultimately advocating for a radical return to epistemic responsibility and the ethical foundations of the university as an uncompromising guardian of scientific truth.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"895-901"},"PeriodicalIF":3.6,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148921399","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

How to deal with controversies in the evaluation of medicalization: a case study of PMS and PMDD. 如何处理医学化评价中的争议：以经前症候群和经前不悦症为例

IF 3.6 2区哲学

Medicine Health Care and Philosophy Pub Date : 2026-12-01 Epub Date: 2026-07-06 DOI: 10.1007/s11019-026-10374-y

Ilvie Prince

{"title":"How to deal with controversies in the evaluation of medicalization: a case study of PMS and PMDD.","authors":"Ilvie Prince","doi":"10.1007/s11019-026-10374-y","DOIUrl":"10.1007/s11019-026-10374-y","url":null,"abstract":"Medicalization has become a key topic in contemporary philosophy of medicine. Discussions about what should be medicalized, what kinds of medicalization are desirable, and how specific cases ought to be evaluated increasingly shape debates about the boundaries and responsibilities of medicine. The medicalization debate is increasingly shaped by pragmatic considerations that draw attention to the complex interactions between mind and body and to the role of social and environmental conditions in shaping health. From this perspective, the value of medical interventions and resources lies in their capacity to contribute to broader goals such as alleviating human suffering and promoting individual and collective well-being. While pragmatic approaches address several shortcomings of stricter, often essentialist frameworks, their existing analytical tools remain limited when it comes to evaluating controversial cases of medicalization. This paper examines these limitations and develops a refined pragmatic framework for distinguishing good from problematic medicalization. Using the case study of the pharmaceutical treatment of behavioral and mood-related symptoms associated with premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD), I propose a two-step approach. This two-step approach acknowledges the complexities of pragmatic medicalization and distinguishes between the potential usefulness of medicines to achieve pragmatic goals and the realization of this potential in actual practice.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"1081-1097"},"PeriodicalIF":3.6,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148392042","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

How ignoring the harm of killing undermines the ethical legitimacy of animal research: a case study from Switzerland. 忽视杀戮的危害如何破坏动物研究的伦理合法性：来自瑞士的一个案例研究。

IF 3.6 2区哲学

Medicine Health Care and Philosophy Pub Date : 2026-12-01 Epub Date: 2026-07-27 DOI: 10.1007/s11019-026-10382-y

Christian Rodriguez, Charlotte E Blattner, Angela K Martin

{"title":"How ignoring the harm of killing undermines the ethical legitimacy of animal research: a case study from Switzerland.","authors":"Christian Rodriguez, Charlotte E Blattner, Angela K Martin","doi":"10.1007/s11019-026-10382-y","DOIUrl":"10.1007/s11019-026-10382-y","url":null,"abstract":"The most established approach to legitimizing animal research worldwide is through Harm-Benefit Analyses (HBAs), which require that the expected benefits of research be compared to and outweigh the harms done to animals. For this process to be ethically sound, all relevant harms must be considered. However, HBAs leave one fundamental harm insufficiently considered: killing, i.e., the deliberate termination of animals' lives as part of the research project. This article argues that the law's ignorance of the harm of killing leads to its trivialization in practice and, consequently, undermines the ethical legitimacy of deadly animal research projects. While our argument applies broadly, we use Switzerland as an illustrative case example. We first disentangle, from an ethical standpoint, the harms that killings inflict on animals in research. Second, we show that most harms of killing, both to the inherent worth and wellbeing of animals, are not accounted for in law, allowing killings to be trivialized. Third, we propose that killing should always (a) be subject to ethical and legal scrutiny by animal research commissions, (b) have to pass the necessity test (i.e., killing should be permitted if, and only if, it is necessary to achieve the purpose of the experiment), and (c) be included in HBAs. Fourth, we consider common objections to our arguments, and, in concluding, show why recognizing the harm of killing is essential to upholding the ethical legitimacy of animal research.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"1125-1138"},"PeriodicalIF":3.6,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652884/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148593882","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

Inner strength in rehabilitation care: a philosophical framework of inner balance and inner posture. 康复护理中的内在力量：内在平衡与内在姿态的哲学框架。

IF 3.6 2区哲学

Medicine Health Care and Philosophy Pub Date : 2026-12-01 Epub Date: 2026-08-01 DOI: 10.1007/s11019-026-10385-9

Hielke Bosma

{"title":"Inner strength in rehabilitation care: a philosophical framework of inner balance and inner posture.","authors":"Hielke Bosma","doi":"10.1007/s11019-026-10385-9","DOIUrl":"10.1007/s11019-026-10385-9","url":null,"abstract":"Rehabilitation care concerns not only the restoration of function but also how persons live through disruption. Injury and illness may bring loss, uncertainty, altered dependence, changed self-understanding, and a changed horizon of life. Concepts such as coping and resilience capture important aspects of adaptation but do not fully clarify the inner work involved in bearing and inhabiting such change. This paper argues that inner strength can provide a useful concept for clarifying that work. The paper develops a philosophical framework with a preparatory layer and two related dimensions. Inner base names foundational exercises of attention, breath, and body awareness. Inner balance names the centering work of recollection and steadier judgment, while inner posture names the orienting work of finding a viable relation to limitation, vulnerability, and a wider horizon of meaning. Drawing on Pierre Hadot's account of philosophy as a way of life, the paper interprets inner balance and inner posture through the complementary movements of concentration and expansion. It places this proposal in dialogue with rehabilitation research on inner posture and global meaning, and with literature on meaning-making, resilience, mindfulness, and existential care. The framework is conceptual rather than a validated intervention model. It offers a more differentiated vocabulary for grounding, centering, and orientation in rehabilitation care.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"1025-1034"},"PeriodicalIF":3.6,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148654976","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