Medicine Health Care and Philosophy最新文献_第3页

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 2.3 2区哲学

Medicine Health Care and Philosophy Pub 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":"https://doi.org/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":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-08","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

The use of social media in social care: a systematic review of the argument-based ethics literature. 社会媒体在社会关怀中的使用：基于论证的伦理学文献的系统回顾。

IF 2.3 2区哲学

Medicine Health Care and Philosophy Pub Date : 2025-05-03 DOI: 10.1007/s11019-025-10269-4

Tijs Vandemeulebroucke, Larissa Bolte

{"title":"The use of social media in social care: a systematic review of the argument-based ethics literature.","authors":"Tijs Vandemeulebroucke, Larissa Bolte","doi":"10.1007/s11019-025-10269-4","DOIUrl":"https://doi.org/10.1007/s11019-025-10269-4","url":null,"abstract":"Digital technologies, especially social media, have become everyday tools. In care settings, the use of social media is considered a possible guarantee to maintain quality practices. This trend is specifically relevant for social care, including social work, psychology, psychiatry, rehabilitation etc., due to their communicative nature. Nevertheless, this use is joined by ethical vulnerabilities. To get insight into these, a systematic review of relevant normative-ethical literature was carried out following a 4-step methodology: developing ethical-conceptual questions; a literature search in four electronic databases (CINAHL, Philosopher's Index, Web of Science, ProQuest Database Psychology); assessment and inclusion of articles based on predefined criteria; extracting, analysing, and synthesizing reported data. Thirty-three articles were included, showing that current ethical debates are governed by nine themes: Benefits of social media; Relations, limits, and boundaries; Searches; Privacy, confidentiality, and trust; Documentation and records; Competency and client suitability; Consultation and referral; Informed consent; and Identity and image. We found that most ethical literature on social media use in social care settings adheres to the principles of biomedical ethics (respect for autonomy, beneficence, non-maleficence, justice) and to an ethics of carefulness, i.e. an ethics which takes social media for granted and considers its impact only on the particular therapeutic relationship. It loses sight of those ethical issues which occur on organizational, societal, and global levels. A full account of the ethics of social media use can only be given by considering these different levels and by informing the ethics of carefulness by an ethics of desirability.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042449","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

"Big chunks of blank memory": complex trauma and dissociative body memory. “大块空白记忆”：复杂的创伤和分离的身体记忆。

IF 2.3 2区哲学

Medicine Health Care and Philosophy Pub Date : 2025-05-03 DOI: 10.1007/s11019-025-10274-7

Jake Dorothy

{"title":"\"Big chunks of blank memory\": complex trauma and dissociative body memory.","authors":"Jake Dorothy","doi":"10.1007/s11019-025-10274-7","DOIUrl":"https://doi.org/10.1007/s11019-025-10274-7","url":null,"abstract":"Research into traumatic memory has focused heavily upon re-experiencing symptoms (e.g. flashbacks). Features predominantly associated with complex trauma, such as gaps in the recollection of traumatic events, remain comparatively underexplored. In this article, I draw on the testimonies of survivors of complex trauma who participated in a survey informed by Phenomenologically Grounded Qualitative Research (Køster and Fernandez in Phenomenol Cogn Sci 22:149, 2023). I provide a phenomenological account of how survivors often experience memory blanks as inchoately disturbing, despite being unable to recount 'missing' events. Although challenging and equivocal, the notion of body memory offers one way of articulating this phenomenon. Specifically, I suggest that the troubling feelings accompanying perceived gaps in recollection arise alongside a form of non-conceptual body memory, which, lacking in propositional content, fails to be meaningfully contextualised. Drawing on the literature on body memory, dissociation, and Husserl's (Collected works. Kluwer, Dordrecht, 1991 [1893-1917]) internal time consciousness, I distinguish this as dissociative body memory and describe two central, non-exhaustive, features: (1) habitual dissociation, and (2) protentive salience. What is taken to be a gap in traumatic memory is in fact only a partial gap, involving a kind of pre-reflective remembering that is not recognised as such. Dissociative body memory additionally prevents the narrative integration required for minimising these perceived gaps, leading to an ongoing sense of foreboding concerning one's past. This has significant clinical implications, highlighting that what survivors experience as forgotten must not be disregarded. At the theoretical level, the phenomenon may be a hitherto unrecognised characteristic of complex posttraumatic stress disorder and related conditions.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144034465","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

Phenomenology and ethics of terminal pain. Cicely Saunders' proposal. 晚期疼痛的现象学与伦理学。Cicely Saunders的提议。

IF 2.3 2区哲学

Medicine Health Care and Philosophy Pub Date : 2025-05-03 DOI: 10.1007/s11019-025-10273-8

Ilaria Malagrinò

{"title":"Phenomenology and ethics of terminal pain. Cicely Saunders' proposal.","authors":"Ilaria Malagrinò","doi":"10.1007/s11019-025-10273-8","DOIUrl":"https://doi.org/10.1007/s11019-025-10273-8","url":null,"abstract":"Differently from pre-technological societies, the contemporary one, when faced with pain, always thinks it can prepare a therapeutic response using the technique as the most valid form to dominate it. However, medicalization and pharmacology of pain prevent it from becoming language. Thus, medical progress makes men much more vulnerable to pain. If, on the one hand, the benefits of anesthesia constitute an unparalleled achievement, on the other, they generate a sense of indifference to life. This is precisely why it is important and urgent to return to listening to the cry of pain. In this sense, particularly commendable were the efforts of Cicely Saunders, who dedicated her entire life to listening to pain and made listening to pain the cornerstone of the philosophy of the Hospice Movement. Therefore, this paper aims to propose a reconstruction of the phenomenology of terminal pain that emerges in Cicely's writings, highlighting its particularity and usefulness in designing a better approach to pain management. Terminal pain has a strong ethical dimension that requires not only a therapeutic but, above all, an ethical response. The proposal of care that derives from Saunders' reflections focuses on the direct encounter with the other caught in its aspect of contact and restores importance to the medical art imagined as \"pathic,\" which, based on a complete or comprehensive wisdom, surpasses the classical humanistic vision and dichotomy which separates it from the purely biomedical one.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051104","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 2.3 2区哲学

Medicine Health Care and Philosophy Pub 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":"https://doi.org/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":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Understanding "interests": historical insights for managing conflicts of interest in healthcare and biomedical science. 理解“利益”：管理医疗保健和生物医学科学利益冲突的历史见解。

IF 2.3 2区哲学

Medicine Health Care and Philosophy Pub Date : 2025-04-22 DOI: 10.1007/s11019-025-10268-5

Miriam Wiersma, Ian Kerridge, Wendy Lipworth

{"title":"Understanding \"interests\": historical insights for managing conflicts of interest in healthcare and biomedical science.","authors":"Miriam Wiersma, Ian Kerridge, Wendy Lipworth","doi":"10.1007/s11019-025-10268-5","DOIUrl":"https://doi.org/10.1007/s11019-025-10268-5","url":null,"abstract":"Conflicts of interest are widely regarded as being morally, socially, and scientifically problematic in the many sectors, including in the health sector. There has been considerable attention paid to managing conflicts of interest in clinical practice, medical research and health policy through strategies such as recusal, disinvestment, and disclosure. While these efforts have been important, they are often based on a superficial account of \"interests\", as few in healthcare and biomedical science have sought to unpack the concept. In this paper, we argue that adopting an historically and philosophically informed account of interests can enrich our thinking about COI in healthcare and biomedical science, and lead to the improvement of COI management strategies. To support this claim, we first provide an overview of contemporary debates about COI in these domains. We then summarise the historical trajectory of the concept of \"interest\" and show how these insights can be used to inform the management of COI in healthcare and biomedical science using the example of physicians' relationships with the pharmaceutical industry. In particular, we challenge assumed hierarchies of interests and call for increased attention to the multiplicities of interests, both financial and non-financial, that may at times converge and conflict.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003323","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

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

IF 2.3 2区哲学

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

Adriana Joanna Mickiewicz

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 2.3 2区哲学

Medicine Health Care and Philosophy Pub 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":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Bodies as communication systems. The relevance of Michel Serres's philosophy of science for health care. 身体作为交流系统。米歇尔·塞雷斯的医疗保健科学哲学的相关性。

IF 2.3 2区哲学

Medicine Health Care and Philosophy Pub Date : 2025-03-01 Epub Date: 2024-12-26 DOI: 10.1007/s11019-024-10244-5

Aldo Houterman

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 : 2025-03-01 Epub Date: 2024-11-13 DOI: 10.1007/s11019-024-10235-6

Michiel De Proost, Giorgia Pozzi

引用次数: 0