Medicine Health Care and Philosophy最新文献_第4页

Addressing the overuse-underuse paradox in healthcare. 解决医疗保健领域过度使用和使用不足的矛盾。

IF 3.1 2区哲学

Medicine Health Care and Philosophy Pub Date : 2025-07-31 DOI: 10.1007/s11019-025-10287-2

Bjørn Hofmann

引用次数: 0

Epistemic injustice suffered by patients with rare diseases, poorly understood diseases, and underdiagnosed diseases, and the epistemic advantage granted by these diseases. 罕见病、不了解疾病、诊断不足疾病患者的认知不公，以及这些疾病带来的认知优势。

IF 3.1 2区哲学

Medicine Health Care and Philosophy Pub Date : 2025-07-29 DOI: 10.1007/s11019-025-10285-4

Mar Rosàs Tosas

{"title":"Epistemic injustice suffered by patients with rare diseases, poorly understood diseases, and underdiagnosed diseases, and the epistemic advantage granted by these diseases.","authors":"Mar Rosàs Tosas","doi":"10.1007/s11019-025-10285-4","DOIUrl":"https://doi.org/10.1007/s11019-025-10285-4","url":null,"abstract":"Fricker (Epistemic Injustice. Power and the Ethics of Knowing, Oxford University Press, Oxford, 2007) coined the term epistemic injustice to refer to the downgrading of credibility of speakers provoked either by prejudices-which she labeled testimonial injustice-or by a gap in interpretative resources that account for a given phenomenon-which she referred to as hermeneutical injustice. This paper reviews the existing literature on how patients with rare diseases, poorly understood diseases, and underdiagnosed diseases are questioned by the healthcare practitioners who assist them in order to explore how they suffer from both these types of epistemic injustice. At the same time, the paper argues that the very epistemic marginalization suffered by these patients actually grants them some epistemic advantages over patients with better-known diseases, and even some meta-epistemic advantages-that is, a deeper understanding of how the very taxonomy that marginalizes or excludes them is, to some extent, a sociocultural construction. The paper therefore applies the notion of \"epistemic advantage\", coined by contemporary standpoint theorists, to the field of healthcare.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733955","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

Compassion in the justification of physician-assisted dying: Gandhi's non-violence vs. Aristotle's virtues and vices. 为医生协助下的死亡辩护时的同情：甘地的非暴力与亚里士多德的美德与罪恶。

IF 2.3 2区哲学

Medicine Health Care and Philosophy Pub Date : 2025-06-01 Epub Date: 2025-01-29 DOI: 10.1007/s11019-025-10251-0

Ercan Avci

引用次数: 0

The need for epistemic humility in AI-assisted pain assessment. 人工智能辅助疼痛评估需要认识上的谦逊。

IF 2.3 2区哲学

Medicine Health Care and Philosophy Pub Date : 2025-06-01 Epub Date: 2025-03-15 DOI: 10.1007/s11019-025-10264-9

Rachel A Katz, S Scott Graham, Daniel Z Buchman

{"title":"The need for epistemic humility in AI-assisted pain assessment.","authors":"Rachel A Katz, S Scott Graham, Daniel Z Buchman","doi":"10.1007/s11019-025-10264-9","DOIUrl":"10.1007/s11019-025-10264-9","url":null,"abstract":"It has been difficult historically for physicians, patients, and philosophers alike to quantify pain given that pain is commonly understood as an individual and subjective experience. The process of measuring and diagnosing pain is often a fraught and complicated process. New developments in diagnostic technologies assisted by artificial intelligence promise more accurate and efficient diagnosis for patients, but these tools are known to reproduce and further entrench existing issues within the healthcare system, such as poor patient treatment and the replication of systemic biases. In this paper we present the argument that there are several ethical-epistemic issues with the potential implementation of these technologies in pain management settings. We draw on literature about self-trust and epistemic and testimonial injustice to make these claims. We conclude with a proposal that the adoption of epistemic humility on the part of both AI tool developers and clinicians can contribute to a climate of trust in and beyond the pain management context and lead to a more just approach to the implementation of AI in pain diagnosis and management.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"339-349"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634920","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

Silence as epistemic agency in mania. 沉默是狂热的认知媒介。

IF 2.3 2区哲学

Medicine Health Care and Philosophy Pub Date : 2025-06-01 Epub Date: 2025-01-29 DOI: 10.1007/s11019-025-10256-9

Dan Degerman

{"title":"Silence as epistemic agency in mania.","authors":"Dan Degerman","doi":"10.1007/s11019-025-10256-9","DOIUrl":"10.1007/s11019-025-10256-9","url":null,"abstract":"Silence is a byword for socially imposed harm in the burgeoning literature on epistemic injustice in psychiatry. While some silence is harmful and should be broken, this understanding of silence is untenably simplistic. Crucially, it neglects the possibility that silence can also play a constructive epistemic role in the lives of people with mental illness. This paper redresses that neglect. Engaging with first-person accounts of mania, it contends that silence constitutes a crucial form of epistemic agency to people who experience mania and that the prevailing failure to recognise this may harm them. The paper proceeds as follows. After briefly examining the negative understanding of silence in the epistemic injustice literature, it outlines three epistemically agential silences: communicative silence, listening silence, and withholding silence. It then deploys these concepts to explore how the ability to perform epistemically agential silence is impaired in mania and why such silences are vital to people. The penultimate section highlights two ways that the failure to recognise the epistemic value of silence can harm people with mania. The paper concludes by drawing out implications for future research on epistemic injustice in psychiatry.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"247-259"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143060901","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

Healthcare exceptionalism: should healthcare be treated differently when it comes to reducing greenhouse gas emissions? 医疗例外主义：在减少温室气体排放方面，医疗是否应该被区别对待？

IF 2.3 2区哲学

Medicine Health Care and Philosophy Pub Date : 2025-06-01 Epub Date: 2025-01-25 DOI: 10.1007/s11019-025-10254-x

Joshua Parker

{"title":"Healthcare exceptionalism: should healthcare be treated differently when it comes to reducing greenhouse gas emissions?","authors":"Joshua Parker","doi":"10.1007/s11019-025-10254-x","DOIUrl":"10.1007/s11019-025-10254-x","url":null,"abstract":"Healthcare systems produce significant greenhouse gas emissions, raising an important question: should healthcare be treated like any other polluter when it comes to reducing its emissions, or is healthcare special because of its essential societal role? On one hand, reducing emissions is critical to combat climate change. On the other, healthcare depends on emissions to deliver vital services. The resulting tension surrounds an idea of healthcare exceptionalism and leads to the question I consider in this paper: to what extent (if any) should the valuable goals of healthcare form an exception to the burdens of reducing greenhouse gas emissions? The goals of this paper are twofold. One is to think about how to address the issue of healthcare exceptionalism. Second is to discuss the extent of healthcare's climatic responsibilities. I examine two perspectives on healthcare exceptionalism. The first treats a responsibility to reduce emissions and the delivery of healthcare as separate issues, each governed by its own principle. I reject this view, proposing instead that we consider healthcare's environmental responsibilities in conjunction with its essential functions. I defend an \"inability to pay\" principle, suggesting that while healthcare should indeed contribute to mitigating climate change, its obligations should be constrained by the necessity of maintaining its core goals like protecting health and preventing disease. Healthcare should be treated differently from other sectors, but not to the extent that it is entirely exempt from efforts to reduce emissions.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"233-245"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103308/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143042106","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

Why a responsibility sensitive healthcare system is not disrespectful. 为什么一个责任敏感的医疗系统不是不尊重。

IF 2.3 2区哲学

Medicine Health Care and Philosophy Pub Date : 2025-06-01 Epub Date: 2025-03-14 DOI: 10.1007/s11019-025-10262-x

Lydia Tsiakiri

{"title":"Why a responsibility sensitive healthcare system is not disrespectful.","authors":"Lydia Tsiakiri","doi":"10.1007/s11019-025-10262-x","DOIUrl":"10.1007/s11019-025-10262-x","url":null,"abstract":"The prevalence of non-communicable diseases, the related increased medical costs, and the recent public health emergency bring out more forcefully pre-existing dilemmas of distributive justice in the healthcare context. Under this reality, would it be justified to hold people responsible for their taken lifestyle decisions, or would it constitute an instance of unjustified disrespectful treatment? From a respect-based standpoint, one could argue that a responsibility-sensitive healthcare system morally disrespects the imprudent ones engaging in disadvantageous differential treatment to their detriment. In contrast, however, we might also have luck egalitarian reasons that explain why this differential treatment is not unjust. Luck egalitarianism is a responsibility-sensitive theory of distributive justice, which argues that it is bad if some people are worse off than others through no voluntary fault of their own. In this paper, I clarify the concerns about disrespect raised against the luck egalitarian viewpoint and offer possible respect-based reasons for why this might not be the case grounded in deontological concepts. First, I employ a revised Double-effect case to support responsibility-sensitive rationing. In the last part of the paper, these are further supported through the Kantian Formula of Humanity supplemented by the concept of duties.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"315-325"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103331/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634922","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

Multi-professional healthcare teams, medical dominance, and institutional epistemic injustice. 多专业医疗团队，医疗优势和制度认识不公正。

IF 2.3 2区哲学

Medicine Health Care and Philosophy Pub Date : 2025-06-01 Epub Date: 2025-01-23 DOI: 10.1007/s11019-025-10252-z

Anke Bueter, Saana Jukola

{"title":"Multi-professional healthcare teams, medical dominance, and institutional epistemic injustice.","authors":"Anke Bueter, Saana Jukola","doi":"10.1007/s11019-025-10252-z","DOIUrl":"10.1007/s11019-025-10252-z","url":null,"abstract":"Multi-professional teams have become increasingly common in healthcare. Collaboration within such teams aims to enable knowledge amalgamation across specializations and to thereby improve standards of care for patients with complex health issues. However, multi-professional teamwork comes with certain challenges, as it requires successful communication across disciplinary and professional frameworks. In addition, work in multi-professional teams is often characterized by medical dominance, i.e., the perspective of physicians is prioritized over those of nurses, social workers, or other professionals. We argue that medical dominance in multi-professional teams can lead to institutional epistemic injustice, which affects both providers and patients negatively. Firstly, it codifies and promotes a systematic and unfair credibility deflation of the perspectives of professionals other than physicians. Secondly, it indirectly promotes epistemic injustice towards patients via leading to institutional opacity; i.e., via creating an intransparent system of credibility norms that is difficult to navigate. To overcome these problems, multi-professional teamwork requires institutional settings that promote epistemic equity of team members.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"219-232"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025123","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

Dual-roles and beyond: values, ethics, and practices in forensic mental health decision-making. 双重角色及超越：法医心理健康决策中的价值观、伦理和实践。

IF 2.3 2区哲学

Medicine Health Care and Philosophy Pub Date : 2025-06-01 Epub Date: 2025-01-25 DOI: 10.1007/s11019-024-10247-2

Sven H Pedersen, Susanna Radovic, Thomas Nilsson, Lena Eriksson

{"title":"Dual-roles and beyond: values, ethics, and practices in forensic mental health decision-making.","authors":"Sven H Pedersen, Susanna Radovic, Thomas Nilsson, Lena Eriksson","doi":"10.1007/s11019-024-10247-2","DOIUrl":"10.1007/s11019-024-10247-2","url":null,"abstract":"Forensic mental health services (FMHS) involve restricting certain individual rights to uphold or promote other ethical values - the restriction of liberty in various forms is justified with reference to health and safety of the individual and the community. The tension that arises from this has been construed as a hallmark of the practice and an ever-present quandary for practitioners. Stating this ethical dilemma upfront is a common point of departure for many texts discussing FMHS. But do we run the risk of missing something important if setting the ethical scene rather than exploring it? This paper draws on interviews with three types of interested parties in mental health law proceedings - patients, psychiatrists and public defenders, and seeks to tease out what values are enacted when they describe and discuss experiences of FMHS and court proceedings. In doing so, we find emphasized values such as acceptance, telling it like it is, atonement, normality, and ensuring the future. We find that well-delineated and separate values are not necessarily the basis for decisions. We also find potential for explanation and guidance in bringing ethical discourse closer to everyday practice.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"199-211"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103350/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143042104","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

Chronic illness as transformative activity. 慢性病是一种变革性的活动。

IF 2.3 2区哲学

Medicine Health Care and Philosophy Pub Date : 2025-06-01 Epub Date: 2025-03-17 DOI: 10.1007/s11019-025-10260-z

Victoria Paul

{"title":"Chronic illness as transformative activity.","authors":"Victoria Paul","doi":"10.1007/s11019-025-10260-z","DOIUrl":"10.1007/s11019-025-10260-z","url":null,"abstract":"Laurie A. Paul (2014) developed the concept of transformative experience. In describing transformative experience as an experience that is both epistemically and personally transformative, she argues that transformative experience challenges the traditional model of rational decision making. Her concept of transformative experiences has been expanded to the field of illness. It has been argued that illness is a transformative experience because it fulfills Paul's criteria for a transformative experience (Carel et al. 2016; Carel and Kidd 2020). Conceptualizing illness as a transformative experience would have far-reaching implications for the agency and for the rational decision-making process of ill persons. In considering these implications, this article questions the assumption that illness is a transformative experience and proposes that illness, especially when it is chronic, can be a transformative activity, in the sense that Agnes Callard (2020), introduced us to the concept of transformative activity. The article argues that conceptualizing (chronic) illness as a transformative activity strengthens the ill person's agency and ability to learn to live with the illness.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"177-184"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651454","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