Medicine Health Care and Philosophy最新文献_第5页

«Doctors must live»: a care ethics inquiry into physicians' late modern suffering. "医生必须活下去"：对医生晚期现代痛苦的护理伦理探究。

IF 2.3 2区哲学

Medicine Health Care and Philosophy Pub Date : 2025-06-01 Epub Date: 2025-02-05 DOI: 10.1007/s11019-025-10258-7

Caroline Engen

{"title":"«Doctors must live»: a care ethics inquiry into physicians' late modern suffering.","authors":"Caroline Engen","doi":"10.1007/s11019-025-10258-7","DOIUrl":"10.1007/s11019-025-10258-7","url":null,"abstract":"In 2023, thousands of young Norwegian physicians joined an online movement called #legermåleve (#doctorsmustlive) and shared stories of their own mental and somatic health issues, which they considered to be caused by unacceptable working conditions. This paper discusses this case as an extreme example of physicians' and healthcare workers' suffering in late modern societies, using Vosman and Niemeijer's approach of rethinking care imaginaries by a structured process of thinking along, counter-thinking and rethinking, bringing to bear suffering as a heuristic device. Thinking along, taking the physicians' stories and arguments literally, reveals an image of an unbearable workload. Counter-thinking resituates their suffering within the broader conditions of late modernity, suggesting that the root cause may lie not in the quantity of the workload itself but in its qualities and in its perceived threat to their integrity as caregivers through epistemic and moral injury and an inability to respond to this threat. In rethinking, the ambiguity of suffering- its dual potential as both a constraint and an opening- becomes central. Following the physicians' own interpretations and the solutions emerging from this framing, both their suffering and that of their patients could paradoxically be exacerbated by further decentering physicians and reinforcing utilitarian, data-driven approaches. However, staying with their suffering and reinterpreting its causes opens possibilities to leverage critiques of medicalization at large and of their own suffering in particular, challenging the assumption that the weight of care must always grow heavier. From this reframing, I argue, it is possible to reclaim and reimagine care and the clinical space as a nexus of epistemic and moral privilege, recentering response-ability both relationally and socially.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"275-290"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103476/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190912","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 disservice of publishing preliminary results based on a premature hypothesis - Semmelweis' ordeal revisited. 发表基于一个不成熟的假设的初步结果的危害——重新审视塞梅尔维斯的苦难。

IF 2.3 2区哲学

Medicine Health Care and Philosophy Pub Date : 2025-06-01 Epub Date: 2025-02-13 DOI: 10.1007/s11019-025-10257-8

Niels Lynøe, Niklas Juth, Anders Eriksson

{"title":"The disservice of publishing preliminary results based on a premature hypothesis - Semmelweis' ordeal revisited.","authors":"Niels Lynøe, Niklas Juth, Anders Eriksson","doi":"10.1007/s11019-025-10257-8","DOIUrl":"10.1007/s11019-025-10257-8","url":null,"abstract":"In an interesting article, Dr Zuzana Parusniková claimed: (i) that Semmelweis' colleagues did not recognise the importance of his animal experiments, (ii) that the resistance to Semmelweis' hypothesis and results was due mainly to applying mono-causality and (iii) Semmelweis inability to communicate, (iv) that the New Vienna Medical School applied evidence-based medicine, and (v) that the philosophy of Karl Popper is the best interpretation of Semmelweis' scientific approach. Here, we present some factual aspects of Semmelweis' text from 1861 and discuss Dr Parusniková's claims against this backdrop. We conclude that Semmelweis might intentionally have abstained from communicating his hypothesis and results between 1847 and 1849 - including the results from his animal experiments - as he thought that they would eventually be understood and accepted. Semmelweis' hypothesis was that cadaveric matters and decaying particles were the cause of childbed fever and increased maternal mortality. This hypothesis might have been controversial, but we claim that the major reason for the resistance was eminence-based and induced by the publication of preliminary and suboptimal results, based on a premature version of his hypothesis. If the New Vienna Medical School had been influenced by evidence-based medicine, we believe that Semmelweis' empirical results would have been accepted - as they were based on an almost randomised controlled trial - and if the results had not been associated with his hypothesis but instead had focused on a black box procedure. We agree that the philosophy of Popper might be appropriate when analysing Semmelweis' scientific approach when abandoning low-level theories. However, to understand the resistance against Semmelweis' hypothesis and results, it is not sufficient to refer to a Pickwickian discussion; a Kuhnian framework is more adequate.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"261-273"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103370/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143410763","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

On value compatibility: reflections on the ethical framework for pandemic healthcare distribution. 论价值相容性：对大流行卫生保健分配伦理框架的思考。

IF 2.3 2区哲学

Medicine Health Care and Philosophy Pub Date : 2025-06-01 Epub Date: 2025-03-07 DOI: 10.1007/s11019-025-10261-y

Yijie Wang

{"title":"On value compatibility: reflections on the ethical framework for pandemic healthcare distribution.","authors":"Yijie Wang","doi":"10.1007/s11019-025-10261-y","DOIUrl":"10.1007/s11019-025-10261-y","url":null,"abstract":"An ethical framework for pandemic healthcare distribution typically encompasses multiple ethical values. However, integrating various ethical values and distributive principles into a single framework raises concerns about their compatibility and the overall coherence of the framework. This issue of value compatibility could lead to moral inconsistencies within the ethical framework, leading to practical indetermination when facing conflicting implications. This paper offers a methodological resolution to the compatibility problem, serving as an effective tool to mitigate the impact of value conflicts where possible. It proposes four pathways: specifying values rather than balancing them, incorporating values rather than weighing them, reinforcing values rather than aggregating them, and seeking scientific evidence. By developing coherent ethical frameworks where values do not contradict each other, this approach also enhances practical ethical decision-making. Using the COVID-19 vaccine distribution as a case study, this approach demonstrates how conflicting values can yield practical prioritization strategies, such as allocating vaccines to healthcare and essential workers, addressing multiple layers of disadvantage, and assessing age-related prioritization. Reflecting on the compatibility of values within ethical frameworks offers crucial insights beyond COVID-19, contributing to the development of robust ethical frameworks for future public health crises.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"303-313"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574232","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

Who decides who goes first? Taking democracy seriously in micro-allocative healthcare decisions. 谁决定谁先走？在微观配置医疗决策中认真对待民主。

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/s11019-025-10263-w

Davide Battisti, Chiara Mannelli

{"title":"Who decides who goes first? Taking democracy seriously in micro-allocative healthcare decisions.","authors":"Davide Battisti, Chiara Mannelli","doi":"10.1007/s11019-025-10263-w","DOIUrl":"10.1007/s11019-025-10263-w","url":null,"abstract":"The structural scarcity of healthcare resources has deeply challenged their fair distribution, prompting the need for allocation criteria. Long under the spotlight of the bioethical debate with an extraordinary peak during the recent COVID-19 pandemic, micro-allocation of healthcare has been extensively discussed in the literature with regard to issues of substantive and formal justice. This paper addresses a relatively underdiscussed question within the field of formal justice: who should define micro-allocation criteria in healthcare? To explore this issue, we first establish formal requirements that must be met for allocation criteria to be considered fair and legitimate. Then, we introduce three possible answers to the research question: the attending physician, the team of physicians, and the team of experts. We discuss and then reject all of them, arguing that the task of defining allocation criteria should be assigned to a political representative, supported by a cross-disciplinary team of experts. This proposal is based on the need to take democracy seriously as a tool for making substantive allocative decisions in light of the inevitable disagreement on such matters within a community. To support this claim, we present two key arguments-the democracy argument and the consistency argument. We also pre-emptively respond to two significant critiques: the too-specificity of the decision critique and the catastrophic outcomes critique. In conclusion, we argue that our proposal offers the fairest and most legitimate decision-making process for healthcare micro-allocation.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"327-337"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634921","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

Well-being and enhancement: reassessing the welfarist account. 福祉与提升：重新评估福利主义账户。

IF 2.3 2区哲学

Medicine Health Care and Philosophy Pub Date : 2025-06-01 Epub Date: 2025-01-10 DOI: 10.1007/s11019-024-10246-3

Anna Hirsch

{"title":"Well-being and enhancement: reassessing the welfarist account.","authors":"Anna Hirsch","doi":"10.1007/s11019-024-10246-3","DOIUrl":"10.1007/s11019-024-10246-3","url":null,"abstract":"There are an increasing number of ways to enhance human abilities, characteristics, and performance. In recent years, the ethical debate on enhancement has focused mainly on the ethical evaluation of new enhancement technologies. Yet, the search for an adequate and shared understanding of enhancement has always remained an important part of the debate. It was initially undertaken with the intention of defining the ethical boundaries of enhancement, often by attempting to distinguish enhancements from medical treatments. One of the more recent approaches comes from Julian Savulescu, Anders Sandberg, and Guy Kahane. With their welfarist account, they define enhancement in terms of its contribution to individual well-being: as any state of a person that increases the chances of living a good life in the given set of circumstances. The account aims to contribute both to a shared and clear understanding of enhancement and to answering the question of whether we should enhance in certain ways or not. I will argue that it cannot live up to either claim, in particular because of its inherent normativity and its failure to adequately define well-being. Nevertheless, it can make a valuable contribution to an ethics of enhancement. As I will show, the welfarist account refocuses the debate on a central value in health care: well-being, which can be a relevant aspect in assessing the permissibility of biomedical interventions - especially against the background of new bioethical challenges. To fulfil this function, however, a more differentiated understanding of well-being is needed.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"185-197"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956256","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

Concepts of self in dementia research: towards theoretical integration. 痴呆研究中的自我概念：走向理论整合。

IF 2.3 2区哲学

Medicine Health Care and Philosophy Pub Date : 2025-06-01 Epub Date: 2025-02-14 DOI: 10.1007/s11019-025-10253-y

T J van Woerkum-Rooker

{"title":"Concepts of self in dementia research: towards theoretical integration.","authors":"T J van Woerkum-Rooker","doi":"10.1007/s11019-025-10253-y","DOIUrl":"10.1007/s11019-025-10253-y","url":null,"abstract":"Research on understanding the self of persons with dementia (PWD) has increased significantly in the past decades across various fields of research. This has led to a profusion of novel conceptualizations of self. Meanwhile, the rise in dementia diagnoses worldwide presents us with complex global societal and individual challenges. Since the understanding of the self of PWD is vital for improving their well-being, autonomy and care needs, this article argues that there is a need to integrate and systematize these conceptualizations of self. The current state of conceptual unclarity undermines the wellbeing of PWD, since it impedes the exchange and development of (empirical) research results and ideas. With the aim of uniting and systematizing the conceptualizations of self in research on PWD, in order to develop a pragmatic, clustered approach based on the research of the field itself which can be applied in an empirical setting with PWD, this article departs from the literature reviews from the various fields involved in the research on the self of PWD. By focusing on the theoretical overlap between the conceptualizations of self employed in these reviews, four overarching clusters of self-aspects can be formulated: minimal, embodied-embedded, reflective and socially-embedded self-aspects. These clusters jointly provide the ground for self-continuity in PWD. This clustered approach provides a framework which unites the current field of research, within which new findings can be integrated and which can be applied in an empirical setting.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"351-366"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426451","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

Fundamental issues in epistemic injustice in healthcare. 在医疗保健认识不公正的基本问题。

IF 2.3 2区哲学

Medicine Health Care and Philosophy Pub Date : 2025-06-01 Epub Date: 2025-03-07 DOI: 10.1007/s11019-025-10259-6

Kasper Møller Nielsen, Julie Nordgaard, Mads Gram Henriksen

{"title":"Fundamental issues in epistemic injustice in healthcare.","authors":"Kasper Møller Nielsen, Julie Nordgaard, Mads Gram Henriksen","doi":"10.1007/s11019-025-10259-6","DOIUrl":"10.1007/s11019-025-10259-6","url":null,"abstract":"The research field of epistemic justice in healthcare has gained traction in the last decade. However, the importation of Miranda Fricker's original philosophical framework to medicine raises several interrelated issues that have largely escaped attention. Instead of pushing forward, crafting new concepts or exploring other medical conditions, we suggest that it is time to take stock, reconsider, and articulate some fundamental issues that confront the field of epistemic injustice in healthcare. This paper articulates such fundamental issues, which we divide into scientific, conceptual, and theoretical issues. Scientifically, the research field is confronted by a lack of empirical evidence. It relies on cases, making generalizations impossible and the field vulnerable to bias. Conceptually, many of the claims advanced in the literature are presented as facts but are merely hypotheses to be tested. Moreover, a criterion for applying the concept of testimonial injustice in medicine is lacking, impeding the development of a construct to empirically measure said injustices. Theoretically, many of the cases discussed in the literature do not prima facie qualify as cases of testimonial injustice, since they lack necessary components of testimonial injustice in Fricker's framework, i.e., being unintentional and caused by identity prejudices in the hearers. If epistemic injustice is as pervasive as it is claimed in this literature, it should be of concern to us all. Addressing the issues raised here may strengthen the conceptualization of epistemic injustice in healthcare and lead to development of constructs that finally can explore its empirical basis.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"291-301"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574297","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

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