Medicine Health Care and Philosophy最新文献

{"title":"Improving bioethics by clarifying and elaborating its methodology: a response to Gomez-Virseda and colleagues.","authors":"Bjørn Hofmann","doi":"10.1007/s11019-026-10368-w","DOIUrl":"10.1007/s11019-026-10368-w","url":null,"abstract":"<p><p>In a recent article Gomez-Virseda and coauthors criticize my previous work on methodology in bioethics and argue that bioethics is a discipline. While I think that Gomez-Virseda and co-authors misconstrue my argument, state the obvious, and fail to address pressing questions to their argument, I am most thankful for the inspiration and opportunity to elaborate on why methodology matters for consolidating bioethics' professional standing, to improving its quality, ascertaining its academic and educational importance, and to advancing its trustworthiness and social impact.</p>","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"847-852"},"PeriodicalIF":3.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13633981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148102061","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}

{"title":"A foundational perspective of deontology and deontological codes through Paul Ricoeur´s \"little ethics\".","authors":"Nuno Ribeiro Ferreira, Pedro Bicho, Américo Pereira, Rui Nunes","doi":"10.1007/s11019-026-10362-2","DOIUrl":"10.1007/s11019-026-10362-2","url":null,"abstract":"<p><p>Paul Ricoeur's ethics comprises three distinct moments where it is possible to recognize the influences of Aristotle, Kant, Rawls and an original ricoeurian moment of practical wisdom, where the concept of phronesis is rehabilitated. When reflecting on medical practices, Ricoeur distinguishes, in continuity with his triadic ethics, three levels of judgment: the prudential and ethical level concerning the singularity of the clinical encounter that is essential for establishing a pact of trust, the formal and moral level where deontological codes emerge and the reflexive level where the two previous judgments become legitimated. Our aim with this paper is, through Paul Ricoeur´s ethics, to perspective deontology and deontological codes as a broader set of implicit philosophical and anthropological conceptions, rooted in the clinical encounter, that constitute a theoretical and foundational background for medical rules and norms.</p>","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"783-792"},"PeriodicalIF":3.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13633976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148017974","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}

{"title":"Vulnerability as a normative concept: reviving the scepticism.","authors":"Hojjat Soofi","doi":"10.1007/s11019-026-10345-3","DOIUrl":"10.1007/s11019-026-10345-3","url":null,"abstract":"","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"601-610"},"PeriodicalIF":3.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13633941/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147619103","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}

{"title":"The interrelationship between soul and body: Plato as pioneer of the philosophy of health.","authors":"Nurdane Şimşek","doi":"10.1007/s11019-026-10357-z","DOIUrl":"10.1007/s11019-026-10357-z","url":null,"abstract":"<p><p>This article argues that Plato was a pioneer of the philosophy of health. It examines the psychosomatic interrelationship between soul (psychē) and body (sōma) primarily in the Charmides and the Timaeus, with selective references to other dialogues, notably the Republic and Phaedrus. The central claim is that Plato's account of the psychosomatic interrelationship can be adequately understood only when its sociopolitical dimension is taken into account. Although this emphasis is relatively novel in contemporary scholarship, it was commonplace in Plato's milieu to conceive of human beings as members and citizens of the city-state (polis). The article further argues that Plato's approach to psychosomatic phenomena extends beyond states of pain or disease and instead encompasses a holistic vision of health and human flourishing. Accordingly, this study aims to deepen the current understanding of Plato's philosophy of health. Given that the philosophy of health is an emerging interdisciplinary field, the article also seeks to contribute to its conceptual development.</p>","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"725-736"},"PeriodicalIF":3.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13633947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147869997","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}

{"title":"Navigating patients' refusal of information in clinical practice - a clinical scenario.","authors":"Jenny Lindberg","doi":"10.1007/s11019-026-10356-0","DOIUrl":"10.1007/s11019-026-10356-0","url":null,"abstract":"<p><p>The right of patients to decline information about their health, prognosis, and available treatment options is a salient principle in both domestic law and international declarations and conventions. This right may be considered either unnegotiable or subject to certain terms and conditions. While respecting this right may seem straightforward, doing so in clinical practice can be challenging. This article uses a realistic hypothetical scenario to examine the epistemic, moral, and practical challenges that can arise, particularly with patients nearing the end of life. These challenges include how and when to honor the right and its potential conflict with moral values such as self-determination, authenticity, and avoiding harm to oneself and others. The end of life exacerbates these issues because of the irretrievability of decisions and the successive reduction of possible courses of action, as well as potentially changing preferences. These potential conflicts of values deserve further attention and must be considered when deciding whether to honor a patient's wish not to know.</p>","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"713-723"},"PeriodicalIF":3.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13633942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822154","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}

{"title":"Prevention and Irony: The Challenge of Expanding Individual Behavioural Choices.","authors":"Urban Wiesing","doi":"10.1007/s11019-026-10350-6","DOIUrl":"10.1007/s11019-026-10350-6","url":null,"abstract":"","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"647-653"},"PeriodicalIF":3.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13634010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147730358","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}

{"title":"Clarifying the muddle: towards a comprehensive taxonomy of cognitive biases in medicine.","authors":"M Cristina Amoretti, Elisabetta Lalumera","doi":"10.1007/s11019-026-10349-z","DOIUrl":"10.1007/s11019-026-10349-z","url":null,"abstract":"<p><p>Cognitive biases are widely discussed in the medical literature as systematic deviations from rational judgment and as significant contributors to diagnostic error. However, the prevailing view of cognitive biases as inherently epistemically detrimental may be challenged by recent research highlighting their potential utility. In this paper, we argue that the impact of cognitive biases in medicine depends not only on their internal cognitive structure, but also on the ecological characteristics of the medical environments in which they operate. We develop a conceptual framework that distinguishes between three types of cognitive biases: (1) those that are epistemically reliable (and practically useful) in so-called \"safe cognitive environments\", where ecological informational structures reliably support the use of \"fast and frugal\" heuristics; (2) those that are practically useful in \"pragmatically permeable contexts\" such as emergency care or public health, where time pressure, uncertainty, or resource constraints justify decisions that are epistemically suboptimal but action-guiding; and (3) those that are neither epistemically nor pragmatically defensible, and thus constitute clear targets for mitigation. By offering this taxonomy, we aim to clarify when and why cognitive biases hinder or support medical reasoning and practical actions. Our analysis also emphasizes the need to reframe some traditional assumptions in medical epistemology and education. Rather than attempting to eliminate all cognitive biases, we advocate for a more nuanced, context-sensitive, and ecologically informed approach in medicine. We conclude by outlining the implications of this framework for improving diagnostic accuracy, professional training, and institutional practices in healthcare.</p>","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"635-646"},"PeriodicalIF":3.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13633963/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640094","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}

{"title":"Tool-mediated patienthood: structural plurality in oncology, surgery, and palliative care.","authors":"Karen Yan, Min-Jung Cheng, Yun-Ying Kuo, Yong Alison Wang","doi":"10.1007/s11019-026-10359-x","DOIUrl":"10.1007/s11019-026-10359-x","url":null,"abstract":"<p><p>Patient-centered care (PCC) is widely endorsed in contemporary medicine, yet philosophical analyses often approach it through concept-first approaches that define patienthood in advance-typically in terms of autonomy, holistic personhood, or rational agency-and then assess clinical practice by reference to these ideals. This paper argues that such an approach can obscure how patienthood is configured in practice. We develop a tool-first approach that treats cognitive, communicative, and material tools as analytically primary for understanding how patients are individuated in clinical reasoning. The argument is grounded in an ethnographic case study conducted in a specialized cancer hospital, focusing on outpatient clinics in medical oncology, colorectal surgery, and palliative care. Rather than treating ethnography as descriptive background, we use it to identify tools-in-use that structure what becomes salient, actionable, and patient-relevant in situated encounters. Across these settings, distinct configurations of tools generate systematically different modes of patienthood. In oncology, staging systems and expectation management configure patients as therapeutic trajectories oriented toward uncertain futures. In surgery, anatomical diagrams and probabilistic framings individuate patients as operative bodies embedded in structured decision spaces. In palliative care, symptom scales, narrative practices, and informational scaffolding configure patients as experiential subjects and epistemic agents. We analyze these differences as instances of structural plurality: patterned, tool-mediated modes of patient individuation that are internally coherent yet irreducible to a single model. On this account, ethical ideals commonly associated with PCC-such as autonomy, shared decision-making, and informed consent-can be understood less as prior normative standards applied to practice, and more as contingent achievements that depend on how tools structure salience, understanding, and possibilities for agency in clinical contexts.</p>","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"747-760"},"PeriodicalIF":3.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13633967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147870030","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}

{"title":"Critical bioethics: a new paradigm for the era of techno-feudalism.","authors":"Giovanni Rubeis","doi":"10.1007/s11019-026-10360-4","DOIUrl":"10.1007/s11019-026-10360-4","url":null,"abstract":"<p><p>The rise of right-wing political movements supported by key players from big tech is transforming Western societies. This so-called techno-feudalism also implies challenges for bioethics. Racist agendas, intentional misinformation on health topics such as vaccinations, banned words and research topics in public institutions, and the massive funding of questionable biomedical research projects undermine health equity, patient safety, and autonomy. This new sociopolitical situation exacerbates a long-standing issue in healthcare that bioethics hitherto mostly failed to address adequately: societal power asymmetries that shape the roles and relationships of actors in healthcare and biomedical research. Although attempts have been made to reflect upon this issue, e.g. in feminist or postcolonial bioethics, there is no coherent bioethical approach that fundamentally focuses on power asymmetries as a lens of bioethical inquiry. In this article, I therefore introduce critical bioethics, an approach that takes epistemic lenses from critical theory, especially the so-called Frankfurt School. These epistemic lenses-totality and embeddedness, instrumental reason, dialectics and emancipation-allow us to uncover the societal causes for ethical issues in healthcare and biomedical research. Based on this methodological foundation, critical bioethics addresses health inequity as a result of power asymmetries by understanding individuals as fundamentally embedded in a concrete socioeconomic context. Through the lens of instrumental reason, it addresses the connection between disruptive technological innovations and economic interests in terms of commodification and solutionism. By using dialectics as a method to uncover contradictions in the way bioethics understands its principles, it provides an emancipatory perspective for normativity that separates it from affirmative forms of bioethical thinking that simply reproduce the suppressive status quo.</p>","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"585-593"},"PeriodicalIF":3.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13633957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147869974","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}

{"title":"Should we be testing pregnant patients' urine for drugs? An applied ethics approach.","authors":"Erica Holland, Michael Ieong","doi":"10.1007/s11019-026-10358-y","DOIUrl":"10.1007/s11019-026-10358-y","url":null,"abstract":"<p><p>Urine toxicology testing among birthing people in the United States remains a clinical practice often informed more by personal values and conscious and unconscious biases, than by medical evidence and ethical obligations. As empirical evidence addressing harms and benefits of toxicology testing in pregnancy grows, and national organizations are taking a moral stance around clinical practice, no published structure explicitly positions the evolving data within an ethical framework. We draw on a model of applied ethics to inform a set of concrete recommendations about what clinicians ought to do with regards to the practice of urine toxicology testing of pregnant patients. These methods facilitate a relationship between empirical data regarding toxicology testing in pregnancy and ethical norms. Our findings serve as a practical guide for clinicians and policymakers seeking clinical guidance around urine toxicology testing in pregnancy as well as a model for future translation of theoretical approaches into clinical action.</p>","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"737-745"},"PeriodicalIF":3.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148176570","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}