Medicine Health Care and Philosophy最新文献_第6页

Moral distress: sometimes, there is no fix. 道德困境：有时，没有解决办法。

IF 3.6 2区哲学

Medicine Health Care and Philosophy Pub Date : 2026-09-01 Epub Date: 2026-03-19 DOI: 10.1007/s11019-026-10343-5

Cullin Brown, Jan Helge Solbakk

引用次数: 0

Recognizing epistemic injustice in healthcare: a case for methodological pluralism. 在医疗保健认识不公正：一个案例的方法多元化。

IF 3.6 2区哲学

Medicine Health Care and Philosophy Pub Date : 2026-09-01 Epub Date: 2026-03-07 DOI: 10.1007/s11019-026-10342-6

Sabine Færge, Lea Muldtofte, Marte Ustrup, Anne Kathrine Kousgaard Mikkelsen, Helene Speyer

{"title":"Recognizing epistemic injustice in healthcare: a case for methodological pluralism.","authors":"Sabine Færge, Lea Muldtofte, Marte Ustrup, Anne Kathrine Kousgaard Mikkelsen, Helene Speyer","doi":"10.1007/s11019-026-10342-6","DOIUrl":"10.1007/s11019-026-10342-6","url":null,"abstract":"Nielsen et al. (2025) recently presented a critique of the current scholarship on epistemic injustice in healthcare, emphasizing the absence of robust empirical evidence, the conceptual difficulty of establishing criteria for identification, and the risk of theoretical misapplication of Miranda Fricker's original framework. While the call for nuance and careful theoretical articulation might be worthwhile, the framing of their critique risks reinforcing precisely the patterns of epistemic exclusion that the concept of epistemic injustice is meant to expose. The implication that epistemic injustice must be operationalized and empirically validated in large-scale quantitative studies before it can be acknowledged as clinically and ethically significant may inadvertently replicate a longstanding hierarchy of knowledge in which certain forms of suffering become \"real\" only once translated into quantifiable data. In this response, we aim to advance the scholarly debate by questioning the argumentative basis of Nielsen et al.'s claim that fundamental scientific, conceptual, and theoretical flaws undermine the field of epistemic injustice in healthcare. We propose instead approaching epistemic injustice with social objectivity and methodological pluralism; the concept should not be dismissed for lacking quantification or standardization, but rather recognized for its complexity and significance in improving equity, care, and clinical encounters.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"867-872"},"PeriodicalIF":3.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147370449","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

Responsibility and disrespect: reply to Tsiakiri. 责任和不尊重：回复Tsiakiri。

IF 3.6 2区哲学

Medicine Health Care and Philosophy Pub Date : 2026-09-01 Epub Date: 2026-03-18 DOI: 10.1007/s11019-026-10344-4

Adam Ehlert, Joar Björk

引用次数: 0

A review of contemporary autonomy: ethics, authority, and the fragility of the late modern subject. 当代自主性检讨：伦理、权威和晚期现代主体的脆弱性。

IF 3.6 2区哲学

Medicine Health Care and Philosophy Pub Date : 2026-09-01 Epub Date: 2026-04-20 DOI: 10.1007/s11019-026-10351-5

Luis Madeira, Cíntia Águas

{"title":"A review of contemporary autonomy: ethics, authority, and the fragility of the late modern subject.","authors":"Luis Madeira, Cíntia Águas","doi":"10.1007/s11019-026-10351-5","DOIUrl":"10.1007/s11019-026-10351-5","url":null,"abstract":"This conceptual review examines how autonomy became the dominant moral grammar of late modern Western societies and how its expansion reshapes subjectivity, institutions, public life, and healthcare practice. A genealogy traces autonomy from Enlightenment duty bound self legislation and civic self rule, through liberal non interference, to later forms shaped by expressive individualism, therapeutic culture, and recognition based claims. The paper argues that autonomy's normative achievements remain decisive, yet its cultural absolutization can generate a fragile subject who is highly expressive but insufficiently equipped for sustained responsibility. Five linked pathologies are analysed: autonomy as entitlement and boundary protection, transgression emptied by indeterminate norms, opinion transformed into performative positioning under hyperpluralism and platform surveillance, symbolic authority eroded across education and the professions, and duties devalued within a rights centred moral economy. In response, the paper proposes a reconstructive framework that redefines autonomy as ethical maturity, a formed capability sustained by responsibility, legitimate authority, deliberative practices of opinion, and duty. Particular attention is given to philosophy of medicine, where patient autonomy and professional autonomy illuminate the difference between supported agency and consumerist choice. Methodologically, the article combines genealogical reconstruction, phenomenological interpretation, and a purposive interdisciplinary synthesis of sociology, developmental psychology, philosophy of medicine, moral psychology, and media studies. Implications are sketched for education, healthcare, professional trust, and platform governance, with emphasis on proportional accountability and repair.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"655-671"},"PeriodicalIF":3.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13633975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147730281","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

Bioethics as bios ethikos. 生命伦理学就是生命伦理学。

IF 3.6 2区哲学

Medicine Health Care and Philosophy Pub Date : 2026-09-01 Epub Date: 2026-05-30 DOI: 10.1007/s11019-026-10367-x

Luis de Miranda

{"title":"Bioethics as bios ethikos.","authors":"Luis de Miranda","doi":"10.1007/s11019-026-10367-x","DOIUrl":"10.1007/s11019-026-10367-x","url":null,"abstract":"Drawing on a genealogical analysis of the distinction between zoē (biological life as organic functioning) and bios (a distinctively human way of life shaped by meaning, orientation, and evaluative practice), the article reconceives bioethics as bios ethikos: ethical reflection on the conditions under which forms of life become meaningful and inhabitable. It introduces the notion of the existential remainder to describe the ethically significant dimensions that persist when institutional deliberation leaves aspects of lived existence under-articulated. The article proposes a renewed structural orientation grounded in the heuristic formula T = PEWS + C. Ethical thinking (T) is distributed across four interrelated domains of lived existence: Person, Earth, Work, and Society (PEWS), while the addition of C designates the creative openness that resists full institutional codification. PEWS-oriented evaluation may be operationalised through more integrative assessment tools, while maintaining vigilance toward the irreducible horizon of existential creativity. Bioethics, thus reconceived, becomes not only the regulation of life, but reflection on whether the governance of life sustains the conditions under which life can remain meaningfully lived.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"835-846"},"PeriodicalIF":3.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13634004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148102103","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

Is there a judgment here? Why medicine cannot endure decision-making without a judging subject in the age of AI. 这里有判决吗？为什么在人工智能时代，没有判断主体的医学无法忍受决策。

IF 3.6 2区哲学

Medicine Health Care and Philosophy Pub Date : 2026-09-01 Epub Date: 2026-04-01 DOI: 10.1007/s11019-026-10346-2

Minoru Matsui

{"title":"Is there a judgment here? Why medicine cannot endure decision-making without a judging subject in the age of AI.","authors":"Minoru Matsui","doi":"10.1007/s11019-026-10346-2","DOIUrl":"10.1007/s11019-026-10346-2","url":null,"abstract":"Artificial intelligence is increasingly integrated into medical decision-making, often framed as a supportive tool that enhances accuracy while leaving final judgment to clinicians. This paper argues that such framing obscures a deeper structural shift: medical action may proceed without any judgment ever occurring. AI systems do not judge; they generate outputs through statistical transduction. Clinicians, under institutional and legal pressures, may relay these outputs without regenerating them as their own reasons. When neither AI nor clinician generates judgment, decisions are enacted without a judging subject. While judgment without a judging subject may be sustainable elsewhere, medicine renders this absence unsustainable. Medical practice is characterized by irreversibility, case-specificity, meaning-demand, and relational accountability-features that presuppose judgment as a human act. Even clinically correct outcomes do not guarantee that patients will recognize a decision as right for them. When judgment disappears, informed consent persists only as a procedural ritual, simulating understanding without grounding it. To make this absence explicit, the paper introduces Metaqualia Theory (MTQ), distinguishing patient experience (Q), technical transduction (T), and judgment as meaning-generating endorsement (M). This leads to a prior ethical question: Is there an M here? This question precedes concerns about explainability and helps clarify the conditions under which consent and responsibility remain meaningful. The analysis suggests that when AI outputs are not regenerated as human judgment, their role in medical practice raises structural limits that cannot be addressed by transparency alone.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"611-618"},"PeriodicalIF":3.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147595121","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

Taking the Right to Die Seriously. 认真对待死亡的权利。

IF 3.6 2区哲学

Medicine Health Care and Philosophy Pub Date : 2026-09-01 Epub Date: 2026-06-01 DOI: 10.1007/s11019-026-10366-y

Konrad Szocik, Matti Häyry, Pawel Januszewicz

{"title":"Taking the Right to Die Seriously.","authors":"Konrad Szocik, Matti Häyry, Pawel Januszewicz","doi":"10.1007/s11019-026-10366-y","DOIUrl":"10.1007/s11019-026-10366-y","url":null,"abstract":"This article offers a Hohfeldian analysis of the right to die and asks what follows, normatively and institutionally, once the relevant incidents are distinguished. It argues that debates about assisted dying frequently conflate four questions: whether choosing death is morally permitted (licence), whether others must not interfere with that choice (negative claim-right), whether a valid request can alter others' normative situation (normative power), and whether anyone owes assistance (positive claim-right). The paper maps major objections to the incident they primarily target and shows that many familiar objections to assisted dying bear most directly on duties of assistance rather than on the underlying permission or the claim against interference. Substantively, it defends a universal moral licence to die and, where competence, voluntariness, and adequate information are satisfied, a corresponding negative claim-right against unjustified interference. Its institutional conclusion is more limited than a direct duty on any particular physician to provide assisted death: what can be justified more securely is a right to make a request that must be assessed under public criteria and, in jurisdictions authorising assisted dying, routed to willing and licensed providers. Separating public validity review from plural provision models, the paper argues, can reduce coercion and conscience-based conflict while preserving access.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"825-834"},"PeriodicalIF":3.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13634011/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148139384","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

Advance directives in psychiatry to foster self-determination: a proposal for the Italian scenario. 精神病学预先指示促进自我决定：意大利方案的建议。

IF 3.6 2区哲学

Medicine Health Care and Philosophy Pub Date : 2026-09-01 Epub Date: 2026-05-26 DOI: 10.1007/s11019-026-10363-1

Giulia Ienco, Corinna Porteri

引用次数: 0

Subdividing bioethics. 细分生物伦理学。

IF 3.6 2区哲学

Medicine Health Care and Philosophy Pub Date : 2026-09-01 DOI: 10.1007/s11019-026-10384-w

Bert Gordijn, Henk Ten Have

引用次数: 0

On planetary health: medicine, ecology, and ethics. 关于地球健康：医学、生态学和伦理学。

IF 3.6 2区哲学

Medicine Health Care and Philosophy Pub Date : 2026-09-01 Epub Date: 2026-09-19 DOI: 10.1007/s11019-026-10361-3

Lydie Fialová

{"title":"On planetary health: medicine, ecology, and ethics.","authors":"Lydie Fialová","doi":"10.1007/s11019-026-10361-3","DOIUrl":"10.1007/s11019-026-10361-3","url":null,"abstract":"The notion of planetary health considers human life and health in the context of biospheric processes. Humans are interconnected with all life on Earth through the evolution from a common ancestor and have developed within omnipresent symbioses with other organisms, and in interactions and nutrients exchanges within the biosphere. Situating human life within the ecological processes and interconnectedness of life on the planet necessitates an expanded perspective on health, and I explore four interpretative contexts: biomedical, biopsychosocial, environmental and ecological. Planetary health is nevertheless also an attempt to conceptualize recent technological interferences with planetary homeostatic processes, resulting in changes of hydrological and atmospheric processes. The expansion of industrial civilization has transformed land and ocean ecosystems, introducing new forms of toxicity and pollution, and destroyed habitats of other forms of life, resulting in diminishing abundance and diversity of life. This predicament has an indisputable ethical dimension, which I explore in my contribution. By grounding human condition as that of biological beings - who share vulnerability, finitude, and interdependence with other forms of life - as primary and central to ethical considerations, I focus on the notions of harm, responsibility, and justice, which reveal also the political dimension of human life. Bringing into dialogue the perspectives of environmental and indigenous ethics, I consider the meaning of ethical concepts such as dignity, personhood, and rights in the ecological context of life, and their implications for medicine. Based on ethical obligation to prevent harm, I argue for a legal transformation to defend the interests of life.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"761-782"},"PeriodicalIF":3.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009225","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