Medicine Health Care and Philosophy最新文献

{"title":"Future-oriented chance prioritarianism: survival prospects as the distributive currency.","authors":"Tomasz Żuradzki","doi":"10.1007/s11019-026-10353-3","DOIUrl":"10.1007/s11019-026-10353-3","url":null,"abstract":"","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"673-682"},"PeriodicalIF":3.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147724373","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}

{"title":"An analysis of Heidegger's concept of angst and death in the Ménière's disease patient.","authors":"David M Kaylie","doi":"10.1007/s11019-026-10355-1","DOIUrl":"10.1007/s11019-026-10355-1","url":null,"abstract":"<p><p>The current state of medical practice is going through tremendous and rapid changes. There is an increasing prevalence of burnout among physicians, where they are questioning the value of practicing medicine. There is also a growing frustration among patients over reduced access to physicians, feeling rushed at appointments and generally feeling that they are not being heard. These conditions point to a sense among doctors and patients that the doctor-patient relationship is compromised without a viable pathway to repair this vital connection. In this paper, I want to show how applying philosophy, particularly, Martin Heidegger's discussion of angst and death can help to show a way for doctors to have a deeper ontological understanding of their patients' conditions, which can provide a bridge for doctors to re-establish a deep doctor-patient relationship. I will use vertigo as a paradigm condition of a disorder in which doctors have a poor understanding of their patients' condition. This leads to frustrating interactions with patients and breakdown of the doctor-patient relationship. Ménière's disease is a particular type of vertigo disorder which will serve as the foundation for this study which will examine the severe vertigo attacks and chronic disequilibrium these patients experience through the lens of Heidegger's highly technical phenomenological analysis of angst and death. Ménière's disease is an inner ear disorder that causes violent vertigo attacks and hearing loss followed by severe disequilibrium. During the attacks patients are incapacitated by the vertigo, and after the attack subsides, the disequilibrium makes life's normal pursuits meaningless. These patients understand the role of entities in their lives, but entities do not matter to them. Heidegger introduces the concept of for-the-sake-of-which to describe how entities in the world are interrelated with Dasein's purpose of disclosing a world. He provides a sense of for-the-sake-of-which where everyday entities are used to fulfill Dasein's activities which is an existentiell mode of for-the-sake-of-which. His famous example is the hammer in the workshop. He also gives a sense of for-the-sake-of-which where the totality of entities in the world are related to Dasein's ultimate goal of being a discloser of its world. This is Dasein's ultimate for-the-sake-of-which, which is an existential mode. In this paper I show that for-the-sakes-of-which can be thought of as having an existentiell and existential sense, and the existentiell for-the-sakes-of-which can be inauthentic or authentic. I will show how Heidegger's analysis of Dasein can be applied to concrete human existence, using the inner ear disorder, Ménière's Disease as an example. I am suggesting that the disequilibrium from Ménière's disease is a naturalized account of Heideggerian angst and is being-towards-death. I am also suggesting that the Ménière's attack is an experience of existential death because all possibil","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"697-711"},"PeriodicalIF":3.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844431","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}

{"title":"Must egalitarians oppose private healthcare?","authors":"Johann Go","doi":"10.1007/s11019-026-10365-z","DOIUrl":"10.1007/s11019-026-10365-z","url":null,"abstract":"<p><p>A central tenet of health equity is that access to healthcare should be responsive to need rather than patients' socioeconomic status. The idea that ability to pay can enable some people to access faster, better, or more healthcare strikes many egalitarians as clearly objectionable. This paper argues that this view is more complicated than may initially appear. While there are egalitarian reasons to oppose private healthcare, these are often less decisive than they may initially appear and prohibiting private healthcare on egalitarian grounds is likely to run afoul of egalitarianism's liberal commitments. There are several important theoretical hurdles to pass through for a successful egalitarian argument against private healthcare, which this paper aims to highlight.</p>","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"815-823"},"PeriodicalIF":3.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13633964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148017919","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":"Digital bioethics: exploring an emerging field.","authors":"Georg Starke, Wolf-Tilo Balke, Lasse Benzinger, Oliver Buchholz, Manuel Burghardt, Lukas J Meier, Emilian Mihailov, Eva Seidlmayer, Robert Ranisch, Frank Ursin, Effy Vayena, Sabine Salloch","doi":"10.1007/s11019-026-10347-1","DOIUrl":"10.1007/s11019-026-10347-1","url":null,"abstract":"<p><p>The uptake of social science methods by bioethics significantly expanded its methodological spectrum, raising new theoretical, methodological, and practical questions. Recently, we are witnessing another trend, adding advanced data science methods to bioethics' toolkit to aid, for example, in online data analysis, support scholarly writing, and inform clinical ethics. This article explores the emerging field of Digital Bioethics across its dimensions by analysing the tangled relationship between topics and methods, highlighting intersections between Digital Bioethics and Bioethics of the Digital, and advocating for a methods-based definition of the field. The use of advanced data science methods within bioethics must be interpreted in the context of the use of Artificial Intelligence (AI) in health care. At the same time, it presents unique opportunities and challenges. Defining, and thus demarcating, Digital Bioethics can create support for the new field but also requires navigating trade-offs. To do so, we take four kindred academic fields as points of comparison (Digital Humanities, Experimental Philosophical Bioethics, computational medicine and digitised biology) to analyse what each of them teaches for critically assessing and further developing Digital Bioethics. The article discusses potential pitfalls and concludes with recommendations on how the field can fully develop its potential to promote bioethical research and argument. Furthermore, the article discusses how a critical reflection of the use of AI methods within bioethics itself will also contribute to the ethical oversight of increasingly AI-driven branches of healthcare.</p>","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"619-633"},"PeriodicalIF":3.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13633968/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147699421","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":"Speaking to no one: ontological dissonance and the double bind of conversational AI.","authors":"Hugh Brosnahan, Izabela Lipińska","doi":"10.1007/s11019-026-10354-2","DOIUrl":"10.1007/s11019-026-10354-2","url":null,"abstract":"<p><p>Recent reports indicate that sustained interaction with conversational artificial intelligence (AI) systems can, in a small subset of users, contribute to the emergence or stabilisation of delusional experience. Existing accounts typically attribute such cases either to individual vulnerability or to failures of safety engineering. These explanations are incomplete. Drawing on phenomenology, psychiatry, and cognitive neuroscience, this paper argues that the risk arises from the relational and ontological structure of the interaction itself. Conversational AI generates ontological dissonance: a conflict between the appearance of relational presence and the absence of any subject capable of sustaining it. Maintained through a communicative double bind and amplified by attentional asymmetries, this dissonance tends, under conditions of affective vulnerability, to stabilise into a technologically mediated analogue of folie à deux. This account explains why explicit disclaimers often fail to disrupt delusional involvement and clarifies the ethical and clinical implications for the design and use of conversational AI.</p>","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"683-695"},"PeriodicalIF":3.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13633959/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822113","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":"Prioritising time for communication in healthcare-a normative analysis.","authors":"Joar Björk","doi":"10.1007/s11019-026-10364-0","DOIUrl":"10.1007/s11019-026-10364-0","url":null,"abstract":"<p><p>Modern healthcare faces a mismatch in terms of supply and demand which makes careful priority setting imperative. The debate on priority setting in healthcare has focussed on pharmaceuticals and other tangible medical interventions. This article instead looks at the time that healthcare professionals have at their disposal. How should healthcare professionals divide their time between tangible medical interventions and communication with patients? What communicative goals should be prioritised? This normative analysis focusses on situations which involve time consuming communication between professionals and patients, which cannot easily be carried out alongside other medical interventions or is itself the main intervention as in psychotherapy. The arguments brought forth are applicable across the healthcare panorama and apply to all healthcare professions. It is argued that there are many different communicative goals which cannot be reduced to one type. Some recommendations are given and defended regarding the priority setting of different communicative goals. For reasons of value coherence and formal equality, all patients should be given a baseline amount of time for communication and time beyond that should be prioritised based on healthcare needs. If accepted, the arguments here highlight that a substantive part of healthcare's (time) resources should be spent on communicative tasks. Indeed, it is time that we take time for communication seriously.</p>","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"805-813"},"PeriodicalIF":3.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13633962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148018161","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":"Algorithmic gaze and subject occlusion: a medical ethical critique of artificial intelligence diagnosis and treatment from a foucaultian perspective.","authors":"Yuxin Dai, Sizhe Guo","doi":"10.1007/s11019-025-10318-y","DOIUrl":"10.1007/s11019-025-10318-y","url":null,"abstract":"<p><p>This paper develops a Foucauldian analysis of artificial intelligence (AI) in medical diagnosis, arguing that AI introduces an \"algorithmic gaze\" that reshapes the epistemic and moral structure of clinical practice. By converting illness narratives into data while generating forms of simulated empathy, AI systems reorder how patients become visible, intelligible, and governable within medical discourse. These developments produce three structural tensions: first, algorithmic opacity alters the conditions under which informed consent, contestation, and responsibility can meaningfully operate; second, simulated empathy appears to acknowledge suffering while subtly directing patients' expressive possibilities; and third, the delegation of emotional engagement to AI fragments the unity of care traditionally embodied in the clinician-patient relationship.Rather than treating these shifts as technologically inevitable, the paper argues that their ethical significance depends on institutional design. Four directions for reconstruction are proposed: securing identifiable responsibility and human-overridable decision pathways; integrating algorithmic outputs into dialogical clinical communication; adopting participatory data governance and strengthening algorithmic literacy; and grounding AI development in a renewed conception of medical humanism that guides design from the outset. The analysis concludes that AI can support, rather than erode, the moral foundations of medicine only if embedded within institutional arrangements that sustain autonomy, dignity, and relational understanding.</p>","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"523-534"},"PeriodicalIF":3.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145758068","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}

{"title":"Towards a medical ethics of suffering: ontological and practical foundations.","authors":"Eduardo García-Rico, Aurea Esparza de la Sota, Ana Olano Daza, Francisco Lopez Muñoz, Lorena Garcia","doi":"10.1007/s11019-026-10338-2","DOIUrl":"10.1007/s11019-026-10338-2","url":null,"abstract":"<p><p>This paper proposes a radical reconfiguration of medical ethics by placing suffering-not as a clinical symptom or ancillary datum, but as an ontological category-at the center of ethical deliberation. In the face of a fragmented and technified clinical practice, we argue that suffering is the only truly universal human experience, irreducible to cultural, linguistic, or ideological variations. As such, it offers a potent, immanent foundation for a non-relative ethics in medicine. Drawing on the philosophical contributions of Heidegger, Levinas, Jonas, Jaspers, Butler, and Schopenhauer, we develop a model of medical ethics rooted in the shared and asymmetrical vulnerability that suffering reveals. Rather than abstract principles or procedural deontology, this model emphasizes narrative, responsibility, and hospitality as structural dimensions of the clinical act. We contend that medicine must move from being a problem-solving technique to becoming a space of presence, attention, and recognition-where suffering is not erased but welcomed. The clinical encounter is thus reimagined as a site of ontological unveiling, where the physician's role is not merely to diagnose or intervene, but to bear witness, to accompany, and to share in the exposure of the other. This ethics of suffering entails epistemological shifts (through narrative and phenomenology), spatial transformations (via architecture of care), and institutional reforms (integrating patients' voices and lived experience). Ultimately, we propose suffering not as a failure of health, but as the ethical ground from which a truly human medicine must begin.</p>","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"383-399"},"PeriodicalIF":3.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147482054","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}

{"title":"It's you it's about! Exploring existential aspects on quality of life with myasthenia gravis.","authors":"Malene Missel, Nanna Witting","doi":"10.1007/s11019-025-10320-4","DOIUrl":"10.1007/s11019-025-10320-4","url":null,"abstract":"<p><p>This article is grounded in a phenomenological and autoethnographic approach, with the neurologist's remark, It's you it's about!, serving as an existential starting point. The aim of this text is to explore quality of life as an existential challenge and opportunity when living with the chronic illness myasthenia gravis, drawing on lived experience and existential philosophy. Through three existential anecdotes based on the first author's experiences with myasthenia gravis, the tension between the body's limitations and the patient's desire to continue living meaningfully, as well as the role of the clinician in supporting the patient's process, is illuminated. Each anecdote is followed by a philosophical reflection - from glimpse to resonance - which deepens the exploration of the complex dimensions of quality of life. The article examines key themes such as; Running, existential positioning, and holding on to quality of life; The stoic trust that sustains a patient's quality of life; and The restoration of clarity and direction for quality of life - one that is not measured, but felt, held, and sustained in relation. By exploring these dimensions, the article proposes a shift from traditional, measurable outcomes to a broader understanding of quality of life that transcends physical symptoms.</p>","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"309-321"},"PeriodicalIF":3.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13086737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145835035","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":"How choice became a goal in itself: analysing the emphasis on choice and control at the end of life through the work of Charles Taylor.","authors":"Els van Wijngaarden","doi":"10.1007/s11019-025-10321-3","DOIUrl":"10.1007/s11019-025-10321-3","url":null,"abstract":"<p><p>Choice has become a defining lens through which modern people imagine dying. A 'good death' is increasingly associated with the ability to articulate and realise personal preferences regarding the dying process: how, where, with whom, and even when one dies. In this paper, I examine the cultural shift that has elevated choice to a central moral ideal at the end of life. My research questions are: Why does choice matter so profoundly in contemporary societies? And how does this aspiration shape the way people live towards the end of life, and ultimately die? To answer these questions, I first offer a historical-cultural account of how choice has gradually come to function as a goal in itself. Drawing primarily on Charles Taylor's analyses, I bring his work into dialogue with that of other scholars including Giddens, Rosa, Dodds, and Mol. I then identify three existential implications of this shift that complicate contemporary engagement with death and dying: (1) an increasingly mastery-oriented stance towards life and death, (2) the arbitrariness of meaning, and (3) an understanding of respect as unquestioning compliance with individual preferences. Finally, I propose several ways to respond to these challenges by moving beyond a narrow focus on choice and control. I argue for a rethinking of the current dominant end-of-life discourse through a more dialogical and ambivalent understanding of our relation to life and death; one that is more attuned to the lived experience and unsettling realities of dying, and better suited to enriching contemporary debates and practices surrounding the end of life.</p>","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"439-450"},"PeriodicalIF":3.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13086746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145949410","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}