Medicine Health Care and Philosophy最新文献_第8页

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. 选择本身是如何成为一个目标的：通过查尔斯·泰勒的作品分析对生命末期选择和控制的强调。

IF 3.6 2区哲学

Medicine Health Care and Philosophy Pub Date : 2026-06-01 Epub Date: 2026-01-10 DOI: 10.1007/s11019-025-10321-3

Els van Wijngaarden

{"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":"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.","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}

引用次数: 0

Aesthetic injustice in healthcare: exploring testimonial and hermeneutical forms. 医疗保健中的美学不公正：探索证明和解释学形式。

IF 3.6 2区哲学

Medicine Health Care and Philosophy Pub Date : 2026-06-01 Epub Date: 2026-03-03 DOI: 10.1007/s11019-026-10334-6

Jonathan Adams

{"title":"Aesthetic injustice in healthcare: exploring testimonial and hermeneutical forms.","authors":"Jonathan Adams","doi":"10.1007/s11019-026-10334-6","DOIUrl":"10.1007/s11019-026-10334-6","url":null,"abstract":"This paper introduces and develops the concepts of aesthetic testimonial injustice and aesthetic hermeneutical injustice, arguing that understanding the aesthetic dimensions of human experience, specifically those concerning physical appearance, is central to justice in healthcare practice. Drawing on Miranda Fricker's framework of epistemic injustice, the paper provides a bridge between emerging literature on aesthetic injustice, which is often focused on lookism and appearance-based discrimination, and accounts that emphasize the recognition of individuals as aesthetic subjects. The concept of aesthetic testimonial injustice relates to the unjust discrediting of a person's aesthetic testimony regarding their own body, often due to biases related to attractiveness, age or disability. Aesthetic hermeneutical injustice, by contrast, pertains to the structural disadvantage faced by individuals who lack the interpretive resources to make sense of or communicate their aesthetic experience as it pertains to bodily appearance, particularly in healthcare contexts. Using examples from prosthetics design, nursing care and disorders of visual perception, the paper shows how healthcare systems can marginalize patients' aesthetic values and perceptions, thereby undermining their dignity and agency. It concludes by calling for a deeper understanding of aesthetics in bioethics, suggesting that respecting patients as embodied aesthetic agents can enhance ethical healthcare delivery and counter systemic injustice. The concepts of aesthetic testimonial injustice and aesthetic hermeneutical injustice thus expand bioethical discourse by highlighting the moral significance of aesthetic experience in healthcare contexts.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"283-291"},"PeriodicalIF":3.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13086673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147345465","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

Physicians' ethical responsibilities in relation to the climate and further environmental crises: a review of academic publications. 与气候和进一步的环境危机有关的医生的道德责任：学术出版物的回顾。

IF 3.6 2区哲学

Medicine Health Care and Philosophy Pub Date : 2026-06-01 Epub Date: 2026-03-09 DOI: 10.1007/s11019-026-10339-1

Cristian Timmermann, Katharina J Pascale Wabnitz, Kerstin Schlögl-Flierl, Verina Wild

{"title":"Physicians' ethical responsibilities in relation to the climate and further environmental crises: a review of academic publications.","authors":"Cristian Timmermann, Katharina J Pascale Wabnitz, Kerstin Schlögl-Flierl, Verina Wild","doi":"10.1007/s11019-026-10339-1","DOIUrl":"10.1007/s11019-026-10339-1","url":null,"abstract":"The climate and further environmental crises have motivated calls for the medical profession to act by taking on additional responsibilities. These calls to assume responsibilities towards environmental protection and to systematically consider the health impacts of these crises greatly vary in their scope and demandingness. Through a review of journal publications, we have mapped the various calls for physicians to take on responsibilities in relation to these crises as individuals and as a professional group. These professional responsibilities, obligations or duties were grouped in four broad categories of physicians' roles as (i) medical practitioners, (ii) medical scientists, (iii) facility (co-)managers, and (iv) citizens. In sum, these responsibilities go beyond actions within the individual patient-physician relationship and setting, demanding from physicians to get involved within their institution, their community, engage with policy-makers, and also concern themselves with the health effects of environmental changes also on distant others, such as people in other parts of the world and future generations.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"559-576"},"PeriodicalIF":3.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13086663/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147379035","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 ethical permissibility of financial incentives. 经济激励的道德容许性。

IF 3.6 2区哲学

Medicine Health Care and Philosophy Pub Date : 2026-06-01 Epub Date: 2026-01-02 DOI: 10.1007/s11019-025-10315-1

Pepijn Al, Jamie Brehaut, Katie Gillies, Justin Presseau, Mei-Lin Yee, Charles Weijer

{"title":"The ethical permissibility of financial incentives.","authors":"Pepijn Al, Jamie Brehaut, Katie Gillies, Justin Presseau, Mei-Lin Yee, Charles Weijer","doi":"10.1007/s11019-025-10315-1","DOIUrl":"10.1007/s11019-025-10315-1","url":null,"abstract":"Randomized controlled trials are central to progress in medicine, but trialists commonly struggle to recruit the required number of participants. Offering financial incentives is one proposed solution, but financial incentives may be problematic when they become irresistible and, thus, undermine the autonomy of potential participants. While some have dismissed this worry about undue inducement and argued that we should be paying participants more to avoid exploitation, we argue that this line of argument is based on a too narrow conception of undue inducement and does not fully appreciate the distinction between reimbursement, compensation, and financial incentives. On another, often overlooked concept of undue inducement, large incentives are an undue inducement when they are irresistible for people who do not want to participate and, thus, undermine voluntariness. This gives reason to limit the financial incentives to trial participants. We argue, furthermore, that large financial incentives could also be disproportionally attractive for people from economically marginalized groups and result in an unjust distribution of the burdens of research participation. We conclude that, while small sums of money are permissible as incentives, larger financial incentives should be avoided. We end by responding to the objection that keeping payments to participants small would be a form of exploitation. We argue that this argument does not apply to financial incentives. Unlike reimbursements and compensation, financial incentives are not payments to which participants can have a claim and, therefore, fall outside the scope of exploitation arguments.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"535-547"},"PeriodicalIF":3.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13086693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145893347","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

Bringing theoretical conceptions in psychiatry to epistemic justice. 将精神病学的理论概念引入认识正义。

IF 3.6 2区哲学

Medicine Health Care and Philosophy Pub Date : 2026-06-01 Epub Date: 2026-03-06 DOI: 10.1007/s11019-026-10335-5

Mia Biturajac

{"title":"Bringing theoretical conceptions in psychiatry to epistemic justice.","authors":"Mia Biturajac","doi":"10.1007/s11019-026-10335-5","DOIUrl":"10.1007/s11019-026-10335-5","url":null,"abstract":"Pathocentric epistemic injustice is a form of epistemic injustice that affects ill persons. In this paper I deal with pathocentric epistemic injustice in psychiatry that impacts persons with psychiatric conditions. There are several sources of such epistemic injustice, ranging from the agential level to the structural, institutional and even to the theoretical level of healthcare and medicine. In this paper I explore theoretical conceptions as sources of pathocentric epistemic injustice in psychiatry. Specifically, I focus on the notion that the naturalistic conception of health is an epistemically unjust theoretical conception when it exclusively privileges the epistemic resources of biomedical sciences. Supposing this claim is correct, this paper tries to offer a way of ameliorating the pathocentric epistemic injustice caused by the naturalistic conception of health. I argue that the first step of the ameliorative project lies in emphasis and acknowledgement of the concepts that embody the patient perspective, such as harm, well-being and suffering. While these concepts are found in the theoretical sphere of psychiatry, they are underdeveloped and lack proper attention. Furthermore, while elaborating on these concepts is necessary, it is not sufficient for epistemic justice in psychiatry. Thus, I introduce the idea of epistemic pillars of psychiatry - scientific research, clinical work and patient's perspective. Epistemic justice in psychiatry does not rely on any one these elements, rather it rests on the collaboration, compromise and mutual recognition of these spheres. It lies in harmony of the three pillars of psychiatry, rather than in either element being the dominant one.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"491-503"},"PeriodicalIF":3.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147366641","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

Palliative sedation as a cultural solution in Israel: a philosophical-ethical inquiry into end-of-life practice in a multicultural society. 作为以色列文化解决方案的姑息性镇静：多元文化社会中临终实践的哲学伦理探究。

IF 3.6 2区哲学

Medicine Health Care and Philosophy Pub Date : 2026-06-01 Epub Date: 2026-01-19 DOI: 10.1007/s11019-026-10323-9

Rotem Waitzman

{"title":"Palliative sedation as a cultural solution in Israel: a philosophical-ethical inquiry into end-of-life practice in a multicultural society.","authors":"Rotem Waitzman","doi":"10.1007/s11019-026-10323-9","DOIUrl":"10.1007/s11019-026-10323-9","url":null,"abstract":"Palliative sedation (PS) is a morally complex end-of-life practice that sits at the intersection of medicine, law, religion, and culture. While often framed as a purely clinical intervention aimed at alleviating intractable suffering, this article argues that PS functions—particularly in pluralistic societies such as Israel—as a form of ethical mediation and cultural accommodation. Through a philosophical-theoretical inquiry, this paper explores PS not as a universally justified act, but as a “cultural solution”: a pragmatic ethical practice that enables care to proceed amid deep moral disagreement. Drawing on ethical theories—including utilitarianism, deontology, virtue ethics, and care ethics—as well as on the concept of relational autonomy, the article demonstrates the limitations of universalist frameworks in contexts where bioethical norms are fragmented. In Israel, where Orthodox Jewish, Muslim, Christian, and secular liberal worldviews coexist, PS is often deployed without explicit naming or ethical consensus. It emerges in the legal and clinical “grey zones” created by the Patient’s Rights Law (1996) and the Dying Patient Act (2005), and is shaped by religious taboos, institutional ambiguity, and family-centered negotiation. Rather than treating this ambiguity as a flaw, the article reframes it as a moral achievement—a space in which physicians act as ethical mediators, and sedation operates as a bridge across conflicting values. By presenting PS as a culturally constructed and philosophically meaningful practice, the article calls for a non-universalist, context-sensitive ethics of end-of-life care, and contributes to the development of an intercultural philosophy of medicine grounded in moral pluralism, practical wisdom, and compassionate realism. The analysis is contextualized within Israel’s updated legal and medical directives on palliative sedation, including the 2015 Ministry of Health circular.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"401-409"},"PeriodicalIF":3.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145999374","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

White by default: conceptual and methodological limits of binary white logic in global health equity research. 默认为白色：全球卫生公平研究中二元白色逻辑的概念和方法限制。

IF 3.6 2区哲学

Medicine Health Care and Philosophy Pub Date : 2026-06-01 Epub Date: 2026-02-20 DOI: 10.1007/s11019-026-10330-w

Joanna Karolina Malinowska

{"title":"White by default: conceptual and methodological limits of binary white logic in global health equity research.","authors":"Joanna Karolina Malinowska","doi":"10.1007/s11019-026-10330-w","DOIUrl":"10.1007/s11019-026-10330-w","url":null,"abstract":"This article examines the conceptual and methodological limitations of how the category “White” is interpreted and used in health equity research. I argue that such studies often rely on a binary White logic – a framework that organises ethnoracial comparisons around a dichotomy between people racialised as White and Non-White Others. Within this logic, the White category is treated as a homogeneous reference group that reliably signals uniform protection from racism and access to White privilege. This assumption operates both statistically and epistemically, with profound implications for how health disparities are measured and understood. Although this framework reflects broad ethnoracial dynamics rooted in White supremacism, it has serious shortcomings. One relevant but underexplored consequence is that it tends to biologise and essentialise Whiteness. It also obscures complex, context-specific processes of racialisation and marginalises groups that do not fit prevailing classificatory practices. I demonstrate that the uncritical use of the White category – as a default homogenous comparator category – in global health equity research reproduces epistemic injustice and misrepresents complex dynamics of racialisation, thereby concealing medically relevant experiences of representatives of such groups. I focus on people racialised as Eastern Europeans, whose ambiguous positioning within global ethnoracial hierarchies – often termed Off-White – renders them largely invisible in scholarship, despite evidence of racism affecting their health. To produce more accurate and socially responsible science, I call for a shift away from binary White logic towards more thoughtful, precise, and contextually appropriate uses of ethnoracial categories – and other proxies for racism – in research on racism and health.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"261-281"},"PeriodicalIF":3.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13086720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146259685","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

Rethinking crossover and recovery in eating disorders through a dynamic and value-sensitive framework. 通过动态和价值敏感的框架重新思考饮食失调的交叉和恢复。

IF 3.6 2区哲学

Medicine Health Care and Philosophy Pub Date : 2026-06-01 Epub Date: 2026-02-18 DOI: 10.1007/s11019-026-10328-4

Davide Serpico, Valentina Petrolini, Silvia Camporesi

{"title":"Rethinking crossover and recovery in eating disorders through a dynamic and value-sensitive framework.","authors":"Davide Serpico, Valentina Petrolini, Silvia Camporesi","doi":"10.1007/s11019-026-10328-4","DOIUrl":"10.1007/s11019-026-10328-4","url":null,"abstract":"Eating Disorders (EDs) raise significant challenges from a diagnostic and nosological perspective. Much of this is due to the extensive overlap among diagnostic criteria, with symptoms being shared by several conditions and subtypes. This nosological uncertainty is further exacerbated by two additional features of EDs, which will be the focus of this paper, namely diagnostic crossover and recovery. First, patients who acquire or lose one or more symptoms over time (symptom shifting) often transition to a new diagnostic category (crossover). Second, researchers working on EDs have recently underscored a problematic lack of inclusion of patients’ perspective on diagnostic and recovery processes, which results in an incomplete understanding of key aspects of EDs. Drawing on theoretical frameworks and concepts from Dynamical Systems Theory and epigenetics, we present a dynamic characterization of EDs that allows us to tackle the challenges of crossover and recovery. In our framework, different conditions represent robust endpoints in individuals’ developmental trajectories that are nonetheless flexible in certain circumstances. Thinking about EDs in diachronic terms also prompts us to significantly reframe our notion of recovery, not so much as the return to health but as the generation of future healthy trajectories, to be pursued in compliance with patients’ self-perception and aims. Indeed, the key role of patients’ values in determining their future trajectories testifies how psychiatric categories are not merely descriptive but constitutive, influencing both self-understanding and clinical practice.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"337-351"},"PeriodicalIF":3.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13086881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146220989","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

Epistemic disadvantage and looping breaks: a reply to Gauld et al. 认知劣势和循环中断：对gold等人的回应。

IF 3.6 2区哲学

Medicine Health Care and Philosophy Pub Date : 2026-06-01 Epub Date: 2026-03-06 DOI: 10.1007/s11019-026-10341-7

Rena Alcalay

引用次数: 0

Is bioethics a discipline? Beyond methodological reductionism. 生命伦理学是一门学科吗？超越了方法论的还原论。

IF 3.6 2区哲学

Medicine Health Care and Philosophy Pub Date : 2026-06-01 Epub Date: 2026-02-21 DOI: 10.1007/s11019-026-10329-3

Carlos Gomez-Virseda, Lara Andreoli, Roshni Jegan

{"title":"Is bioethics a discipline? Beyond methodological reductionism.","authors":"Carlos Gomez-Virseda, Lara Andreoli, Roshni Jegan","doi":"10.1007/s11019-026-10329-3","DOIUrl":"10.1007/s11019-026-10329-3","url":null,"abstract":"Is bioethics a discipline? This question has accompanied the field since its emergence, revealing persistent tensions about what defines a discipline and what bioethics is expected to achieve. This article revisits the debate through the lens of conceptual analysis. While engaging critically with Bjørn Hofmann's argument-representative of a narrow, method-focused view of disciplinarity-we propose a broader and more dynamic account. In the pars destruens, we show that Hofmann's criteria rely on an overly restrictive conception of disciplines, one that is inconsistent with current practices. In the pars construens, we adopt Krishnan's comprehensive framework to demonstrate how bioethics meets six core elements of disciplinarity: a particular object of research, a body of specialized knowledge, structuring theories and concepts, shared terminology and technical language, specific research methods, and institutional manifestations. We argue that bioethics' pluralism and normative orientation are not signs of epistemic immaturity, but appropriate responses to the complexity of its subject matter. Rather than undermining its status, these features affirm bioethics as a discipline in its own right-one that bridges philosophical reflection and practical engagement in contemporary medicine and healthcare.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":"549-558"},"PeriodicalIF":3.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146259710","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