Medicine Health Care and Philosophy最新文献_第9页

Ontological insecurity in the post-covid-19 fallout: using existentialism as a method to develop a psychosocial understanding to a mental health crisis. 2019冠状病毒病后的本体不安全感:利用存在主义作为一种方法，发展对精神健康危机的社会心理理解。

IF 2.1 2区哲学

Medicine Health Care and Philosophy Pub Date : 2023-09-01 DOI: 10.1007/s11019-023-10157-9

Matthew Bretton Oakes

{"title":"Ontological insecurity in the post-covid-19 fallout: using existentialism as a method to develop a psychosocial understanding to a mental health crisis.","authors":"Matthew Bretton Oakes","doi":"10.1007/s11019-023-10157-9","DOIUrl":"https://doi.org/10.1007/s11019-023-10157-9","url":null,"abstract":"In the wake of the Covid-19 pandemic we are witnessing a significant rise in mental illness diagnosis and corresponding anti-depressant prescription uptake. The drug response to this situation is unsurprising and reinforces the dominant role (neuro)biology continues to undertake within modern psychiatry. In contrast to this biologically informed, medicalised approach, the World Health Organisation (WHO) issued a statement stressing the causal role of psychological and social factors.Using the concept of ontological insecurity, contextualised within the WHO guidance, the interrelation of psychological and social factors is illuminated, and a psychosocial framework is produced as a means of understanding the mental health consequence of the post-Covid-19 fallout.The psychosocial framework generated provides a rationale to revise and reprioritise how we engage with the biopsychosocial model that is intended to underpin modern psychiatry. This framework establishes a connection between psychological and social theory which are too often addressed as disparate terrains within mental health services and policy creation.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":"26 3","pages":"425-432"},"PeriodicalIF":2.1,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10425504/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10133779","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: 1

Relating to foetal persons: why women's Voices come first and last, but not alone in Abortion debates. 与胎儿有关：为什么在堕胎辩论中，妇女的声音既是第一位的，也是最后一位的，而不是唯一的。

IF 2.3 2区哲学

Medicine Health Care and Philosophy Pub Date : 2023-09-01 Epub Date: 2023-05-12 DOI: 10.1007/s11019-023-10144-0

Stephen Milford

{"title":"Relating to foetal persons: why women's Voices come first and last, but not alone in Abortion debates.","authors":"Stephen Milford","doi":"10.1007/s11019-023-10144-0","DOIUrl":"10.1007/s11019-023-10144-0","url":null,"abstract":"Abortion remains a controversial topic, with pro-life and pro-choice advocates clashing fiercely. However, public polling demonstrates that the vast majority of the Western public holds a middle position: being in favour of abortion but not in all circumstances nor at any time. The intuitions held by the majority seem to imply a contradiction: two early foetuses at the same point in development have different moral statuses. Providing coherent philosophical grounding for this intuition has proved challenging. Solutions given by philosophers such as Feinberg, Harman and Räsänen are complex and do not fully account for the lived experience of pregnancy loss. This article argues for a relational ontological construction of human personhood as the basis of foetal personhood. This approach takes seriously the literature of pregnancy loss and the lived experiences of pregnant persons. Focusing on the manner in which persons relate to early foetuses (especially pregnant persons), provides a coherent ground for distinct foetal value. Importantly, this approach is both simple and intuitive. Therefore, it can be more easily adopted by middle. To counter an implied equality of human relationality, the article argues for a clear hierarchy based on relational proximity that affirms pregnant persons? primary role in deciding the moral significance of foetal termination.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":"26 3","pages":"293-300"},"PeriodicalIF":2.3,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10425503/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10453009","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

Engaging otherness: care ethics radical perspectives on empathy. 参与他人:关怀伦理对移情的激进观点。

IF 2.1 2区哲学

Medicine Health Care and Philosophy Pub Date : 2023-09-01 DOI: 10.1007/s11019-023-10152-0

Jolanda van Dijke, Inge van Nistelrooij, Pien Bos, Joachim Duyndam

{"title":"Engaging otherness: care ethics radical perspectives on empathy.","authors":"Jolanda van Dijke, Inge van Nistelrooij, Pien Bos, Joachim Duyndam","doi":"10.1007/s11019-023-10152-0","DOIUrl":"https://doi.org/10.1007/s11019-023-10152-0","url":null,"abstract":"Throughout the years, care ethicists have raised concerns that prevalent definitions of empathy fail to adequately address the problem of otherness. They have proposed alternative conceptualizations of empathy that aim to acknowledge individual differences, help to extend care beyond one's inner circle, and develop a critical awareness of biases and prejudices. We explore three such alternatives: Noddings' concept of engrossment, Meyers' account of broad empathy, and Baart's concept of perspective-shifting. Based on these accounts, we explain that care ethics promotes a conceptualization of empathy that is radical in its commitment to engage otherness and that is characterized by being: (1) receptive and open, (2) broad and deep in scope, (3) relational and interactive, (4) mature and multifaceted, (5) critical and reflective, (6) disruptive and transformative. This type of empathy is both demanding and rewarding, as it may inspire health professionals to rethink empathy, its challenges, and its contribution to good care and as it may enrich empathy education and professional empathy practices in health care.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":"26 3","pages":"385-399"},"PeriodicalIF":2.1,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10425473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10453010","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

What does it mean to call a medical device invasive? 医疗设备侵入性是什么意思?

IF 2.1 2区哲学

Medicine Health Care and Philosophy Pub Date : 2023-09-01 DOI: 10.1007/s11019-023-10147-x

Eran Klein

引用次数: 2

Precision medicine and the problem of structural injustice. 精准医疗与结构性不公正问题。

IF 2.3 2区哲学

Medicine Health Care and Philosophy Pub Date : 2023-09-01 Epub Date: 2023-05-25 DOI: 10.1007/s11019-023-10158-8

Sara Green, Barbara Prainsack, Maya Sabatello

{"title":"Precision medicine and the problem of structural injustice.","authors":"Sara Green, Barbara Prainsack, Maya Sabatello","doi":"10.1007/s11019-023-10158-8","DOIUrl":"10.1007/s11019-023-10158-8","url":null,"abstract":"Many countries currently invest in technologies and data infrastructures to foster precision medicine (PM), which is hoped to better tailor disease treatment and prevention to individual patients. But who can expect to benefit from PM? The answer depends not only on scientific developments but also on the willingness to address the problem of structural injustice. One important step is to confront the problem of underrepresentation of certain populations in PM cohorts via improved research inclusivity. Yet, we argue that the perspective needs to be broadened because the (in)equitable effects of PM are also strongly contingent on wider structural factors and prioritization of healthcare strategies and resources. When (and before) implementing PM, it is crucial to attend to how the organisation of healthcare systems influences who will benefit, as well as whether PM may present challenges for a solidaristic sharing of costs and risks. We discuss these issues through a comparative lens of healthcare models and PM-initiatives in the United States, Austria, and Denmark. The analysis draws attention to how PM hinges on-and simultaneously affects-access to healthcare services, public trust in data handling, and prioritization of healthcare resources. Finally, we provide suggestions for how to mitigate foreseeable negative effects.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":"26 3","pages":"433-450"},"PeriodicalIF":2.3,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10212228/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10118904","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

Black-box assisted medical decisions: AI power vs. ethical physician care. 黑箱辅助医疗决策:人工智能与道德医生护理。

IF 2.1 2区哲学

Medicine Health Care and Philosophy Pub Date : 2023-09-01 DOI: 10.1007/s11019-023-10153-z

Berman Chan

引用次数: 1

Adaptation and illness severity: the significance of suffering. 适应与疾病严重程度:痛苦的意义。

IF 2.1 2区哲学

Medicine Health Care and Philosophy Pub Date : 2023-09-01 DOI: 10.1007/s11019-023-10155-x

Borgar Jølstad

{"title":"Adaptation and illness severity: the significance of suffering.","authors":"Borgar Jølstad","doi":"10.1007/s11019-023-10155-x","DOIUrl":"https://doi.org/10.1007/s11019-023-10155-x","url":null,"abstract":"Adaptation to illness, and its relevance for distribution in health care, has been the subject of vigorous debate. In this paper I examine an aspect of this discussion that seems so far to have been overlooked: that some illnesses are difficult, or even impossible, to adapt to. This matters because adaptation reduces suffering. Illness severity is a priority setting criterion in several countries. When considering severity, we are interested in the extent to which an illness makes a person worse-off. I argue that no plausible theory of well-being can disregard suffering when determining to what extent someone is worse-off in terms of health. We should accept, all else equal, that adapting to an illness makes the illness less severe by reducing suffering. Accepting a pluralist theory of well-being allows us to accept my argument, while still making room for the possibility that adaptation is sometimes, all things considered, bad. Finally, I argue that we should conceptualize adaptability as a feature of illness, and thereby account for adaptation on a group level for the purposes of priority setting.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":"26 3","pages":"413-423"},"PeriodicalIF":2.1,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10425500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10132745","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

Empowerment: Freud, Canguilhem and Lacan on the ideal of health promotion. 授权:弗洛伊德，冈居朗和拉康关于健康促进的理想。

IF 2.1 2区哲学

Medicine Health Care and Philosophy Pub Date : 2023-09-01 DOI: 10.1007/s11019-023-10145-z

Bas de Boer, Ciano Aydin

{"title":"Empowerment: Freud, Canguilhem and Lacan on the ideal of health promotion.","authors":"Bas de Boer, Ciano Aydin","doi":"10.1007/s11019-023-10145-z","DOIUrl":"https://doi.org/10.1007/s11019-023-10145-z","url":null,"abstract":"Empowerment is a prominent ideal in health promotion. However, the exact meaning of this ideal is often not made explicit. In this paper, we outline an account of empowerment grounded in the human capacity to adapt and adjust to environmental and societal norms without being completely determined by those norms. Our account reveals a tension at the heart of empowerment between (a) the ability of self-governance and (b) the need to adapt and adjust to environmental and societal norms. We address this tension by drawing from the work of Freud, Canguilhem, and Lacan. First, we clarify through a discussion of Freud's notion of sublimation that it is difficult to assess empowerment independent of any social valuations, but also that it is no less problematic to make it dependent on social valuations alone. Second, we draw from the work of Canguilhem to show how empowerment can be understood in terms of the individual's capacity to tolerate the aggressions of a multiplicity of environments. Third, using Lacan, we show how empowerment requires incorporation of social and symbolic norms, without necessarily rendering ourselves a mere product of these norms. Finally, we demonstrate how the views of these authors can complement one another, resulting in a more sophisticated understanding of empowerment.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":"26 3","pages":"301-311"},"PeriodicalIF":2.1,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10139663/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10079175","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

Towards a concept of embodied autonomy: In what ways can a patient's body contribute to the autonomy of medical decisions? 实现自主的概念:病人的身体在哪些方面有助于医疗决策的自主?

IF 2.1 2区哲学

Medicine Health Care and Philosophy Pub Date : 2023-09-01 DOI: 10.1007/s11019-023-10159-7

Jonathan Lewis, Søren Holm

{"title":"Towards a concept of embodied autonomy: In what ways can a patient's body contribute to the autonomy of medical decisions?","authors":"Jonathan Lewis, Søren Holm","doi":"10.1007/s11019-023-10159-7","DOIUrl":"https://doi.org/10.1007/s11019-023-10159-7","url":null,"abstract":"\"Bodily autonomy\" has received significant attention in bioethics, medical ethics, and medical law in terms of the general inviolability of a patient's bodily sovereignty and the rights of patients to make choices (e.g., reproductive choices) that concern their own body. However, the role of the body in terms of how it can or does contribute to a patient's capacity for, or exercises of their autonomy in clinical decision-making situations has not been explicitly addressed. The approach to autonomy in this paper is aligned with traditional theories that conceive autonomy in terms of an individual's capacities for, and exercises of rational reflection. However, at the same time, this paper extends these accounts by arguing that autonomy is, in part, embodied. Specifically, by drawing on phenomenological conceptions of the experience of autonomy, we argue that, in principle, the body is a necessary component of the capacity for autonomy. Secondly, through the presentation of two different cases, we highlight ways in which a patient's body can contribute to the autonomy of treatment choices. Ultimately, we hope to encourage others to explore additional conditions under which a concept of embodied autonomy should be employed in medical decision making, how its underlying principles might be operationalised in clinical situations, and its consequences for approaches to patient autonomy in healthcare practice, policy, and law.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":"26 3","pages":"451-463"},"PeriodicalIF":2.1,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10425513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10078324","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: 1

The fertility of moral ambiguity in precision medicine. 精准医疗中道德歧义的泛滥。

IF 2.1 2区哲学

Medicine Health Care and Philosophy Pub Date : 2023-09-01 DOI: 10.1007/s11019-023-10160-0

Jeanette Bresson Ladegaard Knox, Mette Nordahl Svendsen

{"title":"The fertility of moral ambiguity in precision medicine.","authors":"Jeanette Bresson Ladegaard Knox, Mette Nordahl Svendsen","doi":"10.1007/s11019-023-10160-0","DOIUrl":"https://doi.org/10.1007/s11019-023-10160-0","url":null,"abstract":"Although precision medicine cuts across a large spectrum of professions, interdisciplinary and cross-sectorial moral deliberation has yet to be widely enacted, let alone formalized in this field. In a recent research project on precision medicine, we designed a dialogical forum (i.e. 'the Ethics Laboratory') giving interdisciplinary and cross-sectorial stakeholders an opportunity to discuss their moral conundrums in concert. We organized and carried out four Ethics Laboratories. In this article, we use Simone de Beauvoir's concept of moral ambiguity as a lens to frame the participants' experience with fluid moral boundaries. By framing our approach through this concept we are able to elucidate irremediable moral issues that are collectively underexplored in the practice of precision medicine. Moral ambiguity accentuates an open and free space where different types of perspectives converge and can inform each other. Based on our study, we identified two dilemmas, or thematic interfaces, in the interdisciplinary moral deliberations which unfolded in the Ethics Laboratories: (1) the dilemma between the individual and the collective good; and (2) the dilemma between care and choice. Through our investigation of these dilemmas, we show how Beauvoir's concept of moral ambiquity not only serves as a fertile catalyst for greater moral awareness but, furthermore, how the concept can become an indispensable part of the practices of and the discourse about precision medicine.","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":"26 3","pages":"465-476"},"PeriodicalIF":2.1,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10243698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10100481","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