Philosophy, ethics, and humanities in medicine : PEHM最新文献

{"title":"Clusters, lines and webs-so does my patient have psychosis? reflections on the use of psychiatric conceptual frameworks from a clinical vantage point.","authors":"Tibor Zoltan Kovacs,&nbsp;Reece William Hill,&nbsp;Stuart Watson,&nbsp;Douglas Turkington","doi":"10.1186/s13010-022-00118-0","DOIUrl":"https://doi.org/10.1186/s13010-022-00118-0","url":null,"abstract":"<p><p>Mental health professionals working in hospitals or community clinics inevitably face the realisation that we possess imperfect conceptual means to understand mental disorders. In this paper the authors bring together ideas from the fields of Philosophy, Psychiatry, Cognitive Psychology and Linguistics to reflect on the ways we represent phenomena of high practical importance that we often take for granted, but are nevertheless difficult to define in ontological terms. The paper follows through the development of the concept of psychosis over the last two centuries in the interplay of three different conceptual orientations: the categorical, dimensional and network approaches. Each of these represent the available knowledge and dominant thinking styles of the era in which they emerged and take markedly different stances regarding the nature of mental phenomena. Without particular commitment to any ontological positions or models described, the authors invite the reader into a thinking process about the strengths and weaknesses of these models, and how they can be reconciled in multidisciplinary settings to benefit the process of patient care.</p>","PeriodicalId":520749,"journal":{"name":"Philosophy, ethics, and humanities in medicine : PEHM","volume":" ","pages":"6"},"PeriodicalIF":1.9,"publicationDate":"2022-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8842805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39610338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retraction Note: Globalization and vulnerable populations in times of a pandemic: A Mayan perspective.","authors":"Claudia Ruiz Sotomayor,&nbsp;Alejandra Barrero","doi":"10.1186/s13010-020-00098-z","DOIUrl":"https://doi.org/10.1186/s13010-020-00098-z","url":null,"abstract":"","PeriodicalId":520749,"journal":{"name":"Philosophy, ethics, and humanities in medicine : PEHM","volume":" ","pages":"14"},"PeriodicalIF":1.9,"publicationDate":"2020-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s13010-020-00098-z","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38371619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of twenty-first century personalized medicine versus twenty-first century medicine's impact on personalization.","authors":"Camille Abettan,&nbsp;Jos V M Welie","doi":"10.1186/s13010-020-00095-2","DOIUrl":"https://doi.org/10.1186/s13010-020-00095-2","url":null,"abstract":"<p><strong>Background: </strong>Over the past decade, the exponential growth of the literature devoted to personalized medicine has been paralleled by an ever louder chorus of epistemic and ethical criticisms. Their differences notwithstanding, both advocates and critics share an outdated philosophical understanding of the concept of personhood and hence tend to assume too simplistic an understanding of personalization in health care.</p><p><strong>Methods: </strong>In this article, we question this philosophical understanding of personhood and personalization, as these concepts shape the field of personalized medicine. We establish a dialogue with phenomenology and hermeneutics (especially with E. Husserl, M. Merleau-Ponty and P. Ricoeur) in order to achieve a more sophisticated understanding of the meaning of these concepts We particularly focus on the relationship between personal subjectivity and objective data.</p><p><strong>Results: </strong>We first explore the gap between the ideal of personalized healthcare and the reality of today's personalized medicine. We show that the nearly exclusive focus of personalized medicine on the objective part of personhood leads to a flawed ethical debate that needs to be reframed. Second, we seek to contribute to this reframing by drawing on the phenomenological-hermeneutical movement in philosophy. Third, we show that these admittedly theoretical analyses open up new conceptual possibilities to tackle the very practical ethical challenges that personalized medicine faces.</p><p><strong>Conclusion: </strong>Finally, we propose a reversal: if personalization is a continuous process by which the person reappropriates all manner of objective data, giving them meaning and thereby shaping his or her own way of being human, then personalized medicine, rather than being personalized itself, can facilitate personalization of those it serves through the data it provides.</p>","PeriodicalId":520749,"journal":{"name":"Philosophy, ethics, and humanities in medicine : PEHM","volume":" ","pages":"11"},"PeriodicalIF":1.9,"publicationDate":"2020-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s13010-020-00095-2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38622550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coronavirus misinformation and the political scenario: the science cannot be 'another' barrier.","authors":"Marcelo Simões Mendes","doi":"10.1186/s13010-020-00092-5","DOIUrl":"https://doi.org/10.1186/s13010-020-00092-5","url":null,"abstract":"<p><p>The sensible and conflicting scenario of the pandemic postulated many challenges to societies around the world in 2020. Part of this problem refers to how the differences between politics and science are not comprehended in their particularities. The recognition of limits and power of science and politics can not only contribute to reaching the actions and strategies facing novel coronavirus but also optimized many domains of society.</p>","PeriodicalId":520749,"journal":{"name":"Philosophy, ethics, and humanities in medicine : PEHM","volume":" ","pages":"8"},"PeriodicalIF":1.9,"publicationDate":"2020-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s13010-020-00092-5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38408887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Humanism in clinical education: a mixed methods study on the experiences of clinical instructors in Iran.","authors":"Hakimeh Hazrati,&nbsp;Shoaleh Bigdeli,&nbsp;Vahideh Zarea Gavgani,&nbsp;Seyed Kamran Soltani Arabshahi,&nbsp;Mozhgan Behshid,&nbsp;Zohreh Sohrabi","doi":"10.1186/s13010-020-00088-1","DOIUrl":"https://doi.org/10.1186/s13010-020-00088-1","url":null,"abstract":"<p><strong>Background: </strong>Medical education is currently more considerate about the human dimension. The present qualitative study aimed to explain the experiences of clinical professors with regard to humanism in clinical education in Iran.</p><p><strong>Methods: </strong>This mixed methods study had two phases, a quanitative phase of scientometrics and a qualitative phase of a content analysis. In the scientometrics phase, Ravar PreMap and VOSviewer software programs were utilized for plotting the conceptual networks. The networks were analyzed at the micro-level based on centrality indices (closeness, degree, and betweenness). The conceptual network was plotted and the prominent topics in clinical education were identified using co-word analysis. In the second qualitative phase on the topic, based on the scientometrics phase, semi-structured interviews were conducted with clinical professors. The interviews were transcribed verbatim and analyzed.</p><p><strong>Results: </strong>On the basis of the analysis of titles, abstracts, and keywords of the retrieved articles on clinical education from ISI Web of Science, Scopus, and PubMed, 1412 keywords were extracted. After the refining process, 356 keywords with 6741 relations remained. Upon plotting the conceptual network, 19 conceptual clusters related to clinical education were obtained. Then, micro-level network analysis (centrality criteria) indicated that the keyword humanism with the frequency of 137 had the highest rate (97.753), closeness (97.802), and betweenness (13.407). Moreover, from the interview data analysis, two themes of \"intertwined nature of the human spirit in clinical education\" and \"humanistic behavior of professors in clinical education\" were extracted.</p><p><strong>Conclusion: </strong>As a part of the educational culture, humanistic values must be intertwined with the medical education curriculum. In this regard, humanism and clinical reasoning are the two major clusters of clinical teaching; moreover, altruism and adherence to humanistic values, and scientific qualification are other main pillars that should be considered as the criteria for the selection of clinical professors and medical students.</p>","PeriodicalId":520749,"journal":{"name":"Philosophy, ethics, and humanities in medicine : PEHM","volume":" ","pages":"5"},"PeriodicalIF":1.9,"publicationDate":"2020-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s13010-020-00088-1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38206696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What we may learn - and need - from pandemic fiction.","authors":"Jane Doherty,&nbsp;James Giordano","doi":"10.1186/s13010-020-00089-0","DOIUrl":"https://doi.org/10.1186/s13010-020-00089-0","url":null,"abstract":"<p><p>N/A.</p>","PeriodicalId":520749,"journal":{"name":"Philosophy, ethics, and humanities in medicine : PEHM","volume":" ","pages":"4"},"PeriodicalIF":1.9,"publicationDate":"2020-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s13010-020-00089-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38181583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Normality in medicine: a critical review.","authors":"Marisa Catita,&nbsp;Artur Águas,&nbsp;Pedro Morgado","doi":"10.1186/s13010-020-00087-2","DOIUrl":"https://doi.org/10.1186/s13010-020-00087-2","url":null,"abstract":"<p><p>What is considered normal determines clinical practice in medicine and has implications at an individual level, doctor-patient relationship and health care policies. With the increase in medical information and technical abilities it is urgent to have a clear concept of normality in medicine so that crucial discussions can be held with unequivocal terms.The different meanings for normality were analyzed throughout the literature and grouped according to their relevance in the academic community in models, namely the Biostatistical Theory (BST), Health, Ideal, Process and Biological advantage. The BST is the most established naturalistic approach, however normal variability can arguably constitute a problem. Health is similar and raises the question of setting the boundaries of pathology. Normality as an Ideal is an useful tool but is naturally unrealistic. As a Process it is comprehensible but is hard to frame for practical purposes. If considered as a Biological Advantage, seems intuitive but abnormality should tend to disappear.After, three examples were presented to discuss these models. They were Anemia, Psychiatric diseases and Psychopathy. In the case of Anemia the BST was applied and the arbitrary boundaries but with social impact were exposed. Psychiatric diseases was discussed under the process of self-organization and non-suffering ideal. With Psychopathy the boundaries of biological advantage are questioned.This review appeals to the importance of redesigning of the concept of normality in medicine according to current times and stresses the importance of integrating concepts such as variability and autonomy.</p>","PeriodicalId":520749,"journal":{"name":"Philosophy, ethics, and humanities in medicine : PEHM","volume":" ","pages":"3"},"PeriodicalIF":1.9,"publicationDate":"2020-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s13010-020-00087-2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37838418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heart in art: cardiovascular diseases in novels, films, and paintings.","authors":"Ad A Kaptein,&nbsp;Pim B van der Meer,&nbsp;Barend W Florijn,&nbsp;Alexander D Hilt,&nbsp;Michael Murray,&nbsp;Martin J Schalij","doi":"10.1186/s13010-020-0086-3","DOIUrl":"https://doi.org/10.1186/s13010-020-0086-3","url":null,"abstract":"<p><strong>Background: </strong>Understanding representations of disease in various art genres provides insights into how patients and health care providers view the diseases. It can also be used to enhance patient care and stimulate patient self-management.</p><p><strong>Methods: </strong>This paper reviews how cardiovascular diseases are represented in novels, films, and paintings: myocardial infarction, aneurysm, hypertension, stroke, heart transplantation, Marfan's disease, congestive heart failure. Various search systems and definitions were used to help identify sources of representations of different cardiovascular diseases. The representations of the different diseases were considered separately. The Common Sense Model was used a theoretical model to outline illness perceptions and self-management in the various identified novels, films, and paintings.</p><p><strong>Results: </strong>Myocardial infarction followed by stroke were the most frequently detailed diseases in all three art genres. This reflects their higher prevalence. Representations ranged from biomedical details through to social and psychological consequences of the diseases.</p><p><strong>Conclusions: </strong>Artistic representations of cardiovascular diseases reflect cognitions, emotions, and images of prevalent disease. These representations shape views and behaviour of ill and healthy persons regarding heart diseases. As these representations are amenable to change, they deserve further research, which may be instrumental in improving the quality of life of persons struck by cardiovascular diseases. Changing illness perceptions appears to be a method to improve self-management and thereby quality of life in patients with various cardiovascular diseases.</p>","PeriodicalId":520749,"journal":{"name":"Philosophy, ethics, and humanities in medicine : PEHM","volume":" ","pages":"2"},"PeriodicalIF":1.9,"publicationDate":"2020-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s13010-020-0086-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37637705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The concept of vulnerability in medical ethics and philosophy.","authors":"Joachim Boldt","doi":"10.1186/s13010-019-0075-6","DOIUrl":"10.1186/s13010-019-0075-6","url":null,"abstract":"<p><strong>Background: </strong>Healthcare is permeated by phenomena of vulnerability and their ethical significance. Nonetheless, application of this concept in healthcare ethics today is largely confined to clinical research. Approaches that further elaborate the concept in order to make it suitable for healthcare as a whole thus deserve renewed attention.</p><p><strong>Methods: </strong>Conceptual analysis.</p><p><strong>Results: </strong>Taking up the task to make the concept of vulnerability suitable for healthcare ethics as a whole involves two challenges. Firstly, starting from the concept as it used in research ethics, a more detailed characterization and systematization of the different realms of human abilities and the various ways in which these realms contain vulnerability is to be established. Secondly, at the same time, the sought-after concept of vulnerability should avoid picturing the relation between healthcare recipient and provider as a relation between a dependent individual in need and another individual capable of providing all the help necessary. An adequate concept of vulnerability should enable one to understand when and in which respects care providers may be vulnerable as well. Philosophical accounts of vulnerability can help to meet both of these challenges.</p><p><strong>Conclusions: </strong>Philosophical accounts of vulnerability can help to make the concept of vulnerability suitable for healthcare ethics as a whole. They come with a price, though. While the ethical role of vulnerability in medical ethics usually is to signify states of affairs that are to be diminished or overcome, philosophical accounts introduce forms of vulnerability that are regarded as valuable. Further analyzing and systematizing forms and degrees of vulnerability thus comprises the task to distinguish between amounts and types of vulnerability that can count as valuable, and amounts and types of vulnerability that are to be alleviated.</p>","PeriodicalId":520749,"journal":{"name":"Philosophy, ethics, and humanities in medicine : PEHM","volume":" ","pages":"6"},"PeriodicalIF":1.9,"publicationDate":"2019-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6458617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37320219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential use of clinical polygenic risk scores in psychiatry - ethical implications and communicating high polygenic risk.","authors":"A C Palk,&nbsp;S Dalvie,&nbsp;J de Vries,&nbsp;A R Martin,&nbsp;D J Stein","doi":"10.1186/s13010-019-0073-8","DOIUrl":"https://doi.org/10.1186/s13010-019-0073-8","url":null,"abstract":"<p><p>Psychiatric disorders present distinct clinical challenges which are partly attributable to their multifactorial aetiology and the absence of laboratory tests that can be used to confirm diagnosis or predict risk. Psychiatric disorders are highly heritable, but also polygenic, with genetic risk conferred by interactions between thousands of variants of small effect that can be summarized in a polygenic risk score. We discuss four areas in which the use of polygenic risk scores in psychiatric research and clinical contexts could have ethical implications. First, there is concern that clinical use of polygenic risk scores may exacerbate existing health inequities. Second, research findings regarding polygenic risk could be misinterpreted in stigmatising or discriminatory ways. Third, there are concerns associated with testing minors as well as eugenics concerns elicited by prenatal polygenic risk testing. Fourth, potential challenges that could arise with the feedback and interpretation of high polygenic risk for a psychiatric disorder would require consideration. While there would be extensive overlap with the challenges of feeding back genetic findings in general, the potential clinical use of polygenic risk scoring warrants discussion in its own right, given the recency of this possibility. To this end, we discuss how lay interpretations of risk and genetic information could intersect. Consideration of these factors would be necessary for ensuring effective and constructive communication and interpretation of polygenic risk information which, in turn, could have implications for the uptake of any therapeutic recommendations. Recent advances in polygenic risk scoring have major implications for its clinical potential, however, care should be taken to ensure that communication of polygenic risk does not feed into problematic assumptions regarding mental disorders or support reductive interpretations.</p>","PeriodicalId":520749,"journal":{"name":"Philosophy, ethics, and humanities in medicine : PEHM","volume":" ","pages":"4"},"PeriodicalIF":1.9,"publicationDate":"2019-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s13010-019-0073-8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37167654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}