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Studies in philosophy of medicine最新文献

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Abject Object Relations and Epistemic Engagement in Clinical Practice 临床实践中的客体关系与认知参与
Studies in philosophy of medicine Pub Date : 2021-11-19 DOI: 10.5195/philmed.2021.45
Helene Scott-Fordsmand
{"title":"Abject Object Relations and Epistemic Engagement in Clinical Practice","authors":"Helene Scott-Fordsmand","doi":"10.5195/philmed.2021.45","DOIUrl":"https://doi.org/10.5195/philmed.2021.45","url":null,"abstract":"The article engages with medical practice to develop a philosophically informed understanding of epistemic engagement in medicine, and epistemic object relations more broadly. I take point of departure in the clinal encounter and draw on French psychoanalytical theory to develop and expand a taxonomy already proposed by Karin Knorr-Cetina. Doing so, I argue for the addition of an abject type object relation, that is, the encounter with objects that transgress frameworks and disrupt further investigation, hence preventing dynamic engagement and negatively shaping our epistemic pathways. The article is primarily theoretical although partly grounded in qualitative fieldwork.","PeriodicalId":82846,"journal":{"name":"Studies in philosophy of medicine","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81344105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
Interpreting Patient-Reported Outcome Measures 解读患者报告的结果测量
Studies in philosophy of medicine Pub Date : 2021-11-19 DOI: 10.5195/philmed.2021.66
K. Meadows
{"title":"Interpreting Patient-Reported Outcome Measures","authors":"K. Meadows","doi":"10.5195/philmed.2021.66","DOIUrl":"https://doi.org/10.5195/philmed.2021.66","url":null,"abstract":"Patient-reported outcome measures (PROMs) are valued in healthcare evaluation for bringing patient perspectives forward, and enabling patient-centered care. The range of evidence permitted by PROMs to measure patients’ quality of life narrowly denies subjective experience. This neglect is rooted in the epistemic assumptions that ground PROMs, and the tension between the standardization (the task of measurement) and the individual and unique circumstances of patients. To counter the resulting methodological shortcomings, this article proposes a hermeutical approach and interpretive phenomenology instead of generic qualitative research methods.","PeriodicalId":82846,"journal":{"name":"Studies in philosophy of medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78734734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
On the Brink of Disaster 在灾难的边缘
Studies in philosophy of medicine Pub Date : 2021-10-01 DOI: 10.5195/philmed.2021.10
Valentina Petrolini
{"title":"On the Brink of Disaster","authors":"Valentina Petrolini","doi":"10.5195/philmed.2021.10","DOIUrl":"https://doi.org/10.5195/philmed.2021.10","url":null,"abstract":"\u0000The notions of at-risk and subthreshold conditions are increasingly discussed in psychiatry to describe mild, brief, or otherwise atypical syndromes that fail to meet the criteria for clinical relevance. However, the concept of vulnerability is still underexplored in philosophy of psychiatry. This article discusses psychiatric vulnerability to clarify some conceptual issues about the various factors contributing to vulnerability, the notions of risk and protection, and the idea that there are multiple ways of crossing the threshold to clinical relevance. My goal is to lay the groundwork for a finer-grained discussion on psychiatric vulnerability that reflects the complex nature of mental conditions and illustrates the kind of thinking needed in clinical practice. \u0000","PeriodicalId":82846,"journal":{"name":"Studies in philosophy of medicine","volume":"71 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74916777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Causal Inference, Moral Intuition, and Modeling in a Pandemic 大流行中的因果推理、道德直觉和建模
Studies in philosophy of medicine Pub Date : 2021-09-17 DOI: 10.5195/philmed.2021.70
S. Harvard, Eric Winsberg
{"title":"Causal Inference, Moral Intuition, and Modeling in a Pandemic","authors":"S. Harvard, Eric Winsberg","doi":"10.5195/philmed.2021.70","DOIUrl":"https://doi.org/10.5195/philmed.2021.70","url":null,"abstract":"Throughout the Covid-19 pandemic, people have been eager to learn what factors, and especially what public health policies, cause infection rates to wax and wane. But figuring out conclusively what causes what is difficult in complex systems with nonlinear dynamics, such as pandemics. We review some of the challenges that scientists have faced in answering quantitative causal questions during the Covid-19 pandemic, and suggest that these challenges are a reason to augment the moral dimension of conversations about causal inference. We take a lesson from Martha Nussbaum—who cautions us not to think we have just one question on our hands when we have at least two—and apply it to modeling for causal inference in the context of cost-benefit analysis.","PeriodicalId":82846,"journal":{"name":"Studies in philosophy of medicine","volume":"54 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73680330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 6
Vaccine Hesitancy by Maya J. Goldenberg 《疫苗犹豫》作者:Maya J. Goldenberg
Studies in philosophy of medicine Pub Date : 2021-07-27 DOI: 10.5195/philmed.2021.57
Inmaculada de Melo-Martín
{"title":"Vaccine Hesitancy by Maya J. Goldenberg","authors":"Inmaculada de Melo-Martín","doi":"10.5195/philmed.2021.57","DOIUrl":"https://doi.org/10.5195/philmed.2021.57","url":null,"abstract":"","PeriodicalId":82846,"journal":{"name":"Studies in philosophy of medicine","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89572552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Why Race and Ethnicity Are Not Like Other Risk Factors 为什么种族和民族不像其他危险因素
Studies in philosophy of medicine Pub Date : 2021-06-30 DOI: 10.5195/philmed.2021.52
S. Valles
{"title":"Why Race and Ethnicity Are Not Like Other Risk Factors","authors":"S. Valles","doi":"10.5195/philmed.2021.52","DOIUrl":"https://doi.org/10.5195/philmed.2021.52","url":null,"abstract":"Since early in the Covid-19 pandemic, there have been wide disparities observed between different US racial groups’ rates of Covid-19 infections and deaths. This challenges physicians and patients to untangle what these race-associated risks mean for an individual patient. I argue that this task of providing individualized risk advice requires physicians to apply two skills: structural competency (an understanding of how societal features affect health, since race-associated risks are the result of social conditions, not innate biological differences) and epistemic humility (being mindful of the limitations of individual knowledge and a habit of working collaboratively to get the knowledge that is needed).","PeriodicalId":82846,"journal":{"name":"Studies in philosophy of medicine","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84668650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
The trade-off between impartiality and freedom in the 21st Century Cures Act 《21世纪治愈法案》中公正性与自由之间的权衡
Studies in philosophy of medicine Pub Date : 2021-05-28 DOI: 10.5195/PHILMED.2021.24
David Fraile Navarro, Niccoló Tempini, David Teira
{"title":"The trade-off between impartiality and freedom in the 21st Century Cures Act","authors":"David Fraile Navarro, Niccoló Tempini, David Teira","doi":"10.5195/PHILMED.2021.24","DOIUrl":"https://doi.org/10.5195/PHILMED.2021.24","url":null,"abstract":"Randomized controlled trials test new drugs using various debiasing devices to prevent participantsfrom manipulating the trials. But participants often dislike controls, arguing that they impose apaternalist constraint on their legitimate preferences. The 21st Century Cures Act, passed by USCongress in 2016, encourages the Food and Drug Administration to use alternative testing methods,incorporating participants’ preferences, for regulatory purposes. We discuss, from a historicalperspective, the trade-off between trial impartiality and participants’ freedom. We argue that the onlyway out is considering which methods improve upon the performance of conventional trials inkeeping dangerous or inefficacious compounds out of pharmaceutical markets.","PeriodicalId":82846,"journal":{"name":"Studies in philosophy of medicine","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90481995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
How to Be a Naturalist and a Social Constructivist about Diseases 如何做一个疾病的自然主义者和社会建构主义者
Studies in philosophy of medicine Pub Date : 2021-04-19 DOI: 10.5195/PHILMED.2021.18
Brandon A. Conley, S. Glackin
{"title":"How to Be a Naturalist and a Social Constructivist about Diseases","authors":"Brandon A. Conley, S. Glackin","doi":"10.5195/PHILMED.2021.18","DOIUrl":"https://doi.org/10.5195/PHILMED.2021.18","url":null,"abstract":"Debates about the concept of disease have traditionally been framed as a competition between two conflicting approaches: naturalism, on the one hand, and normativism or social constructivism, on the other. In this article, we lay the groundwork for a naturalistic form of social constructivism by (1) dissociating the presumed link between value-free conceptions of disease and a broadly naturalistic approach; (2) offering a naturalistic argument for a form of social constructivism; and (3) suggesting avenues that strike us as especially promising for filling in the details of an alternative approach and addressing the most obvious objections.","PeriodicalId":82846,"journal":{"name":"Studies in philosophy of medicine","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81565472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 4
‘Isn’t Everyone a Little OCD?’ The Epistemic Harms of Wrongful Depathologization “每个人不都有点强迫症吗?”错误去病态化的认知危害
Studies in philosophy of medicine Pub Date : 2021-04-19 DOI: 10.5195/PHILMED.2021.19
L. Spencer, H. Carel
{"title":"‘Isn’t Everyone a Little OCD?’ The Epistemic Harms of Wrongful Depathologization","authors":"L. Spencer, H. Carel","doi":"10.5195/PHILMED.2021.19","DOIUrl":"https://doi.org/10.5195/PHILMED.2021.19","url":null,"abstract":"This article develops the concept of wrongful depathologization, in which a psychiatric disorder is simultaneously stigmatized (because of sanist attitudes towards mental illness) and trivialized (as it is not considered a “proper” illness). We use OCD as a case study to argue that cumulatively these two effects generate a profound epistemic injustice to OCD sufferers, and possibly to those with other mental disorders. We show that even seemingly positive stereotypes attached to mental disorders give rise to both testimonial injustice and wilful hermeneutical ignorance. We thus expose an insidious form of epistemic harm that has been overlooked in the literature.","PeriodicalId":82846,"journal":{"name":"Studies in philosophy of medicine","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88321668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 9
On the Meaning of Medical Evidence Hierarchies 论医学证据层次的意义
Studies in philosophy of medicine Pub Date : 2021-04-19 DOI: 10.5195/PHILMED.2021.31
Jesper Jerkert
{"title":"On the Meaning of Medical Evidence Hierarchies","authors":"Jesper Jerkert","doi":"10.5195/PHILMED.2021.31","DOIUrl":"https://doi.org/10.5195/PHILMED.2021.31","url":null,"abstract":"\u0000 \u0000 \u0000Evidence hierarchies are investigative strategies ordered with regard to the claimed strength of evidence. They have been used for a couple of decades in EBM, particularly in assessing evidence for treatment recommendations, but remain controversial. An under-investigated question is what the order in the hierarchy means. Four interpretations are discussed here. The two most credible are “typically stronger” or “ideally stronger.” The well-known GRADE framework seems to assume some “typically stronger” reading. Even if the interpretation of an evidence hierarchy were established, hierarchies are rather unhelpful for the task of evidence aggregation. Specifying the intended order relation may help to sort out disagreements. \u0000 \u0000 \u0000","PeriodicalId":82846,"journal":{"name":"Studies in philosophy of medicine","volume":"65 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83565017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
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