Theoretical medicine and bioethics最新文献

Reification as a vice: rethinking bioethics beyond moral status. 作为一种恶习的物化：超越道德地位的生命伦理学反思。

Theoretical medicine and bioethics Pub Date : 2026-12-01 Epub Date: 2026-08-21 DOI: 10.1007/s11017-026-09768-z

Anna Smajdor

引用次数: 0

An ethical defense of safer supply. 安全供应的道德辩护。

Theoretical medicine and bioethics Pub Date : 2026-12-01 Epub Date: 2026-07-15 DOI: 10.1007/s11017-026-09767-0

Arthur Krieger

引用次数: 0

Flourishing within vulnerability: on human fragility and the conditions for a habitable environment. 在脆弱中繁荣：关于人类的脆弱性和宜居环境的条件。

Theoretical medicine and bioethics Pub Date : 2026-12-01 Epub Date: 2026-06-24 DOI: 10.1007/s11017-026-09764-3

Irene Quiliconi

{"title":"Flourishing within vulnerability: on human fragility and the conditions for a habitable environment.","authors":"Irene Quiliconi","doi":"10.1007/s11017-026-09764-3","DOIUrl":"10.1007/s11017-026-09764-3","url":null,"abstract":"In recent philosophical discourse, flourishing has emerged as a concept of growing importance-often linked to the field of well-being studies and explored by various and different disciplines. The article approaches flourishing not as an abstract ideal, but rather as a condition that must be understood as rooted in the lived reality of human vulnerability. More specifically, I argue that any genuine account of human flourishing must regard vulnerability- human inherent fragility and reciprocal dependence-not as an impediment, but as the very foundation from which meaningful flourishing can arise. Building on Alasdair MacIntyre's reflections-who observes that this perspective is insufficiently acknowledged in comparison to the prevailing standard of moral philosophy-I understand vulnerability as a fundamental human characteristic arising from the interconnectedness of dependence, rationality, and animality. The second part of the paper engages with phenomenological perspectives in order to establish a dialogue between this tradition and MacIntyre's framework of virtue ethics. The aim is to anchor the concept of a virtuous moral life-implicit in the notion of flourishing-in the lived, embodied experience of the individual. In this light, three fundamental categories intrinsic to human vulnerability are identified as essential compass points for understanding what must be preserved, pursued, and guaranteed even under conditions of extreme fragility. Only by attending to these dimensions-embodiment, co-existence and lived temporality-can ensure that the human environment remains habitable, and thus adequate for a disposition toward flourishing.","PeriodicalId":94251,"journal":{"name":"Theoretical medicine and bioethics","volume":" ","pages":"487-502"},"PeriodicalIF":0.0,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645888/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148311254","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}

引用次数: 0

Practical wisdom in medicine: defending a multidimensional, integrated view of an indispensable virtue. 医学中的实用智慧：捍卫一种不可或缺的美德的多维的、综合的观点。

Theoretical medicine and bioethics Pub Date : 2026-12-01 Epub Date: 2026-05-23 DOI: 10.1007/s11017-026-09760-7

Lauris C Kaldjian, Kristján Kristjánsson, Shane McLoughlin

{"title":"Practical wisdom in medicine: defending a multidimensional, integrated view of an indispensable virtue.","authors":"Lauris C Kaldjian, Kristján Kristjánsson, Shane McLoughlin","doi":"10.1007/s11017-026-09760-7","DOIUrl":"10.1007/s11017-026-09760-7","url":null,"abstract":"By defending practical wisdom (phronesis) as a multidimensional virtue that complements the moral virtues, we offer a critique of \"practical wisdom eliminativism\", with special attention to the context of medicine, arguing that the core dimensions of practical wisdom enjoy broad consensus. As the meta-virtue that demonstrates excellence in ethical decision-making, practical wisdom recognizes and employs the best means to achieve good and worthwhile ends by integrating goals, perception of context, moral virtues, deliberation, reason-guided emotion, and motivation. In medicine, practical wisdom encompasses patient-centered deliberation directed toward ends of health and flourishing that promote the patient's good. To counter the notion that practical wisdom is a redundant concept (the eliminativist view), we provide philosophical arguments, evidence from medical practitioners, and psychometric data from a detailed empirical study of US and UK adults. Practical wisdom has survived for more than 2300 years as a unified and unifying intellectual meta-virtue that guides the moral virtues. We believe the reasons we put forward explain why phronesis should be expected to endure as a meaningful, multidimensional concept reflecting the nature of moral deliberation in response to practical challenges in life and medicine.","PeriodicalId":94251,"journal":{"name":"Theoretical medicine and bioethics","volume":" ","pages":"465-486"},"PeriodicalIF":0.0,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148007747","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}

引用次数: 0

Camouflaging in autism as a dual-normative construct: a philosophical critique. 作为双重规范结构的自闭症伪装：哲学批判。

Theoretical medicine and bioethics Pub Date : 2026-12-01 Epub Date: 2026-06-23 DOI: 10.1007/s11017-026-09763-4

Marios Adamou, Athanasios Koutsoklenis

引用次数: 0

The ethics of separation: conjoined twins, bodily autonomy, and abortion. 分离的伦理：连体双胞胎、身体自主和堕胎。

Theoretical medicine and bioethics Pub Date : 2026-10-08 DOI: 10.1007/s11017-026-09769-y

Christian O'Connell

{"title":"The ethics of separation: conjoined twins, bodily autonomy, and abortion.","authors":"Christian O'Connell","doi":"10.1007/s11017-026-09769-y","DOIUrl":"https://doi.org/10.1007/s11017-026-09769-y","url":null,"abstract":"This essay examines a prominent claim in abortion ethics: that bodily autonomy alone suffices to justify abortion even if the fetus is granted the moral status of a person. Instead of revisiting Thomson's violinist, it introduces a comparator offered less as a direct analogy to pregnancy than as a stress test of-and possible counterexample to-that claim. It imagines conjoined twin sisters, one temporarily dependent on the other's body, though a safe separation allowing both to survive is expected within months. The supporting twin's condition imposes serious but non-catastrophic demands; immediate separation would free her at once but kill her sister. The case combines attached, asymmetric dependence with substantial burden and an impending safe separation. In that setting, the familiar autonomy-based framing of the act as withdrawal of bodily support rather than direct lethal intervention begins to look strained. Engaging Thomson, Boonin, Effron, the English decision In re A, and philosophical and clinical-ethical literature on conjoined-twin separation, the essay argues that where immediate release can be achieved only by advancing a death that need not occur at all, bodily autonomy alone no longer seems sufficient. Resisting that conclusion requires either some further premise (about intention, means, development, or personhood) or willingness to accept the high philosophical cost of claiming that autonomy alone may justify bringing about the death of a dependent person who could survive if one waited.","PeriodicalId":94251,"journal":{"name":"Theoretical medicine and bioethics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149140118","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

The mechanics of epistemic justice: a response to Toding et al. and their application of my epistemic approach to dignity. 认识论正义的机制：对Toding等人的回应，以及他们将我的认识论方法应用于尊严。

Theoretical medicine and bioethics Pub Date : 2026-10-01 Epub Date: 2026-07-01 DOI: 10.1007/s11017-026-09766-1

Peter J Katz

引用次数: 0

Safeguarding the dead donor rule in the age of normothermic regional perfusion: organismic unity, irreversibility, and epistemic responsibility. 正常区域灌注时代对死亡供体规则的维护：机体统一性、不可逆性与认知责任。

Theoretical medicine and bioethics Pub Date : 2026-10-01 Epub Date: 2026-04-16 DOI: 10.1007/s11017-026-09752-7

Ersun Augustinus Kayra

{"title":"Safeguarding the dead donor rule in the age of normothermic regional perfusion: organismic unity, irreversibility, and epistemic responsibility.","authors":"Ersun Augustinus Kayra","doi":"10.1007/s11017-026-09752-7","DOIUrl":"10.1007/s11017-026-09752-7","url":null,"abstract":"Contemporary controlled donation after circulatory determination of death (cDCD) faces a widening epistemic gap: as resuscitative and perfusion technologies expand the ability to restore regional circulation, the inferential distance between the concept of death and bedside determinations becomes more salient. I defend organismic unity-the permanent loss of the organism's capacity for integrated self-maintenance-as the most defensible biological criterion of death. Yet this criterion is underdeterminate at the bedside: it must be tracked by fallible proxies operating under time pressure and uncertainty. The central claim is modal: if irreversibility is constitutive of death, then protocols must distinguish biological impossibility from practical or policy-based non-intervention. In cDCD contexts, what is often operationally established is not biological irreversibility in the strongest sense but a form of prudential warrant under a normative frame of non-intervention (i.e., permanence). I develop (1) a taxonomy and protocol-facing hierarchy of irreversibility senses, (2) an analysis of what 5-min no-touch intervals can and cannot establish, and (3) a conceptual geography of normothermic regional perfusion (NRP) variants, including the thoracoabdominal hard case. From these epistemic limits I derive second-order safeguards-conservatism, transparency, independence, corrigibility, and public accountability-grounded both in deontic respect for the patient and in the dead donor rule (DDR)'s role as a trust-sustaining commitment device. I conclude that safeguarding the dead donor rule in the age of NRP requires neither metaphysical pretense nor DDR abandonment, but institutional integrity: taxonomic clarity about irreversibility, verifiable cerebral exclusion, and second-order safeguards that make uncertainty governable.","PeriodicalId":94251,"journal":{"name":"Theoretical medicine and bioethics","volume":" ","pages":"365-379"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147701389","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

Clinical reasoning as a hermeneutic arc: teleology, narrative, and practical wisdom in patient care. 临床推理作为一个解释学弧：目的论，叙事，和实践智慧在病人护理。

Theoretical medicine and bioethics Pub Date : 2026-10-01 DOI: 10.1007/s11017-026-09771-4

Toshiki Nishimura

{"title":"Clinical reasoning as a hermeneutic arc: teleology, narrative, and practical wisdom in patient care.","authors":"Toshiki Nishimura","doi":"10.1007/s11017-026-09771-4","DOIUrl":"https://doi.org/10.1007/s11017-026-09771-4","url":null,"abstract":"Clinical reasoning is often described through partially independent frameworks, including causal explanation, probabilistic inference, ethical deliberation, and narrative understanding. What remains insufficiently clarified is how these dimensions are structurally integrated in the care of a particular patient. Drawing on Paul Ricoeur, this paper argues that clinical reasoning is best understood as a hermeneutic and practical movement structured by three interrelated arcs: an epistemological arc (from naive understanding, through explanation, to informed understanding), an ethical arc (from teleology, through deontology, to practical wisdom), and an anthropological arc (from suffering, through cultural works, to renewed acting). Within the epistemological arc, explanation unfolds through four modes of intelligibility-causal, probabilistic, teleological, and narrative-and is coordinated by the clinical skill of scale shifting. The paper's central claim is that teleology mediates between diagnosis and ethics: first as a mode of intelligibility that discloses what is at stake in the patient's life, and then as a normative orientation guiding deliberation about action. Narrative, in turn, does not replace causal, probabilistic, or ethical reasoning, but configures these heterogeneous elements into a meaningful whole and renders them appropriable within the patient's lived world. Finally, this paper presents a fictional clinical case to show how clinical explanation may support patient self-understanding and renewed agency.","PeriodicalId":94251,"journal":{"name":"Theoretical medicine and bioethics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149121369","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

Do not harm: a minimal defense of conscientious objection in the medical profession. 不伤害：医学界出于良心拒服兵役的最低限度辩护。

Theoretical medicine and bioethics Pub Date : 2026-10-01 Epub Date: 2026-05-20 DOI: 10.1007/s11017-026-09759-0

Darrin W Snyder Belousek

引用次数: 0