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Theoretical medicine and bioethics最新文献

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The bioethicist as advisor. 由生物伦理学家担任顾问。
Theoretical medicine and bioethics Pub Date : 2026-08-01 Epub Date: 2026-04-22 DOI: 10.1007/s11017-026-09753-6
Max F Kramer
{"title":"The bioethicist as advisor.","authors":"Max F Kramer","doi":"10.1007/s11017-026-09753-6","DOIUrl":"10.1007/s11017-026-09753-6","url":null,"abstract":"<p><p>Services dedicated to clinical ethics consultation (CEC) have rapidly proliferated through American hospital systems. One concern about this notable rate of growth is the possibility that practice has outstripped theory. In particular, it is controversial whether clinical ethicists should offer substantive recommendations as part of their practice. This article addresses the status, legitimacy, and authority of such recommendations, proceeding from the idea that they are to be treated as advisory. Taking this idea seriously and developing it through recent philosophical work on advising helps to defuse challenges to CEC as a profession and promotes a conception of CEC as a collaborative activity with a clear distribution of responsibility between ethicist and stakeholders. Moreover, moral norms for advising that exist in abstraction from particular knowledge domains can help to substantiate and clarify professional norms for CEC practice, including the loci of moral responsibility for patient outcomes, the relationship to patient advocacy, and the norm against functioning as the \"ethics police.\"</p>","PeriodicalId":94251,"journal":{"name":"Theoretical medicine and bioethics","volume":" ","pages":"323-341"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793657","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
Palmer, Chris: Brain energy: a revolutionary breakthrough in understanding mental health-and improving treatment for anxiety, depression, OCD, PTSD, and more. Dallas, TX: BenBella Books, 2022. 320 pp, ISBN: 978-1637741580. 克里斯·帕默：《大脑能量：理解心理健康的革命性突破——改善焦虑、抑郁、强迫症、创伤后应激障碍等的治疗。》达拉斯，德克萨斯州：BenBella Books， 2022。320页，ISBN: 978-1637741580。
Theoretical medicine and bioethics Pub Date : 2026-07-07 DOI: 10.1007/s11017-026-09765-2
Adiv Johnson
{"title":"Palmer, Chris: Brain energy: a revolutionary breakthrough in understanding mental health-and improving treatment for anxiety, depression, OCD, PTSD, and more. Dallas, TX: BenBella Books, 2022. 320 pp, ISBN: 978-1637741580.","authors":"Adiv Johnson","doi":"10.1007/s11017-026-09765-2","DOIUrl":"https://doi.org/10.1007/s11017-026-09765-2","url":null,"abstract":"","PeriodicalId":94251,"journal":{"name":"Theoretical medicine and bioethics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148407702","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
Promoting deceased organ donation: should familist incentives be adopted in Islamic regions? 促进死者器官捐献：伊斯兰地区应采取家庭主义激励措施吗？
Theoretical medicine and bioethics Pub Date : 2026-06-01 Epub Date: 2026-03-03 DOI: 10.1007/s11017-026-09746-5
Sanwar Siraj, Ruiping Fan
{"title":"Promoting deceased organ donation: should familist incentives be adopted in Islamic regions?","authors":"Sanwar Siraj, Ruiping Fan","doi":"10.1007/s11017-026-09746-5","DOIUrl":"10.1007/s11017-026-09746-5","url":null,"abstract":"<p><p>This essay presents arguments for adopting a familist incentive approach for promoting deceased organ donation in Islamic regions. It argues that the familist incentive (a system in which the immediate relatives of a deceased donor are given priority in organ allocation within the waitlist of medically similar patients) should be adopted in Islamic regions, where the prevailing Islamic moral culture shapes the way of life for the majority of inhabitants by following the Islamic classics. The classics value the preservation of human life and legitimize the priority of saving the lives of family members. The essay also provides practical reasons to address objections to adopting such an approach in Islamic regions. It concludes that adopting a familist incentive approach could be both morally defensible and practically effective in these regions, thereby optimizing deceased organ donations, protecting the progeny of the family, and improving overall healthcare outcomes.</p>","PeriodicalId":94251,"journal":{"name":"Theoretical medicine and bioethics","volume":" ","pages":"195-212"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13102804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147346206","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
The importance of enworlded selfhood for understanding chronic pain-related suffering. 赋予自我对于理解慢性疼痛相关痛苦的重要性。
Theoretical medicine and bioethics Pub Date : 2026-06-01 Epub Date: 2026-03-03 DOI: 10.1007/s11017-026-09747-4
Fredrik Svenaeus
{"title":"The importance of enworlded selfhood for understanding chronic pain-related suffering.","authors":"Fredrik Svenaeus","doi":"10.1007/s11017-026-09747-4","DOIUrl":"10.1007/s11017-026-09747-4","url":null,"abstract":"<p><p>In the research and literature on pain-related suffering, a difference has recently been made between suffering processes of the minimal self in contrast to the hardships of the narrative self. This article proposes that an in-between layer of selfhood needs to be distinguished and studied to understand pain-related suffering in a more thorough manner: the enworlded self. Pain-related suffering is a complex phenomenon involving mood-related processes and everyday challenges on at least three different levels: lived bodily experiences, lifeworld matters, and questions about personal identity. These three different levels correspond to three connected aspects of layered selfhood: the minimal self, the enworlded self, and the narrative self. By using a published memoire focusing on chronic pain experiences, this article attempts to enlighten the middle ground of enworlded selfhood and also identifies two different regions of the lifeworld in which the damaging and alienating experiences take their toll: the work-world and the family-world. In addition, a third region of the lifeworld is identified: the patient-world, a region which is formed and expands as the chronic-pain sufferer searches for medical-professional advice and assistance. By addressing the three different layers of selfhood and how they interact in the everyday life of the patient, chronic-pain suffering can be better understood and, also, possibly alleviated by taking appropriate measures that fit the attuned pattern of the pain experiences of each individual.</p>","PeriodicalId":94251,"journal":{"name":"Theoretical medicine and bioethics","volume":" ","pages":"213-230"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13102727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147350224","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
On the method of diagnosis. 论诊断方法。
Theoretical medicine and bioethics Pub Date : 2026-06-01 Epub Date: 2026-03-12 DOI: 10.1007/s11017-026-09741-w
Ammar Naqvi
{"title":"On the method of diagnosis.","authors":"Ammar Naqvi","doi":"10.1007/s11017-026-09741-w","DOIUrl":"10.1007/s11017-026-09741-w","url":null,"abstract":"<p><p>Diagnosis is a foundational task in clinical medicine, yet its reasoning structure remains under-explained in medical education. This paper presents a five-step model of diagnostic reasoning that analyses the epistemic foundation of diagnosis: namely, the structured process by which clinicians construct coherence under constraint. The model describes diagnosis as a disciplined convergence from presenting data toward an explanatory frame that is internally consistent, pathophysiologically plausible, and resistant to contradiction. Grounded in coherence-based epistemology and abductive inference, the framework clarifies how clinicians move from presentation to working diagnosis through five recursive phases: problem framing, perspective construction, constraint application, stabilisation, and clarification. It integrates, rather than replaces, existing approaches-such as dual-process theory, illness script development, and Bayesian updating-by making their underlying reasoning structure explicit and teachable. The model serves as a scaffold for reasoning transparency, structured feedback, and reflective practice. It provides coherence criteria for assessing diagnostic thought and supports formative instruction across simulation, objective structured clinical examination (OSCE), and bedside contexts. While awaiting empirical validation, the present framework offers a theoretical foundation for studying how diagnostic coherence develops and can be taught. In this account, diagnosis is not defined by classification or probability alone, but by the clinician's capacity to construct and sustain an explanatory model that coheres with evidence and contextual constraints.</p>","PeriodicalId":94251,"journal":{"name":"Theoretical medicine and bioethics","volume":" ","pages":"149-194"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147446579","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
An inability-based account of psychiatric harm. 一种基于残疾的精神伤害的描述。
Theoretical medicine and bioethics Pub Date : 2026-06-01 Epub Date: 2026-03-23 DOI: 10.1007/s11017-026-09749-2
Luca Malatesti
{"title":"An inability-based account of psychiatric harm.","authors":"Luca Malatesti","doi":"10.1007/s11017-026-09749-2","DOIUrl":"10.1007/s11017-026-09749-2","url":null,"abstract":"<p><p>Analytical and conceptual engineering approaches converge in showing that harm should be a necessary component of the general concept of mental disorder, particularly within the Diagnostic and Statistical Manual of Mental Disorders (DSM). Nevertheless, the notion of harm in this and similar manuals remains vague and insufficiently defined. Using conceptual engineering, which refines or constructs concepts to better serve theoretical and practical aims, I develop an explication of psychiatric harm. Psychiatric harm arises when psychological inabilities obstruct the formation or pursuit of admissible conceptions of the good life. I reject definitions grounded in uncritical social consensus, rationalist exclusions, or essentialist ideals of human flourishing, and instead propose standards rooted in normative pluralism and democratic values that respect individual diversity. Finally, I indicate that this framework could be operationalised through methodologies exemplified by the World Health Organization's International Classification of Functioning, Disability and Health (ICF).</p>","PeriodicalId":94251,"journal":{"name":"Theoretical medicine and bioethics","volume":" ","pages":"259-275"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147505757","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
A structured analysis of the concept of brain death. 对脑死亡概念的结构化分析。
Theoretical medicine and bioethics Pub Date : 2026-06-01 Epub Date: 2026-03-21 DOI: 10.1007/s11017-026-09748-3
Rainer J Beckmann
{"title":"A structured analysis of the concept of brain death.","authors":"Rainer J Beckmann","doi":"10.1007/s11017-026-09748-3","DOIUrl":"10.1007/s11017-026-09748-3","url":null,"abstract":"<p><p>The tests and procedures used to determine death must be consistent with a coherent concept of death. This concept includes the subject of death, the definition of death, the sign/criterion of death, and the methods used to diagnose death. All four levels must logically build on one another. Additionally, any concept of death must align with the generally accepted meaning of the term \"death\" in everyday language. Judged by these standards, the current guidelines for determining death based on neurological criteria are not convincing: brain death does not indicate the disintegration of the human organism, and intensive care keeps patients alive and does not 'mask' death. Furthermore, 'permanent' loss of organ function can never reliably indicate death. Thus, the criterion and the definition of death do not match.</p>","PeriodicalId":94251,"journal":{"name":"Theoretical medicine and bioethics","volume":" ","pages":"231-258"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13102739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147494815","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
Ethical thinking and practice in the healthcare professions. 医疗保健专业的伦理思考与实践。
Theoretical medicine and bioethics Pub Date : 2026-04-01 Epub Date: 2026-03-24 DOI: 10.1007/s11017-026-09745-6
David T Ozar
{"title":"Ethical thinking and practice in the healthcare professions.","authors":"David T Ozar","doi":"10.1007/s11017-026-09745-6","DOIUrl":"10.1007/s11017-026-09745-6","url":null,"abstract":"<p><p>Every aspect of what healthcare professionals do for patients is ethically significant, so it might seem strange that, when healthcare professionals are asked if anything ethically significant has occurred, their answer frequently is: \"No, there were no ethical issues here.\" But this answer does not mean that nothing ethically significant occurred during their caregiving. For healthcare professionals attend to the ethical content of their caregiving so routinely, so habitually, that their doing this is rarely thought of as involving a method of ethical reflection. This essay will examine this kind of ethical reflection in detail: its main components, how it works in practice, and how to grow in doing it effectively.</p>","PeriodicalId":94251,"journal":{"name":"Theoretical medicine and bioethics","volume":" ","pages":"85-101"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13021680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147505738","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
Denial of benefits: reply to Cordeiro-Rodrigues. 剥夺利益：对Cordeiro-Rodrigues的答复。
Theoretical medicine and bioethics Pub Date : 2026-04-01 Epub Date: 2026-02-03 DOI: 10.1007/s11017-026-09742-9
Jeremy W Skrzypek
{"title":"Denial of benefits: reply to Cordeiro-Rodrigues.","authors":"Jeremy W Skrzypek","doi":"10.1007/s11017-026-09742-9","DOIUrl":"10.1007/s11017-026-09742-9","url":null,"abstract":"","PeriodicalId":94251,"journal":{"name":"Theoretical medicine and bioethics","volume":" ","pages":"141-144"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146115509","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
Relational ethics and the justification of parental permission in pediatrics. 关系伦理与儿科家长许可的正当性。
Theoretical medicine and bioethics Pub Date : 2026-04-01 Epub Date: 2026-02-12 DOI: 10.1007/s11017-026-09740-x
Christopher Bobier
{"title":"Relational ethics and the justification of parental permission in pediatrics.","authors":"Christopher Bobier","doi":"10.1007/s11017-026-09740-x","DOIUrl":"10.1007/s11017-026-09740-x","url":null,"abstract":"<p><p>Beyond legal requirement, why should physicians obtain parental permission to treat a pediatric patient? Children are not the property of their parents, physicians have the relevant medical expertise, and a physician's primary responsibility is to the child, not the parents. In response, scholars have provided several instrumental reasons grounded in the parent-child relationship beyond legal obligation (e.g., parents know their child best; parents can resist substandard care; doing so fosters parental buy-in). While I agree with these reasons, they are not enough to support parental permission in every case in which it should be obtained. Accordingly, I defend a further reason: physicians should obtain parental permission as part of their role responsibility in the physician-parent relationship. I delineate this largely neglected but morally significant relationship and explain why it helps account for physician responsibilities toward parents in pediatric care.</p>","PeriodicalId":94251,"journal":{"name":"Theoretical medicine and bioethics","volume":" ","pages":"103-120"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146168634","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
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