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Journal of Medicine and Philosophy

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https://www.readbyqxmd.com/read/29746687/medicine-without-cure-a-cluster-analysis-of-the-nature-of-medicine
#1
Thaddeus Metz
In his article "Prediction, Understanding, and Medicine," Alex Broadbent argues that the nature of medicine is determined by its competences, that is, which things it can do well. He argues that although medicine cannot cure well, it can do a good job of enabling people not only to understand states of the human organism and of what has caused them, but also to predict future states of it. From this, Broadbent concludes that medicine is (at least in part) essentially a practice of understanding and predicting, not curing...
May 9, 2018: Journal of Medicine and Philosophy
https://www.readbyqxmd.com/read/29746686/taking-respect-seriously-clinical-research-and-the-demands-of-informed-consent
#2
Lynn A Jansen
There is broad agreement among research ethicists that investigators have a duty to obtain the informed consent of all subjects who participate in their research trials. On a common view, the duty to obtain this informed consent follows from the need to respect persons and their autonomous decisions. However, the nature of informed consent and the demands it places on investigators are open to dispute and recently have been challenged. Respect for persons, it has been claimed, does not require investigators to guarantee that the subjects enrolled in their trials comprehend the risk/benefit information disclosed to them or even that they appreciate the difference between research and therapy...
May 9, 2018: Journal of Medicine and Philosophy
https://www.readbyqxmd.com/read/29746685/the-continuing-allure-of-cure-a-response-to-alex-broadbent-s-prediction-understanding-and-medicine
#3
Chadwin Harris
In "Prediction, Understanding, and Medicine," Alex Broadbent rejects the curative thesis, the view that the core medical competence is to cure, in favor of his predictive thesis that the main intellectual medical competence is to explain and the main practical medical competence is to predict. Broadbent thinks his account explains the phenomenon of multiple consultation, which is the fact that people persist in consulting alternative medical traditions despite having access to mainstream medicine...
May 9, 2018: Journal of Medicine and Philosophy
https://www.readbyqxmd.com/read/29746684/prediction-understanding-and-medicine
#4
Alex Broadbent
What is medicine? One obvious answer in the context of the contemporary clinical tradition is that medicine is the process of curing sick people. However, this "curative thesis" is not satisfactory, even when "cure" is defined generously and even when exceptions such as cosmetic surgery are set aside. Historian of medicine Roy Porter argues that the position of medicine in society has had, and still has, little to do with its ability to make people better. Moreover, the efficacy of medicine for improving population health has been famously doubted by historians and epidemiologists...
May 9, 2018: Journal of Medicine and Philosophy
https://www.readbyqxmd.com/read/29746683/intellectualizing-medicine-a-reply-to-commentaries-on-prediction-understanding-and-medicine
#5
Alex Broadbent
This article is a reply to two critics of my "Prediction, Understanding, and Medicine," published elsewhere in this journal issue. In that essay, I argued that medicine is best understood not as essentially a curative enterprise, but rather as one essentially oriented towards prediction and understanding. Here, I defend this position from several criticisms made of it.
May 9, 2018: Journal of Medicine and Philosophy
https://www.readbyqxmd.com/read/29546416/embodied-concepts-and-mental-health
#6
Somogy Varga
Often drawing on the phenomenological tradition, a number of philosophers and cognitive scientists working in the field of "embodied cognition" subscribe to the general view that cognition is grounded in aspects of its sensorimotor embodiment and should be comprehended as the result of a dynamic interaction of nonneural and neural processes. After a brief introduction, the paper critically engages Lakoff and Johnson's "conceptual metaphor theory" (CMT), and provides a review of recent empirical evidence that appears to support it...
March 13, 2018: Journal of Medicine and Philosophy
https://www.readbyqxmd.com/read/29546415/misconceptions-inherent-in-the-substance-ontology-approach-to-assigning-moral-status-a-reply-to-patrick-lee-christopher-tollefsen-and-robert-george
#7
Jason Z Morris
I have argued that substance ontology cannot be used to determine the moral status of embryos. Patrick Lee, Christopher Tollefsen, and Robert George wrote a Reply to those arguments in this Journal. In that Reply, Lee, Tollefsen, and George defended and clarified their position that their substance ontology arguments prove that the zygote and the adult into which it develops are the same entity that share the same essence. Here, I show the following: (A) Even using the substance ontology framework to which Lee, Tollefsen, and George subscribe, we cannot know when in development substance changes cease...
March 13, 2018: Journal of Medicine and Philosophy
https://www.readbyqxmd.com/read/29546414/donation-after-the-circulatory-determination-of-death-some-responses-to-recent-criticisms
#8
Andrew McGee, Dale Gardiner
This article defends the criterion of permanence as a valid criterion for declaring death against some well-known recent objections. We argue that it is reasonable to adopt the criterion of permanence for declaring death, given how difficult it is to know when the point of irreversibility is actually reached. We claim that this point applies in all contexts, including the donation after circulatory determination of death context. We also examine some of the potentially unpalatable ramifications, for current death declaration practices, of adopting the irreversibility criterion...
March 13, 2018: Journal of Medicine and Philosophy
https://www.readbyqxmd.com/read/29546413/human-animal-chimeras-and-hybrids-an-ethical-paradox-behind-moral-confusion
#9
Dietmar Hübner
The prospect of creating and using human-animal chimeras and hybrids (HACHs) that are significantly human-like in their composition, phenotype, cognition, or behavior meets with divergent moral judgments: on the one side, it is claimed that such beings might be candidates for human-analogous rights to protection and care; on the other side, it is supposed that their existence might disturb fundamental natural and social orders. This paper tries to show that both positions are paradoxically intertwined: they rely on two kinds of species arguments, "individual species arguments" and "group species arguments," which formulate opposing demands but are conceptually interdependent...
March 13, 2018: Journal of Medicine and Philosophy
https://www.readbyqxmd.com/read/29546412/the-moral-status-of-the-human-embryo
#10
Mark T Brown
Moral status ascribes equal obligations and rights to individuals on the basis of membership in a protected group. Substance change is an event that results in the origin or cessation of individuals who may be members of groups with equal moral status. In this paper, two substance changes that affect the moral status of human embryos are identified. The first substance change begins with fertilization and ends with the formation of the blastocyst, a biological individual with moral status comparable to that ascribed to human organs...
March 13, 2018: Journal of Medicine and Philosophy
https://www.readbyqxmd.com/read/29301011/should-mitochondrial-donation-be-anonymous
#11
John B Appleby
Currently in the United Kingdom, anyone donating gametes has the status of an open-identity donor. This means that, at the age of 18, persons conceived with gametes donated since April 1, 2005 have a right to access certain pieces of identifying information about their donor. However, in early 2015, the UK Parliament approved new regulations that make mitochondrial donors anonymous. Both mitochondrial donation and gamete donation are similar in the basic sense that they involve the contribution of gamete materials to create future persons...
March 13, 2018: Journal of Medicine and Philosophy
https://www.readbyqxmd.com/read/29342286/the-ethics-of-general-population-preventive-genomic-sequencing-rights-and-social-justice
#12
Clair Morrissey, Rebecca L Walker
Advances in DNA sequencing technology open new possibilities for public health genomics, especially in the form of general population preventive genomic sequencing (PGS). Such screening programs would sit at the intersection of public health and preventive health care, and thereby at once invite and resist the use of clinical ethics and public health ethics frameworks. Despite their differences, these ethics frameworks traditionally share a central concern for individual rights. We examine two putative individual rights-the right not to know, and the child's right to an open future-frequently invoked in discussions of predictive genetic testing, in order to explore their potential contribution to evaluating this new practice...
January 12, 2018: Journal of Medicine and Philosophy
https://www.readbyqxmd.com/read/29342285/serial-participation-and-the-ethics-of-phase-1-healthy-volunteer-research
#13
Rebecca L Walker, Marci D Cottingham, Jill A Fisher
Phase 1 healthy volunteer clinical trials-which financially compensate subjects in tests of drug toxicity levels and side effects-appear to place pressure on each joint of the moral framework justifying research. In this article, we review concerns about phase 1 trials as they have been framed in the bioethics literature, including undue inducement and coercion, unjust exploitation, and worries about compromised data validity. We then revisit these concerns in light of the lived experiences of serial participants who are income-dependent on phase 1 trials...
January 12, 2018: Journal of Medicine and Philosophy
https://www.readbyqxmd.com/read/29342284/two-ways-to-kill-a-patient
#14
Ben Bronner
According to the Standard View, a doctor who withdraws life-sustaining treatment does not kill the patient but rather allows the patient to die-an important distinction, according to some. I argue that killing (and causing death) can be understood in either of two ways, and given the relevant understanding, the Standard View is insulated from typical criticisms. I conclude by noting several problems for the Standard View that remain to be fully addressed.
January 12, 2018: Journal of Medicine and Philosophy
https://www.readbyqxmd.com/read/29300981/chromosome-screening-using-noninvasive-prenatal-testing-beyond-trisomy-21-what-to-screen-for-and-why-it-matters
#15
Kristien Hens
With the new and highly accurate noninvasive prenatal test (NIPT), new options for screening become available. I contend that the current state of the art of NIPT is already in need of a thorough ethical investigation and that there are different points to consider before any chromosomal or subchromosomal condition is added to the screening panel of a publicly funded screening program. Moreover, the application of certain ethical principles makes the inclusion of some conditions unethical in a privately funded scheme, even if such screening would enhance a woman's reproductive autonomy...
January 12, 2018: Journal of Medicine and Philosophy
https://www.readbyqxmd.com/read/29300977/schemata-consort-and-the-salk-polio-vaccine-trial
#16
Charles J Kowalski, Adam J Mrdjenovich
In this essay, we defend the design of the Salk polio vaccine trial and try to put some limits on the role schemata should play in designing clinical research studies. Our presentation is structured as a response to de Freitas and Pietrobon (de Freitas, R. S. and R. Pietrobon. 2007. Whoever could get rid of the context of discovery/context of justification dichotomy? A proposal based on recent developments in clinical research. Journal of Medicine and Philosophy 32:25-42.) who identified the CONSORT statement as a schema that would have, had it existed at the time, ruled out the design of the Salk polio vaccine trial of 1954 in favor of a completely randomized controlled clinical trial (RCT)...
January 12, 2018: Journal of Medicine and Philosophy
https://www.readbyqxmd.com/read/29149335/liberty-in-health-care-a-comparative-study-between-hong-kong-and-mainland-china
#17
Jingxian Wu, Ying Mao
This essay contends that individual liberty, understood as the permissibility of making choices about one's own health care in support of one's own good and the good of one's family utilizing private resources, is central to the moral foundations of a health care system. Such individual freedoms are important not only because they often support more efficient and effective health care services, but because they permit individuals to fulfill important moral duties. A comparative study of the health care systems in Hong Kong and mainland China is utilized to illustrate the conceptual and moral concerns at stake...
November 15, 2017: Journal of Medicine and Philosophy
https://www.readbyqxmd.com/read/29149334/reassessing-the-likely-harms-to-kidney-vendors-in-regulated-organ-markets
#18
Luke Semrau
Julian Koplin, drawing extensively on empirical data, has argued that vendors, even in well-regulated kidney markets, are likely to be significantly harmed. I contend that his reasoning to this conclusion is dangerously mistaken. I highlight two failures. First, Koplin is insufficiently attentive to the differences between existing markets and the regulated markets proposed by advocates. On the basis of this error, he wrongly concludes that many harms will persist even in a well-regulated system. Second, Koplin misunderstands the utilitarian assessment of the market...
November 15, 2017: Journal of Medicine and Philosophy
https://www.readbyqxmd.com/read/29149333/misleading-by-omission-rethinking-the-obligation-to-inform-research-subjects-about-funding-sources
#19
Neil C Manson
Informed consent requirements for medical research have expanded over the past half-century. The Declaration of Helsinki now includes an explicit positive obligation to inform subjects about funding sources. This is problematic in a number of ways and seems to oblige researchers to disclose information irrelevant to most consent decisions. It is argued here that such a problematic obligation involves an "informational fallacy." The aim in the second part of the paper is to provide a better approach to making sense of how a failure to inform about funding sources wrongs subjects: by making appeals to obligations to refrain from misleading by omission...
November 15, 2017: Journal of Medicine and Philosophy
https://www.readbyqxmd.com/read/29149332/kidney-sales-and-market-regulation-a-reply-to-semrau
#20
Julian J Koplin
Luke Semrau argues that the documented harms of existing organ markets do not undermine the case for establishing regulated systems of paid kidney donation. He offers two arguments in support of this conclusion. First, Semrau argues that the harms of kidney selling are straightforwardly amenable to regulatory solution. Second, Semrau argues that even in existing black markets, sellers would likely have experienced greater harm if the option of selling a kidney were not available. This commentary challenges both of Semrau's claims...
November 15, 2017: Journal of Medicine and Philosophy
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