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Journal of Medicine and Philosophy

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https://www.readbyqxmd.com/read/29149335/liberty-in-health-care-a-comparative-study-between-hong-kong-and-mainland-china
#1
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
#2
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
#3
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
#4
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
https://www.readbyqxmd.com/read/29149331/the-ethics-of-organ-tourism-role-morality-and-organ-transplantation
#5
Marcus P Adams
Organ tourism occurs when individuals in countries with existing organ transplant procedures, such as the United States, are unable to procure an organ by using those transplant procedures in enough time to save their life. In this paper, I am concerned with the following question: When organ tourists return to the United States and need another transplant, do US transplant physicians have an obligation to place them on a transplant list? I argue that transplant physicians have a duty not to relist organ tourists...
November 15, 2017: Journal of Medicine and Philosophy
https://www.readbyqxmd.com/read/28922907/organ-vouchers-and-barter-markets-saving-lives-reducing-suffering-and-trading-in-human-organs
#6
Mark J Cherry
The essays in this issue of The Journal of Medicine and Philosophy explore an innovative voucher program for encouraging kidney donation. Discussions cluster around a number of central moral and political/theoretical themes: (1) What are the direct and indirect health care costs and benefits of such a voucher system in human organs? (2) Do vouchers lead to more effective and efficient organ procurement and allocation or contribute to greater inequalities and inefficiencies in the transplantation system? (3) Do vouchers contribute to the inappropriate commodification of human body parts? (4) Is there a significant moral difference between such a voucher system and a market in human organs for transplantation? This paper argues that while kidney vouchers constitute a step in the right direction, fuller utilization of market-based incentives, including, but not limited to, barter exchanges (e...
October 1, 2017: Journal of Medicine and Philosophy
https://www.readbyqxmd.com/read/28922906/ethical-and-logistical-issues-raised-by-the-advanced-donation-program-pay-it-forward-scheme
#7
Lainie Friedman Ross, James R Rodrigue, Robert M Veatch
The advanced donation program was proposed in 2014 to allow an individual to donate a kidney in order to provide a voucher for a kidney in the future for a particular loved one. In this article, we explore the logistical and ethical issues that such a program raises. We argue that such a program is ethical in principle but there are many logistical issues that need to be addressed to ensure that the actual program is fair to both those who do and do not participate in this program.
October 1, 2017: Journal of Medicine and Philosophy
https://www.readbyqxmd.com/read/28922905/kidney-vouchers-and-inequity-in-transplantation
#8
Samuel J Kerstein
This article probes the voucher program from an ethical perspective. It focuses mainly on an issue of inequity. A disparity exists in US kidney transplantation. Although African-Americans suffer far higher rates of ESRD than whites, African-Americans are much less likely than whites to get a transplant (Ilori et al., 2015, 1). The article explores the voucher program in light of this disparity. It motivates the view that, at least in the short term, more whites than African-Americans are likely to take advantage of the voucher program...
October 1, 2017: Journal of Medicine and Philosophy
https://www.readbyqxmd.com/read/28922904/the-body-as-gift-commodity-or-something-in-between-ethical-implications-of-advanced-kidney-donation
#9
Julian J Koplin
An innovative program recently initiated at the University of California, Los Angeles (UCLA) Medical Center allows people to donate a kidney in exchange for a voucher that a loved one can redeem for a kidney if and when needed. As a relatively new practice, the ethical implications of advanced kidney donation have not yet been widely discussed. This paper reflects on some of the bioethical issues at stake in this new donation program, as well as some broader philosophical issues related to the meaning and moral salience of commodification...
October 1, 2017: Journal of Medicine and Philosophy
https://www.readbyqxmd.com/read/28922903/banking-on-living-kidney-donors-a-new-way-to-facilitate-donation-without-compromising-on-ethical-values
#10
Dominique E Martin, Gabriel M Danovitch
Public surveys conducted in many countries report widespread willingness of individuals to donate a kidney while alive to a family member or close friend, yet thousands suffer and many die each year while waiting for a kidney transplant. Advocates of financial incentive programs or "regulated markets" in kidneys present the problem of the kidney shortage as one of insufficient public motivation to donate, arguing that incentives will increase the number of donors. Others believe the solutions lie-at least in part-in facilitating so-called "altruistic donation;" harnessing the willingness of relatives and friends to donate by addressing the many barriers which serve as disincentives to living donation...
October 1, 2017: Journal of Medicine and Philosophy
https://www.readbyqxmd.com/read/28922902/from-directed-donation-to-kidney-sale-does-the-argument-hold-up
#11
James Stacey Taylor
The UCLA Medical Center has initiated a "voucher program" under which a person who donated a kidney would receive a voucher that she could provide to someone of her choosing who could then use it to move to the top of the renal transplantation waiting list. If the use of such vouchers as incentives for donors is morally permissible, then cash payments for kidneys are also morally permissible. But, that argument faces five objections. First, there are some goods whose nature allows them to be exchanged for similar goods but renders them monetarily inalienable...
October 1, 2017: Journal of Medicine and Philosophy
https://www.readbyqxmd.com/read/28859465/progress-in-defining-disease-improved-approaches-and-increased-impact
#12
Peter H Schwartz
In a series of recent papers, I have made three arguments about how to define "disease" and evaluate and apply possible definitions. First, I have argued that definitions should not be seen as traditional conceptual analyses, but instead as proposals about how to define and use the term "disease" in the future. Second, I have pointed out and attempted to address a challenge for dysfunction-requiring accounts of disease that I call the "line-drawing" problem: distinguishing between low-normal functioning and dysfunctioning...
August 1, 2017: Journal of Medicine and Philosophy
https://www.readbyqxmd.com/read/28859464/how-to-proceed-in-the-disease-concept-debate-a-pragmatic-approach
#13
Leen De Vreese
In the traditional philosophical debate over different conceptual analyses of "disease," it is often presupposed that "disease" is univocally definable and that there are clear boundaries which distinguish this univocal category "disease" from the category of "nondisease." In this paper, I will argue for a shift in the discussion on the concept of "disease" and propose an alternative, pragmatic approach that is based on the conviction that "disease" is not a theoretical concept but a practical term. I develop a view on which our use of the term "disease" is determined by two interacting factors, namely, value-laden considerations about the (un)desirabilty of certain states and discoveries of cause(s) which is/are explanatorily relevant...
August 1, 2017: Journal of Medicine and Philosophy
https://www.readbyqxmd.com/read/28641396/geneticization-in-mim-omim%C3%A2-exploring-historic-and-epistemic-drivers-of-contemporary-understandings-of-genetic-disease
#14
Rachel A Ankeny
Prior to the genomic sequencing era, the bible for those working in clinical genetics was McKusick's Mendelian Inheritance in Man (MIM), which appeared in multiple editions between the 1960s and the late 1990s. This catalogue was organized according to general patterns of inheritance and focused on phenotypes. Beginning in the mid-1980s, it was replaced by Online Mendelian Inheritance in Man (OMIMĀ®), a continuously updated catalogue documenting molecular relationships between genetic variation and phenotypic expression...
August 1, 2017: Journal of Medicine and Philosophy
https://www.readbyqxmd.com/read/28475734/biological-criteria-of-disease-four-ways-of-going-wrong
#15
John Matthewson, Paul E Griffiths
We defend a view of the distinction between the normal and the pathological according to which that distinction has an objective, biological component. We accept that there is a normative component to the concept of disease, especially as applied to human beings. Nevertheless, an organism cannot be in a pathological state unless something has gone wrong for that organism from a purely biological point of view. Biology, we argue, recognises two sources of biological normativity, which jointly generate four "ways of going wrong" from a biological perspective...
August 1, 2017: Journal of Medicine and Philosophy
https://www.readbyqxmd.com/read/28444342/harm-and-the-boundaries-of-disease
#16
Patrick McGivern, Sarah Sorial
What is the relationship between harm and disease? Discussions of the relationship between harm and disease typically suffer from two shortcomings. First, they offer relatively little analysis of the concept of harm itself, focusing instead on examples of clear cases of harm such as death and dismemberment. This makes it difficult to evaluate such accounts in borderline cases, where the putative harms are less severe. Second, they assume that harm-based accounts of disease must be understood normatively rather than naturalistically, in the sense that they are inherently value based...
August 1, 2017: Journal of Medicine and Philosophy
https://www.readbyqxmd.com/read/28444298/the-line-drawing-problem-in-disease-definition
#17
Wendy A Rogers, Mary Jean Walker
Biological dysfunction is regarded, in many accounts, as necessary and perhaps sufficient for disease. But although disease is conceptualized as all-or-nothing, biological functions often differ by degree. A tension is created by attempting to use a continuous variable as the basis for a categorical definition, raising questions about how we are to pinpoint the boundary between health and disease. This is the line-drawing problem. In this paper, we show how the line-drawing problem arises within "dysfunction-requiring" accounts of disease, such as those of Christopher Boorse and Jerome Wakefield...
August 1, 2017: Journal of Medicine and Philosophy
https://www.readbyqxmd.com/read/28444218/current-dilemmas-in-defining-the-boundaries-of-disease
#18
Jenny Doust, Mary Jean Walker, Wendy A Rogers
Boorse's biostatistical theory states that diseases should be defined in ways that reflect disturbances of biological function and that are objective and value free. We use three examples from contemporary medicine that demonstrate the complex issues that arise when defining the boundaries of disease: polycystic ovary syndrome, chronic kidney disease, and myocardial infarction. We argue that the biostatistical theory fails to provide sufficient guidance on where the boundaries of disease should be drawn, contains ambiguities relating to choice of reference class, and is out of step with medical processes for identifying disease boundaries...
August 1, 2017: Journal of Medicine and Philosophy
https://www.readbyqxmd.com/read/28419307/truth-or-spin-disease-definition-in-cancer-screening
#19
Lynette Reid
Are the small and indolent cancers found in abundance in cancer screening normal variations, risk factors, or disease? Naturalists in philosophy of medicine turn to pathophysiological findings to decide such questions objectively. To understand the role of pathophysiological findings in disease definition, we must understand how they mislead in diagnostic reasoning. Participants on all sides of the definition of disease debate attempt to secure objectivity via reductionism. These reductivist routes to objectivity are inconsistent with the Bayesian nature of clinical reasoning; when they appeal to the sciences, they are inconsistent with what philosophy of biology tells us about its natural kinds...
August 1, 2017: Journal of Medicine and Philosophy
https://www.readbyqxmd.com/read/28499043/bioethics-and-transhumanism
#20
Allen Porter
Transhumanism is a "technoprogressive" socio-political and intellectual movement that advocates for the use of technology in order to transform the human organism radically, with the ultimate goal of becoming "posthuman." To this end, transhumanists focus on and encourage the use of new and emerging technologies, such as genetic engineering and brain-machine interfaces. In support of their vision for humanity, and as a way of reassuring those "bioconservatives" who may balk at the radical nature of that vision, transhumanists claim common ground with a number of esteemed thinkers and traditions, from the ancient philosophy of Plato and Aristotle to the postmodern philosophy of Nietzsche...
June 1, 2017: Journal of Medicine and Philosophy
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