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Journal of Medicine and Philosophy

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https://www.readbyqxmd.com/read/28922907/organ-vouchers-and-barter-markets-saving-lives-reducing-suffering-and-trading-in-human-organs
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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 (OMIM®), 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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
https://www.readbyqxmd.com/read/28444334/antiquity-s-missive-to-transhumanism1
#16
Susan B Levin
To reassure those concerned about wholesale discontinuity between human existence and posthumanity, transhumanists assert shared ground with antiquity on vital challenges and aspirations. Because their claims reflect key misconceptions, there is no shared vision for transhumanists to invoke. Having exposed their misuses of Prometheus, Plato, and Aristotle, I show that not only do transhumanists and antiquity crucially diverge on our relation to ideals, contrast-dependent aspiration, and worthy endeavors but that illumining this divide exposes central weaknesses in transhumanist argumentation...
June 1, 2017: Journal of Medicine and Philosophy
https://www.readbyqxmd.com/read/28430994/personhood-and-natural-kinds-why-cognitive-status-need-not-affect-moral-status
#17
Joseph Vukov
Lockean accounts of personhood propose that an individual is a person just in case that individual is characterized by some advanced cognitive capacity. On these accounts, human beings with severe cognitive impairment are not persons. Some accept this result-I do not. In this paper, I therefore advance and defend an account of personhood that secures personhood for human beings who are cognitively impaired. On the account for which I argue, an individual is a person just in case that individual belongs to a natural kind that is normally characterized by advanced cognitive capacities...
June 1, 2017: Journal of Medicine and Philosophy
https://www.readbyqxmd.com/read/28419342/future-generations-and-the-justifiability-of-germline-engineering
#18
Ioana Petre
The possibility of performing germline modifications on currently living individuals targets future generations' health and well-being by reducing the diversity of the human gene pool. This can have two negative repercussions: (1) reduction of heterozygosity, the latter being associated with a health or performance advantage; (2) uniformization of the genes involved in reproductive recombination, which may lead to the health risks involved in asexual reproduction. I argue that germline interventions aimed at modifying the genomes of future people cannot be ethically justifiable if there is no possibility of controlling the intervention either by reversing or altering it, whenever need demands it...
June 1, 2017: Journal of Medicine and Philosophy
https://www.readbyqxmd.com/read/28419302/the-posthuman-as-hollow-idol-a-nietzschean-critique-of-human-enhancement
#19
Ciano Aydin
In this paper, the author aims to show that transhumanists are confused about their own conception of the posthuman: transhumanists anticipate radical transformation of the human through technology and at the same time assume that the criteria to determine what is "normal" and what is "enhanced" are univocal, both in our present time and in the future. Inspired by Nietzsche's notion of the Overhuman, the author argues that the slightest "historical and phenomenological sense" discloses copious variations of criteria, both diachronic and synchronic, for what can be considered "normal" and "enhanced...
June 1, 2017: Journal of Medicine and Philosophy
https://www.readbyqxmd.com/read/28201749/the-ethical-principles-of-the-portuguese-psychologists-a-universal-dimension
#20
Miguel Ricou, Eduardo Sá, Rui Nunes
Ethical principles are fundamental for the exercise of any profession. Portuguese psychologists have waited for 30 years for professional validation. This paper will define the Portuguese psychologists' ethical principles, with a universal view as a starting point and then an adaptation to the cultural and professional reality in Portugal. The level of acceptability of these principles will be ascertained in a later paper.
April 1, 2017: Journal of Medicine and Philosophy
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