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Health Care Analysis: HCA: Journal of Health Philosophy and Policy

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https://www.readbyqxmd.com/read/29987446/the-demands-of-beauty-editors-introduction
#1
EDITORIAL
Heather Widdows, Fiona MacCallum
This article introduces a Special Issue comprising four papers emerging from the Beauty Demands Network project, and maps key issues in the beauty debate. The introduction first discusses the purpose of the Network; to consider the changing demands of beauty across disciplines and beyond academia. It then summarises the findings of the Network workshops, emphasising the complex place of notions of normality, and the different meanings and functions attached to 'normal' in the beauty context. Concerns are raised here about the use of normal to justify and motivate engaging in beauty practices such as cosmetic surgery and 'non-invasive' procedures...
July 9, 2018: Health Care Analysis: HCA: Journal of Health Philosophy and Policy
https://www.readbyqxmd.com/read/29961214/between-the-reasonable-and-the-particular-deflating-autonomy-in-the-legal-regulation-of-informed-consent-to-medical-treatment
#2
Michael Dunn, K W M Fulford, Jonathan Herring, Ashok Handa
The law of informed consent to medical treatment has recently been extensively overhauled in England. The 2015 Montgomery judgment has done away with the long-held position that the information to be disclosed by doctors when obtaining valid consent from patients should be determined on the basis of what a reasonable body of medical opinion agree ought to be disclosed in the circumstances. The UK Supreme Court concluded that the information that is material to a patient's decision should instead be judged by reference to a new two-limbed test founded on the notions of the 'reasonable person' and the 'particular patient'...
June 30, 2018: Health Care Analysis: HCA: Journal of Health Philosophy and Policy
https://www.readbyqxmd.com/read/29936644/pain-as-the-perception-of-someone-an-analysis-of-the-interface-between-pain-medicine-and-philosophy
#3
Emmanuel Bäckryd
Based largely on the so-called problem of "asymmetry in concept application", philosopher Murat Aydede has argued for a non-perceptual view of pain. Aydede is of course not denying basic neurobiological facts about neurons, action potentials, and the like, but he nonetheless makes a strong philosophical case for pain not being the perception of something extramental. In the present paper, after having stated some of the presuppositions I hold as a physician and pain researcher, and after having shortly described Aydede's critique of perceptual theories of pain, I make a constructive proposal centred around the concept of pain as the perception of some-one, not some-thing...
June 23, 2018: Health Care Analysis: HCA: Journal of Health Philosophy and Policy
https://www.readbyqxmd.com/read/29270810/improvement-science-meets-improvement-scholarship-reframing-research-for-better-healthcare
#4
Alan Cribb
In this editorial essay I explore the possibilities of 'improvement scholarship' in order to set the scene for the theme of, and the other papers in, this issue. I contrast a narrow conception of quality improvement (QI) research with a much broader and more inclusive conception, arguing that we should greatly extend the existing dialogue between 'problem-solving' and 'critical' currents in improvement research. I have in mind the potential for building a much larger conversation between those people in 'improvement science' who are expressly concerned with tackling the problems facing healthcare and the wider group of colleagues who are engaged in health-related scholarship but who do not see themselves as particularly interested in quality improvement, indeed who may be critical of the language or concerns of QI...
June 2018: Health Care Analysis: HCA: Journal of Health Philosophy and Policy
https://www.readbyqxmd.com/read/29147898/-don-t-mind-the-gap-reflections-on-improvement-science-as-a-paradigm
#5
Trenholme Junghans
Responding to this issue's invitation to bring new disciplinary insights to the field of improvement science, this article takes as its starting point one of the field's guiding metaphors: the imperative to "mind the gap". Drawing on insights from anthropology, history, and philosophy, the article reflects on the origins and implications of this metaphoric imperative, and suggests some ways in which it might be in tension with the means and ends of improvement. If the industrial origins of improvement science in the twentieth century inform a metaphor of gaps, chasms, and spaces of misalignment as invariably imperfect and potentially dangerous, and therefore requiring bridging or closure, other currents that feed the discipline of improvement science suggest the potential value and uses of spaces of openness and ambiguity...
June 2018: Health Care Analysis: HCA: Journal of Health Philosophy and Policy
https://www.readbyqxmd.com/read/29063364/history-matters-the-critical-contribution-of-historical-analysis-to-contemporary-health-policy-and-health-care
#6
Sally Sheard
History is popular with health policymakers, if the regularity with which they invoke historical anecdotes to support policy change is used as an indicator. Yet the ways in which they 'use' history vary enormously, as does its impact. This paper explores, from the perspective of a UK academic historian, the development of 'applied' history in health policy. It draws on personal experience of different types and levels of engagement with policymakers, and highlights mechanisms through which this dialogue and partnership can be made more efficient, effective, and intellectually rewarding for all involved...
June 2018: Health Care Analysis: HCA: Journal of Health Philosophy and Policy
https://www.readbyqxmd.com/read/29058204/valuing-healthcare-improvement-implicit-norms-explicit-normativity-and-human-agency
#7
Stacy M Carter
I argue that greater attention to human agency and normativity in both researching and practicing service improvement may be one strategy for enhancing improvement science, illustrating with examples from cancer screening. Improvement science tends to deliberately avoid explicit normativity, for paradigmatically coherent reasons. But there are good reasons to consider including explicit normativity in thinking about improvement. Values and moral judgements are central to social life, so an adequate account of social life must include these elements...
June 2018: Health Care Analysis: HCA: Journal of Health Philosophy and Policy
https://www.readbyqxmd.com/read/29038985/showing-the-unsayable-participatory-visual-approaches-and-the-constitution-of-patient-experience-in-healthcare-quality-improvement
#8
Constantina Papoulias
This article considers the strengths and potential contributions of participatory visual methods for healthcare quality improvement research. It argues that such approaches may enable us to expand our understanding of 'patient experience' and of its potential for generating new knowledge for health systems. In particular, they may open up dimensions of people's engagement with services and treatments which exceed both the declarative nature of responses to questionnaires and the narrative sequencing of self reports gathered through qualitative interviewing...
June 2018: Health Care Analysis: HCA: Journal of Health Philosophy and Policy
https://www.readbyqxmd.com/read/28986710/scientism-in-medical-education-and-the-improvement-of-medical-care-opioids-competencies-and-social-accountability
#9
Lynette Reid
Scientism in medical education distracts educators from focusing on the content of learning; it focuses attention instead on individual achievement and validity in its measurement. I analyze the specific form that scientism takes in medicine and in medical education. The competencies movement attempts to challenge old "scientistic" views of the role of physicians, but in the end it has invited medical educators to focus on validity in the measurement of individual performance for attitudes and skills that medicine resists conceptualizing as objective...
June 2018: Health Care Analysis: HCA: Journal of Health Philosophy and Policy
https://www.readbyqxmd.com/read/29644562/exacerbating-inequalities-health-policy-and-the-behavioural-sciences
#10
Kathryn MacKay, Muireann Quigley
There have been calls for some time for a new approach to public health in the United Kingdom and beyond. This is consequent on the recognition and acceptance that health problems often have a complex and multi-faceted aetiology. At the same time, policies which utilise insights from research in behavioural economics and psychology ('behavioural science') have gained prominence on the political agenda. The relationship between the social determinants of health (SDoH) and behavioural science in health policy has not hitherto been explored...
April 11, 2018: Health Care Analysis: HCA: Journal of Health Philosophy and Policy
https://www.readbyqxmd.com/read/29594896/in-defence-of-moral-pluralism-and-compromise-in-health-care-networks
#11
Kasper Raus, Eric Mortier, Kristof Eeckloo
The organisation of health care is rapidly changing. There is a trend to move away from individual health care institutions towards transmural integrated care and interorganizational collaboration in networks. However, within such collaboration and network there is often likely to be a pluralism of values as different health care institutions often have very different values. For this paper, we examine three different models of how we believe institutions can come to collaborate in networks, and thus reap the potential benefits of such collaboration, despite having different moral beliefs or values...
March 29, 2018: Health Care Analysis: HCA: Journal of Health Philosophy and Policy
https://www.readbyqxmd.com/read/29574503/evidence-emotion-and-eminence-a-qualitative-and-evaluative-analysis-of-doctors-skills-in-macroallocation
#12
Siun Gallagher, Miles Little, Claire Hooker
In this analysis of the ethical dimensions of doctors' participation in macroallocation we set out to understand the skills they use, how they are acquired, and how they influence performance of the role. Using the principles of grounded moral analysis, we conducted a semi-structured interview study with Australian doctors engaged in macroallocation. We found that they performed expertise as argument, bringing together phronetic and rhetorical skills founded on communication, strategic thinking, finance, and health data...
March 24, 2018: Health Care Analysis: HCA: Journal of Health Philosophy and Policy
https://www.readbyqxmd.com/read/28332130/if-you-re-a-rawlsian-how-come-you-re-so-close-to-utilitarianism-and-intuitionism-a-critique-of-daniels-s-accountability-for-reasonableness
#13
Gabriele Badano
Norman Daniels's theory of 'accountability for reasonableness' is an influential conception of fairness in healthcare resource allocation. Although it is widely thought that this theory provides a consistent extension of John Rawls's general conception of justice, this paper shows that accountability for reasonableness has important points of contact with both utilitarianism and intuitionism, the main targets of Rawls's argument. My aim is to demonstrate that its overlap with utilitarianism and intuitionism leaves accountability for reasonableness open to damaging critiques...
March 2018: Health Care Analysis: HCA: Journal of Health Philosophy and Policy
https://www.readbyqxmd.com/read/28224293/health-without-care-vulnerability-medical-brain-drain-and-health-worker-responsibilities-in-underserved-contexts
#14
Yusuf Yuksekdag
There is a consensus that the effects of medical brain drain, especially in the Sub-Saharan African countries, ought to be perceived as more than a simple misfortune. Temporary restrictions on the emigration of health workers from the region is one of the already existing policy measures to tackle the issue-while such a restrictive measure brings about the need for quite a justificatory work. A recent normative contribution to the debate by Gillian Brock provides a fruitful starting point. In the first step of her defence of emigration restrictions, Brock provides three reasons why skilled workers themselves would hold responsibilities to assist with respect to vital needs of their compatriots...
March 2018: Health Care Analysis: HCA: Journal of Health Philosophy and Policy
https://www.readbyqxmd.com/read/28161761/beyond-fair-benefits-reconsidering-exploitation-arguments-against-organ-markets
#15
Julian J Koplin
One common objection to establishing regulated live donor organ markets is that such markets would be exploitative. Perhaps surprisingly, exploitation arguments against organ markets have been widely rejected in the philosophical literature on the subject. It is often argued that concerns about exploitation should be addressed by increasing the price paid to organ sellers, not by banning the trade outright. I argue that this analysis rests on a particular conception of exploitation (which I refer to as 'fair benefits' exploitation), and outline two additional ways that the charge of exploitation can be understood (which I discuss in terms of 'fair process' exploitation and complicity in injustice)...
March 2018: Health Care Analysis: HCA: Journal of Health Philosophy and Policy
https://www.readbyqxmd.com/read/27896539/why-health-and-social-care-support-for-people-with-long-term-conditions-should-be-oriented-towards-enabling-them-to-live-well
#16
Vikki A Entwistle, Alan Cribb, John Owens
There are various reasons why efforts to promote "support for self-management" have rarely delivered the kinds of sustainable improvements in healthcare experiences, health and wellbeing that policy leaders internationally have hoped for. This paper explains how the basis of failure is in some respects built into the ideas that underpin many of these efforts. When (the promotion of) support for self-management is narrowly oriented towards educating and motivating patients to adopt the behaviours recommended for disease control, it implicitly reflects and perpetuates limited and somewhat instrumental views of patients...
March 2018: Health Care Analysis: HCA: Journal of Health Philosophy and Policy
https://www.readbyqxmd.com/read/27590144/how-much-care-is-enough-carer-s-guilt-and-bergsonian-time
#17
Will Johncock
Despite devoting their time to another person's needs, many carers paradoxically experience guilt during their caregiving tenure concerning whether they are providing enough care. When discussing the "enough" of anything, what is at stake is that thing's quantification. Given that there are seemingly no quantifiable units of care by which to measure the role, concerns regarding whether enough care is being provided often focus on what constitutes enough time as a carer. In exploring this aspect of the carer's experience, two key parameters emerge; (1) guilt, and, (2) quantified time...
March 2018: Health Care Analysis: HCA: Journal of Health Philosophy and Policy
https://www.readbyqxmd.com/read/27544140/individualised-claims-of-conscience-clinical-judgement-and-best-interests
#18
Stephen W Smith
Conscience and conscientious objections are important issues in medical law and ethics. However, discussions tend to focus on a particular type of conscience-based claim. These types of claims are based upon predictable, generalizable rules in which an individual practitioner objects to what is otherwise standard medical treatment (for example, the objections recognised in the Abortion Act). However, not all conscience based claims are of this type. There are other claims which are based not on an objection to a treatment in general but in individual cases...
March 2018: Health Care Analysis: HCA: Journal of Health Philosophy and Policy
https://www.readbyqxmd.com/read/27376952/examining-the-social-benefits-principle-in-research-with-human-participants
#19
David B Resnik
The idea that research with human participants should benefit society has become firmly entrenched in various regulations, policies, and guidelines, but there has been little in-depth analysis of this ethical principle in the bioethics literature. In this paper, I distinguish between strong and weak versions and the social benefits principle and examine six arguments for it. I argue that while it is always ethically desirable for research with human subjects to offer important benefits to society (or the public), the reasonable expectation of substantial public benefit should be a necessary condition for regarding research as ethical only when (a) it imposes more than minimal risks on non-consenting subjects; or (b) it is supported by public resources...
March 2018: Health Care Analysis: HCA: Journal of Health Philosophy and Policy
https://www.readbyqxmd.com/read/27277736/addressing-deficits-and-injustices-the-potential-epistemic-contributions-of-patients-to-research
#20
Katrina Hutchison, Wendy Rogers, Vikki A Entwistle
Patient or public involvement (PPI) in health research is increasingly expected as a matter of policy. In theory, PPI can contribute both to the epistemic aims intrinsic to research (generating knowledge), and to extrinsically valued features of research such as social inclusion and transparency. In practice, the aims of PPI have not always been clear, although there has been a tendency to encourage the involvement of so-called ordinary people who are regarded as representative of an assumed patient perspective...
December 2017: Health Care Analysis: HCA: Journal of Health Philosophy and Policy
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