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

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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
#1
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...
November 28, 2016: Health Care Analysis: HCA: Journal of Health Philosophy and Policy
https://www.readbyqxmd.com/read/27734213/the-ir-relevance-of-group-size-in-health-care-priority-setting-a-reply-to-juth
#2
Lars Sandman, Erik Gustavsson
How to handle orphan drugs for rare diseases is a pressing problem in current health-care. Due to the group size of patients affecting the cost of treatment, they risk being disadvantaged in relation to existing cost-effectiveness thresholds. In an article by Niklas Juth it has been argued that it is irrelevant to take indirectly operative factors like group size into account since such a compensation would risk discounting the use of cost, a relevant factor, altogether. In this article we analyze Juth's argument and observe that we already do compensate for indirectly operative factors, both outside and within cost-effectiveness evaluations, for formal equality reasons...
October 12, 2016: Health Care Analysis: HCA: Journal of Health Philosophy and Policy
https://www.readbyqxmd.com/read/27614688/the-athletic-body
#3
Andrew Edgar
This paper seeks to explore the attraction and the beauty of the contemporary athletic body. It will be suggested that a body shaped through muscular bulk and definition has come to be seen as aesthetically normative. This body differs from the body of athletes from the early and mid-twentieth century. It will be argued that the contemporary body is not merely the result of advances in sports science, but rather that it is expressive of certain meanings and values. The visual similarity of the contemporary athletic body and that of the comic book superhero suggests that both bodies carry a similar potential for narrative story-telling, and that their attraction is bound up with this narrative potential...
September 10, 2016: Health Care Analysis: HCA: Journal of Health Philosophy and Policy
https://www.readbyqxmd.com/read/25030339/health-2-0-relational-resources-for-the-development-of-quality-in-healthcare
#4
Celiane Camargo-Borges, Murilo Santos Moscheta
Traditional approaches in healthcare have been challenged giving way to broader forms of users' participation in treatment. In this article we present the Health 2.0 movement as an example of relational and participatory practices in healthcare. Health 2.0 is an approach in which participation is the major aim, aspiring to reshape the system into more collaborative and less hierarchical relationships. We offer two illustrations in order to discuss how Health 2.0 is related and can contribute to a positive uptake of patient's knowledge, which implies challenging healthcare practices exclusively focused on scientific expertise...
December 2016: 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
#5
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...
September 2, 2016: Health Care Analysis: HCA: Journal of Health Philosophy and Policy
https://www.readbyqxmd.com/read/27461537/special-issue-of-health-care-analysis-translational-bodies-ethical-aspects-of-uses-of-human-biomaterials
#6
EDITORIAL
David R Lawrence, Catherine Rhodes
No abstract text is available yet for this article.
September 2016: Health Care Analysis: HCA: Journal of Health Philosophy and Policy
https://www.readbyqxmd.com/read/27453050/the-re-production-of-the-genetically-related-body-in-law-technology-and-culture-mitochondria-replacement-therapy
#7
Danielle Griffiths
Advances in medicine in the latter half of the twentieth century have dramatically altered human bodies, expanding choices around what we do with them and how they connect to other bodies. Nowhere is this more so than in the area of reproductive technologies (RTs). Reproductive medicine and the laws surrounding it in the UK have reconfigured traditional boundaries surrounding parenthood and the family. Yet culture and regulation surrounding RTs have combined to try to ensure that while traditional boundaries may be pushed, they are reconstructed in similar ways...
September 2016: Health Care Analysis: HCA: Journal of Health Philosophy and Policy
https://www.readbyqxmd.com/read/26646672/implantable-smart-technologies-ist-defining-the-sting-in-data-and-device
#8
Gill Haddow, Shawn H E Harmon, Leah Gilman
In a world surrounded by smart objects from sensors to automated medical devices, the ubiquity of 'smart' seems matched only by its lack of clarity. In this article, we use our discussions with expert stakeholders working in areas of implantable medical devices such as cochlear implants, implantable cardiac defibrillators, deep brain stimulators and in vivo biosensors to interrogate the difference facets of smart in 'implantable smart technologies', considering also whether regulation needs to respond to the autonomy that such artefacts carry within them...
September 2016: Health Care Analysis: HCA: Journal of Health Philosophy and Policy
https://www.readbyqxmd.com/read/26297608/potential-international-approaches-to-ownership-control-of-human-genetic-resources
#9
Catherine Rhodes
In its governance activities for genetic resources, the international community has adopted various approaches to their ownership, including: free access; common heritage of mankind; intellectual property rights; and state sovereign rights. They have also created systems which combine elements of these approaches. While governance of plant and animal genetic resources is well-established internationally, there has not yet been a clear approach selected for human genetic resources. Based on assessment of the goals which international governance of human genetic resources ought to serve, and the implications for how they will be accessed and utilised, it is argued that common heritage of mankind will be the most appropriate approach to adopt to their ownership/control...
September 2016: Health Care Analysis: HCA: Journal of Health Philosophy and Policy
https://www.readbyqxmd.com/read/26246070/ethical-reflections-on-genetic-enhancement-with-the-aim-of-enlarging-altruism
#10
David DeGrazia
When it comes to caring about and helping those in need, our imaginations tend to be weak and our motivation tends to be parochial. This is a major moral problem in view of how much unmet need there is in the world and how much material capacity there is to address that need. With this problem in mind, the present paper will focus on genetic means to the enhancement of a moral capacity-a disposition to altruism-and of a cognitive capacity that facilitates use of the moral capacity: the ability to grasp vividly the needs of individuals who are unknown and not present...
September 2016: Health Care Analysis: HCA: Journal of Health Philosophy and Policy
https://www.readbyqxmd.com/read/26240021/a-troubled-past-reassessing-ethics-in-the-history-of-tissue-culture
#11
Duncan Wilson
Recent books, articles and plays about the 'immortal' HeLa cell line have prompted renewed interest in the history of tissue culture methods that were first employed in 1907 and became common experimental tools during the twentieth century. Many of these sources claim tissue cultures like HeLa had a "troubled past" because medical researchers did not seek informed consent before using tissues in research, contravening a long held desire for self-determination on the part of patients and the public. In this article, I argue these claims are unfair and misleading...
September 2016: 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
#12
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...
August 20, 2016: Health Care Analysis: HCA: Journal of Health Philosophy and Policy
https://www.readbyqxmd.com/read/27432005/altered-images-understanding-the-influence-of-unrealistic-images-and-beauty-aspirations
#13
Fiona MacCallum, Heather Widdows
In this paper we consider the impact of digitally altered images on individuals' body satisfaction and beauty aspirations. Drawing on current psychological literature we consider interventions designed to increase knowledge about the ubiquity and unreality of digital images and, in the form of labelling, provide information to the consumer. Such interventions are intended to address the negative consequences of unrealistic beauty ideals. However, contrary to expectations, such initiatives may not be effective, especially in the long-term, and may even be counter-productive...
July 18, 2016: 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
#14
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...
July 4, 2016: Health Care Analysis: HCA: Journal of Health Philosophy and Policy
https://www.readbyqxmd.com/read/27277737/medical-need-evaluating-a-conceptual-critique-of-universal-health-coverage
#15
Lynette Reid
Some argue that the concept of medical need is inadequate to inform the design of a universal health care system-particularly an institutional (universal, comprehensive) rather than a residual (minimalist, safety net) system. They argue that the concept (a) contradicts the idea of comprehensiveness; (b) leads to unsustainable expenditures; (c) is too indeterminate for policy; and (d) supports only a prioritarian distribution (and therefore a residual system). I argue (a) that 'comprehensive' understood as 'including the full continuum of care' and 'medically necessary' understood as 'prioritized by medical criteria' are not contradictory, and (b) that UHC is a solution to the problem of sustainability, not its cause...
June 8, 2016: 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
#16
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...
June 8, 2016: Health Care Analysis: HCA: Journal of Health Philosophy and Policy
https://www.readbyqxmd.com/read/27259288/concierge-wellness-and-block-fee-models-of-primary-care-ethical-and-regulatory-concerns-at-the-public-private-boundary
#17
Lynette Reid
In bioethics and health policy, we often discuss the appropriate boundaries of public funding; how the interface of public and private purchasers and providers should be organized and regulated receives less attention. In this paper, I discuss ethical and regulatory issues raised at this interface by three medical practice models (concierge care, executive wellness clinics, and block fee charges) in which physicians provide insured services (whether publicly insured, privately insured, or privately insured by public mandate) while requiring or requesting that patients pay for services or for the non-insured services of the physicians themselves or their associates...
June 3, 2016: Health Care Analysis: HCA: Journal of Health Philosophy and Policy
https://www.readbyqxmd.com/read/27108422/dying-is-the-most-grown-up-thing-we-ever-do-but-do-health-care-professionals-prevent-us-from-taking-it-seriously
#18
Valerie Iles
This paper takes a somewhat slant perspective on flourishing and care in the context of suffering, death and dying, arguing that care in this context consists principally of 'acts of work and courage that enable flourishing'. Starting with the perception that individuals, society and health care professionals have become dulled to death and the process of dying in Western advanced health systems, it suggests that for flourishing to occur, both of these aspects of life need to be faced more directly. The last days of life need to be 'undulled'...
June 2016: Health Care Analysis: HCA: Journal of Health Philosophy and Policy
https://www.readbyqxmd.com/read/27015998/flourishing-and-posttraumatic-growth-an-empirical-take-on-ancient-wisdoms
#19
Hugh Middleton
Considerations of well-being or flourishing include Maslow's and Rogers' concepts of self-actualisation and actualising tendency. Recent empirical findings suggest that only a modest proportion of the population might be considered to be flourishing. Separate findings focused upon the nature and determinants of post-traumatic growth identify it as comparable to flourishing, and facilitated by supported accommodation to the trauma. This can be understood as reflecting self-actualisation. Empirical findings such as these provide ontological stability to a set of phenomena that share much with ancient teachings extolling redemption through suffering...
June 2016: Health Care Analysis: HCA: Journal of Health Philosophy and Policy
https://www.readbyqxmd.com/read/26924743/flourishing-and-freedom-exploring-their-tensions-and-their-relevance-to-chronic-disease
#20
João Calinas Correia
In this paper I will briefly discuss flourishing and freedom, relating them to health and disease; discuss the tensions between flourishing and freedom; and exemplify how those discussions are relevant to chronic disease suffering. The concept of freedom has significant connections with the concepts of health, disability and disease. Understanding disease and disability in terms of the loss of aspects of freedom may help our understanding of the suffering that arises from chronic disease. On the other hand, flourishing may require a degree of adversity...
June 2016: Health Care Analysis: HCA: Journal of Health Philosophy and Policy
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