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Medicine, Health Care, and Philosophy

Eva van Baarle, Ineke van de Braak, Desiree Verweij, Guy Widdershoven, Bert Molewijk
There is considerable support for the idea that an atmosphere of safety can foster learning in groups, especially during ethics training courses. However, the question how safety dynamics works during ethics courses is still understudied. This article aims to investigate safety dynamics by examining a critical incident during a military ethics train-the trainer course during which safety was threatened. We examine this incident by means of a four-factor analysis model from the field of Theme-Centered Interaction (TCI)...
July 10, 2018: Medicine, Health Care, and Philosophy
Emilia Kaczmarek
Is medicalization always harmful? When does medicine overstep its proper boundaries? The aim of this article is to outline the pragmatic criteria for distinguishing between medicalization and over-medicalization. The consequences of considering a phenomenon to be a medical problem may take radically different forms depending on whether the problem in question is correctly or incorrectly perceived as a medical issue. Neither indiscriminate acceptance of medicalization of subsequent areas of human existence, nor criticizing new medicalization cases just because they are medicalization can be justified...
June 27, 2018: Medicine, Health Care, and Philosophy
Weyma Lübbe
Thirty years of debate have passed since the term "Rule of Rescue" has been introduced into medical ethics. Its main focus was on whether or why medical treatment for acute conditions should have priority over preventive measures irrespective of opportunity costs. Recent contributions, taking account of the widespread reluctance to accept purely efficiency-oriented prioritization approaches, advance another objection: Prioritizing treatment, they hold, discriminates against statistical lives. The reference to opportunity costs has also been renewed in a distinctly ethical fashion: It has been stipulated that favoring help for identifiable lives amounts to a lack of benevolence for one's fellow creatures...
June 26, 2018: Medicine, Health Care, and Philosophy
Bert Gordijn, Henk Ten Have
No abstract text is available yet for this article.
June 21, 2018: Medicine, Health Care, and Philosophy
C M M L Bontemps-Hommen, A Baart, F T H Vosman
In recent times, daily, ordinary medical practices have incontrovertibly been developing under the condition of complexity. Complexity jeopardizes the moral core of practicing medicine: helping people, with their illnesses and suffering, in a medically competent way. Practical wisdom (a modification of the Aristotelian phronèsis) has been proposed as part of the solution to navigate complexity, aiming at the provision of morally good care. Practical wisdom should help practitioners to maneuver in complexity, where the presupposed linear ways of operating prove to be insufficient...
June 20, 2018: Medicine, Health Care, and Philosophy
Uri Kartoun
To accelerate the adoption of a new method with a high potential to replace or extend an existing, presumably less accurate, medical scoring system, evaluation should begin days after the new concept is presented publicly, not years or even decades later. Metaphorically speaking, as chameleons capable of quickly changing colors to help their bodies adjust to changes in temperature or light, health-care decision makers should be capable of more quickly evaluating new data-driven insights and tools and should integrate the highest performing ones into national and international care systems...
June 7, 2018: Medicine, Health Care, and Philosophy
Aya Enzo, Taketoshi Okita, Atsushi Asai
The global increase in patients with chronic conditions has led to increased interest in ethical issues regarding such conditions. A basic biomedical principle-respect for autonomy-is being reexamined more critically in its clinical implications. New accounts of this basic principle are being proposed. While new accounts of respect for autonomy do underpin the design of many public programs and policies worldwide, addressing both chronic disease management and health promotion, the risk of applying such new accounts to clinical setting remain understudied...
May 29, 2018: Medicine, Health Care, and Philosophy
Māra Grīnfelde
During the last few decades, many thinkers have advocated for the importance of the phenomenological approach in developing the understanding of the lived experience of illness. In their attempts, they have referred to ideas found in the history of phenomenology, most notably, in the works of Edmund Husserl, Martin Heidegger, Maurice Merleau-Ponty and Jean-Paul Sartre. The aim of this paper is to sketch out an interpretation of illness based on a yet unexplored conceptual framework of the phenomenology of French thinker Jean-Luc Marion...
May 24, 2018: Medicine, Health Care, and Philosophy
Hane Htut Maung
It is often claimed in parts of the psychiatric literature that neuroscientific research into the biological basis of mental disorder undermines dualism in the philosophy of mind. This paper shows that such a claim does not apply to all forms of dualism. Focusing on Kenneth Kendler's discussion of the mind-body problem in biological psychiatry, I argue that such criticism of dualism often conflates the psychological and phenomenal concepts of the mental. Moreover, it fails to acknowledge that there are different varieties of dualism, and so overlooks the important metaphysical insights of contemporary dualist philosophers...
May 19, 2018: Medicine, Health Care, and Philosophy
Johan Brännmark
This paper discusses the relation between medical ethics and general moral theory, the argument being that medical ethics is best seen as independent from general moral theory. According to this independence thesis, here explicated in terms of what is called a disunitarian stance, the very idea of applied ethics, which is often seen as underlying medical ethics (as well as many other more specific fields of ethics), is misguided. We should instead think of medical ethics as a domain-specific ethical inquiry among other domain-specific ethical inquiries...
May 16, 2018: Medicine, Health Care, and Philosophy
Henk Ten Have, Bert Gordijn
No abstract text is available yet for this article.
May 9, 2018: Medicine, Health Care, and Philosophy
Michael Saraga, Donald Boudreau, Abraham Fuks
In order to understand the lived experiences of physicians in clinical practice, we interviewed eleven expert, respected clinicians using a phenomenological interpretative methodology. We identified the essence of clinical practice as engagement. Engagement accounts for the daily routine of clinical work, as well as the necessity for the clinician to sometimes trespass common boundaries or limits. Personally engaged in the clinical situation, the clinician is able to create a space/time bubble within which the clinical encounter can unfold...
May 8, 2018: Medicine, Health Care, and Philosophy
Manuel Schaper, Sabine Wöhlke, Silke Schicktanz
Direct-to-consumer genetic testing (DTC GT) has been available for several years now, with varying degrees of regulation across different countries. Despite a restrictive legal framework it is possible for consumers to order genetic tests from companies located in other countries. However, German laypeople's awareness and perceptions of DTC GT services is still unexplored. We conducted seven focus groups (participants n = 43) with German laypeople to explore their perceptions of and attitudes towards commercial genetic testing and its ethical implications...
April 28, 2018: Medicine, Health Care, and Philosophy
Gabrielle Natalie Samuel, Bobbie Farsides
The UK Chief Medical Officer's 2016 Annual Report, Generation Genome, focused on a vision to fully integrate genomics into all aspects of the UK's National Health Service (NHS). This process of integration, which has now already begun, raises a wide range of social and ethical concerns, many of which were discussed in the final Chapter of the report. This paper explores how the UK's 100,000 Genomes Project (100 kGP)-the catalyst for Generation Genome, and for bringing genomics into the NHS-is negotiating these ethical concerns...
June 2018: Medicine, Health Care, and Philosophy
Pål Møller, Eivind Hovig
The concept 'hereditary breast cancer' is commonly used to delineate a group of people genetically at risk for breast cancer-all of whom also having risk for other cancers. People carrying pathogenic variants of the BRCA1 and BRCA2 genes are often referred to as those having predisposition for 'hereditary breast cancer'. The two genes, however, are when altered, associated with different risks for and dying from breast cancer. The main risk for dying for carriers of both genes is from ovarian cancer. These biological facts are of philosophical interest, because they are the facts underlying the public debate on BRCA1/2 genetic testing as a model for the discussion of how to implement genetic knowledge and technologies in personalized medicine...
June 2018: Medicine, Health Care, and Philosophy
Maria do Céu Patrão Neves
The notion of "integrity" is currently quite common and broadly recognized as complex, mostly due to its recurring and diverse application in various distinct domains such as the physical, psychic or moral, the personal or professional, that of the human being or of the totality of beings. Nevertheless, its adjectivation imprints a specific meaning, as happens in the case of "scientific integrity". This concept has been defined mostly by via negativa, by pointing out what goes against integrity, that is, through the identification of its infringements, which has also not facilitated the elaboration of an overarching and consensual code of scientific integrity...
June 2018: Medicine, Health Care, and Philosophy
Zainab Sheikh, Klaus Hoeyer
Trust features prominently in a number of policy documents that have been issued in recent years to facilitate data sharing and international collaboration in medical research. However, it often remains unclear what is meant by 'trust'. By exploring a concrete international collaboration between Denmark and Pakistan, we develop a way of unpacking trust that shifts focus from what trust 'is' to what people invest in relationships and what references to trust do for them in these relationships. Based on interviews in both Pakistan and Denmark with people who provide blood samples and health data for the same laboratory, we find that when participants discuss trust they are trying to shape their relationship to researchers while simultaneously communicating important hopes, fears and expectations...
June 2018: Medicine, Health Care, and Philosophy
Alison Wheatley
There has been a great deal of discussion about the ethical implications of donating sperm and of the ways in which donated tissue is presented, selected, and sold for use in assisted reproduction. Debates have emerged within the academic sphere, from donor offspring and recipients, and in broader popular culture, including questions about the commodification of human tissue and the eugenic potential of selecting donors from particular demographic categories. However, the voices of donors themselves on this subject have been largely silent...
June 2018: Medicine, Health Care, and Philosophy
Christopher Cowley
Ronald Dworkin (1993) introduced the example of Margo, who was so severely demented that she could not recognise any family or friends, and could not remember anything of her life. At the same time, however, she seemed full of childish delight. Dworkin also imagines that, before her dementia, Margo signed an advance refusal of life-saving treatment. Now severely demented, she develops pneumonia, easy to treat, but lethal if untreated. Dworkin argues that the advance refusal ought to be heeded and Margo be allowed to die of that pneumonia, on the basis that the prior refusal expresses her true wishes (her 'critical interests')...
June 2018: Medicine, Health Care, and Philosophy
Maria Cristina Murano
In 2003, the Food and Drug Administration approved the use of growth hormone treatment for idiopathic short stature children, i.e. children shorter than average due to an unknown medical cause. Given the absence of any pathological conditions, this decision has been contested as a case of medicalisation. The aim of this paper is to broaden the debate over the reasons for and against the treatment, to include considerations of the sociocultural phenomenon of the medicalisation of short stature, by means of a critical understanding of the concept of medicalisation...
June 2018: Medicine, Health Care, and Philosophy
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