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Medicine, Health Care, and Philosophy

Michal Pruski
Medical resource allocation is a controversial topic, because in the end it prioritises some peoples' medical problems over those of others. This is less controversial when there is a clear clinical reason for such a prioritisation, but when such a reason is not available people might perceive it as deeming certain individuals more important than others. This article looks at the role of social utility in medical resource allocation, in a situation where the clinical outcome would be identical if either person received the treatment...
March 1, 2018: Medicine, Health Care, and Philosophy
David A Jensen
Seemingly ever improving medical technology and techniques portend the possibility of prenatally enhancing otherwise healthy, normal children-seamlessly enhancing or adding to a child's natural abilities and characteristics. Though parents normally engage in enhancing children, i.e., child rearing, these technologies present radically new possibilities. This sort of enhancement, I argue, is morally problematic for the parent: the expectations of the enhancing parent necessarily conflict with attitudes of acceptance that moral parenting requires...
February 21, 2018: Medicine, Health Care, and Philosophy
Nicholas Agar
Transformation is a memorable feature of some of the most iconic works of science fiction. These works feature characters who begin as humans and change into radically different kinds of being. This paper examines transformative change in the context of the Invasion of the Body Snatchers movies. I discuss how humans should approach the prospect of being body snatched. I argue that we shouldn't welcome the transformation even if we are convinced that we will have very positive experiences as pod aliens. When considering a transformative change, it is appropriate to give priority to your pre-transformation attitudes to potential future experiences and achievements over your predicted post-transformation attitudes...
February 19, 2018: Medicine, Health Care, and Philosophy
Alberto Giubilini, Thomas Douglas, Julian Savulescu
We argue that individuals who have access to vaccines and for whom vaccination is not medically contraindicated have a moral obligation to contribute to the realisation of herd immunity by being vaccinated. Contrary to what some have claimed, we argue that this individual moral obligation exists in spite of the fact that each individual vaccination does not significantly affect vaccination coverage rates and therefore does not significantly contribute to herd immunity. Establishing the existence of a moral obligation to be vaccinated (both for adults and for children) despite the negligible contribution each vaccination can make to the realisation of herd immunity is important because such moral obligation would strengthen the justification for coercive vaccination policies...
February 10, 2018: Medicine, Health Care, and Philosophy
M W Vegter
Precision Medicine has become a common label for data-intensive and patient-driven biomedical research. Its intended future is reflected in endeavours such as the Precision Medicine Initiative in the USA. This article addresses the question whether it is possible to discern a new 'medical cosmology' in Precision Medicine, a concept that was developed by Nicholas Jewson to describe comprehensive transformations involving various dimensions of biomedical knowledge and practice, such as vocabularies, the roles of patients and physicians and the conceptualisation of disease...
February 10, 2018: Medicine, Health Care, and Philosophy
Verna Jans, Wybo Dondorp, Ellen Goossens, Heidi Mertes, Guido Pennings, Guido de Wert
In the field of medically assisted reproduction (MAR), there is a growing emphasis on the importance of introducing new assisted reproductive technologies (ARTs) only after thorough preclinical safety research, including the use of animal models. At the same time, there is international support for the three R's (replace, reduce, refine), and the European Union even aims at the full replacement of animals for research. The apparent tension between these two trends underlines the urgency of an explicit justification of the use of animals for the development and preclinical testing of new ARTs...
February 7, 2018: Medicine, Health Care, and Philosophy
Anders Herlitz
It is a common view that benefits to the worse off should be given priority when health benefits are distributed. This paper addresses how to understand who is worse off in this context when individuals are differently well off at different times. The paper argues that the view that this judgment about who is worse off should be based solely on how well off individuals are when their complete lives are considered (i.e. 'the complete lives view') is implausible in this context. Instead, it is argued that a pluralistic stance toward this issue should be accepted...
January 19, 2018: Medicine, Health Care, and Philosophy
Marjolein Oele
This paper contends, following Plato and Broekman, that (1) seeing images as images is crucial to theorizing medicine and that (2) considering clinical pictures as images of images is a much-needed epistemic complement to the domineering view that sees clinical pictures as mirrors of disease. This does not only offer epistemic, but also ethical benefits to individual patients, especially in those cases where patients suffer from chronic, debilitating, and terminal illnesses and where medicine provides no, or limited, answers in terms of treatment, intervention, and meaning...
January 17, 2018: Medicine, Health Care, and Philosophy
Anne Hambro Alnæs
Norway provides total social welfare coverage for organ transplantations, including free immunosuppressive medication and prepaid life-long follow up for both recipients and donors. Despite these benefits the proportion of living kidney donors (LKD) has in recent years declined from around 40% (2011) of all kidney transplantations to 24% (2016). This study suggests harnessing patient- and donor-narratives as a tool for addressing the current fall in donation rates. The hospital records of 18 recipient/donor dyads were compared with patient and donor accounts elicited in semi-structured interviews...
January 13, 2018: Medicine, Health Care, and Philosophy
Casey Rentmeester
Communication between medical professionals and patients is an important aspect of therapy and patient satisfaction. Common barriers that get in the way of effective communication in this sphere include: (1) gender, age, and cultural differences; (2) physical or psychological discomfort or pain; (3) medical literacy; and (4) distraction due to technological factors or simply being overworked. The author examines these communicative barriers from a philosophical lens and then utilizes Martin Heidegger's phenomenology and hermeneutics to provide guidance for medical professional-patient interactions...
January 12, 2018: Medicine, Health Care, and Philosophy
Bert Gordijn, Henk Ten Have
No abstract text is available yet for this article.
December 20, 2017: Medicine, Health Care, and Philosophy
Urban Wiesing
Personalized medicine plays an important role in the development of current medicine. Among the numerous statements regarding the future of personalized medicine, some can be found that accord medicine a new scientific status. Medicine will be transformed from an art to a science due to personalized medicine. This prognosis is supported by references to models of historical developments. The article examines what is meant by this prognosis, what consequences it entails, and how feasible it is. It refers to the long tradition of epistemological thinking in medicine and the use of historical models for the development of medicine...
December 20, 2017: Medicine, Health Care, and Philosophy
Daniel W Tigard
Recent medical and bioethics literature shows a growing concern for practitioners' emotional experience and the ethical environment in the workplace. Moral distress, in particular, is often said to result from the difficult decisions made and the troubling situations regularly encountered in health care contexts. It has been identified as a leading cause of professional dissatisfaction and burnout, which, in turn, contribute to inadequate attention and increased pain for patients. Given the natural desire to avoid these negative effects, it seems to most authors that systematic efforts should be made to drastically reduce moral distress, if not altogether eliminate it from the lives of vulnerable practitioners...
December 15, 2017: Medicine, Health Care, and Philosophy
Kaja Heidenreich, Anders Bremer, Lars Johan Materstvedt, Ulf Tidefelt, Mia Svantesson
In Moral Case Deliberation (MCD), healthcare professionals discuss ethically difficult patient situations in their daily practice. There is a lack of knowledge regarding the content of MCD and there is a need to shed light on this ethical reflection in the midst of clinical practice. Thus, the aim of the study was to describe the content of healthcare professionals' moral reasoning during MCD. The design was qualitative and descriptive, and data consisted of 22 audio-recorded inter-professional MCDs, analysed with content analysis...
December 14, 2017: Medicine, Health Care, and Philosophy
Gert Helgesson, Stefan Eriksson
This paper concerns the responsibility of co-authors in cases of scientific misconduct. Arguments in research integrity guidelines and in the bioethics literature concerning authorship responsibilities are discussed. It is argued that it is unreasonable to claim that for every case where a research paper is found to be fraudulent, each author is morally responsible for all aspects of that paper, or that one particular author has such a responsibility. It is further argued that it is more constructive to specify what task responsibilities come with different roles in a project and describe what kinds of situations or events call for some kind of action, and what the appropriate actions might be...
December 8, 2017: Medicine, Health Care, and Philosophy
Anders Nordgren
It is a common experience among care professionals that persons with dementia often say 'no' to conventional caring measures such as taking medication, eating or having a shower. This tendency to say 'no' may also concern the use of assistive technologies such as fall detectors, mobile safety alarms, Internet for social contact and robots. This paper provides practical recommendations for care professionals in home health care and social care about how to respond to such resistiveness towards assistive technologies...
December 6, 2017: Medicine, Health Care, and Philosophy
Henk Ten Have, Bert Gordijn
No abstract text is available yet for this article.
December 2017: Medicine, Health Care, and Philosophy
Bjørn Hofmann
Overdiagnosis and disease are related concepts. Widened conceptions of disease increase overdiagnosis and vice versa. This is partly because there is a close and complex relationship between disease and overdiagnosis. In order to address the problems with overdiagnosis, we may benefit from a closer understanding this relationship. Accordingly, the objective of this article is to elucidate the relationship between disease and overdiagnosis. To do so, the article starts with scrutinizing how overdiagnosis can explain the expansion of the concept of disease...
December 2017: Medicine, Health Care, and Philosophy
Timothy Allen, Michael J Selgelid
The influential public health ethics framework proposed by Childress et al. includes five "justificatory conditions," two of which are "necessity" and "least infringement." While the framework points to important moral values, we argue it is redundant for it to list both necessity and least infringement because they are logically equivalent. However, it is ambiguous whether Childress et al. would endorse this view, or hold the two conditions distinct. This ambiguity has resulted in confusion in public health ethics discussions citing the Childress et al...
December 2017: Medicine, Health Care, and Philosophy
Ilhan Ilkilic, Hakan Ertin
BACKGROUND: For an effective treatment of patients, quality-assured safe implementation of drug therapy is indispensable. Fasting during Ramadan, an essential religious practice for Muslims, affects Muslim diabetics' drug use in a number of different ways. OBJECTIVES: Ethical problems arising from fasting during the month of Ramadan for practicing Muslim patients are being discussed on the basis of extant research literature. Relevant conflicts of interest originating in this situation are being analysed from an ethical perspective...
December 2017: Medicine, Health Care, and Philosophy
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