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Medicine, Health Care, and Philosophy

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https://www.readbyqxmd.com/read/28444477/ethical-conflicts-in-the-treatment-of-fasting-muslim-patients-with-diabetes-during-ramadan
#1
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...
April 25, 2017: Medicine, Health Care, and Philosophy
https://www.readbyqxmd.com/read/28432483/what-s-in-a-gold-standard-in-defence-of-randomised-controlled-trials
#2
Marius Backmann
The standardised randomised clinical trial (RCT) has been exceedingly popular in medical research, economics, and practical policy making. Recently, RCTs have faced criticism. First, it has been argued by John Worrall that we cannot be certain that our sample is not atypical with regard to possible confounding factors. I will argue that at least in the case of medical research, we know enough about the relevant causal mechanisms to be justified to ignore a number of factors we have good reason not to expect to be disruptive...
April 21, 2017: Medicine, Health Care, and Philosophy
https://www.readbyqxmd.com/read/28432482/the-sensible-health-care-professional-a-care-ethical-perspective-on-the-role-of-caregivers-in-emotionally-turbulent-practices
#3
Vivianne Baur, Inge van Nistelrooij, Linus Vanlaere
This article discusses the challenging context that health care professionals are confronted with, and the impact of this context on their emotional experiences. Care ethics considers emotions as a valuable source of knowledge for good care. Thinking with care ethical theory and looking through a care ethical lens at a practical case example, the authors discern reflective questions that (1) shed light on a care ethical approach toward the role of emotions in care practices, and (2) may be used by practitioners and facilitators for care ethical reflection on similar cases, in the particular and concrete context where issues around emotional experiences arise...
April 21, 2017: Medicine, Health Care, and Philosophy
https://www.readbyqxmd.com/read/28429249/are-there-moral-differences-between-maternal-spindle-transfer-and-pronuclear-transfer
#4
César Palacios-González
This paper examines whether there are moral differences between the mitochondrial replacement techniques that have been recently developed in order to help women afflicted by mitochondrial DNA diseases to have genetically related children absent such conditions: maternal spindle transfer (MST) and pronuclear transfer (PNT). Firstly, it examines whether there is a moral difference between MST and PNT in terms of the divide between somatic interventions and germline interventions. Secondly, it considers whether PNT and MST are morally distinct under a therapy/creation optic...
April 20, 2017: Medicine, Health Care, and Philosophy
https://www.readbyqxmd.com/read/28401326/clinical-judgment-moral-anxiety-and-the-limits-of-psychiatry
#5
Bradley Murray
It is common for clinicians working in psychiatry and related clinical disciplines to be called on to make diagnostic clinical judgments concerning moral anxiety, which is a kind of anxiety that is closely bound up with decisions individuals face as moral agents. To make such a judgment, it is necessary to make a moral judgment. Although it has been common to acknowledge that there are ways in which moral and clinical judgment interact, this type of interaction has remained unacknowledged. This raises questions as to the nature and limits of psychiatry-particularly concerning the extent to which psychiatric discourse ought to incorporate moral discourse, and the role of the clinician as an expert in identifying problematic anxiety...
April 11, 2017: Medicine, Health Care, and Philosophy
https://www.readbyqxmd.com/read/28401325/publication-ethics-science-versus-commerce
#6
EDITORIAL
Henk Ten Have, Bert Gordijn
No abstract text is available yet for this article.
April 11, 2017: Medicine, Health Care, and Philosophy
https://www.readbyqxmd.com/read/28382518/is-decision-making-capacity-an-essentially-contested-concept-in-pediatrics
#7
Eva De Clercq, Katharina Ruhe, Michel Rost, Bernice Elger
Key legislations in many countries emphasize the importance of involving children in decisions regarding their own health at a level commensurate with their age and capacities. Research is engaged in developing tools to assess capacity in children in order to facilitate their responsible involvement. These instruments, however, are usually based on the cognitive criteria for capacity assessment as defined by Appelbaum and Grisso and thus ill adapted to address the life-situation of children. The aim of this paper is to revisit and critically reflect upon the current definitions of decision-making capacity...
April 5, 2017: Medicine, Health Care, and Philosophy
https://www.readbyqxmd.com/read/28374105/suffering-and-dying-well-on-the-proper-aim-of-palliative-care
#8
Govert den Hartogh
In recent years a large empirical literature has appeared on suffering at the end of life. In this literature it is recognized that suffering has existential and social dimensions in addition to physical and psychological ones. The non-physical aspects of suffering, however, are still understood as pathological symptoms, to be reduced by therapeutical interventions as much as possible. But suffering itself and the negative emotional states it consists of are intentional states of mind which, as such, make cognitive claims: they are more or less appropriate responses to the actual circumstances of the patient...
April 3, 2017: Medicine, Health Care, and Philosophy
https://www.readbyqxmd.com/read/28374104/understanding-patient-needs-without-understanding-the-patient-the-need-for-complementary-use-of-professional-interpreters-in-end-of-life-care
#9
Demi Krystallidou, Ignaas Devisch, Dominique Van de Velde, Peter Pype
High-quality doctor-patient communication in end-of-life care results in better quality of life for patients. In linguistically and culturally diverse societies, language discordant consultations become daily practice, leading to difficulties in eliciting patient preferences toward end-of-life care. Although family members invariably act as informal interpreters, this may cause some ethical dilemmas. We present a case of a palliative patient whose son acted as an interpreter. This case generated a triple- layered ethical dilemma: (i) how to safeguard patient autonomy against paternalistic interventions by family members, (ii) how to respect the relational context in which patient autonomy can be realized, and (iii) how to respect the ethno-cultural values of the patient and his family...
April 3, 2017: Medicine, Health Care, and Philosophy
https://www.readbyqxmd.com/read/28353031/abortion-for-fetal-defects-two-current-arguments
#10
Susana Nuccetelli
A common utilitarian argument in favor of abortion for fetal defects rests on some controversial assumptions about what counts as a life worth living. Yet critics of abortion for fetal defects are also in need of an argument free from controversial assumptions about the future child's quality of life. Christopher Kaczor (in: Kaczor (ed), The ethics of abortion: women's rights, human life, and the question of justice, Routledge, New York, 2011) has devised an analogy that apparently satisfies this condition...
March 28, 2017: Medicine, Health Care, and Philosophy
https://www.readbyqxmd.com/read/28342053/an-increasing-problem-in-publication-ethics-publication-bias-and-editors-role-in-avoiding-it
#11
Perihan Elif Ekmekci
Publication bias is defined as "the tendency on the parts of investigators, reviewers, and editors to submit or accept manuscripts for publication based on the direction or the strength of the study findings."Publication bias distorts the accumulated data in the literature, causes the over estimation of potential benefits of intervention and mantles the risks and adverse effects, and creates a barrier to assessing the clinical utility of drugs as well as evaluating the long-term safety of medical interventions...
March 25, 2017: Medicine, Health Care, and Philosophy
https://www.readbyqxmd.com/read/28332007/rethinking-critical-reflection-on-care-late-modern-uncertainty-and-the-implications-for-care-ethics
#12
Frans Vosman, Alistair Niemeijer
Care ethics as initiated by Gilligan, Held, Tronto and others (in the nineteen eighties and nineties) has from its onset been critical towards ethical concepts established in modernity, like 'autonomy', alternatively proposing to think from within relationships and to pay attention to power. In this article the question is raised whether renewal in this same critical vein is necessary and possible as late modern circumstances require rethinking the care ethical inquiry. Two late modern realities that invite to rethink care ethics are complexity and precariousness...
March 22, 2017: Medicine, Health Care, and Philosophy
https://www.readbyqxmd.com/read/28289851/withdrawal-of-artificial-nutrition-and-hydration-in-neonatal-intensive-care-parents-and-healthcare-practitioners-views
#13
Véronique Fournier, Elisabeth Belghiti, Laurence Brunet, Marta Spranzi
Withdrawing Artificial Nutrition and Hydration (WANH) in the neonatal intensive care units (NICUs) has long been controversial. In France, the practice has become a legal option since 2005. But even though, the question remains as to what the stakeholders' experience is, and whether they consider it ethically appropriate. In order to contribute to the debate, we initiated a study in 2009 to evaluate parental and health care professionals (HCP) perspectives, after they experienced WAHN for a newborn. The study included 25 cases from 5 different clinical neonatology departments...
March 13, 2017: Medicine, Health Care, and Philosophy
https://www.readbyqxmd.com/read/28275937/-re-disclosing-physician-financial-interests-rebuilding-trust-or-making-unreasonable-burdens-on-physicians
#14
Daniel Sperling
Recent professional guidelines published by the General Medical Council instruct physicians in the UK to be honest and open in any financial agreements they have with their patients and third parties. These guidelines are in addition to a European policy addressing disclosure of physician financial interests in the industry. Similarly, In the US, a national open payments program as well as Federal regulations under the Affordable Care Act re-address the issue of disclosure of physician financial interests in America...
March 8, 2017: Medicine, Health Care, and Philosophy
https://www.readbyqxmd.com/read/28258404/some-thoughts-on-phenomenology-and-medicine
#15
Miguel Kottow
Phenomenology in medicine's main contribution is to present a first-person narrative of illness, in an effort to aid medicine in reaching an accurate disease diagnosis and establishing a personal relationship with patients whose lived experience changes dramatically when severe disease and disabling condition is confirmed. Once disease is diagnosed, the lived experience of illness is reconstructed into a living-with-disease narrative that medicine's biological approach has widely neglected. Key concepts like health, sickness, illness, disease and the clinical encounter are being diversely and ambiguously used, leading to distortions in socio-medical practices such as medicalization, pharmaceuticalization, emphasis on surveillance medicine...
March 4, 2017: Medicine, Health Care, and Philosophy
https://www.readbyqxmd.com/read/28251445/a-phenomenological-construct-of-caring-among-spouses-following-acute-coronary-syndrome
#16
Janice Gullick, Mark Krivograd, Susan Taggart, Susana Brazete, Lise Panaretto, John Wu
The aim of this study was interpret the existential construct of family caring following Acute Coronary Syndrome. Family support is known to have a positive impact on recovery and adjustment after cardiac events. Few studies provide philosophically-based, interpretative explorations of carer experience following a spouse's ischaemic event. As carer experiences, behaviours and meaning-making may impact on the quality of the support they provide to patients, further understanding could improve both patient outcomes and family experience...
March 1, 2017: Medicine, Health Care, and Philosophy
https://www.readbyqxmd.com/read/28247200/compulsory-administration-of-oxytocin-does-not-result-in-genuine-moral-enhancement
#17
Vojin Rakić
The question will be raised whether oxytocin can serve as an effective moral enhancer. Different types of moral enhancement will be addressed, one of them being compulsory moral enhancement. It will be argued that oxytocin cannot serve as an effective moral enhancer if its use is being made compulsory. Hence, compulsory administration of oxytocin does not result in genuine moral enhancement. In order to demonstrate this, a stipulation of the main potentially beneficial outcomes of using oxytocin as a moral enhancer will be offered, as well as a discussion of objections to the notion that oxytocin can be an effective moral enhancer...
February 28, 2017: Medicine, Health Care, and Philosophy
https://www.readbyqxmd.com/read/28220344/personal-factors-affecting-ethical-performance-in-healthcare-workers-during-disasters-and-mass-casualty-incidents-in-iran-a-qualitative-study
#18
Mehrzad Kiani, Mohsen Fadavi, Hamidreza Khankeh, Fariba Borhani
In emergencies and disasters, ethics are affected by both personal and organizational factors. Given the lack of organizational ethical guidelines in the disaster management system in Iran, the present study was conducted to explain the personal factors affecting ethics and ethical behaviors among disaster healthcare workers. The present qualitative inquiry was conducted using conventional content analysis to analyze the data collected from 21 in-depth unstructured interviews with healthcare workers with an experience of attending one or more fields of disaster...
February 20, 2017: Medicine, Health Care, and Philosophy
https://www.readbyqxmd.com/read/28204950/-unnatural-thoughts-on-moral-enhancement-of-the-human-animal
#19
Norman K Swazo
Recent discussions about moral enhancement presuppose and recommend sets of values that relate to both the Western tradition of moral philosophy and contemporary empirical results of natural and social sciences, including moral psychology. It is argued here that this is a typology of thought that requires a fundamental interrogation. Proponents of moral enhancement do not account for important critical analyses of moral discourse, beginning with that of Friedrich Nietzsche and continuing with more prominent twentieth century thinkers such as the poststructuralist Michel Foucault, the deconstructionist Jacques Derrida, and the moral philosopher Alasdair MacIntyre...
February 15, 2017: Medicine, Health Care, and Philosophy
https://www.readbyqxmd.com/read/28204949/caregiver-burden-and-the-medical-ethos
#20
Karsten Witt, Johanne Stümpel, Christiane Woopen
Are physicians sometimes morally required to ease caregiver burden? In our paper we defend an affirmative answer to this question. First, we examine the well-established principle that medical care should be centered on the patient. We argue that although this principle seems to give physicians some leeway to lessen caregivers' suffering, it is very restrictive when spelled out precisely. Based on a critical analysis of existing cases for transcending patient-centeredness we then go on to argue that the medical ethos should indeed contain a rule requiring physicians to alleviate caregiver burden under certain circumstances...
February 15, 2017: Medicine, Health Care, and Philosophy
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