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Medicine, Health Care, and Philosophy

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https://www.readbyqxmd.com/read/28647893/the-overdiagnosis-of-what-on-the-relationship-between-the-concepts-of-overdiagnosis-disease-and-diagnosis
#1
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...
June 24, 2017: Medicine, Health Care, and Philosophy
https://www.readbyqxmd.com/read/28601921/the-history-of-autonomy-in-medicine-from-antiquity-to-principlism
#2
Toni C Saad
Respect for Autonomy (RFA) has been a mainstay of medical ethics since its enshrinement as one of the four principles of biomedical ethics by Beauchamp and Childress' in the late 1970s. This paper traces the development of this modern concept from Antiquity to the present day, paying attention to its Enlightenment origins in Kant and Rousseau. The rapid C20th developments of bioethics and RFA are then considered in the context of the post-war period and American socio-political thought. The validity and utility of the RFA are discussed in light of this philosophical-historical account...
June 10, 2017: Medicine, Health Care, and Philosophy
https://www.readbyqxmd.com/read/28601920/human-dignity-as-a-basis-for-providing-post-trial-access-to-healthcare-for-research-participants-a-south-african-perspective
#3
Pamela Andanda, Jane Wathuta
This paper discusses the need to focus on the dignity of human participants as a legal and ethical basis for providing post-trial access to healthcare. Debate about post-trial benefits has mostly focused on access to products or interventions proven to be effective in clinical trials. However, such access may be modelled on a broad fair benefits framework that emphasises both collateral benefits and interventional products of research, instead of prescribed post-trial access alone (Legal and ethical regulation of biomedical research in developing countries p...
June 10, 2017: Medicine, Health Care, and Philosophy
https://www.readbyqxmd.com/read/28597325/the-impossibility-of-reliably-determining-the-authenticity-of-desires-implications-for-informed-consent
#4
Jesper Ahlin
It is sometimes argued that autonomous decision-making requires that the decision-maker's desires are authentic, i.e., "genuine," "truly her own," "not out of character," or similar. In this article, it is argued that a method to reliably determine the authenticity (or inauthenticity) of a desire cannot be developed. A taxonomy of characteristics displayed by different theories of authenticity is introduced and applied to evaluate such theories categorically, in contrast to the prior approach of treating them individually...
June 8, 2017: Medicine, Health Care, and Philosophy
https://www.readbyqxmd.com/read/28551773/should-physicians-tell-the-truth-without-taking-social-complications-into-account-a-striking-case
#5
Ercan Avci
The principle of respect for autonomy requires informing patients adequately and appropriately about diagnoses, treatments, and prognoses. However, some clinical cases may cause ethical dilemmas regarding telling the truth. Under the existence especially of certain cultural, social, and religious circumstances, disclosing all the relevant information to all pertinent parties might create harmful effects. Even though the virtue of telling the truth is unquestionable, sometimes de facto conditions compel physicians to act paternalistically to protect the patient/patients from imminent dangers...
May 27, 2017: Medicine, Health Care, and Philosophy
https://www.readbyqxmd.com/read/28551772/e-health-beyond-technology-analyzing-the-paradigm-shift-that-lies-beneath
#6
Tania Moerenhout, Ignaas Devisch, Gustaaf C Cornelis
Information and computer technology has come to play an increasingly important role in medicine, to the extent that e-health has been described as a disruptive innovation or revolution in healthcare. The attention is very much focused on the technology itself, and advances that have been made in genetics and biology. This leads to the question: What is changing in medicine today concerning e-health? To what degree could these changes be characterized as a 'revolution'? We will apply the work of Thomas Kuhn, Larry Laudan, Michel Foucault and other philosophers-which offers an alternative understanding of progress and revolution in medicine to the classic discovery-oriented approach-to our analysis...
May 27, 2017: Medicine, Health Care, and Philosophy
https://www.readbyqxmd.com/read/28527046/on-harm-thresholds-and-living-organ-donation-must-the-living-donor-benefit-on-balance-from-his-donation
#7
Nicola Jane Williams
For the majority of scholars concerned with the ethics of living organ donation, inflicting moderate harms on competent volunteers in order to save the lives or increase the life chances of others is held to be justifiable provided certain conditions are met. These conditions tend to include one, or more commonly, some combination of the following: (1) The living donor provides valid consent to donation. (2) Living donation produces an overall positive balance of harm-benefit for donors and recipients which cannot be obtained in a less harmful manner...
May 19, 2017: Medicine, Health Care, and Philosophy
https://www.readbyqxmd.com/read/28456925/necessity-and-least-infringement-conditions-in-public-health-ethics
#8
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...
April 29, 2017: Medicine, Health Care, and Philosophy
https://www.readbyqxmd.com/read/28444477/ethical-conflicts-in-the-treatment-of-fasting-muslim-patients-with-diabetes-during-ramadan
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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