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Medicine, Health Care, and Philosophy

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
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
Bert Gordijn, Henk Ten Have
No abstract text is available yet for this article.
February 8, 2017: Medicine, Health Care, and Philosophy
Martin Hähnel
This paper illuminates the explanatory role of vagueness und species membership against the background of scientific developments in recent stem cell research. With the help of the Neo-Aristotelian concept of "life form naturalism" ontologically vague entities such as stem cells, all above induced pluripotent stem cells (iPS), could be described as necessary constituents for the correct sorting and naming of natural processes and its bearers. Furthermore this specific assessment allows drawing some important ontological and ethical consequences...
February 7, 2017: Medicine, Health Care, and Philosophy
W Seekles, G Widdershoven, P Robben, G van Dalfsen, B Molewijk
There is an increasing body of research on what kind of ethical challenges health care professionals experience regarding the quality of care. In the Netherlands the Dutch Health Care Inspectorate is responsible for monitoring and regulating the quality of health care. No research exists on what kind of ethical challenges inspectors experience during the regulation process itself. In a pilot study we used moral case deliberation as method in order to reflect upon inspectors' ethical challenges. The objective of this paper is to give an overview of the ethical challenges which health care inspectors encounter in their daily work...
January 27, 2017: Medicine, Health Care, and Philosophy
David W Evans, Nicholas Lucas, Roger Kerry
Causation is important when considering: how an organism maintains health; why disease arises in a healthy person; and, how one may intervene to change the course of a disease. This paper explores the form of causative relationships in health, disease and intervention, with particular regard to the pathological and biopsychosocial models. Consistent with the philosophical view of dispositionalism, we believe that objects are the fundamental relata of causation. By accepting the broad scope of the biopsychosocial model, we argue that psychological and social constructs be considered objects...
January 25, 2017: Medicine, Health Care, and Philosophy
(no author information available yet)
No abstract text is available yet for this article.
December 31, 2016: Medicine, Health Care, and Philosophy
Benita Spronk, Margreet Stolper, Guy Widdershoven
In healthcare practice, care providers are confronted with tragic situations, in which they are expected to make choices and decisions that can have far-reaching consequences. This article investigates the role of moral case deliberation (MCD) in dealing with tragic situations. It focuses on experiences of care givers involved in the treatment of a pregnant woman with a brain tumour, and their evaluation of a series of MCD meetings in which the dilemmas around care were discussed. The study was qualitative, focusing on the views and experiences of the participants...
December 2, 2016: Medicine, Health Care, and Philosophy
Thana Cristina de Campos
This paper suggests that the focus on abortion legalization in the aftermath of the Zika outbreak is distracting for policy and lawmakers from what needs to be done to address the outbreak effectively. Meeting basic health needs (i.e. preventive measures), together with research and development conducive to a vaccine or treatment for the Zika virus should be priorities.
November 29, 2016: Medicine, Health Care, and Philosophy
Perihan Elif Ekmekci
Vulnerability is a broad concept widely addressed in recent scholarly literature. Lesbian, gay, bisexual, and transgender (LGBT) people are among the vulnerable populations with significant disadvantages related to health and the social determinants of health. Medical ethics discourse tackles vulnerability from philosophical and political perspectives. LGBT people experience several disadvantages from both perspectives. This article aims to justify the right to health for LGBT people and their particular claims regarding healthcare because they belong to a vulnerable group...
November 26, 2016: Medicine, Health Care, and Philosophy
Henk Ten Have, Bert Gordijn
No abstract text is available yet for this article.
December 2016: Medicine, Health Care, and Philosophy
John W Murphy, Berkeley A Franz
The move to patient-centered medical practice is important for providing relevant and sustainable health care. Narrative medicine, for example, suggests that patients should be involved significantly in diagnosis and treatment. In order to understand the meaning of symptoms and interventions, therefore, physicians must enter the life worlds of patients. But physicians face high patient loads and limited time for extended consultations. In current medical practice, then, is narrative medicine possible? We argue that engaging patient perspectives in the medical visit does not necessarily require a lengthy interview...
December 2016: Medicine, Health Care, and Philosophy
Corine Mouton Dorey
The increased complexity of health information management sows the seeds of inequalities between health care stakeholders involved in the production and use of health information. Patients may thus be more vulnerable to use of their data without their consent and breaches in confidentiality. Health care providers can also be the victims of a health information system that they do not fully master. Yet, despite its possible drawbacks, the management of health information is indispensable for advancing science, medical care and public health...
December 2016: Medicine, Health Care, and Philosophy
Jeffrey Kirby
A provocative question has emerged since the Supreme Court of Canada's decision on assisted dying: Should Canadians who request, and are granted, an assisted death be considered a legitimate source of transplantable organs? A related question is addressed in this paper: is controlled organ donation after assisted death (cDAD) more or less ethically-problematic than standard, controlled organ donation after circulatory determination of death (cDCDD)? Controversial, ethics-related dimensions of cDCD that are of relevance to this research question are explored, and morally-relevant distinctions between cDAD and cDCD are identified...
December 2016: Medicine, Health Care, and Philosophy
Luciana Caenazzo, Pamela Tozzo, Daniele Rodriguez
We refer to hospitalized convicted hunger strikers in Padua Hospital who decided to fast for specific reasons, often demanding, to be heard by the judge, to complain about the existing custodial situation or to claim unjust treatment. The medical ethics of hunger strikers are debated because the use of force feeding by physicians is widely condemned as unethical, but courts, in Italy, sometimes order to transfer the convicted person to hospital and oblige healthcare practitioners to perform forcible feeding...
December 2016: Medicine, Health Care, and Philosophy
Eivind Engebretsen, Kristin Heggen, Sietse Wieringa, Trisha Greenhalgh
The evidence-based practice and evidence-based medicine (EBM) movements have promoted standardization through guideline development methodologies based on systematic reviews and meta-analyses of best available research. EBM has challenged clinicians to question their reliance on practical reasoning and clinical judgement. In this paper, we argue that the protagonists of EBM position their mission as reducing uncertainty through the use of standardized methods for knowledge evaluation and use. With this drive towards uniformity, standardization and control comes a suspicion towards intuition, creativity and uncertainty as integral parts of medical practice...
December 2016: Medicine, Health Care, and Philosophy
Bettine Pluut
Patient-centeredness can be considered a popular, and at the same time "fuzzy", concept. Scientists have proposed different definitions and models. The present article studies scientific publications that discuss the meaning of patient-centeredness to identify different "discourses" of patient-centeredness. Three discourses are presented; the first is labelled as "caring for patients", the second as "empowering patients" and the third as "being responsive". Each of these discourses has different things to say about (a) the why of patient-centeredness; (b) the patient's identity; (c) the role of the healthcare professional; (d) responsibilities for medical decision-making, and (e) the role of health information...
December 2016: Medicine, Health Care, and Philosophy
Annette Sofie Davidsen, Ann Dorrit Guassora, Susanne Reventlow
Patients' experience of symptoms does not follow the body-mind divide that characterizes the classification of disease in the health care system. Therefore, understanding patients in their entirety rather than in parts demands a different theoretical approach. Attempts have been made to formulate such approaches but many of these, such as the biopsychosocial model, are still basically dualistic or methodologically reductionist. In primary care, patients often present with diffuse symptoms, making primary care the ideal environment for understanding patients' undifferentiated symptoms and disease patterns which could readily fit both bodily and mental categories...
December 2016: Medicine, Health Care, and Philosophy
Hub Zwart
This article aims to develop a Lacanian approach to bioethics. Point of departure is the fact that both psychoanalysis and bioethics are practices of language, combining diagnostics with therapy. Subsequently, I will point out how Lacanian linguistics may help us to elucidate the dynamics of both psychoanalytical and bioethical discourse, using the movie One flew over the Cuckoo's Nest and Sophocles' tragedy Antigone as key examples. Next, I will explain the 'topology' of the bioethical landscape with the help of Lacan's three dimensions: the imaginary, the symbolical and the real...
December 2016: Medicine, Health Care, and Philosophy
Fabrice Jotterand, Antonio Amodio, Bernice S Elger
The fiduciary nature of the patient-physician relationship requires clinicians to act in the best interest of their patients. Patients are vulnerable due to their health status and lack of medical knowledge, which makes them dependent on the clinicians' expertise. Competent patients, however, may reject the recommendations of their physician, either refusing beneficial medical interventions or procedures based on their personal views that do not match the perceived medical indication. In some instances, the patients' refusal may jeopardize their health or life but also compromise the clinician's moral responsibility to promote the patient's best interests...
December 2016: Medicine, Health Care, and Philosophy
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