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Medical Ethics

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1702 papers 500 to 1000 followers Trending issues in health policy, medical ethics and philosophy of medicine
By Michael Young Harvard Medical School
https://www.readbyqxmd.com/read/29966134/understanding-the-blind-spots-of-psychosis-a-wittgensteinian-and-first-person-approach
#1
Zeno Van Duppen, Rob Sips
BACKGROUND: Experiences of psychosis are often assumed to be strange, bizarre, or incomprehensible. The aim of this article is to offer a new step towards a better understanding of how the psychotic process affects a prereflective background. METHODS: We use concepts from the philosophy of Ludwig Wittgenstein to clarify the first-person perspective on psychosis of one of the authors. RESULTS: We describe the early psychotic process as breaking down the "nest of propositions," shaking the scaffolds of our language games...
July 2, 2018: Psychopathology
https://www.readbyqxmd.com/read/29674589/ultralarge-elastic-deformation-of-nanoscale-diamond
#2
Amit Banerjee, Daniel Bernoulli, Hongti Zhang, Muk-Fung Yuen, Jiabin Liu, Jichen Dong, Feng Ding, Jian Lu, Ming Dao, Wenjun Zhang, Yang Lu, Subra Suresh
Diamonds have substantial hardness and durability, but attempting to deform diamonds usually results in brittle fracture. We demonstrate ultralarge, fully reversible elastic deformation of nanoscale (~300 nanometers) single-crystalline and polycrystalline diamond needles. For single-crystalline diamond, the maximum tensile strains (up to 9%) approached the theoretical elastic limit, and the corresponding maximum tensile stress reached ~89 to 98 gigapascals. After combining systematic computational simulations and characterization of pre- and postdeformation structural features, we ascribe the concurrent high strength and large elastic strain to the paucity of defects in the small-volume diamond nanoneedles and to the relatively smooth surfaces compared with those of microscale and larger specimens...
April 20, 2018: Science
https://www.readbyqxmd.com/read/29459756/humility
#3
Salman Akhtar
This paper offers a nuanced discourse on the otherwise ignored topic of humility. It brings together scattered comments within psychoanalysis, secular lay-literature, sociocultural studies, and religious thought on humility. The paper also describes pathological variants of humility (excessive, deficient, false, and compartmentalized) and delineates five areas of clinical practice where humility plays an important role: (i) humility in selecting patients to treat, (ii) humility in daily conduct with patients, (iii) humility in the attitude of listening to clinical material, (iv) humility in the manner of intervening, and (v) humility in deciding upon the longevity of our professional careers...
March 2018: American Journal of Psychoanalysis
https://www.readbyqxmd.com/read/29559088/william-james-nitrous-oxide-and-the-anaesthetic-revelation
#4
Jane S Moon, Catherine M Kuza, Manisha S Desai
William James greatly influenced the fields of psychology, philosophy, and religion during the late 19th and early 20th centuries. This was the era of Modernism, a time when many writers rejected the certainty of Enlightenment ideals. Positivism, which rose to prominence in the early 19th century, had emphasized physical phenomena, empirical evidence, and the scientific method. Darwin's On the Origin of Species (1859), with its theory of natural selection, provided an explanation for the evolution of species apart from a divine Creator...
January 2018: Journal of Anesthesia History
https://www.readbyqxmd.com/read/29609724/did-ren%C3%A3-descartes-have-exploding-head-syndrome
#5
Abidemi Idowu Otaiku
René Descartes (1596-1650), "the Father of Modern Philosophy" and advocate of mind-body dualism, had three successive dreams on November 10, 1619 that changed the trajectory of his life and the trajectory of human thought. Descartes' influential dreams have been of interest to a number of commentators including the famous neurologist and psychoanalyst Sigmund Freud. Descartes' second dream in particular, in which he heard a loud noise in his head before seeing a bright flash of light upon awakening, has been discussed extensively...
April 15, 2018: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/29620766/how-philosophy-was-squeezed-out-of-the-phd
#6
LETTER
Michael Stocker
No abstract text is available yet for this article.
April 5, 2018: Nature
https://www.readbyqxmd.com/read/29540165/enhancing-second-order-empathy-in-medical-practice-by-supplementing-patients-narratives-with-certainties
#7
José María Ariso
Most scholars agree that empathy is one of the keys for medical education, but it is not yet clear precisely how this term should be defined. Currently, the predominant tendency in this area consists in considering empathy within the context of narrative medicine or, more specifically, within the interaction theory instead of the simulation theory of empathy. A significant development of the interaction theory is "second-order empathy". After describing the outlines of this kind of empathy, I suggest that the practitioner should also inquire about the patient's certainties - in Wittgenstein's sense - in order the better to enrich and understand her narrative...
March 14, 2018: BMC Medical Education
https://www.readbyqxmd.com/read/29446388/train-phd-students-to-be-thinkers-not-just-specialists
#8
Gundula Bosch
No abstract text is available yet for this article.
February 15, 2018: Nature
https://www.readbyqxmd.com/read/29406201/proton-pump-inhibitors-review-of-emerging-concerns
#9
REVIEW
Avinash K Nehra, Jeffrey A Alexander, Conor G Loftus, Vandana Nehra
First introduced in 1989, proton pump inhibitors (PPIs) are among the most widely utilized medications worldwide, both in the ambulatory and inpatient clinical settings. The PPIs are currently approved by the US Food and Drug Administration for the management of a variety of gastrointestinal disorders including symptomatic peptic ulcer disease, gastroesophageal reflux disease, and nonulcer dyspepsia as well as for prevention of gastrointestinal bleeding in patients receiving antiplatelet therapy. PPIs inhibit gastric acid secretion, and the most commonly associated adverse effects include abdominal pain, diarrhea, and headache...
February 2018: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29373752/identity-disturbance-feelings-of-emptiness-and-the-boundaries-of-the-schizophrenia-spectrum
#10
Maja Zandersen, Josef Parnas
Historical and current research on borderline personality disorder reveal certain affinities with schizophrenia spectrum psychopathology. This is also the case for the borderline criteria of "identity disturbance" and "feelings of emptiness," which reflect symptomatology frequently found in schizophrenia and schizotypal personality disorder. Unfortunately, the diagnostic manuals offer limited insight into the nature of these criteria, including possible deviations and similarities with schizophrenia spectrum symptomatology...
January 24, 2018: Schizophrenia Bulletin
https://www.readbyqxmd.com/read/29373621/modafinil-associated-with-new-onset-obsessivecompulsive-disorder
#11
Jeannie D Lochhead, Michele A Nelson, Rimal Bera
No abstract text is available yet for this article.
February 2018: Annals of Clinical Psychiatry: Official Journal of the American Academy of Clinical Psychiatrists
https://www.readbyqxmd.com/read/29301011/should-mitochondrial-donation-be-anonymous
#12
John B Appleby
Currently in the United Kingdom, anyone donating gametes has the status of an open-identity donor. This means that, at the age of 18, persons conceived with gametes donated since April 1, 2005 have a right to access certain pieces of identifying information about their donor. However, in early 2015, the UK Parliament approved new regulations that make mitochondrial donors anonymous. Both mitochondrial donation and gamete donation are similar in the basic sense that they involve the contribution of gamete materials to create future persons...
March 13, 2018: Journal of Medicine and Philosophy
https://www.readbyqxmd.com/read/29149331/the-ethics-of-organ-tourism-role-morality-and-organ-transplantation
#13
Marcus P Adams
Organ tourism occurs when individuals in countries with existing organ transplant procedures, such as the United States, are unable to procure an organ by using those transplant procedures in enough time to save their life. In this paper, I am concerned with the following question: When organ tourists return to the United States and need another transplant, do US transplant physicians have an obligation to place them on a transplant list? I argue that transplant physicians have a duty not to relist organ tourists...
November 15, 2017: Journal of Medicine and Philosophy
https://www.readbyqxmd.com/read/28983928/highly-identified-power-holders-feel-responsible-the-interplay-between-social-identification-and-social-power-within-groups
#14
Annika Scholl, Kai Sassenberg, Naomi Ellemers, Daan Scheepers, Frank de Wit
Power relations affect dynamics within groups. Power-holders' decisions not only determine their personal outcomes, but also the outcomes of others in the group that they control. Yet, power-holders often tend to overlook this responsibility to take care of collective interests. The present research investigated how social identification - with the group to which both the powerful and the powerless belong - alters perceived responsibility among power-holders (and the powerless). Combining research on social power and social identity, we argue that power-holders perceive more responsibility than the powerless when strongly (rather than when weakly) identifying with the group...
January 2018: British Journal of Social Psychology
https://www.readbyqxmd.com/read/29187031/minocycline-plus-n-acetylcysteine-reduce-behavioral-deficits-and-improve-histology-with-a-clinically-useful-time-window
#15
Michael A Sangobowale, Natalia M Grin'kina, Kristen Whitney, Elena Nikulina, Karrah St Laurent-Ariot, Johnson S Ho, Narek Bayzan, Peter J Bergold
There are no drugs to manage traumatic brain injury (TBI) presently. A major problem in developing therapeutics is that drugs to manage TBI lack sufficient potency when dosed within a clinically relevant time window. Previous studies have shown that minocycline (MINO, 45 mg/kg) plus N-acetylcysteine (NAC, 150 mg/kg) synergistically improved cognition and memory, modulated inflammation, and prevented loss of oligodendrocytes that remyelinated damaged white matter when first dosed 1 h after controlled cortical impact (CCI) in rats...
February 9, 2018: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28854084/abandonment
#16
Ranjana Srivastava
"Hospice. It’s where people go to die," she says, surprising me with her sudden lucidity. "And also for symptom management," I add gently. "Like my headache," she notes. And your homelessness, I think — the fact that your one-bedroom, upstairs council flat just won’t do anymore. "I could go home,"..
August 31, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28503834/respect-for-autonomy-in-light-of-neuropsychiatry
#17
Sabine Müller
Bioethics needs an elaborated concept of autonomy based on empirical knowledge about the prerequisites of the capacity of autonomy. Whereas Beauchamp and Childress, and many other bioethicists have discussed social influences on the capacity of autonomy in depth, neurobiological influences have received less attention. A comprehensive concept of autonomy should consider both social and biological factors that can diminish the capacity of autonomy. This article focuses on neurobiological influences that can reduce the capacity of autonomy...
June 2017: Bioethics
https://www.readbyqxmd.com/read/28786173/human-organisms-begin-to-exist-at-fertilization
#18
Calum Miller, Alexander Pruss
Eugene Mills has recently argued that human organisms cannot begin to exist at fertilization because the evidence suggests that egg cells persist through fertilization and simply turn into zygotes. He offers two main arguments for this conclusion: that 'fertilized egg' commits no conceptual fallacy, and that on the face of it, it looks as though egg cells survive fertilization when the process is watched through a microscope. We refute these arguments and offer several reasons of our own to think that egg cells do not survive fertilization, appealing to various forms of essentialism regarding persons, fission cases, and a detailed discussion of the biological facts relevant to fertilization and genetics...
September 2017: Bioethics
https://www.readbyqxmd.com/read/28844200/oxygen-therapy-in-suspected-acute-myocardial-infarction
#19
RANDOMIZED CONTROLLED TRIAL
Robin Hofmann, Stefan K James, Tomas Jernberg, Bertil Lindahl, David Erlinge, Nils Witt, Gabriel Arefalk, Mats Frick, Joakim Alfredsson, Lennart Nilsson, Annica Ravn-Fischer, Elmir Omerovic, Thomas Kellerth, David Sparv, Ulf Ekelund, Rickard Linder, Mattias Ekström, Jörg Lauermann, Urban Haaga, John Pernow, Ollie Östlund, Johan Herlitz, Leif Svensson
BACKGROUND: The clinical effect of routine oxygen therapy in patients with suspected acute myocardial infarction who do not have hypoxemia at baseline is uncertain. METHODS: In this registry-based randomized clinical trial, we used nationwide Swedish registries for patient enrollment and data collection. Patients with suspected myocardial infarction and an oxygen saturation of 90% or higher were randomly assigned to receive either supplemental oxygen (6 liters per minute for 6 to 12 hours, delivered through an open face mask) or ambient air...
September 28, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28821958/midlife-work-related-stress-is-associated-with-late-life-cognition
#20
Shireen Sindi, Ingemar Kåreholt, Alina Solomon, Babak Hooshmand, Hilkka Soininen, Miia Kivipelto
To investigate the associations between midlife work-related stress and late-life cognition in individuals without dementia from the general population. The Cardiovascular Risk Factors, Aging and Dementia (CAIDE) study population (n = 2000) was randomly selected from independent Finnish population-based surveys (baseline mean age 50 years). Participants underwent two re-examinations in late life (mean age 71 and 78 years, respectively). 1511 subjects participated in at least one re-examination (mean total follow-up 25 years)...
September 2017: Journal of Neurology
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