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Reconsidering harm in psychiatric manuals within an explicationist framework
AbstractThe notion of harm has been a recurring and a significant notion in the characterization of mental disorder. It is present in eminent diagnostic manuals such as DSM and ICD, as well as in the discussion on mental disorders in philosophy of psychiatry. Recent demotion of harm in the definition of mental disorders in DSM-5 shows a general trend towards reducing the significance of harm when thinking about the nature of mental disorders. In this paper, we defend the relevance of the notion of harm in the characterization of mental disorder against some of these attacks. We approach this issue by using the method of co...
Source: Medicine, Health Care and Philosophy - January 17, 2022 Category: Medical Ethics Source Type: research

The significance of the distinction between “having a life” vs. “being alive” in end-of-life care
AbstractIn end-of-life care discussions, I contend that the distinction between “having a life” vs. “being alive” is an underutilized distinction. This distinction is significant in separating different states of existence conflated by patients, families, and clinicians. In the clinical setting, applying this distinction in end-of-life care discussions aids patients’ and family members’ decision-making by helping them understand that being alive can differ from having a life. Moreover, this distinction helps them decide which state may be the most important to them. After applying this distinction to three comp...
Source: Medicine, Health Care and Philosophy - January 11, 2022 Category: Medical Ethics Source Type: research

Precision medicine and the fragmentation of solidarity (and justice)
AbstractSolidarity is a fundamental social value in many European countries, though its precise practical and theoretical meaning is disputed. In a health care context, I agree with European writers who take solidarity normatively to mean roughly equal access to effective health care for all. That is, solidarity includes a sense of justice. Given that, I will argue that precision medicine represents a potential weakening of solidarity, albeit not a unique weakening. Precision medicine includes 150 targeted cancer therapies (mostly for metastatic cancer), all of which are extraordinarily expensive. Our critical question: Mu...
Source: Medicine, Health Care and Philosophy - January 10, 2022 Category: Medical Ethics Source Type: research

Medicine, health and the human side: responsibility in medical practice
AbstractThroughout history, the world has been concerned with progress in different areas, and Medicine has not been the exception. Nevertheless, has this progress been positive in the sense of entailing benefits? The question emerges considering that through this progress, human beings have been able to modify natural processes. Considering this, the research question is: What is the role that medicine a human and scientific disciplinemust play, and which is the concept of what a human being must have in a world where utilitarianism prevails over non-material benefits? Also, what are the implications of that role and co...
Source: Medicine, Health Care and Philosophy - January 8, 2022 Category: Medical Ethics Source Type: research

Shades of hope: Marcel s notion of hope in end-of-life care
This article examines the compatibility and relevance of Gabriel Marcel s phenomenology of hope in interdisciplinary research on the role of hope in end-of-life (EOL) care. Our analysis is divided into three thematic topics which examine the various shades of hope observed in Marcels phenomenology of hope and in the collection of 20 EOL studies on hope as experien ced by adult palliative care (PC) patients, health care professionals (HCP) and parents of terminally ill children. The three topics defining the shades of hope are: the meaning of hope in its dynamic aspects, the dialectics of hope and despair, and the transce...
Source: Medicine, Health Care and Philosophy - December 1, 2021 Category: Medical Ethics Source Type: research

Chronic pain patients need for recognition and their current struggle
AbstractChronic pain patients often miss receiving acknowledgement for the multidimensional struggles they face with their specific conditions. People suffering from chronic pain experience a type ofinvisibility that is also borne by other chronically ill people and their respective medical conditions. However, chronic pain patients face both passive and active exclusion from social participation in activities like family interactions or workplace inclusion. Although such aspects are discussed in the debates lead by the bio-psycho-social model of pain, there seems to be a lack of a distinct interest in assessing more speci...
Source: Medicine, Health Care and Philosophy - December 1, 2021 Category: Medical Ethics Source Type: research

Empathy in patient care: from Clinical Empathy to Empathic Concern
AbstractAs empathy gains importance within academia, we propose this review as an attempt to bring clarity upon the diverse and widely debated definitions and conceptions of empathy within the medical field. In this paper, we first evaluate the limits of the Western mainstream medical culture and discuss the origins of phenomena such asdehumanization anddetached concern as well as their impacts on patient care. We then pass on to a structured overview of the debate surrounding the notion of clinical empathy and its taxonomy in the medical setting. In particular, we present the dichotomous conception of clinical empathy tha...
Source: Medicine, Health Care and Philosophy - December 1, 2021 Category: Medical Ethics Source Type: research

Authenticity and physician-assisted suicide: a reply to Ahlz n
AbstractIn a recent article in this journal, Rolf Ahlz n treats a moral problem related to physician-assisted suicide (PAS) and the notion of authenticity. The problem is whether considerations of a patients true self should be included in judgments of PAS. In this short commentary, it is argued that Ahlzn (1) neglects to attend to central contributions to the philosophy of authenticity, (2) provides an internally inconsistent theory thereof, and (3) conflates crucial distinctions in the debate. (Source: Medicine, Health Care and Philosophy)
Source: Medicine, Health Care and Philosophy - December 1, 2021 Category: Medical Ethics Source Type: research

Listening to vaccine refusers
AbstractIn bioethics vaccine refusal is often discussed as an instance of free riding on the herd immunity of an infectious disease. However, the social science of vaccine refusal suggests that the reasoning behind refusal to vaccinate more often stems from previous negative experiences in healthcare practice as well as deeply felt distrust of healthcare institutions. Moreover, vaccine refusal often acts like an exit mechanism. Whilst free riding is often met with sanctions, exit, according to Albert Hirschman ’s theory of exit and voice is most efficiently met by addressing concerns and increasing the quality and number...
Source: Medicine, Health Care and Philosophy - October 30, 2021 Category: Medical Ethics Source Type: research

Gentle medicine
(Source: Medicine, Health Care and Philosophy)
Source: Medicine, Health Care and Philosophy - October 22, 2021 Category: Medical Ethics Source Type: research

Explaining rule of rescue obligations in healthcare allocation: allowing the patient to tell the right kind of story about their life
AbstractI consider various principles which might explain our intuitive obligation to rescue people from imminent death at great cost, even when the same resources could produce more benefit elsewhere. Our obligation to rescue is commonly explained in terms of the identifiability of the rescuee, but I reject this account. Instead, I offer two considerations which may come into play. Firstly, I explain the seeming importance of identifiability in terms of an intuitive obligation to prioritise life-extending interventions for people who face a high risk of an early death, and I explain this in turn with a fair innings-style ...
Source: Medicine, Health Care and Philosophy - September 12, 2021 Category: Medical Ethics Source Type: research

Wherein is the concept of disease normative? From weak normativity to value-conscious naturalism
AbstractIn this paper we focus on some new normativist positions and compare them with traditional ones. In so doing, we claim that if normative judgments are involved in determining whether a condition is a disease only in the sense identified by new normativisms, then disease is normative only in a weak sense, which must be distinguished from the strong sense advocated by traditional normativisms. Specifically, we argue that weak and strong normativity are different to the point that one ‘normativist’ label ceases to be appropriate for the whole range of positions. If values and norms are not explicit components of t...
Source: Medicine, Health Care and Philosophy - August 30, 2021 Category: Medical Ethics Source Type: research

The need for “gentle medicine” in a post Covid-19 world
AbstractAs it has historically been the case with many pandemics, the Covid-19 experience will induce many philosophers to reconsider the value of medical practice. This should be a good opportunity to critically scrutinize the way medical research and medical interventions are carried out. For much of its history, medicine has been very inefficient. But, even in its contemporary forms, a review of common protocols in medical research and medical interventions reveal many shortcomings, especially related to methodological flaws, and more importantly, conflicts of interests due to profit incentives. In the face of these pro...
Source: Medicine, Health Care and Philosophy - August 20, 2021 Category: Medical Ethics Source Type: research

Philosophers in research ethics committees —what do they think they’re doing? An empirical-ethical analysis
AbstractResearch ethics committees in Germany usually don ’t have philosophers as members and if so, only contingently, not provided for by statute. This is interesting from a philosophical perspective, assuming that ethics is a discipline of philosophy. It prompts the question what role philosophers play in those committees they can be found in. Eight q ualitative semi-structured interviews were conducted to explore the self-perception of philosophers regarding their contribution to research ethics committees. The results show that the participants generally don’t view themselves as ethics experts. They are rather una...
Source: Medicine, Health Care and Philosophy - August 16, 2021 Category: Medical Ethics Source Type: research

Resource allocation in the Covid-19 health crisis: are Covid-19 preventive measures consistent with the Rule of Rescue?
AbstractThe Covid-19 pandemic has led to a health crisis of a scale unprecedented in post-war Europe. In response, a large amount of healthcare resources have been redirected to Covid-19 preventive measures, for instance population-wide vaccination campaigns, large-scale SARS-CoV-2 testing, and the large-scale distribution of protective equipment (e.g., N95 respirators) to high-risk groups and hospitals and nursing homes. Despite the importance of these measures in epidemiological and economic terms, health economists and medical ethicists have been relatively silent about the ethical rationales underlying the large-scale ...
Source: Medicine, Health Care and Philosophy - August 16, 2021 Category: Medical Ethics Source Type: research