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Decision-making capacity: from testing to evaluation
AbstractDecision-making capacity (DMC) is the gatekeeping element for a patient ’s right to self-determination with regard to medical decisions. A DMC evaluation is not only conducted on descriptive grounds but is an inherently normative task including ethical reasoning. Therefore, it is dependent to a considerable extent on the values held by the clinicians involved in the D MC evaluation. Dealing with the question of how to reasonably support clinicians in arriving at a DMC judgment, a new tool is presented that fundamentally differs from existing ones: the U-Doc. By putting greater emphasis on the judgmental process r...
Source: Medicine, Health Care and Philosophy - April 28, 2020 Category: Medical Ethics Source Type: research

Ubuntu philosophy and the consensus regarding incidental findings in genomic research: a heuristic approach
This study adopts a heuristic technique to argue the thesis that a set of norms rooted in the African philosophy of Ubuntu can usefully supplement current research guidelines for dealing with incidental findings discovered in genomic research. The consensus regarding incidental findings is that there is an ethical obligation to return individual genetic incidental findings that meet the threshold of analytic and clinical validity, have clinical utility, and are actionable, provided that research contributors have not opted out from receiving such information. This study outlines the hurdles that may hinder the integration ...
Source: Medicine, Health Care and Philosophy - April 24, 2020 Category: Medical Ethics Source Type: research

Defensive practice is indefensible: how defensive medicine runs counter to the ethical and professional obligations of clinicians
This article examines defensive medicine from an ethics and professionalism perspective, showing how defensive medicine is deeply problematic. First, a definition of defensive medicine is offered that describes the essence of defensive practice: clinical actions with the goal of protecting the clinician against litigation or some adverse outcome. Ethical arguments against defensive medicine are considered: (1) defensive medicine is deceptive and undermines patient autonomy; (2) defensive medicine subjugates patient interests to physician interests and violate fiduciary obligations; (3) defensive medicine exposes patients t...
Source: Medicine, Health Care and Philosophy - April 16, 2020 Category: Medical Ethics Source Type: research

Medical conspiracy theories: cognitive science and implications for ethics
This article reviews some of the most notorious health-related conspiracy theories. It then approaches the reasons why people believe these theories, using concepts from cognitive science. On the basis of that knowledge, the article makes normative proposals for public health officials and health workers as a whole, to deal with conspiracy theories, in order to preserve some of the fundamental principles of medical ethics. (Source: Medicine, Health Care and Philosophy)
Source: Medicine, Health Care and Philosophy - April 15, 2020 Category: Medical Ethics Source Type: research

Experiencing objectified health: turning the body into an object of attention
In conclusion, I argue that both technologies make present the objective body as a site for hermeneutic inquiry such that it can be interacted with in terms of health parameters. Furthermore, I point to some relevant differences in how different technologies make aspects of our own body phenomenologically present. (Source: Medicine, Health Care and Philosophy)
Source: Medicine, Health Care and Philosophy - April 2, 2020 Category: Medical Ethics Source Type: research

A critical perspective on guidelines for responsible and trustworthy artificial intelligence
In this study, these three documents will be analyzed with respect to the ethical principles and values they involve, their perspectives for approaching ethical issues, and their prospects for ethical reasoning when one or more of these values and principles are in conflict. Then, the sufficiency of these guidelines for addressing current or prospective ethical issues emerging from the existence of AI technology in medicine will be evaluated. The discussion will be pursued in terms of the ambiguity of interlocutors and efficiency for working out ethical dilemmas occurring in practical life. (Source: Medicine, Health Care and Philosophy)
Source: Medicine, Health Care and Philosophy - March 30, 2020 Category: Medical Ethics Source Type: research

Can reproductive genetic manipulation save lives?
AbstractIt has recently been argued that reproductive genetic manipulation technologies like mitochondrial replacement and germline CRISPR modifications cannot be said to save anyone ’s life because, counterfactually, no one would suffer more or die sooner absent the intervention. The present article argues that, on the contrary, reproductive genetic manipulations may be life-saving (and, from this, have therapeutic value) under an appropriate population health perspective. As such, popular reports of reproductive genetic manipulations potentially saving lives or preventing disease are not necessarily mistaken, though su...
Source: Medicine, Health Care and Philosophy - March 30, 2020 Category: Medical Ethics Source Type: research

Striking the balance with epistemic injustice in healthcare: the case of Chronic Fatigue Syndrome/Myalgic Encephalomyelitis
AbstractMiranda Fricker ’s influential concept of epistemic injustice (Oxford University Press, Oxford, 2007) has recently seen application to many areas of interest, with an increasing body of healthcare research using the concept of epistemic injustice in order to develop both general frameworks and accounts of specifi c medical conditions and patient groups. This paper illuminates tensions that arise between taking steps to protect against committing epistemic injustice in healthcare, and taking steps to understand the complexity of one’s predicament and treat it accordingly. Work on epistemic injustice is ther efor...
Source: Medicine, Health Care and Philosophy - March 12, 2020 Category: Medical Ethics Source Type: research

Sustainability
(Source: Medicine, Health Care and Philosophy)
Source: Medicine, Health Care and Philosophy - March 11, 2020 Category: Medical Ethics Source Type: research

Neonatology in Austria: ethics to improve practice
AbstractIn the world of Austrian neonatal intensive care units, the role of ethics is recognized only partially. The normatively tense cases that are at the backdrop of this essay concern the situations around the limit of viability (weeks 22  + 0 days to 25 + 6 days of gestation), which is the point in the development of an extremely preterm infant at which there are chances of extra-uterine survival. This essay first outlines the key explicit ethical challenges that are mainly concerned with notions of uncertainty and best in terest. Then, it attempts to elucidate the less explicit ethical challenges related to...
Source: Medicine, Health Care and Philosophy - March 6, 2020 Category: Medical Ethics Source Type: research

Search engines, cognitive biases and the man –computer interaction: a theoretical framework for empirical researches about cognitive biases in online search on health-related topics
AbstractThe widespread use of online search engines to answer the general public ’s needs for information has raised concerns about possible biases and the emerging of a ‘filter bubble’ in which users are isolated from attitude-discordant messages. Research is split between approaches that largely focus on the intrinsic limitations of search engines and approaches that inv estigate user search behavior. This work evaluates the findings and limitations of both approaches and advances a theoretical framework for empirical investigations of cognitive biases in online search activities about health-related topics. We aim...
Source: Medicine, Health Care and Philosophy - February 12, 2020 Category: Medical Ethics Source Type: research

Medical discernment and dialogical praxis: treatment as healing oneself
AbstractThis essay investigates the hermeneutic idea of health and the resulting formative notion of treatment. In its first part, the essay diagnoses, based on some texts of the German philosopher Hans-Georg Gadamer, the increasing technologization of contemporary professions and, specifically in the case of medicine, the risk of disappearance of self-treatment that this technologization causes. In addition to medicine, it also briefly takes psychoanalysis and pedagogy to exemplify the risk of over-specialized professionalization. In the second part, the essay seeks to doubly ground the hermeneutical idea of health: on th...
Source: Medicine, Health Care and Philosophy - February 11, 2020 Category: Medical Ethics Source Type: research

Moral distress in health care: when is it fitting?
AbstractNurses and other medical practitioners often experiencemoral distress: they feel an anguished sense of responsibility for what they take to be their own moral failures, even when those failures were unavoidable. However, in such cases other people do not tend to think it is right to hold them responsible. This is an interesting mismatch of reactions. It might seem that the mismatch should be remedied by assuring the practitioner that they are not responsible, but I argue that this denies something important that the phenomenon of moral distress tells us. In fact, both the practitioners ’ tendencies to hold themse...
Source: Medicine, Health Care and Philosophy - February 6, 2020 Category: Medical Ethics Source Type: research

Should we have a right to refuse diagnostics and treatment planning by artificial intelligence?
AbstractShould we be allowed to refuse any involvement of artificial intelligence (AI) technology in diagnosis and treatment planning? This is the relevant question posed by Ploug and Holm in a recent article inMedicine, Health Care and Philosophy. In this article, I adhere to their conclusions, but not necessarily to the rationale that supports them. First, I argue that the idea that we should recognize this right on the basis of a rational interest defence is not plausible, unless we are willing to judge each patient ’s ideology or religion. Instead, I consider that the right must be recognized by virtue of values such...
Source: Medicine, Health Care and Philosophy - January 19, 2020 Category: Medical Ethics Source Type: research

All in the family
(Source: Medicine, Health Care and Philosophy)
Source: Medicine, Health Care and Philosophy - January 12, 2020 Category: Medical Ethics Source Type: research