Empowerment through health self-testing apps? Revisiting empowerment as a process
This article first demonstrates the absence of empowerment conceptualisations in the context of self-testing apps by engaging with empowerment literature. It then contrasts the service these apps provide with two widely cited empowerment definitions by the WHO, which describe the term as a process that, broadly, leads to knowledge and control of health decisions. We conclude that self-testing apps can only partly empower their users, as they, we argue, do not provide the type of knowledge and control the WHO definitions describe. More importantly, we observe that this shortcoming stems from the fact that in the literature ...
Source: Medicine, Health Care and Philosophy - January 2, 2023 Category: Medical Ethics Source Type: research

Social inclusion revisited: sheltered living institutions for people with intellectual disabilities as communities of difference
AbstractThe dominant idea in debates on social inclusion of people with intellectual disabilities is that social inclusion requires recognition of their ‘sameness’. As a result, most care providers try to enable people with intellectual disabilities to live and participate in ‘normal’ society, ‘in the community’. In this paper, we draw on (Pols, Medicine Health Care and Philosophy 18:81–90, 2015) empirical ethics of care approach to gi ve an in-depth picture of places that have a radically different take on what social inclusion for people with intellectual disabilities looks like: places known as ‘sheltere...
Source: Medicine, Health Care and Philosophy - December 30, 2022 Category: Medical Ethics Source Type: research

How to derive ethically appropriate recommendations for action? A methodology for applied ethics
AbstractResearchers in applied ethics, and some areas of bioethics particularly, aim to develop concrete and appropriate recommendations for action in morally relevant real-world situations. When proceeding from more abstract levels of ethical reasoning to such concrete recommendations, however, even with regard to the very same normative principle or norm, it seems possible to develop divergent or even contradictory recommendations for action regarding a certain situation. This may give the impression that such recommendations would be arbitrary and, hence, not well justified. Against this background, we, first, aim at sh...
Source: Medicine, Health Care and Philosophy - December 15, 2022 Category: Medical Ethics Source Type: research

Correction to: On the relation between decision quality and autonomy in times of patient ‑centered care: a case study
(Source: Medicine, Health Care and Philosophy)
Source: Medicine, Health Care and Philosophy - December 5, 2022 Category: Medical Ethics Source Type: research

The ‘false hope’ argument in discussions on expanded access to investigational drugs: a critical assessment
AbstractWhen seriously ill patients reach the end of the standard treatment trajectory for their condition, they may qualify for the use of unapproved, investigational drugs regulated via expanded access programs. In medical-ethical discourse, it is often argued that expanded access to investigational drugs raises ‘false hope’ among patients and is therefore undesirable. We set out to investigate what is meant by the false hope argument in this discourse. In this paper, we identify and analyze five versions of the false hope argument which we call: (1) the limited chance at benefit argument, (2) the side effects outwei...
Source: Medicine, Health Care and Philosophy - December 1, 2022 Category: Medical Ethics Source Type: research

Pathologies and the Healing of the soul: medical terms as metaphors in philosophy
AbstractThis paper critically examines the metaphorical use of medical terms in philosophy. Three examples selected from distinct philosophical contexts demonstrate that such terms have been employed as metaphors both to describe the practice of philosophising and historically to diagnose philosophical positions. The selected examples are (i) the title of Avicenna ’s main philosophical work,The Book of Healing, (ii) the criticism of medical metaphors in Enlightenment philosophy, and (iii) recent historical diagnoses in philosophy. The underlying epistemological assumptions of all three contexts are reconstructed to criti...
Source: Medicine, Health Care and Philosophy - December 1, 2022 Category: Medical Ethics Source Type: research

Systemising triage: COVID-19 guidelines and their underlying theories of distributive justice
AbstractThe COVID-19 pandemic has been overwhelming public health-care systems around the world. With demand exceeding the availability of medical resources in several regions, hospitals have been forced to invoke triage. To ensure that this difficult task proceeds in a fair and organised manner, governments scrambled experts to draft triage guidelines under enormous time pressure. Although there are similarities between the documents, they vary considerably in how much weight their respective authors place on the different criteria that they propose. Since most of the recommendations do not come with ethical justification...
Source: Medicine, Health Care and Philosophy - December 1, 2022 Category: Medical Ethics Source Type: research

Autonomy, procedural and substantive: a discussion of the ethics of cognitive enhancement
AbstractAs cognitive enhancement research advances, important ethical questions regarding individual autonomy and freedom are raised. Advocates of cognitive enhancement frequently adopt a procedural approach to autonomy, arguing that enhancers improve an individual ’s reasoning capabilities, which are quintessential to being an autonomous agent. On the other hand, critics adopt a more nuanced approach by considering matters of authenticity and self-identity, which go beyond the mere assessment of one’s reasoning capacities. Both positions, nevertheless, re quire further philosophical scrutiny. In this paper, we investi...
Source: Medicine, Health Care and Philosophy - December 1, 2022 Category: Medical Ethics Source Type: research

On the relation between decision quality and autonomy in times of patient-centered care: a case study
AbstractIt is commonplace that care should be patient-centered. Nevertheless, no universally agreed-upon definition of patient-centered care exists. By consequence, the relation between patient-centered care as such and ethical principles cannot be investigated. However, some research has been performed on the relation between specificmodels of patient-centered care and ethical principles such as respect for autonomy and beneficence. In this article, I offer a detailed case study on the relationship between specificmeasures of patient-centered care and the ethical principle of respect for autonomy. Decision Quality Instrum...
Source: Medicine, Health Care and Philosophy - December 1, 2022 Category: Medical Ethics Source Type: research

Moralization and Mismoralization in Public Health
AbstractMoralization is a social-psychological process through which morally neutral issues take on moral significance. Often linked to health and disease, moralization may sometimes lead to good outcomes; yet moralization is often detrimental to individuals and to society as a whole. It is therefore important to be able to identify when moralization is inappropriate. In this paper, we offer a systematic normative approach to the evaluation of moralization. We introduce and develop the concept of ‘mismoralization’, which is when moralization is metaethically unjustified. In order to identify mismoralization, we argue t...
Source: Medicine, Health Care and Philosophy - December 1, 2022 Category: Medical Ethics Source Type: research

Suicide and Homicide:  Symmetries and Asymmetries in Kant’s Ethics
AbstractKant formulated a secular argument against suicide ’s permissibility based on what he regarded as the intrinsic value of humanity. In this paper, I first show that Kant’s moral framework entails that some types of suicide are morally permissible. Just as some homicides are morally permissible, according to Kant, so are suicides that are performe d according to equivalent maxims. Intention, foreseeability, voluntariness, diminished responsibility, and mental capacity determine the moral characterization of the killing. I argue that a suicide taxonomy that differentiates types of suicide according to morally rele...
Source: Medicine, Health Care and Philosophy - December 1, 2022 Category: Medical Ethics Source Type: research

Issues for a phenomenology of illness – transgressing psychologizations
AbstractPhenomenology of illness has grown increasingly popular in recent times. However, the most prominent phenomenologists of illness defend a psychologizing notion of phenomenology, which argues that illness is primarily constituted by embodied experiences, feelings, and emotions of suffering, alienation etc. The article argues that this gives rise to three issues that need to be addressed. (1) How is the theory of embodiment compatible with the strong distinction between disease and illness? (2) What is the difference between problematic embodiment and illness? (3) How is existential edification, that illness can give...
Source: Medicine, Health Care and Philosophy - December 1, 2022 Category: Medical Ethics Source Type: research

Epistemic solidarity in medicine and healthcare
AbstractIn this article, I apply the concept of solidarity to collective knowledge practices in healthcare. Generally, solidarity acknowledges that people are dependent on each other in many respects, and it captures those support practices that people engage in out of concern for others in whom they recognise a relevant similarity. Drawing on the rich literature on solidarity in bioethics and beyond, this article specifically discusses the role thatepistemic solidarity can play in healthcare. It thus focuses, in particular, on solidarity ’s relationship with justice and injustice. In this regard, it is argued (1) that j...
Source: Medicine, Health Care and Philosophy - December 1, 2022 Category: Medical Ethics Source Type: research