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The structure of analogical reasoning in bioethics
AbstractCasuistry, which involves analogical reasoning, is a popular methodological approach in bioethics. The method has its advantages and challenges, which are widely acknowledged. Meta-philosophical reflection on exactly how bioethical casuistry works and how the challenges can be addressed is limited. In this paper we propose a framework for structuring casuistry and analogical reasoning in bioethics. The framework is developed by incorporating theories and insights from the philosophy of science: Mary Hesse ’s ideas on horizontal and vertical relations in analogical reasoning in the sciences, Paul Bartha’s articu...
Source: Medicine, Health Care and Philosophy - November 9, 2022 Category: Medical Ethics Source Type: research

Lost in translation? Conceptions of privacy and independence in the technical development of AI-based AAL
AbstractAAL encompasses smart home technologies that are installed in the personal living environment in order to support older, disabled, as well as chronically ill people with the goal of delaying or reducing their need for nursing care in a care facility. Artificial intelligence (AI) is seen as an important tool for assisting the target group in their daily lives. A literature search and qualitative content analysis of 255 articles from computer science and engineering was conducted to explore the usage of ethical concepts. From an ethical point of view, the concept of independence and self-determination on the one hand...
Source: Medicine, Health Care and Philosophy - November 8, 2022 Category: Medical Ethics Source Type: research

Not in their hands only: hospital hygiene, evidence and collective moral responsibility
AbstractHospital acquired infections (HAIs) are a major threat to patient safety. This paper addresses the following question: given what is known about the causes of and possible interventions on HAIs, to whom or what should the moral responsibility for preventing these infections be attributed? First, we show how generating robust evidence on the effectiveness of preventive hygiene measures is a complex endeavour and review the existing evidence on the causes of HAIs. Second, we demonstrate that the existing literature on the ethical aspects of infection control has focused on responsibility at the individual-level. Thir...
Source: Medicine, Health Care and Philosophy - November 5, 2022 Category: Medical Ethics Source Type: research

The role of knowledge and medical involvement in the context of informed consent: a course or a blessing?
AbstractInformed consent (IC) is a key patients ’ right. It gives patients the opportunity to access relevant information/knowledge and to support their decision-making role in partnership with clinicians. Despite this promising account of IC, the relationship between ‘knowledge’, as derived from IC, and the role of clinicians is often misu nderstood. I offer two examples of this: (1) the prenatal testing and screening for disabilities; (2) the consent process in the abortion context. In the first example, IC is often over-medicalized, that is to say the disclosure of information appears to be strongly in the clinici...
Source: Medicine, Health Care and Philosophy - November 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 - October 27, 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 - October 27, 2022 Category: Medical Ethics Source Type: research

Metaphors in medicine
(Source: Medicine, Health Care and Philosophy)
Source: Medicine, Health Care and Philosophy - October 20, 2022 Category: Medical Ethics Source Type: research

Covid-19 and age discrimination: benefit maximization, fairness, and justified age-based rationing
AbstractAge-based rationing remains highly controversial. This question has been paramount during the Covid-19 pandemic. Analyzing the practices, proposals, and guidelines applied or put forward during the current pandemic, three kinds of age-based rationing are identified: an age-based cut-off, age as a tiebreaker, and indirect age rationing, where age matters to the extent that it affects prognosis. Where age is allowed to play a role in terms of who gets treated, it is justified either because this is believed to maximize benefits from scarce resources or because it is believed to be in accordance with the value of fair...
Source: Medicine, Health Care and Philosophy - October 15, 2022 Category: Medical Ethics Source Type: research

Ethical, legal, and social aspects of symptom checker applications: a scoping review
AbstractSymptom Checker Applications (SCA) are mobile applications often  designed for the end-user to assist with symptom assessment and self-triage. SCA are meant to provide the user with easily accessible information about their own health conditions. However, SCA raise questions regarding ethical, legal, and social aspects (ELSA), for example, regarding fair access to this new technology. The aim of this scoping review is to identify the ELSA of SCA in the scientific literature. A scoping review was conducted to identify the ELSA of SCA. Ten databases (e.g., Web of Science and PubMed) were used. Studies on SCA that ad...
Source: Medicine, Health Care and Philosophy - October 1, 2022 Category: Medical Ethics Source Type: research

Disclosing the person in renal care coordination: why unpredictability, uncertainty, and irreversibility are inherent in person-centred care
This article explores an example of person-centred care: the work of so-called renal care coordinators. The empirical basis of the article consists of qualitative interviews with renal care coordinators, alongside participant observations of their patient interactions. During the analyses of the empirical material, I found that that one of the coordinators ’ most fundamental ambitions is to get to knowwho the patient is. This is also a central tenet of person-centred care. The aim of the article is not only to argue for the plausibility of this tenet, but also, and more importantly, to highlight and explore its implicati...
Source: Medicine, Health Care and Philosophy - September 20, 2022 Category: Medical Ethics Source Type: research

The continuing formation of relational caring professionals
AbstractLearning to work as a relational caring professional in healthcare and social welfare, is foremost a process of transformative learning, of Building, of professional subjectification. In this article we contribute to the design of such a process of formation by presenting a structured map of five domains of formational goals. It is mainly informed by many years of care-ethical research and training of professionals in healthcare and social work. The five formational domains are:Relational Caring Approach,Perception,Knowledge,Interpretation, andPractical Wisdom. The formation process, described as the recurring deto...
Source: Medicine, Health Care and Philosophy - August 27, 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 - August 25, 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 - August 11, 2022 Category: Medical Ethics Source Type: research

Chronic pain as a blind spot in the diagnosis of a depressed society. On the implications of the connection between depression and chronic pain for interpretations of contemporary society
AbstractOne popular description of current society is that it is adepressed society and medical evidence about depression ’s prevalence may well make such an estimation plausible. However, such normative-critical assessments surrounding depression have to date usually operated with a one-sided understanding of depression. This understanding widely neglects the various ways depression manifests as well as its comorbid ities. This becomes evident at the latest when considering one of depression’s most prominent and well-known comorbidities: chronic pain. Against this background, we aim in this article to substantiate our...
Source: Medicine, Health Care and Philosophy - August 11, 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 - August 9, 2022 Category: Medical Ethics Source Type: research