Fran çoise Baylis and Angela Ballantyne (eds): Clinical research involving pregnant women
(Source: Theoretical Medicine and Bioethics)
Source: Theoretical Medicine and Bioethics - August 25, 2019 Category: Medical Ethics Source Type: research
Leroy C. Edozien: Self-determination in health care: a property approach to the protection of patients ’ rights
(Source: Theoretical Medicine and Bioethics)
Source: Theoretical Medicine and Bioethics - August 13, 2019 Category: Medical Ethics Source Type: research
Intervention principles in pediatric health care: the difference between physicians and the state
AbstractAccording to various accounts, intervention in pediatric decisions is justified either by the best interests standard or by the harm principle. While these principles have various nuances that distinguish them from each other, they are similar in the sense that both focus primarily on the features of parental decisions that justify intervention, rather than on the competency or authority of the parties that intervene. Accounts of these principles effectively suggest that intervention in pediatric decision making is warranted for both physicians and the state under precisely the same circumstances. This essay argu...
Source: Theoretical Medicine and Bioethics - August 11, 2019 Category: Medical Ethics Source Type: research
Ezekiel Emanuel, Andrew Steinmetz, and Harald Schmidt (eds): Rationing and resource allocation in healthcare: essential readings
(Source: Theoretical Medicine and Bioethics)
Source: Theoretical Medicine and Bioethics - August 8, 2019 Category: Medical Ethics Source Type: research
Stephen Scher and Kasia Kozlowska: Rethinking health care ethics
(Source: Theoretical Medicine and Bioethics)
Source: Theoretical Medicine and Bioethics - August 6, 2019 Category: Medical Ethics Source Type: research
Professing clinical medicine in an evolving health care network
AbstractFor at least the past several decades, medicine has been embroiled in a crisis concerning the nature of its professionalism. The fundamental questions that drive this ongoing crisis are primarily three. First, what is the nature of medical professionalism? Second, who are medical professionals? Third, what does medicine or these professionals profess or promise? In this paper, the professionalism crisis vis- à-vis these questions is examined and analyzed chiefly in terms of both Francis Peabody’s and Edmund Pellegrino’s writings. Based on their writings, I introduce a conceptual framework for professionalism t...
Source: Theoretical Medicine and Bioethics - August 2, 2019 Category: Medical Ethics Source Type: research
Pellegrino, MacIntyre, and the internal morality of clinical medicine
AbstractThere has been significant debate about whether the moral norms of medical practice arise from some feature or set of features internal to the discipline of medicine. In this article, I analyze Edmund Pellegrino ’s conception of the internal morality of medicine, and situate it in the context of Alasdair MacIntyre’s influential account of “practice.” Building upon MacIntyre, Pellegrino argued that medicine is a social practice with its own unique goals—namely, the medical, human, and spiritual goo d of the patient—and that the moral norms that govern medical practice are derived from these goals. After ...
Source: Theoretical Medicine and Bioethics - August 2, 2019 Category: Medical Ethics Source Type: research
Grounding medical ethics in philosophy of medicine: problematic and potential
AbstractAfter considering two of Pellegrino ’s papers that address the relation between philosophy of medicine and medical ethics, I identify several overarching problems in his account that revolve around his self-described essentialism and the lack of a systematic attempt to relate clinical medicine to biomedicine and public health. I add ress these from the critical realist position of Bernard Lonergan, who grounds both metaphysics and ethics on the normative structure of human inquiry and seeks to understand historical development, such as we are witnessing in health science and health care, in terms of the dynamic s...
Source: Theoretical Medicine and Bioethics - August 2, 2019 Category: Medical Ethics Source Type: research
Engaging Pellegrino ’s philosophy of medicine: Can one of the founders of the field still help us today?
(Source: Theoretical Medicine and Bioethics)
Source: Theoretical Medicine and Bioethics - July 30, 2019 Category: Medical Ethics Source Type: research
The healing relationship: Edmund Pellegrino ’s philosophy of the physician–patient encounter
AbstractIn this paper I briefly summarize Pellegrino ’s phenomenological analysis of the ethics of the physician–patient relationship. In delineating the essential elements of the healing relationship (the fact of illness, the profession of healing, and the act of medicine), Pellegrino demonstrates the necessity for health care professionals to un derstand the patient’s lived experience of illness. In considering the phenomenon of illness, I identify certain essential characteristics of illness-as-lived that provide a basis for developing a rigorous understanding of the patient’s experience. I note recent developme...
Source: Theoretical Medicine and Bioethics - July 28, 2019 Category: Medical Ethics Source Type: research
The ends of medicine and the crisis of chronic pain
AbstractPellegrino and Thomasma have proposed a normative medical ethics founded on a conception of the end of medicine detached from any broader notion of thetelos of human life. In this essay, I question whether such a narrow teleological account of medicine can be sustained, taking as a starting point Pellegrino and Thomasma ’s own contention that the end of medicine projects itself onto the intermediate acts that aim at that end. In order to show how the final end of human life similarly alters intermediate ends, such as the end of medicine, I describe Thomas Aquinas’s concept of pain and explain how his remedies f...
Source: Theoretical Medicine and Bioethics - July 26, 2019 Category: Medical Ethics Source Type: research
Toward a Pellegrino-inspired theory of value in health care
AbstractContemporary medical practice and health policy are increasingly animated by the concept of providing high value care. Nevertheless, there can be disagreements about how value is defined and from whose perspective. Individual patients suffering from terminal cancer, for example, may have a different perception of the value of an expensive chemotherapy when compared to health policymakers, insurers, or others responsible for the financial solvency of health care organizations. Thus it seems reasonable to ask what is meant by “value” in high value care. In light of Edmund Pellegrino’s significant contributions ...
Source: Theoretical Medicine and Bioethics - July 8, 2019 Category: Medical Ethics Source Type: research
Taking patient virtue seriously
AbstractVirtue theory in philosophical bioethics has influenced clinical ethics with depictions of the virtuous doctor or nurse. Comparatively little has been done with the concept of the virtuous patient, however. Bioethicists should correct the asymmetry in virtue theory between physician virtues and patient virtues in a way that provides a practical theory for the new patient-centered medicine —something clinicians and administrators can take seriously. (Source: Theoretical Medicine and Bioethics)
Source: Theoretical Medicine and Bioethics - April 9, 2019 Category: Medical Ethics Source Type: research
Is “aid in dying” suicide?
AbstractThe practice whereby terminally ill patients choose to end their own lives painlessly by ingesting a drug prescribed by a physician has commonly been referred to as physician-assisted suicide. There is, however, a strong trend forming that seeks to deny that this act should properly be termedsuicide. The purpose of this paper is to examine and reject the view that the termsuicide should be abandoned in reference to what has been called physician-assisted suicide. I argue that there are no good conceptual or philosophical reasons to avoid the suicide label. I contend that intending one ’s death is essential to the...
Source: Theoretical Medicine and Bioethics - April 5, 2019 Category: Medical Ethics Source Type: research
Death, unity, and the brain
AbstractThe dead donor rule holds that removing organs from living human beings without their consent is wrongful killing. The rule still prevails in most countries, and I assume it without argument in order to pose the question: is it possible to have a metaphysically correct, clinically relevant analysis of human death that makes organ donation ethically permissible? I argue that the two dominant criteria of death —brain death and circulatory death—are both empirically and metaphysically inadequate as definitions of human death and therefore hold no epistemic value in themselves. I first set out a neo-Aristotelian th...
Source: Theoretical Medicine and Bioethics - April 2, 2019 Category: Medical Ethics Source Type: research
