Comforting when we cannot heal: the ethics of palliative sedation
AbstractThis essay considers whether palliative sedation is or is not appropriate medical care. This requires one to consider (a) whether, in addition to the good of health, relief of suffering is also a proper end of medicine; (b) whether unconsciousness can ever be a good for a human being; and (c) how double-effect reasoning can help us think about difficult cases. The author concludes that palliative sedation may be proper medical care, but only in a limited range of cases. (Source: Theoretical Medicine and Bioethics)
Source: Theoretical Medicine and Bioethics - August 4, 2018 Category: Medical Ethics Source Type: research
James Tabery: Beyond versus: the struggle to understand the interaction of nature and nurture
(Source: Theoretical Medicine and Bioethics)
Source: Theoretical Medicine and Bioethics - August 2, 2018 Category: Medical Ethics Source Type: research
Twin Inc.
AbstractThis paper presents an account of how human spontaneous embryonic chimeras are formed. On the prevalent view in the philosophical literature, it is said that chimeras are the product of two embryos that fuse to form a new third embryo. We call this version of fusionsynthesis. In contrast to synthesis, we present an alternative mechanism for chimera formation calledincorporation, wherein one embryo incorporates the cells of a second embryo into its body. We argue that the incorporation thesis explains other types of chimera formation, which are better understood, and is more consistent than synthesis with what is kn...
Source: Theoretical Medicine and Bioethics - August 1, 2018 Category: Medical Ethics Source Type: research
Violence, research, and non-identity in the psychiatric clinic
AbstractViolence in psychiatric clinics has been a consistent problem since the birth of modern psychiatry. In this paper, I examine current efforts to understand and reduce both violence and coercive responses to violence in psychiatry, arguing that these efforts are destined to fall short. By and large, scholarship on psychiatric violence reduction has focused on identifying discrete factors that are statistically associated with violence, such as patient demographics and clinical qualities, in an effort to quantify risk and predict violent acts before they happen. Using the work of Horkheimer and Adorno, I characteri...
Source: Theoretical Medicine and Bioethics - August 1, 2018 Category: Medical Ethics Source Type: research
Prisoners ’ competence to die: hunger strike and cognitive competence
AbstractSeveral bioethicists have recently advocated the force-feeding of prisoners, based on the assumption that prisoners have reduced or no autonomy. This assumed lack of autonomy follows from a decrease in cognitive competence, which, in turn, supposedly derives from imprisonment and/or being on hunger strike. In brief, causal links are made between imprisonment or voluntary total fasting (VTF) and mental disorders and between mental disorders and lack of cognitive competence. I engage the bioethicists that support force-feeding by severing both of these causal links. Specifically, I refute the claims that VTF automati...
Source: Theoretical Medicine and Bioethics - August 1, 2018 Category: Medical Ethics Source Type: research
The discourse on faith and medicine: a tale of two literatures
AbstractResearch and writing at the intersection of faith and medicine by now include thousands of published studies, review articles, books, chapters, and essays. Yet this emerging field has been described, from within, as disheveled on account of imprecision and lack of careful attention to conceptual and theoretical concerns. An important source of confusion is the fact that scholarship in this field constitutes two distinct literatures, or rather meta-literatures, which can be termed (a) faith as a problematic for medicine and (b) medicine as a problematic for faith. These categories represent distinct theoretical lens...
Source: Theoretical Medicine and Bioethics - August 1, 2018 Category: Medical Ethics Source Type: research
Sarah Ferber: Bioethics in historical perspective
(Source: Theoretical Medicine and Bioethics)
Source: Theoretical Medicine and Bioethics - August 1, 2018 Category: Medical Ethics Source Type: research
Benjamin Smart: Concepts and causes in the philosophy of disease
(Source: Theoretical Medicine and Bioethics)
Source: Theoretical Medicine and Bioethics - August 1, 2018 Category: Medical Ethics Source Type: research
Letter to the editor
(Source: Theoretical Medicine and Bioethics)
Source: Theoretical Medicine and Bioethics - August 1, 2018 Category: Medical Ethics Source Type: research
James Tabery: Beyond versus: the struggle to understand the interaction of nature and nurture
(Source: Theoretical Medicine and Bioethics)
Source: Theoretical Medicine and Bioethics - August 1, 2018 Category: Medical Ethics Source Type: research
Taking responsibility for health in an epistemically polluted environment
AbstractProposals for regulating or nudging healthy choices are controversial. Opponents often argue that individuals should take responsibility for their own health, rather than be paternalistically manipulated for their own good. In this paper, I argue that people can take responsibility for their own health only if they satisfy certain epistemic conditions, but we live in an epistemic environment in which these conditions are not satisfied. Satisfying the epistemic conditions for taking responsibility, I argue, requires regulation of this environment. I describe some proposals for such regulation and show that we can...
Source: Theoretical Medicine and Bioethics - July 28, 2018 Category: Medical Ethics Source Type: research
Conscientious objection and person-centered care
AbstractPerson-centered care offers a promising way to manage clinicians ’ conscientious objection to providing services they consider morally wrong. Health care centered on persons, rather than patients, recognizes clinicians and patients on the same stratum. The moral interests of clinicians, as persons, thus warrant as much consideration as those of other persons, i ncluding patients. Interconnected moral interests of clinicians, patients, and society construct the clinician as a socially embedded and integrated self, transcending the simplistic duality of private conscience versus public role expectations. In this mi...
Source: Theoretical Medicine and Bioethics - July 19, 2018 Category: Medical Ethics Source Type: research
Against the iDoctor: why artificial intelligence should not replace physician judgment
AbstractExperts in medical informatics have argued for the incorporation of ever more machine-learning algorithms into medical care. As artificial intelligence (AI) research advances, such technologies raise the possibility of an “iDoctor,” a machine theoretically capable of replacing the judgment of primary care physicians. In this article, I draw on Martin Heidegger’s critique of technology to show how an algorithmic approach to medicine distorts the physician–patient relationship. Among other problems, AI cannot a dapt guidelines according to the individual patient’s needs. In response to the objection that AI...
Source: Theoretical Medicine and Bioethics - July 10, 2018 Category: Medical Ethics Source Type: research
Sedation and care at the end of life
AbstractThis special issue ofTheoretical Medicine andBioethics takes up the question of palliative sedation as a source of potential concern or controversy among Christian clinicians and thinkers. Christianity affirms a duty to relieve unnecessary suffering yet also proscribes euthanasia. Accordingly, the question arises as to whether it is ever morally permissible to render dying patients unconscious in order to relieve their suffering. If so, under what conditions? Is this practice genuinely morally distinguishable from euthanasia? Can one ever aim directly at making a dying person unconscious, or is it only permissible ...
Source: Theoretical Medicine and Bioethics - July 2, 2018 Category: Medical Ethics Source Type: research
The composite redesign of humanity ’s nature: a work in process
(Source: Theoretical Medicine and Bioethics)
Source: Theoretical Medicine and Bioethics - June 29, 2018 Category: Medical Ethics Source Type: research
