What does the character of medicine as a social practice imply for professional conscientious objection?
AbstractThe dispute over professional conscientious objection presumes a picture of medicine as a practice governed by rules. This rule-based conception of medical practice is identifiable with John Rawls ’s conception of social practices. This conception does not capture the character of medical practice as experienced by practitioners, for whom it is a sensibility or “form of life” rather than rules. Moreover, the sensibility of medical practice as experienced by physicians is at best neutral , and at worst hostile, to the demands of those who would override physician conscientious objection to the provision of cur...
Source: Theoretical Medicine and Bioethics - October 13, 2017 Category: Medical Ethics Source Type: research
Gender by Dasein ? A Heideggerian critique of Suzanne Kessler and the medical management of infants born with disorders of sexual development
This article explores the relationship between gender, technology, language, and how infants and children born with disorders of sexual development are shaped into intelligible members of the community. The contemporary medical model maintains that children ought to be both socially and surgically assigned and reared as one particular gender. Gender scholar Suzanne Kessler rejects this position and argues for the acceptance of greater genital variability through the use of language. Using a Heideggerian lens, the main question I seek to answer in this article is: does Kessler ’s approach succeed in its aim to better trea...
Source: Theoretical Medicine and Bioethics - September 25, 2017 Category: Medical Ethics Source Type: research
Narrative self-appropriation: embodiment, alienness, and personal responsibility in the context of borderline personality disorder
AbstractIt is often emphasised that persons diagnosed with borderline personality disorder (BPD) show difficulties in understanding their own psychological states. In this article, I argue that from a phenomenological perspective, BPD can be understood as an existential modality in which the embodied self is profoundly saturated by an alienness regarding the person ’s own affects and responses. However, the balance of familiarity and alienness is not static, but can be cultivated through, e.g., psychotherapy. Following this line of thought, I present the idea that narrativising experiences can play an important role in p...
Source: Theoretical Medicine and Bioethics - September 11, 2017 Category: Medical Ethics Source Type: research
John C. Moskop: Ethics and health care: an introduction
(Source: Theoretical Medicine and Bioethics)
Source: Theoretical Medicine and Bioethics - September 11, 2017 Category: Medical Ethics Source Type: research
Robyn Bluhm: Knowing and acting in medicine
(Source: Theoretical Medicine and Bioethics)
Source: Theoretical Medicine and Bioethics - September 11, 2017 Category: Medical Ethics Source Type: research
Personhood, pregnancy, and gender: a reply to Hershenov and Hershenov
(Source: Theoretical Medicine and Bioethics)
Source: Theoretical Medicine and Bioethics - August 23, 2017 Category: Medical Ethics Source Type: research
Health, interests, and equality
(Source: Theoretical Medicine and Bioethics)
Source: Theoretical Medicine and Bioethics - August 14, 2017 Category: Medical Ethics Source Type: research
If Abortion, then Infanticide
AbstractOur contention is that all of the major arguments for abortion are also arguments for permitting infanticide. One cannot distinguish the fetus from the infant in terms of a morally significant intrinsic property, nor are they morally discernible in terms of standing in different relationships to others. The logic of our position is that if such arguments justify abortion, then they also justify infanticide. If we are right that infanticide is not justified, then such arguments will fail to justify abortion. We respond to those philosophers who accept infanticide by putting forth a novel account of how the mindless ...
Source: Theoretical Medicine and Bioethics - August 2, 2017 Category: Medical Ethics Source Type: research
Exemplars, ethics, and illness narratives
AbstractMany people report that reading first-person narratives of the experience of illness can be morally instructive or educative. But although they are ubiquitous and typically sincere, the precise nature of such educative experiences is puzzling, for those narratives typically lack the features that modern philosophers regard as constitutive of moral reason. I argue that such puzzlement should disappear, and the morally educative power of illness narratives explained, if one distinguishes two different styles of moral reasoning: an inferentialist style that generates the puzzlement and an alternative exemplarist style...
Source: Theoretical Medicine and Bioethics - July 13, 2017 Category: Medical Ethics Source Type: research
Understanding disease and illness
(Source: Theoretical Medicine and Bioethics)
Source: Theoretical Medicine and Bioethics - July 13, 2017 Category: Medical Ethics Source Type: research
Harm and the concept of medical disorder
AbstractAccording to Jerome Wakefield ’s harmful dysfunction analysis (HDA) of medical disorder, the inability of some internal part or mechanism to perform its natural function is necessary, but not sufficient, for disorder. HDA also requires that the part dysfunction be harmful to the individual. I consider several problems for HDA’ s harm criterion in this article. Other accounts on which harm is necessary for disorder will suffer from all or almost all of these problems. Comparative accounts of harm imply that one is harmed when one is made worse off, that is, worse off than one otherwise would have been. Non-compa...
Source: Theoretical Medicine and Bioethics - July 11, 2017 Category: Medical Ethics Source Type: research
Symptom modelling can be influenced by psychiatric categories: choices for research domain criteria (RDoC)
AbstractPsychiatric researchers typically assume that the modelling of psychiatric symptoms is not influenced by psychiatric categories; symptoms are modelled and then grouped into a psychiatric category. I highlight this primarily through analysing research domain criteria (RDoC). RDoC ’s importance makes it worth scrutinizing, and this assessment also serves as a case study with relevance for other areas of psychiatry. RDoC takes inadequacies of existing psychiatric categories as holding back causal investigation. Consequently, RDoC aims to circumnavigate existing psychiatric c ategories by directly investigating the c...
Source: Theoretical Medicine and Bioethics - July 10, 2017 Category: Medical Ethics Source Type: research
Diagnosis, narrative identity, and asymptomatic disease
AbstractAn increasing number of patients receive diagnoses of disease without having any symptoms. These include diseases detected through screening programs, as incidental findings from unrelated investigations, or via routine checks of various biological variables like blood pressure or cholesterol. In this article, we draw on narrative identity theory to examine how the process of making sense of being diagnosed with asymptomatic disease can trigger certain overlooked forms of harm for patients. We show that the experience of asymptomatic disease can involve ‘mismatches’ between one’s beliefs about one’s health ...
Source: Theoretical Medicine and Bioethics - July 5, 2017 Category: Medical Ethics Source Type: research
Where ’s the problem? Considering Laing and Esterson’s account of schizophrenia, social models of disability, and extended mental disorder
AbstractIn this article, I compare and evaluate R. D. Laing and A. Esterson’s account of schizophrenia as developed inSanity, Madness and the Family (1964), social models of disability, and accounts of extended mental disorder. These accounts claim that some putative disorders (schizophrenia, disability, certain mental disorders) should not be thought of as reflecting biological or psychological dysfunction within the afflicted individual, but instead as external problems (to be located in the family, or in the material and social environment). In this article, I consider the grounds on which such claims might be suppo...
Source: Theoretical Medicine and Bioethics - July 5, 2017 Category: Medical Ethics Source Type: research
Multiple studies and weak evidential defeat
AbstractWhen a study shows statistically significant correlation between an exposure and an outcome, the credence of a real connection between the two increases. Should that credence remain the same when it is discovered that further independent studies between the exposure and other independent outcomes were conducted? Matthew Kotzen argues that it should remain the same, even if the results of those further studies are discovered. However, we argue that it can differ dependent upon the results of the studies. (Source: Theoretical Medicine and Bioethics)
Source: Theoretical Medicine and Bioethics - July 4, 2017 Category: Medical Ethics Source Type: research
