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Beyond Conceptual Analysis: Social Objectivity and Conceptual Engineering to Define Disease J. Med. Philos. (IF 1.493) Pub Date : 2024-02-29 Anne-Marie Gagné-Julien
In this article, I side with those who argue that the debate about the definition of “disease” should be reoriented from the question “what is disease” to the question of what it should be. However, I ground my argument on the rejection of the naturalist approach to define disease and the adoption of a normativist approach, according to which the concept of disease is normative and value-laden. Based
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The Heterogeneity of Bioethics: Discussions of Harm, Abortion, and Conceptual Clarity of Bioethical Terminology J. Med. Philos. (IF 1.493) Pub Date : 2023-11-07 Ryan Hrabovsky
This issue of The Journal of Medicine and Philosophy exemplifies the diverse range of topics that fall under the scope of bioethics and the philosophy of medicine. The eight essays in this number challenge many of the underlying assumptions made in the philosophy of medicine, health care, the abortion debate, the nature of harm, disability, the moral status of human beings, and pandemic lockdown procedures
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Civil Liberties in a Lockdown: The Case of COVID-19. J. Med. Philos. (IF 1.493) Pub Date : 2023-11-03 Samuel Director,Christopher Freiman
In response to the spread of COVID-19, governments across the world, with very few exceptions, have enacted sweeping restrictive lockdown policies that impede citizens' freedom to move, work, and assemble. This paper critically responds to the central arguments for restrictive lockdown legislation. We build our critique on the following assumption: public policy that enjoys virtually unanimous support
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Patient Expertise and Medical Authority: Epistemic Implications for the Provider-Patient Relationship. J. Med. Philos. (IF 1.493) Pub Date : 2023-10-24 Jamie Carlin Watson
The provider-patient relationship is typically regarded as an expert-to-novice relationship, and with good reason. Providers have extensive education and experience that have developed in them the competence to treat conditions better and with fewer harms than anyone else. However, some researchers argue that many patients with long-term conditions (LTCs), such as arthritis and chronic pain, have become
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Intentions at the End of Life: Continuous Deep Sedation and France's Claeys-Leonetti law. J. Med. Philos. (IF 1.493) Pub Date : 2023-10-06 Steven Farrelly-Jackson
In 2016, France passed a major law that is unique in giving terminally ill and suffering patients the right to the controversial procedure of continuous deep sedation until death (CDS). In so doing, the law identifies CDS as a sui generis clinical practice, distinct from other forms of palliative sedation therapy, as well as from euthanasia. As such, it reconfigures the ethical debate over CDS in interesting
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How to Exercise Integrity in Medical Billing: Don't Distort Prices, Don't Free-Ride on Other Physicians. J. Med. Philos. (IF 1.493) Pub Date : 2023-10-06 Christopher Langston
This paper proposes that billing gamesmanship occurs when physicians free-ride on the billing practices of other physicians. Gamesmanship is non-universalizable and does not exercise a competitive advantage; consequently, it distorts prices and allocates resources inefficiently. This explains why gamesmanship is wrong. This explanation differs from the recent proposal of Heath (2020. Ethical issues
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The "Risks of Routine Tests" and Analogical Reasoning in Assessments of Minimal Risk. J. Med. Philos. (IF 1.493) Pub Date : 2023-10-06 Adrian Kwek
Research risks have to meet minimal risk requirements in order for the research to qualify for expedited ethics review, to be exempted from ethics review, or to be granted consent waivers. The definition of "minimal risk" in the Common Rule (45 CFR 46) relies on the risks-of-daily-life and risks-of-routine-tests as comparators against which research activities are assessed to meet minimal risk requirements
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The Relational Care Framework: Promoting Continuity or Maintenance of Selfhood in Person-Centered Care J. Med. Philos. (IF 1.493) Pub Date : 2023-09-30 Matthew Tieu, Steve Matthews
We argue that contemporary conceptualizations of “persons” have failed to achieve the moral goals of “person-centred care” (PCC, a model of dementia care developed by Tom Kitwood) and that they are detrimental to those receiving care, their families, and practitioners of care. We draw a distinction between personhood and selfhood, pointing out that continuity or maintenance of the latter is what is
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Moral Distress, Conscientious Practice, and the Endurance of Ethics in Health Care through Times of Crisis and Calm. J. Med. Philos. (IF 1.493) Pub Date : 2023-09-28 Lauris Christopher Kaldjian
When health professionals experience moral distress during routine clinical practice, they are challenged to maintain integrity through conscientious practice guided by ethical principles and virtues that promote the dignity of all human beings who need care. Their integrity also needs preservation during a crisis like the COVID-19 pandemic, especially when faced with triage protocols that allocate
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Phenomenological Interview and Gender Dysphoria: A Third Pathway for Diagnosis and Treatment. J. Med. Philos. (IF 1.493) Pub Date : 2023-09-27 Geoffrey Dierckxsens,Teresa R Baron
Gender dysphoria (GD) is marked by an incongruence between a person's biological sex at birth, and their felt gender (or gender identity). There is continuing debate regarding the benefits and drawbacks of physiological treatment of GD in children, a pathway, beginning with endocrine treatment to suppress puberty. Currently, the main alternative to physiological treatment consists of the so-called
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Disability, Transition Costs, and the Things That Really Matter J. Med. Philos. (IF 1.493) Pub Date : 2023-07-08 Tommy Ness, Linda Barclay
This article develops a detailed, empirically driven analysis of the nature of the transition costs incurred in becoming disabled. Our analysis of the complex nature of these costs supports the claim that it can be wrong to cause disability, even if disability is just one way of being different. We also argue that close attention to the nature of transition costs gives us reason to doubt that well-being
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On The Problem of Defending Basic Equality: Natural Law and The Substance View J. Med. Philos. (IF 1.493) Pub Date : 2023-07-05 Henrik Friberg-Fernros
While most theorists agree with the claim that human beings have high and equal moral standing, there are strong disagreements about how to justify this claim. These disagreements arise because there are different ways of managing the difficulty of finding a basis for this claim, which is sufficiently substantial to do this justifying work, but not vary in degree in order to not give rise to inequality
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What’s the Harm in Cardiopulmonary Resuscitation? J. Med. Philos. (IF 1.493) Pub Date : 2023-07-03 Peter M Koch
In clinical ethics, there remains a great deal of uncertainty regarding the appropriateness of attempting cardiopulmonary resuscitation (CPR) for certain patients. Although the issue continues to receive ample attention and various frameworks have been proposed for navigating such cases, most discussions draw heavily on the notion of harm as a central consideration. In the following, I use emerging
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Evictionism, Libertarianism, and Duties of the Fetus J. Med. Philos. (IF 1.493) Pub Date : 2023-07-03 Łukasz Dominiak, Igor Wysocki
In “Evictionism and Libertarianism,” published in this journal, Walter Block defends the view that, although the fetus is a human being with all the rights to its body, it may nonetheless be evicted from the woman’s body as a trespasser, provided the pregnancy is unwanted. We argue that this view is untenable: the statement that the unwanted fetus is a trespasser does not follow from the premises that
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Abortion, Impairment, and Well-Being J. Med. Philos. (IF 1.493) Pub Date : 2023-06-28 Alex R Gillham
Hendricks’ The Impairment Argument (TIA) claims that it is immoral to impair a fetus by causing it to have fetal alcohol syndrome (FAS). Since aborting a fetus impairs it to a greater degree than causing it to have FAS, then abortion is also immoral. In this article, I argue that TIA ought to be rejected. This is because TIA can only succeed if it explains why causing an organism to have FAS impairs
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Inconsistency between the Circulatory and the Brain Criteria of Death in the Uniform Determination of Death Act J. Med. Philos. (IF 1.493) Pub Date : 2023-06-26 Alberto Molina-Pérez, James L Bernat, Anne Dalle Ave
The Uniform Determination of Death Act (UDDA) provides that “an individual who has sustained either (1) irreversible cessation of circulatory and respiratory functions or (2) irreversible cessation of all functions of the entire brain, including the brain stem, is dead.” We show that the UDDA contains two conflicting interpretations of the phrase “cessation of functions.” By one interpretation, what
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On Drugs J. Med. Philos. (IF 1.493) Pub Date : 2023-06-24 Sam Baron, Sara Linton, Maureen A O’malley
Despite their centrality to medicine, drugs are not easily defined. We introduce two desiderata for a basic definition of medical drugs. It should: (a) capture everything considered to be a drug in medical contexts and (b) rule out anything that is not considered to be a drug. After canvassing a range of options, we find that no single definition of drugs can satisfy both desiderata. We conclude with
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Bioethics: Shaping Medical Practice and Taking Diversity Seriously J. Med. Philos. (IF 1.493) Pub Date : 2023-06-20 Mark J Cherry
Bioethics functions within a world of deep moral pluralism; a universe of discourse debating ethical analysis, public policy, and clinical practice in which a common, generally accepted morality does not exist. While religious thinkers are often approached within a hermeneutic of suspicion for assuming moral standards that cannot be justified in rational terms, secular bioethicists routinely find themselves
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Is Death Irreversible? J. Med. Philos. (IF 1.493) Pub Date : 2023-06-17 Nada Gligorov
There are currently two legally established criteria for death: the irreversible cessation of circulation and respiration and the irreversible cessation of neurologic function. Recently, there have been technological developments that could undermine the irreversibility requirement. In this paper, I focus both on whether death should be identified as an irreversible state and on the proper scope of
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Memories without Survival: Personal Identity and the Ascending Reticular Activating System J. Med. Philos. (IF 1.493) Pub Date : 2023-06-14 Lukas J Meier
Lockean views of personal identity maintain that we are essentially persons who persist diachronically by virtue of being psychologically continuous with our former selves. In this article, I present a novel objection to this variant of psychological accounts, which is based on neurophysiological characteristics of the brain. While the mental states that constitute said psychological continuity reside
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Involuntary Childlessness, Suffering, and Equality of Resources: An Argument for Expanding State-funded Fertility Treatment Provision J. Med. Philos. (IF 1.493) Pub Date : 2023-06-09 Giulia Cavaliere
Assessing what counts as infertility has practical implications: access to (state-funded) fertility treatment is usually premised on meeting the criteria that constitute the chosen definition of infertility. In this paper, I argue that we should adopt the expression “involuntary childlessness” to discuss the normative dimensions of people’s inability to conceive. Once this conceptualization is adopted
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Toward a Hybrid Theory of How to Allocate Health-related Resources J. Med. Philos. (IF 1.493) Pub Date : 2023-06-09 Anders Herlitz
How should scarce health-related resources be allocated? This paper argues that values that apply to these decisions fail to always fully determine what we should do. Health maximization and allocation-according-to-need are suggested as two values that should be part of a general theory of how to allocate health-related resources. The “small improvement argument” is used to argue that it is implausible
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On the Anatomy of Health-related Actions for Which People Could Reasonably be Held Responsible: A Framework J. Med. Philos. (IF 1.493) Pub Date : 2023-05-31 Kristine Bærøe, Andreas Albertsen, Cornelius Cappelen
Should we let personal responsibility for health-related behavior influence the allocation of healthcare resources? In this paper, we clarify what it means to be responsible for an action. We rely on a crucial conceptual distinction between being responsible and holding someone responsible, and show that even though we might be considered responsible and blameworthy for our health-related actions,
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Priority for Organ Donors in the Allocation of Organs: Priority Rules from the Perspective of Equality of Opportunity J. Med. Philos. (IF 1.493) Pub Date : 2023-05-26 Andreas Albertsen
Should priority in the allocation of organs be given to those who have previously donated or declared their willingness to do so? This article examines the Israeli priority rule in light of two prominent critiques of priority rules, pertaining to failure to reciprocate and unfairness. The scope and content of these critiques are interpreted from the perspective of equality of opportunity. Because the
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Democratic Justifications for Patient Public Involvement and Engagement in Health Research: An Exploration of the Theoretical Debates and Practical Challenges J. Med. Philos. (IF 1.493) Pub Date : 2023-05-25 Lucy Frith
The literature on patient public involvement and engagement (PPIE) in health research has grown significantly in the last decade, with a diverse range of definitions and topologies promulgated. This has led to disputes over what the central functions and purpose of PPIE in health research is, and this in turn makes it difficult to assess and evaluate PPIE in practice. This paper argues that the most
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Preclinical Disease or Risk Factor? Alzheimer’s Disease as a Case Study of Changing Conceptualizations of Disease J. Med. Philos. (IF 1.493) Pub Date : 2023-05-19 Maartje H N Schermer
Alzheimer’s Disease (AD) provides an excellent case study to investigate emerging conceptions of health, disease, pre-disease, and risk. Two scientific working groups have recently reconceptualized AD and created a new category of asymptomatic biomarker positive persons, who are either said to have preclinical AD, or to be at risk for AD. This article examines how prominent theories of health and disease
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Unintended Intrauterine Death and Preterm Delivery: What Does Philosophy Have to Offer? J. Med. Philos. (IF 1.493) Pub Date : 2023-05-16 Nicholas Colgrove
This special issue of the Journal of Medicine and Philosophy focuses on unintended intrauterine death (UID) and preterm delivery (both phenomena that are commonly—and unhelpfully—referred to as “miscarriage,” “spontaneous abortion,” and “early pregnancy loss”). In this essay, I do two things. First, I outline contributors’ arguments. Most contributors directly respond to “inconsistency arguments,”
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Prevention of Disease and the Absent Body: A Phenomenological Approach to Periodontitis J. Med. Philos. (IF 1.493) Pub Date : 2023-05-16 Dylan Rakhra, Māra Grīnfelde
A large part of the contemporary phenomenology of medicine has been devoted to accounts of health and illness, arguing that they contribute to the improvement of health care. Less focus has been paid to the issue of prevention of disease and the associated difficulty of adhering to health-promoting behaviours, which is arguably of equal importance. This article offers a phenomenological account of
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Death as the Cessation of an Organism and the Moral Status Alternative J. Med. Philos. (IF 1.493) Pub Date : 2023-05-03 Piotr Grzegorz Nowak
The mainstream concept of death—the biological one—identifies death with the cessation of an organism. In this article, I challenge the mainstream position, showing that there is no single well-established concept of an organism and no universal concept of death in biological terms. Moreover, some of the biological views on death, if applied in the context of bedside decisions, might imply unacceptable
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Evidence-based Medicine and Mechanistic Evidence: The Case of the Failed Rollout of Efavirenz in Zimbabwe J. Med. Philos. (IF 1.493) Pub Date : 2023-05-03 Andrew Park, Daniel Steel, Elicia Maine
Evidence-based medicine (EBM) has long deemphasized mechanistic reasoning and pathophysiological rationale in assessing the effectiveness of interventions. The EBM+ movement has challenged this stance, arguing that evidence of mechanisms and comparative studies should both be seen as necessary and complementary. Advocates of EBM+ provide a combination of theoretical arguments and examples of mechanistic
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A Human Right to What Kind of Medicine? J. Med. Philos. (IF 1.493) Pub Date : 2023-05-02 Kathryn Muyskens
The human right to health, insofar as it is widely recognized, is typically thought to include the right to fair access to adequate healthcare, but the operating conception of healthcare in this context has been under-defined. This lack of conceptual clarity has often led in practice to largely Western cultural assumptions about what validly constitutes “healthcare” and “medicine.” Ethnocentric and
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Bioethics, Sociality, and Mental Illness J. Med. Philos. (IF 1.493) Pub Date : 2023-04-20 Magnus Englander
The phenomenology of bioethics is approached here in relation to the lived experience as it relates to the everyday lifeworld of persons suffering from mental illness. Taking a road less traveled, the purpose here is to elucidate ethical issues relating to sociality, using findings from qualitative phenomenological psychological research. Qualitative studies of schizophrenia and postpartum depression
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Phenomenological Bioethics J. Med. Philos. (IF 1.493) Pub Date : 2023-04-20 Susi Ferrarello
Eudaimonia, that is, the experience of flourishing and welfare at the center of Greek philosophical investigations, describes the qualitative experience of being able to feel well in our bodies. Reductionism in medicine as well as in philosophy would instead reduce well-being to a set of standards that the human body or its mind must meet in order to be recognized as functioning. This journal issue
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Miscarriage, Abortion, and Disease J. Med. Philos. (IF 1.493) Pub Date : 2023-04-20 Tom Waters
The frequency of death from miscarriage is very high, greater than the number of deaths from induced abortion or major diseases. Berg (2017, Philosophical Studies 174:1217–26) argues that, given this, those who contend that personhood begins at conception (PAC) are obliged to reorient their resources accordingly—towards stopping miscarriage, in preference to stopping abortion or diseases. This argument
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The Logic of Pregnancy J. Med. Philos. (IF 1.493) Pub Date : 2023-04-20 Jonna Bornemark
This article takes its point of departure in Bracha Ettinger’s discussion on the “matrixial borderspace”: the structure of the experience of “the womb,” both from a “mother-pole” and a “fetus-pole”. Ettinger describes this borderspace as a place of differentiation-in-co-emergence, separation-in-jointness, and distance-in-proximity. The question this article poses is what kind of logic this experience
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Anti-abortionist Action Theory and the Asymmetry between Spontaneous and Induced Abortions J. Med. Philos. (IF 1.493) Pub Date : 2023-04-20 Matthew Lee Anderson
This essay defends the asymmetry between the badness of spontaneous and induced abortions in order to explain why anti-abortionists prioritize stopping induced abortions over preventing spontaneous abortions. Specifically, it argues (1) the distinction between killing and letting-die is of more limited use in explaining the asymmetry than has sometimes been presumed, and (2) that accounting for intentions
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Which Kind of Body in “Mental” Pathologies? Phenomenological Insights on the Nature of the Disrupted Self J. Med. Philos. (IF 1.493) Pub Date : 2023-04-20 Valeria Bizzari
Guided by a phenomenological perspective, this paper aims to account for the existence of a corporeal consciousness—something that clinicians should take into account, not merely in the case of physical pathologies but especially in the case of mental disorders. Firstly, I will highlight three cases: schizophrenia, depression, and autism spectrum disorder. Then, I will show how these cases correspond
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What is Phenomenological Bioethics? A Critical Appraisal of Its Ends and Means J. Med. Philos. (IF 1.493) Pub Date : 2023-04-20 Lewis Coyne
In recent years the phenomenological approach to bioethics has been rejuvenated and reformulated by, among others, the Swedish philosopher Fredrik Svenaeus. Building on the now-relatively mainstream phenomenological approach to health and illness, Svenaeus has sought to bring phenomenological insights to bear on the bioethical enterprise, with a view to critiquing and refining the “philosophical anthropology”
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Solastalgia: Climatic Anxiety—An Emotional Geography to Find Our Way Out J. Med. Philos. (IF 1.493) Pub Date : 2023-04-20 Susi Ferrarello
This paper will discuss the notion of solastalgia or climatic anxiety (Albrecht et al., 2007; Galea et al., 2005) as a form of anxiety connected to traumatic environmental changes that generate an emotional blockage between individuals, their environment (Cloke et al., 2004) and their place (Nancy, 1993). I will use a phenomenological approach to explain the way in which emotions shape our constitution
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The Phenomenology of Objectification in and Through Medical Practice and Technology Development J. Med. Philos. (IF 1.493) Pub Date : 2023-04-20 Fredrik Svenaeus
Objectification is a real problem in medicine that can lead to bad medical practice or, in the worst case, dehumanization of the patient. Nevertheless, objectification also plays a major and necessary role in medicine: the patient’s body should be viewed as a biological organism in order to find diseases and be able to cure them. Listening to the patient’s illness story should not be replaced, but
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The Saturated Phenomenon of Flesh and Mineness and Otherness of the Body in Illness J. Med. Philos. (IF 1.493) Pub Date : 2023-04-20 Māra Grīnfelde
A key topic within the field of the phenomenology of medicine has been the relationship between body and self in illness, including discussions about the otherness and mineness of the body. The aim of this article is to distinguish between different meanings of bodily otherness and mineness in illness with reference to the interpretation of the body as “saturated phenomenon,” inspired by the phenomenology
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The Mereotopology of Pregnancy J. Med. Philos. (IF 1.493) Pub Date : 2023-04-16 Suki Finn
Consider the following two metaphysical questions about pregnancy: (1) When does a new organism of a certain kind start to exist? (2) What is the mereological and topological relationship between the pregnant organism and with what it is pregnant? Despite assumptions made in the literature, I take these questions to be independent of each other, such that an answer to one does not provide an answer
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Embryo Loss and Moral Status J. Med. Philos. (IF 1.493) Pub Date : 2023-04-16 James Delaney
There is a significant debate over the moral status of human embryos. This debate has important implications for practices like abortion and IVF. Some argue that embryos have the same moral status as infants, children, and adults. However, critics claim that the frequency of pregnancy loss/miscarriage/spontaneous abortion shows a moral inconsistency in this view. One line of criticism is that those
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When Words Fail: “Miscarriage,” Referential Ambiguity, and Psychological Harm J. Med. Philos. (IF 1.493) Pub Date : 2023-04-16 Jessalyn A Bohn
Despite significant efforts to support those bereaved by intrauterine death, they remain susceptible to avoidable psychological harm such as disenfranchised grief, misplaced guilt, and emotional shock. This is in part because the words available to describe intrauterine death—“miscarriage,” “spontaneous abortion,” and “pregnancy loss”—are referentially ambiguous. Despite appearing to refer to one event
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The Scourges: Why Abortion Is Even More Morally Serious than Miscarriage J. Med. Philos. (IF 1.493) Pub Date : 2023-04-16 Calum Miller
Several recent papers have suggested that the pro-life view entails a radical, implausible thesis: that miscarriage is the biggest public health crisis in the history of our species and requires radical diversion of funds to combat. In this paper, I clarify the extent of the problem, showing that the number of miscarriages about which we can do anything morally significant is plausibly much lower than
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Below the Surface of Clinical Ethics J. Med. Philos. (IF 1.493) Pub Date : 2023-02-17 J Clint Parker
Often lurking below the surface of many clinical ethical issues are questions regarding background metaphysical, epistemological, meta-ethical, and political beliefs. In this issue, authors critically examine the effects of background beliefs on conscientious objection, explore ethical issues through the lenses of particular theoretical approaches like pragmatism and intersectional theory, rigorously
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A New Defense of Brain Death as the Death of the Human Organism. J. Med. Philos. (IF 1.493) Pub Date : 2023-09-14 Andrew McGee,Dale Gardiner,Melanie Jansen
This paper provides a new rationale for equating brain death with the death of the human organism, in light of well-known criticisms made by Alan D Shewmon, Franklin Miller and Robert Truog and a number of other writers. We claim that these criticisms can be answered, but only if we accept that we have slightly redefined the concept of death when equating brain death with death simpliciter. Accordingly
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Uncertainty, Evidence, and the Integration of Machine Learning into Medical Practice J. Med. Philos. (IF 1.493) Pub Date : 2023-01-11 Thomas Grote, Philipp Berens
In light of recent advances in machine learning for medical applications, the automation of medical diagnostics is imminent. That said, before machine learning algorithms find their way into clinical practice, various problems at the epistemic level need to be overcome. In this paper, we discuss different sources of uncertainty arising for clinicians trying to evaluate the trustworthiness of algorithmic
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Alzheimer’s, Advance Directives, and Interpretive Authority J. Med. Philos. (IF 1.493) Pub Date : 2023-01-11 Charles L Barzun
Philosophers have debated whether the advance directives of Alzheimer’s patients should be enforced, even if patients seem content in their demented state. The debate raises deep questions about the nature of human autonomy and personal identity. But it tends to proceed on the assumption that the advance directive’s terms are clear, whereas in practice they are often vague or ambiguous, requiring the
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Patient Safety and the Question of Dignitary Harms J. Med. Philos. (IF 1.493) Pub Date : 2023-01-02 Polly Mitchell, Alan Cribb, Vikki Entwistle
Patient safety is a central aspect of healthcare quality, focusing on preventable, iatrogenic harm. Harm, in this context, is typically assumed to mean physical injury to patients, often caused by technical error. However, some contributions to the patient safety literature have argued that disrespectful behavior towards patients can cause harm, even when it does not lead to physical injury. This paper
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Philosophical Failure and the Reasonability View of Conscientious Objection: Can Reason Adjudicate Metaphysical or Religious Claims? J. Med. Philos. (IF 1.493) Pub Date : 2022-12-27 Abram L Brummett
Robert Card has proposed a reasonability view of conscientious objection that asks providers to state the reasons for their objection for evaluation and approval by a review board. Jason Marsh has challenged Card to provide explicit criteria for what makes a conscientious objection reasonable, which he claims will be too difficult a task given that such objections often involve contentious metaphysical
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Pathologizing Ugliness: A Conceptual Analysis of the Naturalist and Normativist Claims in “Aesthetic Pathology” J. Med. Philos. (IF 1.493) Pub Date : 2022-12-23 Yves Saint James Aquino
Pathologizing ugliness refers to the use of disease language and medical processes to foster and support the claim that undesirable features are pathological conditions requiring medical or surgical intervention. Primarily situated in cosmetic surgery, the practice appeals to the concept of “aesthetic pathology”, which is a medical designation for features that deviate from some designated aesthetic
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Is Aging a Disease? The Theoretical Definition of Aging in the Light of the Philosophy of Medicine J. Med. Philos. (IF 1.493) Pub Date : 2022-12-23 Cristian Saborido, Pablo García-Barranquero
In the philosophical debate on aging, it is common to raise the question of the theoretical definition of aging in terms of its possible characterization as a disease. Understanding aging as a disease seems to imply its medicalization, which has important practical consequences. In this paper, we analyze the question of whether aging is a disease by appealing to the concept of disease in the philosophy
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Being in Relation, Being through Change J. Med. Philos. (IF 1.493) Pub Date : 2022-12-23 Martin J Fitzgerald
Ethics exists among beings that can relate to one another and who can create change in one another. Although this may appear as a simple truism, the implications of relation and change in bioethics are manifold. For instance, one can relate not only to others, but also can enter into self-relation by relating to oneself. Self-relation problematizes autonomy insofar as one does not have immediate access
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Tōjisha Research and Narrative Medicine: Contribution of a Japanese Experiment in the Investigation of Patients’ Personal Experience J. Med. Philos. (IF 1.493) Pub Date : 2022-12-23 Maxence Gaillard
Tōjisha research is a methodology intended to help psychiatric patients through dialogue. It was introduced in the context of community care in Bethel House (Hokkaido, Japan) in the early 2000s and later spread to other parts of Japan as well as abroad because of its originality and apparent therapeutic success. It offers patients a framework to investigate their own problems, symptoms, and delusions
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The Desirability of Difference: Georges Canguilhem and Body Integrity Identity Disorder J. Med. Philos. (IF 1.493) Pub Date : 2022-12-23 Richard B Gibson
Opponents of the provision of therapeutic, healthy limb amputation in Body Integrity Identity Disorder cases argue that such surgeries stand in contrast to the goal of medical practice – that of health restoration and maintenance. This paper refutes such a conclusion via an appeal to the nuanced and reflective model of health proposed by Georges Canguilhem. The paper examines the conceptual entanglement
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Moral Injury, Moral Identity, and “Dirty Hands” in War Fighting and Police Work J. Med. Philos. (IF 1.493) Pub Date : 2022-12-23 Seumas Miller
In this article, I undertake three main tasks. First, I argue that, contrary to the standard view, moral injury is not a species of PTSD (post-traumatic stress disorder) but rather, on the most coherent conception of moral injury, PTSD is (in effect) a species of moral injury. In doing so, I make use of the notion of caring deeply about something or someone worthy of being cared deeply about. Second
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Assisted Death, Dignity, and Respect for Humanity. J. Med. Philos. (IF 1.493) Pub Date : 2022-12-23 Morten Dige
Recent works on the concept of dignity have opened up the otherwise quite deadlocked debate about assisted death (AD). Rather than just reinforcing already fixed positions, it seems to me that these conceptions of dignity make room for a moderate and normatively richer position on the moral permissibility of AD. I do not think that we have seen the full potential of the said conceptions and interpretations
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"Accompanied Only by My Thoughts": A Kantian Perspective on Autonomy at the End of Life. J. Med. Philos. (IF 1.493) Pub Date : 2022-12-23 Anna Magdalena Elsner,Vanessa Rampton
Within bioethics, Kant's conception of autonomy is often portrayed as excessively rationalistic, abstract, and individualistic, and, therefore, far removed from the reality of patients' needs. Drawing on recent contributions in Kantian philosophy, we argue that specific features of Kantian autonomy remain relevant for medical ethics and for patient experience. We use contemporary end-of-life illness
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Critically Appraising Pragmatist Critiques of Evidence-Based Medicine: Is EBM Defensible on Pragmatist Grounds? J. Med. Philos. (IF 1.493) Pub Date : 2023-02-17 S Joshua Thomas
Significant contributions to debates in the philosophy of evidence-based medicine (EBM) have come from a variety of different philosophical quarters, yet mainstream discourse in the field has been largely devoid of contributions from scholars working in the pragmatist tradition. This is a particularly conspicuous omission, given pragmatism's commitment to the melioristic view that philosophy both can