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  1.  3
    Remapping the Organ Donation Ethical Climate: A Care Ethics Consideration.Hui Yun Chan - 2020 - Medicine, Health Care and Philosophy 23 (2):295-308.
    Organ donation has gained much attention as the need for transplant exceeds the supply of organs. Various proposals have been put forward to address the organ shortage challenge, ranging from offering incentives to donors, addressing family refusals to donations and instituting presumed consent laws. Presumed consent as the favoured approach has not been universally effective in increasing actual transplants despite its appeal. Few considerations have been given to the broader ethical climate influencing the organ donation debate. This paper examines the (...)
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  2.  7
    Psychosis, Vulnerability, and the Moral Significance of Biomedical Innovation in Psychiatry. Why Ethicists Should Join Efforts.Paolo Corsico - 2020 - Medicine, Health Care and Philosophy 23 (2):269-279.
    The study of the neuroscience and genomics of mental illness are increasingly intertwined. This is mostly due to the translation of medical technologies into psychiatry and to technological convergence. This article focuses on psychosis. I argue that the convergence of neuroscience and genomics in the context of psychosis is morally problematic, and that ethics scholarship should go beyond the identification of a number of ethical, legal, and social issues. My argument is composed of two strands. First, I argue that we (...)
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  3.  2
    Medical Discernment and Dialogical Praxis: Treatment as Healing Oneself.Claudio Almir Dalbosco, Francisco Carlos dos Santos Filho, Renata Maraschin & Luciana Oltramari Cezar - 2020 - Medicine, Health Care and Philosophy 23 (2):205-214.
    This essay investigates the hermeneutic idea of health and the resulting formative notion of treatment. In its first part, the essay diagnoses, based on some texts of the German philosopher Hans-Georg Gadamer, the increasing technologization of contemporary professions and, specifically in the case of medicine, the risk of disappearance of self-treatment that this technologization causes. In addition to medicine, it also briefly takes psychoanalysis and pedagogy to exemplify the risk of over-specialized professionalization. In the second part, the essay seeks to (...)
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  4.  2
    Should We Have a Right to Refuse Diagnostics and Treatment Planning by Artificial Intelligence?Iñigo de Miguel Beriain - 2020 - Medicine, Health Care and Philosophy 23 (2):247-252.
    Should we be allowed to refuse any involvement of artificial intelligence technology in diagnosis and treatment planning? This is the relevant question posed by Ploug and Holm in a recent article in Medicine, Health Care and Philosophy. In this article, I adhere to their conclusions, but not necessarily to the rationale that supports them. First, I argue that the idea that we should recognize this right on the basis of a rational interest defence is not plausible, unless we are willing (...)
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  5.  4
    Suffering-Based Medicine: Practicing Scientific Medicine with a Humanistic Approach.Auro del Giglio - 2020 - Medicine, Health Care and Philosophy 23 (2):215-219.
    Suffering, defined as a state of undergoing pain, distress or hardship, is a multidimensional concept; it can entail physical, psychological and spiritual distress that prompts the sufferer to seek medical attention. As a construct originating from and unique to each patient, no patient’s suffering is equal to another’s or completely reducible to any generalizable frame of understanding. As it happens in a common medical encounter, the suffering patient requires an anamnesis provided by attentive and comprehensive listening to both the said (...)
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  6.  4
    Humor and Sympathy in Medical Practice.Carter Hardy - 2020 - Medicine, Health Care and Philosophy 23 (2):179-190.
    Medical professionals seem to interpret their uses of humor very differently from those outside the medical profession. Nurses and physicians argue that humor is necessary for them to do their jobs well. Many patients are horrified that they could one day be the butt of their physician’s jokes. The purpose of this paper is to encourage the respectful use of humor in clinical prac-tice, so as to support its importance in medical practice, while simultaneously protecting against its potential abuse. I (...)
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  7.  1
    Is ‘Gender Disappointment’ a Unique Mental Illness?Tereza Hendl & Tamara Kayali Browne - 2020 - Medicine, Health Care and Philosophy 23 (2):281-294.
    ‘Gender disappointment’ is the feeling of sadness when a parent’s strong desire for a child of a certain sex is not realised. It is frequently mentioned as a reason behind parents’ pursuit of sex selection for social reasons. It also tends to be framed as a mental disorder on a range of platforms including the media, sex selection forums and among parents who have been interviewed about sex selection. Our aim in this paper is to investigate whether ‘gender disappointment’ represents (...)
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  8.  5
    Decision-Making Capacity: From Testing to Evaluation.Helena Hermann, Martin Feuz, Manuel Trachsel & Nikola Biller-Andorno - 2020 - Medicine, Health Care and Philosophy 23 (2):253-259.
    Decision-making capacity is the gatekeeping element for a patient’s right to self-determination with regard to medical decisions. A DMC evaluation is not only conducted on descriptive grounds but is an inherently normative task including ethical reasoning. Therefore, it is dependent to a considerable extent on the values held by the clinicians involved in the DMC evaluation. Dealing with the question of how to reasonably support clinicians in arriving at a DMC judgment, a new tool is presented that fundamentally differs from (...)
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  9.  6
    Consumed by Prestige: The Mouth, Consumerism and the Dental Profession.Alexander C. L. Holden - 2020 - Medicine, Health Care and Philosophy 23 (2):261-268.
    Commercialisation and consumerism have had lasting and profound effects upon the nature of oral health and how dental services are provided. The stigma of a spoiled dental appearance, along with the attraction of the smile as a symbol of status and prestige, places the mouth and teeth as an object and product to be bought and sold. How the dental profession interacts with this acquired status of the mouth has direct implications for the professional status of dentistry and the relationship (...)
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  10.  8
    Paternal Consent in Prenatal Research: Ethical Aspects.Mats Johansson, Göran Hermerén & Nils-Eric Sahlin - 2020 - Medicine, Health Care and Philosophy 23 (2):325-331.
    The role of mothers in prenatal research has been discussed extensively. Significantly less work has been done on the father’s role. In this article, focusing on ethical issues, we seek to redress this imbalance. Examining the father’s position in research conducted on pregnant women, we ask whether or not paternal consent ought to be required in addition to that of the pregnant woman. Having distinguished between different concepts of father and mother, we proceed by giving an overview of the reasons (...)
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  11.  4
    Overcoming the Limits of Empathic Concern: The Case for Availability and its Application to the Medical Domain.Elodie Malbois & Christine Clavien - 2020 - Medicine, Health Care and Philosophy 23 (2):191-203.
    Empathic concern is essential to our social lives because it motivates helping behavior. It has, however, well-known shortcomings such as its limitation in scope. Here, we highlight a further shortcoming of empathic concern: it contributes little to understanding the relevant features of complex social situations, and unaided by further cognitive inputs, likely fails to produce effective helping. We then elaborate on the conditions needed for an accurate assessment of others’ situations: the ability to pay attention and try to understand others (...)
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  12.  4
    The Elephant in the Room: A Postphenomenological View on the Electronic Health Record and its Impact on the Clinical Encounter.Tania Moerenhout, Gary S. Fischer & Ignaas Devisch - 2020 - Medicine, Health Care and Philosophy 23 (2):227-236.
    Use of electronic health records within clinical encounters is increasingly pervasive. The digital record allows for data storage and sharing to facilitate patient care, billing, research, patient communication and quality-of-care improvement—all at once. However, this multifunctionality is also one of the main reasons care providers struggle with the EHR. These problems have often been described but are rarely approached from a philosophical point of view. We argue that a postphenomenological case study of the EHR could lead to more in-depth insights. (...)
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  13.  9
    Wrongful Genetic Connection: Neither Blood of My Blood, nor Flesh of My Flesh.Vera Lúcia Raposo - 2020 - Medicine, Health Care and Philosophy 23 (2):309-319.
    The use of reproductive techniques and the eventual reproductive negligence from the provider of reproductive services gave rise to situations in which the intended parents are deprived of raising a child genetically connected to them. Courts have been dealing with cases of those for years, but have systemically denied claimants compensation, failing to recognise as damage the loss of genetic connection. In 2017, for the first time, the Singapore High Court provided compensation for that damage, labelled “loss of genetic affinity”. (...)
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  14.  2
    Search Engines, Cognitive Biases and the Man–Computer Interaction: A Theoretical Framework for Empirical Researches About Cognitive Biases in Online Search on Health-Related Topics.Luca Russo & Selena Russo - 2020 - Medicine, Health Care and Philosophy 23 (2):237-246.
    The widespread use of online search engines to answer the general public’s needs for information has raised concerns about possible biases and the emerging of a ‘filter bubble’ in which users are isolated from attitude-discordant messages. Research is split between approaches that largely focus on the intrinsic limitations of search engines and approaches that investigate user search behavior. This work evaluates the findings and limitations of both approaches and advances a theoretical framework for empirical investigations of cognitive biases in online (...)
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  15.  3
    Sustainability.Henk ten Have & Bert Gordijn - 2020 - Medicine, Health Care and Philosophy 23 (2):153-154.
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  16.  3
    Moral Distress in Health Care: When is It Fitting?Lisa Tessman - 2020 - Medicine, Health Care and Philosophy 23 (2):165-177.
    Nurses and other medical practitioners often experience moral distress: they feel an anguished sense of responsibility for what they take to be their own moral failures, even when those failures were unavoidable. However, in such cases other people do not tend to think it is right to hold them responsible. This is an interesting mismatch of reactions. It might seem that the mismatch should be remedied by assuring the practitioner that they are not responsible, but I argue that this denies (...)
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  17.  5
    Richard Dean: The Value of Humanity in Kant’s Moral Theory: Clarendon Press, Oxford, 2006, Pp. X + 267. Cloth, £28.12.Victor Chidi Wolemonwu - 2020 - Medicine, Health Care and Philosophy 23 (2):221-226.
    This is critical review of Richard Dean’ book, The Value of Humanity in Kant’s Moral Theory. Dean’s book was evaluated, and some of his interpretations of Kant were critiqued. However, it concludes that Dean’s book is illuminating especially, as regards the distinction he made between consent and informed consent and their roles in biomedical practice.
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  18.  2
    Discourse on the Idea of Sustainability: With Policy Implications for Health and Welfare Reform.Ming-Jui Yeh - 2020 - Medicine, Health Care and Philosophy 23 (2):155-163.
    Sustainability has become a major goal of domestic and international development. This essay analyzes the transitions of normative ideas embedded in the notion of sustainability by reviewing the discourses in the representative reports and literature from different periods. Three sets of ideas are proposed: inter- and intra-generational equity, stability of public systems, and a sense of solidarity, which confirms the scope of community and functions as a precondition for the previous two ideas. This essay uses the case of a health (...)
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  19.  13
    The Problem with Reproductive Freedom. Procreation Beyond Procreators’ Interests.Giulia Cavaliere - 2020 - Medicine, Health Care and Philosophy 23 (1):131-140.
    Reproductive freedom plays a pivotal role in debates on the ethics of procreation. This moral principle protects people’s interests in procreative matters and allows them discretion over whether to have children, the number of children they have and, to a certain extent, the type of children they have. Reproductive freedom’s theoretical and political emphasis on people’s autonomy and well-being is grounded in an individual-centred framework for discussing the ethics of procreation. It protects procreators’ interests and significantly reduces the permissible grounds (...)
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  20.  9
    The Ethical Obligation of the Dead Donor Rule.Anne L. Dalle Ave, Daniel P. Sulmasy & James L. Bernat - 2020 - Medicine, Health Care and Philosophy 23 (1):43-50.
    The dead donor rule originally stated that organ donors must not be killed by and for organ donation. Scholars later added the requirement that vital organs should not be procured before death. Some now argue that the DDR is breached in donation after circulatory determination of death programs. DCDD programs do not breach the original version of the DDR because vital organs are procured only after circulation has ceased permanently as a consequence of withdrawal of life-sustaining therapy. We hold that (...)
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  21.  10
    ‘I Am Your Son, Mother’: Severe Dementia and Duties to Visit Parents Who Can’T Recognise You.Bouke de Vries - 2020 - Medicine, Health Care and Philosophy 23 (1):17-24.
    It is commonly assumed that many, if not most, adult children have moral duties to visit their parents when they can do so at reasonable cost. However, whether such duties persist when the parents lose the ability to recognise their children, usually due to dementia, is more controversial. Over 40% of respondents in a public survey from the British Alzheimer’s Society said that it was “pointless” to keep up contact at this stage. Insofar as one cannot be morally required to (...)
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  22.  1
    A Gap Between the Philosophy and the Practice of Palliative Healthcare: Sociological Perspectives on the Practice of Nurses in Specialised Palliative Homecare.Stinne Glasdam, Frida Ekstrand, Maria Rosberg & Ann-Margrethe van der Schaaf - 2020 - Medicine, Health Care and Philosophy 23 (1):141-152.
    Palliative care philosophy is based on a holistic approach to patients, but research shows that possibilities for living up to this philosophy seem limited by historical and administrative structures. From the nurse perspective, this article aims to explore nursing practice in specialised palliative homecare, and how it is influenced by organisational and cultural structures. Qualitative, semi-structured interviews with nine nurses were conducted, inspired by Bourdieu. The findings showed that nurses consolidate the doxa of medicine, including medical-professional values that configure a (...)
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  23.  4
    Heideggerian Hermeneutic Phenomenology as Method: Modelling Analysis Through a Meta-Synthesis of Articles on Being-Towards-Death.Janice Gullick & Sandra West - 2020 - Medicine, Health Care and Philosophy 23 (1):87-105.
    While the richness of Heideggerian philosophy is attractive as a healthcare research framework, its density means authors rarely utilise its fullest possibilities as an hermeneutic analytic structure. This article aims to clarify Heideggerian hermeneutic analysis by taking one discrete element of Heideggerian philosophy, and using it’s clearly defined structure to conduct a meta-synthesis of Heideggerian phenomenological studies on the experience of living with a potentially life-limiting illness. The findings richly illustrate Heidegger’s philosophy that there is either an inauthentic positioning towards (...)
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  24.  1
    All in the Family.Henk ten Have & Bert Gordijn - 2020 - Medicine, Health Care and Philosophy 23 (1):1-2.
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  25.  2
    Stories of Despair: A Kierkegaardian Read of Suffering and Selfhood in Survivorship.Jeanette Bresson Ladegaard Knox - 2020 - Medicine, Health Care and Philosophy 23 (1):61-72.
    A life-threatening illness such as cancer can bring about much existential suffering and a disconnect to self in spite of surviving cancer. In my recent research project, I interviewed 14 long-term cancer survivors on being post cancer. Contrary to common assumptions about long-term survivorship, my interviewees reported grave existential difficulties in finding a firm footing in their sense of self, fostering a variety of stories of despair. This article examines long-term cancer survivors’ suffering from the vantage point of selfhood and (...)
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  26.  12
    The Right to Refuse Diagnostics and Treatment Planning by Artificial Intelligence.Thomas Ploug & Søren Holm - 2020 - Medicine, Health Care and Philosophy 23 (1):107-114.
    In an analysis of artificially intelligent systems for medical diagnostics and treatment planning we argue that patients should be able to exercise a right to withdraw from AI diagnostics and treatment planning for reasons related to the physician’s role in the patients’ formation of and acting on personal preferences and values, the bias and opacity problem of AI systems, and rational concerns about the future societal effects of introducing AI systems in the health care sector.
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  27. Schrödinger’s Fetus.Joona Räsänen - 2020 - Medicine, Health Care and Philosophy 23 (1):125-130.
    This paper defends and develops Elizabeth Harman’s Actual Future Principle with a concept called Schrödinger’s Fetus. I argue that all early fetuses are Schrödinger’s Fetuses: those early fetuses that survive and become conscious beings have full moral status already as early fetuses, but those fetuses that die as early fetuses lack moral status. With Schrödinger’s Fetus, it becomes possible to accept two widely held but contradictory intuitions to be true, and to avoid certain reductiones ad absurdum that pro-life and pro-choice (...)
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  28.  8
    Automated Vehicles, Big Data and Public Health.David Shaw, Bernard Favrat & Bernice Elger - 2020 - Medicine, Health Care and Philosophy 23 (1):35-42.
    In this paper we focus on how automated vehicles can reduce the number of deaths and injuries in accident situations in order to protect public health. This is actually a problem not only of public health and ethics, but also of big data—not only in terms of all the different data that could be used to inform such decisions, but also in the sense of deciding how wide the scope of data should be. We identify three key different types of (...)
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  29.  14
    Autism, Autonomy, and Authenticity.Elisabeth M. A. Späth & Karin R. Jongsma - 2020 - Medicine, Health Care and Philosophy 23 (1):73-80.
    Autonomy of people on the autism-spectrum has only been very rarely conceptually explored. Autism spectrum is commonly considered a hetereogenous disorder, and typically described as a behaviorally-defined neurodevelopmental disorder associated with the presence of social-communication deficits and restricted and repetitive behaviors. Autism research mainly focuses on the behavior of autistic people and ways to teach them skills that are in line with social norms. Interventions such as therapies are being justified with the assumption that autists lack the capacity to be (...)
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  30.  6
    Health and Capabilities: A Conceptual Clarification.Per-Anders Tengland - 2020 - Medicine, Health Care and Philosophy 23 (1):25-33.
    There are great health disparities in the world today, both between countries and within them. This problem might be seen as related to the access to various kinds of capabilities. It is not fully clear, however, what the exact relation is between health and capabilities. Neither Amartya Sen nor Martha Nussbaum has explicitly formulated a theory of health to go with their theories of capabilities. This paper attempts to present a clarification of the conceptual relation between health and capabilities. Health, (...)
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  31.  11
    Mechanisms in Clinical Practice: Use and Justification.Mark R. Tonelli & Jon Williamson - 2020 - Medicine, Health Care and Philosophy 23 (1):115-124.
    While the importance of mechanisms in determining causality in medicine is currently the subject of active debate, the role of mechanistic reasoning in clinical practice has received far less attention. In this paper we look at this question in the context of the treatment of a particular individual, and argue that evidence of mechanisms is indeed key to various aspects of clinical practice, including assessing population-level research reports, diagnostic as well as therapeutic decision making, and the assessment of treatment effects. (...)
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  32.  22
    Can Self-Validating Neuroenhancement Be Autonomous?Jukka Varelius - 2020 - Medicine, Health Care and Philosophy 23 (1):51-59.
    Consider that an individual improves her capacities by neuroscientific means. It turns out that, besides altering her in the way(s) she intended, the enhancement also changes her personality in significant way(s) she did not foresee. Yet the person endorses her new self because the neuroenhancement she underwent changed her. Can the person’s approval of her new personality be autonomous? While questions of autonomy have already gathered a significant amount of attention in philosophical literature on human enhancement, the problem just described—henceforth (...)
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  33.  13
    Is It Ever Morally Permissible to Select for Deafness in One’s Child?Jacqueline Mae Wallis - 2020 - Medicine, Health Care and Philosophy 23 (1):3-15.
    As reproductive genetic technologies advance, families have more options to choose what sort of child they want to have. Using preimplantation genetic diagnosis, for example, allows parents to evaluate several existing embryos before selecting which to implant via in vitro fertilization. One of the traits PGD can identify is genetic deafness, and hearing embryos are now preferentially selected around the globe using this method. Importantly, some Deaf families desire a deaf child, and PGD–IVF is also an option for them. Selection (...)
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  34.  2
    The Hippocratic Oath and the Declaration of Geneva: Legitimisation Attempts of Professional Conduct.Urban Wiesing - 2020 - Medicine, Health Care and Philosophy 23 (1):81-86.
    The Hippocratic Oath and the Declaration of Geneva of the World Medical Association are compared in terms of content and origin. Their relevance for current medical practice is investigated. The status which is ascribed to these documents will be shown and the status which they can reasonably claim to have will be explored. Arguments in favor of the Hippocratic Oath that rely on historical stability or historical origin are being examined. It is demonstrated that they get caught up in paradoxes. (...)
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  35.  79
    Can Reproductive Genetic Manipulation Save Lives?G. Owen Schaefer - 2020 - Medicine, Health Care and Philosophy.
    It has recently been argued that reproductive genetic manipulation technologies like mitochondrial replacement and germline CRISPR modifications cannot be said to save anyone’s life because, counterfactually, no one would suffer more or die sooner absent the intervention. The present article argues that, on the contrary, reproductive genetic manipulations may be life-saving (and, from this, have therapeutic value) under an appropriate population health perspective. As such, popular reports of reproductive genetic manipulations potentially saving lives or preventing disease are not necessarily mistaken, (...)
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