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  1.  25
    A Fictionalist Account of Open-Label Placebo.Doug Hardman - 2024 - Journal of Medicine and Philosophy 49 (3):246-256.
    The placebo effect is now generally defined widely as an individual’s response to the psychosocial context of a clinical treatment, as distinct from the treatment’s characteristic physiological effects. Some researchers, however, argue that such a wide definition leads to confusion and misleading implications. In response, they propose a narrow definition restricted to the therapeutic effects of deliberate placebo treatments. Within the framework of modern medicine, such a scope currently leaves one viable placebo treatment paradigm: the non-deceptive and non-concealed administration of (...)
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  2.  13
    Psychopathology and Metaphysics: Can One Be a Realist About Mental Disorder?Simoni Iliadi - 2024 - Journal of Medicine and Philosophy 49 (3):283-297.
    Metaphysical realism about mental disorder is the thesis that mental disorder exists mind-independently. There are two ways to challenge metaphysical realism about mental disorder. The first is by denying that mental disorder exists. The second is by denying that mental disorder exists mind-independently. Or, differently put, by arguing that mental disorder is mind-dependent. The aim of this paper is three-fold: (a) to examine three ways in which mental disorder can be said to be mind-dependent (namely, by being causally dependent on (...)
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  3.  19
    Expanding the Use of Continuous Sedation Until Death and Physician-Assisted Suicide.Samuel H. LiPuma & Joseph P. Demarco - 2024 - Journal of Medicine and Philosophy 49 (3):313-323.
    The controversy over the equivalence of continuous sedation until death (CSD) and physician-assisted suicide/euthanasia (PAS/E) provides an opportunity to focus on a significant extended use of CSD. This extension, suggested by the equivalence of PAS/E and CSD, is designed to promote additional patient autonomy at the end-of-life. Samuel LiPuma, in his article, “Continuous Sedation Until Death as Physician-Assisted Suicide/Euthanasia: A Conceptual Analysis” claims equivalence between CSD and death; his paper is seminal in the equivalency debate. Critics contend that sedation follows (...)
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  4.  14
    The Dynamics of Disease: Toward a Processual Theory of Health.Thor Hennelund Nielsen - 2024 - Journal of Medicine and Philosophy 49 (3):271-282.
    The following article presents preliminary reflections on a processual theory of health and disease. It does this by steering the discussion more toward an ontology of organisms rather than conceptual analysis of the semantic content of the terms “health” and “disease.” In the first section, four meta-theoretical assumptions of the traditional debate are identified and alternative approaches to the problems are presented. Afterwards, the view that health and disease are constituted by a dynamic relation between demands imposed on an organism (...)
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  5. The Social Epistemology of Clinical Placebos.Melissa Rees - 2024 - Journal of Medicine and Philosophy 49 (3):233-245.
    Many extant theories of placebo focus on their causal structure wherein placebo effects are those that originate from select features of the therapy (e.g., client expectations or “incidental” features like size and shape). Although such accounts can distinguish placebos from standard medical treatments, they cannot distinguish placebos from everyday occurrences, for example, when positive feedback improves our performance on a task. Providing a social-epistemological account of a treatment context can rule out such occurrences, and furthermore reveal a new way to (...)
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  6.  6
    The Altruism Requirement as Moral Fiction.Luke Semrau - 2024 - Journal of Medicine and Philosophy 49 (3):257-270.
    It is widely agreed that living kidney donation is permitted but living kidney sales are not. Call this the Received View. One way to support the Received View is to appeal to a particular understanding of the conditions under which living kidney transplantation is permissible. It is often claimed that donors must act altruistically, without the expectation of payment and for the sake of another. Call this the Altruism Requirement. On the conventional interpretation, the Altruism Requirement is a moral fact. (...)
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  7.  32
    Three Arguments Against Institutional Conscientious Objection, and Why They Are (Metaphysically) Unconvincing.Xavier Symons & Reginald Mary Chua - 2024 - Journal of Medicine and Philosophy 49 (3):298-312.
    The past decade has seen a burgeoning of scholarly interest in conscientious objection in healthcare. While the literature to date has focused primarily on individual healthcare practitioners who object to participation in morally controversial procedures, in this article we consider a different albeit related issue, namely, whether publicly funded healthcare institutions should be required to provide morally controversial services such as abortions, emergency contraception, voluntary sterilizations, and voluntary euthanasia. Substantive debates about institutional responsibility have remained largely at the level of (...)
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  8. Philosophical Acts of Wonder in Bioethics.Alexander Zhang - 2024 - Journal of Medicine and Philosophy 49 (3):221-232.
    Two sources of possible disagreement in bioethics may be associated with pessimism about what bioethics can achieve. First, pluralism implies that bioethics engages with interlocutors who hold divergent moral beliefs. Pessimists might believe that these disagreements significantly limit the extent to which bioethics can provide normatively robust guidance in relevant areas. Second, the interdisciplinary nature of bioethics suggests that interlocutors may hold divergent views on the nature of bioethics itself—particularly its practicality. Pessimists may suppose that interdisciplinary disagreements could frustrate the (...)
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  9.  9
    Reference-Class Problems Are Real: Health-Adjusted Reference Classes and Low Bone Mineral Density.Nicholas Binney - 2024 - Journal of Medicine and Philosophy 49 (2):jhae005.
    Elselijn Kingma argues that Christopher Boorse’s biostatistical theory (the BST) does not show how the reference classes it uses are objective and naturalistic. Recently, philosophers of medicine have attempted to rebut Kingma’s concerns. I argue that these rebuttals are theoretically unconvincing, and that there are clear examples of physicians adjusting their reference classes according to their prior knowledge of health and disease. I focus on the use of age-adjusted reference classes to diagnose low bone mineral density in children. In addition (...)
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  10.  31
    Beyond Conceptual Analysis: Social Objectivity and Conceptual Engineering to Define Disease.Anne-Marie Gagné-Julien - 2024 - Journal of Medicine and Philosophy 49 (2):jhae002.
    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 on this normativist approach, I defend two main theses: (1) that conceptual analysis (...)
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  11.  23
    Interventionism and Intelligibility: Why Depression is not (Always) a Brain Disease.Quinn Hiroshi Gibson - 2024 - Journal of Medicine and Philosophy 49 (2):160-177.
    Major Depressive Disorder (MDD) is a serious condition with a large disease burden. It is often claimed that MDD is a “brain disease.” What would it mean for MDD to be a brain disease? I argue that the best interpretation of this claim is as offering a substantive empirical hypothesis about the causes of the syndrome of depression. This syndrome-causal conception of disease, combined with the idea that MDD is a disease of the brain, commits the brain disease conception of (...)
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  12.  19
    Unfreedom or Mere Inability? The Case of Biomedical Enhancement.Ji Young Lee - 2024 - Journal of Medicine and Philosophy 49 (2):195-206.
    Mere inability, which refers to what persons are naturally unable to do, is traditionally thought to be distinct from unfreedom, which is a social type of constraint. The advent of biomedical enhancement, however, challenges the idea that there is a clear division between mere inability and unfreedom. This is because bioenhancement makes it possible for some people’s mere inabilities to become matters of unfreedom. In this paper, I discuss several ways that this might occur: first, bioenhancement can exacerbate social pressures (...)
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  13.  14
    Persons and their Brains: Life, Death, and Lessened Humanity.Caitlin Maples - 2024 - Journal of Medicine and Philosophy 49 (2):117-127.
    The authors of the articles in this issue of The Journal of Medicine and Philosophy address a wide variety of topics, from definitions of disease to bioenhancement. Each author, however, draws out the importance of careful use of language. Over the years, philosophers of medicine and bioethicists have debated questions such as what qualifies something as a disease, whether disease language is evaluative, whether the term “person” encompasses more than just human beings, and what language ought to be used to (...)
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  14.  25
    Phenomenological Interview and Gender Dysphoria: A Third Pathway for Diagnosis and Treatment.Geoffrey Dierckxsens & Teresa R. Baron - 2024 - Journal of Medicine and Philosophy 49 (1):28-42.
    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 “wait-and-see” approach, which often includes counseling or other psychotherapeutic treatment. In this paper, we argue in favor of a “third pathway” for the (...)
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  15.  22
    Intentions at the End of Life: Continuous Deep Sedation and France’s Claeys-Leonetti law.Steven Farrelly-Jackson - 2024 - Journal of Medicine and Philosophy 49 (1):43-57.
    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 ways. This paper addresses one aspect of this reconfiguration and its implications for the (...)
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  16.  16
    Moral Distress, Conscientious Practice, and the Endurance of Ethics in Health Care through Times of Crisis and Calm.Lauris Christopher Kaldjian - 2024 - Journal of Medicine and Philosophy 49 (1):11-27.
    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 scarce resources. Although a crisis may change our ability to provide life-saving treatment to all who need it, a crisis should not change the ethical (...)
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  17.  13
    The “Risks of Routine Tests” and Analogical Reasoning in Assessments of Minimal Risk.Adrian Kwek - 2024 - Journal of Medicine and Philosophy 49 (1):102-115.
    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. While either or both comparators have been adopted by major ethics codes, they have also been criticized. In response (...)
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  18.  5
    Society, Social Structures, and Community in Clinical Ethics.J. Clint Parker - 2024 - Journal of Medicine and Philosophy 49 (1):1-10.
    Society and social structures play an important role in the formation and evaluation of concepts and practices in clinical ethics. This is evident in the ways the authors in this issue explore a wide range of arguments and concepts in clinical ethics including moral distress and conscience based practice, phenomenological interview techniques and gender dysphoria, continuous deep sedation (CDS) at the end of life, the notion of patient expertise, ethically permissible medical billing practices, the notion of selfhood and patient centered (...)
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  19.  25
    Patient Expertise and Medical Authority: Epistemic Implications for the Provider–Patient Relationship.Jamie Carlin Watson - 2024 - Journal of Medicine and Philosophy 49 (1):58-71.
    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 “experts” at managing their LTC. Unfortunately, there is no generally agreed-upon conception of “patient expertise” or what it implies for the provider–patient relationship. I (...)
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