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  1.  3
    Are We Obliged to Enhance for Moral Perfection?Alfred Archer - 2018 - Journal of Medicine and Philosophy 43 (5):490-505.
    Suppose, we could take a pill that would turn us into morally better people. Would we have a duty to take such a pill? In recent years, a number of philosophers have discussed this issue. Most prominently, Ingmar Persson and Julian Savulescu have argued that we would have a duty to take such a pill. In this article, I wish to investigate the possible limits of a duty to take moral enhancement drugs through investigating the related question of whether it (...)
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  2.  3
    Eight Kinds of Critters: A Moral Taxonomy for the Twenty-Second Century.Michael Bess - 2018 - Journal of Medicine and Philosophy 43 (5):585-612.
    Over the coming century, the accelerating advance of bioenhancement technologies, robotics, and artificial intelligence may significantly broaden the qualitative range of sentient and intelligent beings. This article proposes a taxonomy of such beings, ranging from modified animals to bioenhanced humans to advanced forms of robots and AI. It divides these diverse beings into three moral and legal categories—animals, persons, and presumed persons—describing the moral attributes and legal rights of each category. In so doing, the article sets forth a framework for (...)
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  3.  30
    Moral Enhancement Can Kill.Parker Crutchfield - 2018 - Journal of Medicine and Philosophy 43 (5):568-584.
    There is recent empirical evidence that personal identity is constituted by one’s moral traits. If true, this poses a problem for those who advocate for moral enhancement, or the manipulation of a person’s moral traits through pharmaceutical or other biological means. Specifically, if moral enhancement manipulates a person’s moral traits, and those moral traits constitute personal identity, then it is possible that moral enhancement could alter a person’s identity. I go a step further and argue that under the right conditions, (...)
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  4.  1
    Can Prudence Be Enhanced?Jason T. Eberl - 2018 - Journal of Medicine and Philosophy 43 (5):506-526.
    Some bioethicists have argued that moral bioenhancement, complementing traditional means of enhancing individuals’ moral dispositions, is essential if we are to survive as a species. Traditional means of moral enhancement have historically included civil legislation, socially recognized moral exemplars, religious teachings and disciplines, and familial upbringing. I explore the necessity and feasibility of pursuing methods of moral bioenhancement as a complement to such traditional means, grounding my analysis within a virtue-theoretic framework. Specifically, I focus on the essential intellectual virtue for (...)
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  5.  2
    Why “Moral Enhancement” Isn’T Always Moral Enhancement: The Case of Traumatic Brain Injury in American Vets.Valerie Gray Hardcastle - 2018 - Journal of Medicine and Philosophy 43 (5):527-546.
    In this article, I argue that as we learn more about how we might intervene in the brain in ways that impact human behavior, the scope of what counts as “moral behavior” becomes smaller and smaller because things we successfully manipulate using evidence-based science are often things that fall outside the sphere of morality. Consequently, the argument that we are morally obligated to morally enhance our neighbors starts to fall apart, not because humans should be free to make terrible choices, (...)
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  6.  1
    Moral Enhancement, Self-Governance, and Resistance.Pei-Hua Huang - 2018 - Journal of Medicine and Philosophy 43 (5):547-567.
    John Harris recently argues that the moral bioenhancement proposed by Persson and Savulescu can damage moral agency by depriving the recipients of their freedom to fall (freedom to make wrongful choices) and therefore should not be pursued. The link Harris makes between moral agency and the freedom to fall, however, implies that all forms of moral enhancement, including moral education, that aim to make the enhancement recipients less likely to “fall” are detrimental to moral agency. In this paper, I present (...)
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  7.  2
    The Moral Imperative to Morally Enhance.Ysabel Johnston, Jeffrey P. Bishop & Griffin Trotter - 2018 - Journal of Medicine and Philosophy 43 (5):485-489.
    What is morality? Is “morality” something that admits of technological enhancement? What could it possibly mean for a society to have a moral imperative to morally enhance? We are compelled to take up questions like these as we move into the future of moral bioenhancement. Each article in this issue of the Journal of Medicine and Philosophy attempts to bring some clarity as to what is meant by morality, such that one could be morally obligated to morally enhance. These articles (...)
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  8.  6
    An Epistemic Argument for Research-Practice Integration in Medicine.Robyn Bluhm & Kirstin Borgerson - 2018 - Journal of Medicine and Philosophy 43 (4):469-484.
    Arguments in favor of greater research-practice integration in medicine have tended to be ethical, political, or pragmatic. There are good epistemic reasons to pursue greater integration, and it is important to think through these reasons in order to avoid inadvertently designing new systems in ways that replicate the epistemic elitism common within current systems. Meaningful transformation within health care is possible with close attention to all reasons in favor of greater research-practice integration, including epistemic reasons.
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  9.  3
    Michel Foucault and the Problematics of Power: Theorizing DTCA and Medicalized Subjectivity.Black Hawk Hancock - 2018 - Journal of Medicine and Philosophy 43 (4):439-468.
    This article explores Foucault’s two different notions of power: one where the subject is constituted by power–knowledge relations and another that emphasizes how power is a central feature of human action. By drawing out these two conceptualizations of power, Foucault’s work contributes three critical points to the formation of medicalized subjectivities: the issue of medicalization needs to be discussed both in terms of both specific practices and holistically ; we need to think how we as human beings are “disciplined” and (...)
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  10.  2
    A Practice-Oriented Review of Health Concepts.Beatrijs Haverkamp, Bernice Bovenkerk & Marcel F. Verweij - 2018 - Journal of Medicine and Philosophy 43 (4):381-401.
    Whereas theories on health generally argue in favor of one specific concept, we argue that, given the variety of health practices, we need different concepts of health. We thus approach health concepts as a Wittgensteinian family of thick concepts. By discussing five concepts of health offered by theory, we argue that all capture something that seems relevant when we talk and think about health. Classifying these concepts reveals their family resemblances: each of these concepts differs from the others in at (...)
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  11.  2
    Boorse’s Theory of Disease: Do Values Matter?Brent M. Kious - 2018 - Journal of Medicine and Philosophy 43 (4):421-438.
    There has been much debate about whether the concept of disease articulated in Boorse’s biostatistical theory is value-neutral or value-laden. Here, I want to examine whether this debate matters. I suggest that there are two basic respects in which value-ladenness might be important: it could threaten either scientific legitimacy or moral permissibility. I argue that value-ladenness does not threaten the scientific legitimacy of our disease-concept because the concept makes little difference to the formulation and testing of scientific hypotheses. Likewise, even (...)
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  12. Do You Have a “Syndrome” If You Have a Flat-Shaped Head?Adam Omelianchuk - 2018 - Journal of Medicine and Philosophy 43 (4):369-380.
    The themes of this issue—which include the meaning of our health and disease concepts, the so-called “medical gaze” and its embedded power relations, and the epistemic value of mixing therapy with research—are introduced by reflecting on a case about an infant girl whose head is observed to be somewhat flat.
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  13.  4
    A New Approach to Defining Disease.Mary Jean Walker & Wendy A. Rogers - 2018 - Journal of Medicine and Philosophy 43 (4):402-420.
    In this paper, we examine recent critiques of the debate about defining disease, which claim that its use of conceptual analysis embeds the problematic assumption that the concept is classically structured. These critiques suggest, instead, developing plural stipulative definitions. Although we substantially agree with these critiques, we resist their implication that no general definition of “disease” is possible. We offer an alternative, inductive argument that disease cannot be classically defined and that the best explanation for this is that the concept (...)
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  14.  2
    Prediction, Understanding, and Medicine.Alex Broadbent - 2018 - Journal of Medicine and Philosophy 43 (3):289-305.
    What is medicine? One obvious answer in the context of the contemporary clinical tradition is that medicine is the process of curing sick people. However, this “curative thesis” is not satisfactory, even when “cure” is defined generously and even when exceptions such as cosmetic surgery are set aside. Historian of medicine Roy Porter argues that the position of medicine in society has had, and still has, little to do with its ability to make people better. Moreover, the efficacy of medicine (...)
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  15.  1
    Intellectualizing Medicine: A Reply to Commentaries on “Prediction, Understanding, and Medicine”.Alex Broadbent - 2018 - Journal of Medicine and Philosophy 43 (3):325-341.
    This article is a reply to two critics of my “Prediction, Understanding, and Medicine,” published elsewhere in this journal issue. In that essay, I argued that medicine is best understood not as essentially a curative enterprise, but rather as one essentially oriented towards prediction and understanding. Here, I defend this position from several criticisms made of it.
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  16.  2
    The Distressed Body.Havi Carel - 2018 - Journal of Medicine and Philosophy 43 (3):361-367.
    Leder, D. 2016. The Distressed Body. Chicago: University of Chicago Press.
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  17.  2
    The Continuing Allure of Cure: A Response to Alex Broadbent’s “Prediction, Understanding, and Medicine”.Chadwin Harris - 2018 - Journal of Medicine and Philosophy 43 (3):313-324.
    In “Prediction, Understanding, and Medicine,” Alex Broadbent rejects the curative thesis, the view that the core medical competence is to cure, in favor of his predictive thesis that the main intellectual medical competence is to explain and the main practical medical competence is to predict. Broadbent thinks his account explains the phenomenon of multiple consultation, which is the fact that people persist in consulting alternative medical traditions despite having access to mainstream medicine. I argue that Broadbent’s explanation of multiple consultation (...)
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  18.  1
    Taking Respect Seriously: Clinical Research and the Demands of Informed Consent.Lynn A. Jansen - 2018 - Journal of Medicine and Philosophy 43 (3):342-360.
    There is broad agreement among research ethicists that investigators have a duty to obtain the informed consent of all subjects who participate in their research trials. On a common view, the duty to obtain this informed consent follows from the need to respect persons and their autonomous decisions. However, the nature of informed consent and the demands it places on investigators are open to dispute and recently have been challenged. Respect for persons, it has been claimed, does not require investigators (...)
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  19.  5
    Medicine Without Cure?: A Cluster Analysis of the Nature of Medicine.Thaddeus Metz - 2018 - Journal of Medicine and Philosophy 43 (3):306-312.
    Part of a symposium devoted to ‘Prediction, Understanding, and Medicine’, in which Alex Broadbent argues that the nature of medicine is determined by its competences, i.e., which things it can do well. He argues that, although medicine cannot cure well, it can do a good job of enabling people not only to understand states of the human organism and of what has caused them, but also to predict future states of it. From this Broadbent concludes that medicine is (at least (...)
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  20.  7
    Advancing the Philosophy of Medicine: Towards New Topics and Sources.Thaddeus Metz & Chadwin Harris - 2018 - Journal of Medicine and Philosophy 43 (3):281-288.
    The first part of a symposium devoted to Alex Broadbent's essay titled ‘Prediction, Understanding and Medicine’, this article notes the under-development of a variety of issues in the philosophy of medicine that transcend bioethics and the long-standing debates about the nature of health/illness and of evidence-based medicine. It also indicates the importance of drawing on non-Western, and particularly African, traditions in addressing these largely metaphysical and epistemological matters.
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  21.  1
    Should Mitochondrial Donation Be Anonymous?John B. Appleby - 2018 - Journal of Medicine and Philosophy 43 (2):261-280.
    Currently in the United Kingdom, anyone donating gametes has the status of an open-identity donor. This means that, at the age of 18, persons conceived with gametes donated since April 1, 2005 have a right to access certain pieces of identifying information about their donor. However, in early 2015, the UK Parliament approved new regulations that make mitochondrial donors anonymous. Both mitochondrial donation and gamete donation are similar in the basic sense that they involve the contribution of gamete materials to (...)
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  22.  8
    The Moral Status of the Human Embryo.Mark T. Brown - 2018 - Journal of Medicine and Philosophy 43 (2):132-158.
    Moral status ascribes equal obligations and rights to individuals on the basis of membership in a protected group. Substance change is an event that results in the origin or cessation of individuals who may be members of groups with equal moral status. In this paper, two substance changes that affect the moral status of human embryos are identified. The first substance change begins with fertilization and ends with the formation of the blastocyst, a biological individual with moral status comparable to (...)
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  23.  5
    Human-Animal Chimeras and Hybrids: An Ethical Paradox Behind Moral Confusion?Dietmar Hübner - 2018 - Journal of Medicine and Philosophy 43 (2):187-210.
    The prospect of creating and using human–animal chimeras and hybrids that are significantly human-like in their composition, phenotype, cognition, or behavior meets with divergent moral judgments: on the one side, it is claimed that such beings might be candidates for human-analogous rights to protection and care; on the other side, it is supposed that their existence might disturb fundamental natural and social orders. This paper tries to show that both positions are paradoxically intertwined: they rely on two kinds of species (...)
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  24.  2
    Donation After the Circulatory Determination of Death: Some Responses to Recent Criticisms.Andrew McGee & Dale Gardiner - 2018 - Journal of Medicine and Philosophy 43 (2):211-240.
    This article defends the criterion of permanence as a valid criterion for declaring death against some well-known recent objections. We argue that it is reasonable to adopt the criterion of permanence for declaring death, given how difficult it is to know when the point of irreversibility is actually reached. We claim that this point applies in all contexts, including the donation after circulatory determination of death context. We also examine some of the potentially unpalatable ramifications, for current death declaration practices, (...)
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  25.  9
    Misconceptions Inherent in the Substance Ontology Approach to Assigning Moral Status: A Reply to Patrick Lee, Christopher Tollefsen, and Robert George.Jason Z. Morris - 2018 - Journal of Medicine and Philosophy 43 (2):159-186.
    I have argued that substance ontology cannot be used to determine the moral status of embryos. Patrick Lee, Christopher Tollefsen, and Robert George wrote a Reply to those arguments in this Journal. In that Reply, Lee, Tollefsen, and George defended and clarified their position that their substance ontology arguments prove that the zygote and the adult into which it develops are the same entity that share the same essence. Here, I show the following: Even using the substance ontology framework to (...)
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  26.  7
    Human Nature and Moral Status in Bioethics.Matthew Shea - 2018 - Journal of Medicine and Philosophy 43 (2):115-131.
    The articles in this issue cover a wide range of topics, including the moral status of human embryos and human-animal chimeras and hybrids, the determination of death, theories of human cognition, and policies on the identity of mitochondrial donors. Despite this variety, there are two underlying questions that tie the articles together: what is a human being? And, what is the basis of moral status? First, I discuss these two questions and why they are important for bioethics. Then I provide (...)
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  27.  2
    Embodied Concepts and Mental Health.Somogy Varga - 2018 - Journal of Medicine and Philosophy 43 (2):241-260.
    Often drawing on the phenomenological tradition, a number of philosophers and cognitive scientists working in the field of “embodied cognition” subscribe to the general view that cognition is grounded in aspects of its sensorimotor embodiment and should be comprehended as the result of a dynamic interaction of nonneural and neural processes. After a brief introduction, the paper critically engages Lakoff and Johnson’s “conceptual metaphor theory”, and provides a review of recent empirical evidence that appears to support it. Subsequently, the paper (...)
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  28. Two Ways to Kill a Patient.Ben Bronner - 2018 - Journal of Medicine and Philosophy 43 (1):44-63.
    According to the Standard View, a doctor who withdraws life-sustaining treatment does not kill the patient but rather allows the patient to die—an important distinction, according to some. I argue that killing can be understood in either of two ways, and given the relevant understanding, the Standard View is insulated from typical criticisms. I conclude by noting several problems for the Standard View that remain to be fully addressed.
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  29.  6
    Chromosome Screening Using Noninvasive Prenatal Testing Beyond Trisomy-21: What to Screen for and Why It Matters.Kristien Hens - 2018 - Journal of Medicine and Philosophy 43 (1):8-21.
    With the new and highly accurate noninvasive prenatal test, new options for screening become available. I contend that the current state of the art of NIPT is already in need of a thorough ethical investigation and that there are different points to consider before any chromosomal or subchromosomal condition is added to the screening panel of a publicly funded screening program. Moreover, the application of certain ethical principles makes the inclusion of some conditions unethical in a privately funded scheme, even (...)
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  30.  3
    Schemata, CONSORT, and the Salk Polio Vaccine Trial.Charles J. Kowalski & Adam J. Mrdjenovich - 2018 - Journal of Medicine and Philosophy 43 (1):64-82.
    In this essay, we defend the design of the Salk polio vaccine trial and try to put some limits on the role schemata should play in designing clinical research studies. Our presentation is structured as a response to de Freitas and Pietrobon who identified the CONSORT statement as a schema that would have, had it existed at the time, ruled out the design of the Salk polio vaccine trial of 1954 in favor of a completely randomized controlled clinical trial. We (...)
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  31.  2
    Bridging the Gap Between Theory and Practice: Philosophy Through a Wide-Angle Lens.Janet Malek - 2018 - Journal of Medicine and Philosophy 43 (1):1-7.
    Philosophers who specialize in bioethics face a distinctive set of challenges in our work: to bring the theoretical insights of philosophical work and methodology to practical dilemmas affecting a diverse group of stakeholders every day. This article describes some of the key contributions that philosophy can make to the field of bioethics. It also identifies some of the pitfalls that can undermine the value of a philosophical approach when used to analyze questions arising in the real world. Recognition of the (...)
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  32.  3
    The Ethics of General Population Preventive Genomic Sequencing: Rights and Social Justice.Clair Morrissey & Rebecca L. Walker - 2018 - Journal of Medicine and Philosophy 43 (1):22-43.
    Advances in DNA sequencing technology open new possibilities for public health genomics, especially in the form of general population preventive genomic sequencing. Such screening programs would sit at the intersection of public health and preventive health care, and thereby at once invite and resist the use of clinical ethics and public health ethics frameworks. Despite their differences, these ethics frameworks traditionally share a central concern for individual rights. We examine two putative individual rights—the right not to know, and the child’s (...)
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  33.  2
    Serial Participation and the Ethics of Phase 1 Healthy Volunteer Research.Rebecca L. Walker, Marci D. Cottingham & Jill A. Fisher - 2018 - Journal of Medicine and Philosophy 43 (1):83-114.
    Phase 1 healthy volunteer clinical trials—which financially compensate subjects in tests of drug toxicity levels and side effects—appear to place pressure on each joint of the moral framework justifying research. In this article, we review concerns about phase 1 trials as they have been framed in the bioethics literature, including undue inducement and coercion, unjust exploitation, and worries about compromised data validity. We then revisit these concerns in light of the lived experiences of serial participants who are income-dependent on phase (...)
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