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721 found
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  1. The Debate on the Ethics of AI in Health Care: A Reconstruction and Critical Review.Jessica Morley, Caio C. V. Machado, Christopher Burr, Josh Cowls, Indra Joshi, Mariarosaria Taddeo & Luciano Floridi - manuscript
    Healthcare systems across the globe are struggling with increasing costs and worsening outcomes. This presents those responsible for overseeing healthcare with a challenge. Increasingly, policymakers, politicians, clinical entrepreneurs and computer and data scientists argue that a key part of the solution will be ‘Artificial Intelligence’ (AI) – particularly Machine Learning (ML). This argument stems not from the belief that all healthcare needs will soon be taken care of by “robot doctors.” Instead, it is an argument that rests on the classic (...)
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  2. Preventing Human Rights Violations in Prison – the Role of Guidelines.Bernice Elger & David Shaw - forthcoming - In Bernice Elger, Catherine Ritter & Heino Stöver (eds.), Emerging Issues in Prison Health. Springer.
    It is well known that prisoners’ human rights are often violated. In this chapter we examine whether guidelines can be effective in preventing such violations and in helping physicians resolve the significant conflicts of interest that they often face in trying to protect prisoners’ rights. We begin by explaining the role of clinical and ethical guidelines outside prisons, in the context of healthcare for non-incarcerated prisoners, and then the specific role of such guidelines within prisons, where the main concerns are (...)
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  3. Ethics Consultation in US Hospitals: A National Survey.Ellen Fox, Sarah Myers & Robert A. Pearlman - forthcoming - Bioethics.
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  4. F23. Shinshu University Hospital Established the Division of Clinical Genetics as One of its Central Service Departments.Yoshimitsu Fukushima - forthcoming - Bioethics in Asia: The Proceedings of the Unesco Asian Bioethics Conference (Abc'97) and the Who-Assisted Satellite Symposium on Medical Genetics Services, 3-8 Nov, 1997 in Kobe/Fukui, Japan, 3rd Murs Japan International Symposium, 2nd Congress of the Asi.
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  5. The Role and Legal Status of Health Care Ethics Committees in the United States.Diane Hoffmann & Anita Tarzian - forthcoming - Legal Perspectives in Bioethics: Annals of Bioethics Series, Ana S. Iltis, Sandra H. Johnson, Barbara A. Hinze, Eds.
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  6. Clarifying Capacity: Reasons and Value.Jules Holroyd - forthcoming - In Lubomira Radoilska (ed.), Autonomy and Mental Health. Oxford University Press.
    It is usually appropriate for adults to make significant decisions, such as about what kinds of medical treatment to undergo, for themselves. But sometimes impairments are suffered - either temporary or permanent - which render an individual unable to make such decisions. The Mental Capacity Act 2005 sets out the conditions under which it is appropriate to regard an individual as lacking the capacity to make a particular decision (and when provisions should be made for a decision on their behalf). (...)
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  7. Congressional Investigating Committees.Alfred Junz - forthcoming - Social Research.
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  8. In Practice: At the Lok Nayak Hospital, Delhi.John D. Lantos - forthcoming - Hastings Center Report.
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  9. Behind Closed Doors: Promises and Pitfalls of Ethics Committees.Bernard Lo - forthcoming - Bioethics.
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  10. Unexpected Complications of Novel Deep Brain Stimulation Treatments: Ethical Issues and Clinical Recommendations.Hannah Maslen, Binith Cheeran, Jonathan Pugh, Laurie Pycroft, Sandra Boccard, Simon Prangnell, Alexander Green, James FitzGerald, Julian Savulescu & Tipu Aziz - forthcoming - Neuromodulation.
    Background -/- Innovative neurosurgical treatments present a number of known risks, the natures and probabilities of which can be adequately communicated to patients via the standard procedures governing obtaining informed consent. However, due to their novelty, these treatments also come with unknown risks, which require an augmented approach to obtaining informed consent. -/- Objective -/- This paper aims to discuss and provide concrete procedural guidance on the ethical issues raised by serious unexpected complications of novel deep brain stimulation treatments. -/- (...)
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  11. Opioid Treatment Agreements and Patient Accountability.Larisa Svirsky - forthcoming - Hastings Center Report.
    Opioid treatment agreements are written agreements between physicians and patients enumerating the risks associated with opioid medications along with the requirements that patients must meet to receive these medications on an ongoing basis. The choice to use such agreements goes beyond the standard informed consent process, and has a distinctive symbolic significance. Specifically, it suggests that physicians regard it as important to hold their patients accountable for adhering to various protocols regarding the use of their opioid medications. After laying out (...)
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  12. Hospital Ethics Committees In: Connor SS, Fuenzilida–Puelma HL, Eds.J. C. Tealdi & J. A. Mainetti - forthcoming - Bioethics: Issues and Perspectives. Washington Dc: Paho.
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  13. An Ethical Framework for Hospital Ethics Committees.Robert M. Veatch - forthcoming - Contemporary Issues in Bioethics, Third Edition (Wadsworth Publishing Company, Belmont, California).
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  14. Institutional Ethics Committees.W. A. W. Walters - forthcoming - Unpublished Paper Presented at Bioethics Course, Monash University Centre for Human Bioethics, Warburton Vic.
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  15. COVID-19 as the Underlying Cause of Death: Disentangling Facts and Values.Maria Cristina Amoretti & Elisabetta Lalumera - 2021 - History and Philosophy of the Life Sciences 43 (1):1-4.
    In the ongoing pandemic, death statistics influence people’s feelings and government policy. But when does COVID-19 qualify as the cause of death? As philosophers of medicine interested in conceptual clarification, we address the question by analyzing the World Health Organization’s rules for the certification of death. We show that for COVID-19, WHO rules take into account both facts and values.
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  16. E-Cigarettes: The Long-Term Liberal Perspective.Kalle Grill - 2021 - Nicotine and Tobacco Research 23 (1):9-13.
    The debate for and against making e-cigarettes available to smokers is to a large extent empirical. We do not know the long-term health effects of vaping and we do not know how smokers will respond to e-cigarettes over time. In addition to these empirical uncertainties, however, there are difficult moral issues to consider. One such issue is that many smokers in some sense choose to smoke. Though smoking is addictive and though many start young, it does not seem impossible to (...)
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  17. Digital Psychiatry: Ethical Risks and Opportunities for Public Health and Well-Being.Christopher Burr, Jessica Morley, Mariarosaria Taddeo & Luciano Floridi - 2020 - IEEE Transactions on Technology and Society 1 (1):21-33.
    Common mental health disorders are rising globally, creating a strain on public healthcare systems. This has led to a renewed interest in the role that digital technologies may have for improving mental health outcomes. One result of this interest is the development and use of artificial intelligence for assessing, diagnosing, and treating mental health issues, which we refer to as ‘digital psychiatry’. This article focuses on the increasing use of digital psychiatry outside of clinical settings, in the following sectors: education, (...)
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  18. Do a Surrogate Decision-Maker's Motives Matter?Michael J. Deem & Jennifer M. Stephen - 2020 - Nursing 50 (2):16-18.
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  19. Public Health and Precarity.Michael D. Doan & Ami Harbin - 2020 - International Journal of Feminist Approaches to Bioethics 13 (2):108-130.
    One branch of bioethics assumes that mainly agents of the state are responsible for public health. Following Susan Sherwin’s relational ethics, we suggest moving away from a “state-centered” approach toward a more thoroughly relational approach. Indeed, certain agents must be reconstituted in and through shifting relations with others, complicating discussions of responsibility for public health. Drawing on two case studies—the health politics and activism of the Black Panther Party and the work of the Common Ground Collective in post-Katrina New Orleans—we (...)
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  20. Responsibility-Sensitive Healthcare Funding: Three Responses to Clavien and Hurst’s Critique.Thomas Douglas - 2020 - Cambridge Quarterly of Healthcare Ethics 2 (29):192-195.
    Christine Clavien and Samia Hurst (henceforth C-H) make at least three valuable contributions to the literature on responsibility and healthcare. They offer an admirably clear and workable set of criteria for determining a patient's degree of responsibility for her health condition; they deploy those criteria to cast doubt on the view that patients with lifestyle-related conditions are typically significantly responsible for their conditions; and they outline several practical difficulties that would be raised by any attempt to introduce responsibility-sensitive healthcare funding. (...)
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  21. Compulsory Medical Intervention Versus External Constraint in Pandemic Control.Thomas Douglas, Lisa Forsberg & Jonathan Pugh - 2020 - Journal of Medical Ethics.
    Would compulsory treatment or vaccination for Covid-19 be justified? In England, there would be significant legal barriers to it. However, we offer a conditional ethical argument in favour of allowing compulsory treatment and vaccination, drawing on an ethical comparison with external constraints—such as quarantine, isolation and ‘lockdown’—that have already been authorised to control the pandemic. We argue that, if the permissive English approach to external constraints for Covid-19 has been justified, then there is a case for a similarly permissive approach (...)
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  22. Public Relations Strategies to Counter Fake News About Vaccines.Gheorghe-Ilie Farte - 2020 - Cahiers de Psychologie Politique 37.
    Comme tous les autres projets humains, les politiques de santé publique sont souvent affectées par des imperfections et des erreurs. Cependant, elles sont mieux ancrées dans les résultats de la recherche scientifique que d’autres actions humaines en général, et politiques gouvernementales en particulier. D’une manière générale, les données sur lesquelles reposent les politiques de santé publique remplissent les conditions suivantes : méthodes de recherche rigoureuses, tests indépendants et précis, reproductibilité des résultats, mesure du taux d’erreur, capacité à écarter des hypothèses (...)
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  23. Cultural Gaslighting.Elena Ruíz - 2020 - Hypatia 35 (4):687-713.
    This essay frames systemic patterns of mental abuse against women of color and Indigenous women on Turtle Island (North America) in terms of larger design-of-distribution strategies in settler colonial societies, as these societies use various forms of social power to distribute, reproduce, and automate social inequalities (including public health precarities and mortality disadvantages) that skew socio-economic gain continuously toward white settler populations and their descendants. It departs from traditional studies in gender-based violence research that frame mental abuses such as gaslighting--commonly (...)
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  24. Antimicrobial Footprints, Fairness, and Collective Harm.Anne Schwenkenbecher - 2020 - In Euzebiusz Jamrozik & Michael Selgelid (eds.), Ethics and Drug Resistance: Collective Responsibility for Global Public Health. Springer. pp. 379-389.
    This chapter explores the question of whether or not individual agents are under a moral obligation to reduce their ‘antimicrobial footprint’. An agent’s antimicrobial footprint measures the extent to which her actions are causally linked to the use of antibiotics. As such, it is not necessarily a measure of her contribution to antimicrobial resistance. Talking about people’s antimicrobial footprint in a way we talk about our carbon footprint may be helpful for drawing attention to the global effects of individual behaviour (...)
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  25. Ethical Considerations for Digitally Targeted Public Health Interventions.Daniel Susser - 2020 - American Journal of Public Health 110 (S3).
    Public health scholars and public health officials increasingly worry about health-related misinformation online, and they are searching for ways to mitigate it. Some have suggested that the tools of digital influence are themselves a possible answer: we can use targeted, automated digital messaging to counter health-related misinformation and promote accurate information. In this commentary, I raise a number of ethical questions prompted by such proposals—and familiar from the ethics of influence and ethics of AI—highlighting hidden costs of targeted digital messaging (...)
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  26. Finding Deborah: Centering Patients and Placing Emotion in the History of Disease.Courtney E. Thompson - 2020 - Isis 111 (4):826-829.
  27. Epistemic Ignorance, Poverty and the COVID-19 Pandemic.Cristian Timmermann - 2020 - Asian Bioethics Review 12.
    In various responses to the COVID-19 pandemic, we can observe insufficient sensitivity towards the needs and circumstances of poorer citizens. Particularly in a context of high inequality, policy makers need to engage with the wider public in debates and consultations to gain better insights in the realities of the worst-off within their jurisdiction. When consultations involve members of traditionally underrepresented groups, these are not only more inclusive, which is in itself an ethical aim, but pool ideas and observations from a (...)
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  28. Childhood Vaccination Mandates: Scope, Sanctions, Severity, Selectivity, and Salience.Katie Attwell & Mark Christopher Navin - 2019 - Milbank Quarterly 97 (4):978–1014.
    Context In response to outbreaks of vaccine‐preventable disease and increasing rates of vaccine refusal, some political communities have recently implemented coercive childhood immunization programs, or they have made existing childhood immunization programs more coercive. Many other political communities possess coercive vaccination policies, and others are considering developing them. Scholars and policymakers generally refer to coercive immunization policies as “vaccine mandates.” However, mandatory vaccination is not a unitary concept. Rather, coercive childhood immunization policies are complex, context‐specific instruments. Their legally and morally (...)
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  29. The Dictates of Conscience: Can They Justify Conscientious Refusals in Healthcare Contexts?Mary Carman - 2019 - Cambridge Quarterly of Healthcare Ethics 28 (2):303-315.
    In a recent article in this journal, Steve Clarke (2017) identifies two different bases for conscience-based refusals in healthcare: (1) all-things-considered moral judgments, and (2) the dictates of conscience. He argues that these two bases have distinct roles in justifying conscientious objection. However, accepting that there are these two bases, I argue that both are not able to justify conscientious objection. In particular, I argue that the second basis of the dictates of conscience cannot justify conscience-based refusal in a healthcare (...)
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  30. The Place for Religious Content in Clinical Ethics Consultations: A Reply to Janet Malek.Nicholas Colgrove & Kelly Kate Evans - 2019 - HEC Forum 31 (4):305-323.
    Janet Malek (91–102, 2019) argues that a “clinical ethics consultant’s religious worldview has no place in developing ethical recommendations or communicating about them with patients, surrogates, and clinicians.” She offers five types of arguments in support of this thesis: arguments from consensus, clarity, availability, consistency, and autonomy. This essay shows that there are serious problems for each of Malek’s arguments. None of them is sufficient to motivate her thesis. Thus, if it is true that the religious worldview of clinical ethics (...)
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  31. Stephen Scher and Kasia Kozlowska: Rethinking Health Care Ethics: Palgrave Macmillan, Singapore, 2018, 169 Pp, $31, ISBN: 978-981-13-0829-1.Patrick Daly - 2019 - Theoretical Medicine and Bioethics 40 (4):347-351.
    Authors present a practical approach to developing health care trainees' native ability as moral agents to become responsible health care practitioners. Highly recommended. Full text available free online.
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  32. Impartiality and Infectious Disease: Prioritizing Individuals Versus the Collective in Antibiotic Prescription.Bernadine Dao, Thomas Douglas, Alberto Giubilini, Julian Savulescu, Michael Selgelid & Nadira S. Faber - 2019 - AJOB Empirical Bioethics 10 (1):63-69.
    Antimicrobial resistance (AMR) is a global public health disaster driven largely by antibiotic use in human health care. Doctors considering whether to prescribe antibiotics face an ethical conflict between upholding individual patient health and advancing public health aims. Existing literature mainly examines whether patients awaiting consultations desire or expect to receive antibiotic prescriptions, but does not report views of the wider public regarding conditions under which doctors should prescribe antibiotics. It also does not explore the ethical significance of public views (...)
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  33. Asbestos Neglect: Why Asbestos Exposure Deserves Greater Policy Attention.Thomas Douglas & Laura Van den Borre - 2019 - Health Policy 123 (5):516-519.
    While many public health threats are now widely appreciated by the public, the risks from asbestos exposure remain poorly understood, even in high-risk groups. This article makes the case that asbestos exposure is an important, ongoing global health threat, and argues for greater policy efforts to raise awareness of this threat. It also proposes the extension of asbestos bans to developing countries and increased public subsidies for asbestos testing and abatement.
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  34. Nudging Immunity: The Case for Vaccinating Children in School and Day Care by Default.Alberto Giubilini, Lucius Caviola, Hannah Maslen, Thomas Douglas, Anne-Marie Nussberger, Nadira Faber, Samantha Vanderslott, Sarah Loving, Mark Harrison & Julian Savulescu - 2019 - HEC Forum 31 (4):325-344.
    Many parents are hesitant about, or face motivational barriers to, vaccinating their children. In this paper, we propose a type of vaccination policy that could be implemented either in addition to coercive vaccination or as an alternative to it in order to increase paediatric vaccination uptake in a non-coercive way. We propose the use of vaccination nudges that exploit the very same decision biases that often undermine vaccination uptake. In particular, we propose a policy under which children would be vaccinated (...)
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  35. Capacity for Preferences and Pediatric Assent: Implications for Pediatric Practice.Mark Christopher Navin & Jason Adam Wasserman - 2019 - Hastings Center Report 49 (1):43-51.
    Children’s preferences about medical treatment—like the preferences of other patients—hold moral weight in decision-making that is independent of considerations of autonomy or best interests. In light of this understanding of the moral value of patient preferences, the American Academy of Pediatrics could strengthen the ethical foundation for its formal guidance on pediatric assent.
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  36. Why Should Medical Care Be Family-Centered?: Understanding Ethical Responsibilities for Patients' Family Members.Nate W. Olson - 2019 - Kennedy Institute of Ethics Journal 29 (2):159-185.
    In recent years, hospitals, clinics, and professional organizations have with increasing frequency pledged their commitment to “patient-and family-centered care”. The movement toward PFCC is especially pronounced in pediatrics, where the American Academy of Pediatrics has a long-held, explicit commitment to PFCC. However, the unified movement toward PFCC obscures differing conceptions of its purpose. First, patient-centered care, as opposed to provider- or disease-centered care, focuses on increasing patient involvement in care to accomplish two related, but distinct objectives: improving health outcomes and (...)
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  37. Understanding the Baby-Friendly Hospital Initiative: A Multidisciplinary Analysis.Erica Preston-Roedder, Hannah Fagen, Jessica Martucci & Anne Barnhill - 2019 - International Journal of Feminist Approaches to Bioethics 12 (2):117-147.
    In the United States, roughly 1 out of 4 births takes place at a hospital certified as Baby-Friendly. This paper offers a multi-disciplinary perspective on the Baby-Friendly Hospital Initiative (BFHI), including empirical, normative, and historical perspectives. Our analysis is novel in that we trace how medical practices of “quality improvement,” which initially appear to have little to do with breastfeeding, may have shaped the BFHI. Ultimately, we demonstrate that a rich understanding of the BFHI can be obtained by tracing how (...)
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  38. Hormone Replacement Therapy: Informed Consent Without Assessment?Toni C. Saad, Bruce Philip Blackshaw & Daniel Rodger - 2019 - Journal of Medical Ethics 45 (12):1-2.
    Florence Ashley has argued that requiring patients with gender dysphoria to undergo an assessment and referral from a mental health professional before undergoing hormone replacement therapy is unethical and may represent an unconscious hostility towards transgender people. We respond, first, by showing that Ashley has conflated the self-reporting of symptoms with self-diagnosis, and that this is not consistent with the standard model of informed consent to medical treatment. Second, we note that the model of informed consent involved in cosmetic surgery (...)
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  39. Epistemic Injustice and Self-Injury: A Concept with Clinical Implications.Patrick Sullivan - 2019 - Philosophy, Psychiatry, and Psychology 26 (4):349-362.
    SELF-INJURY IS A COMPLEX phenomenon that is encountered on a regular basis by health care professionals in mental health care. In this article, I use the concept of epistemic injustice to examine this complex phenomenon and argue that this helps us to understand developments in the way we think about and support people who self-injure. Individuals with lived experience have important knowledge about the nature of self-injury and particularly how it relates to them. If the credibility of this knowledge is (...)
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  40. Social Justice, Equality and Primary Care: (How) Can ‘Big Data’ Help?Kristin Voigt - 2019 - Philosophy and Technology 32 (1):57-68.
    A growing body of research emphasises the role of ‘social determinants of health’ in generating inequalities in health outcomes. How, if at all, should primary care providers respond? In this paper, I want to shed light on this issue by focusing on the role that ‘big data’ might play in allowing primary care providers to respond to the social determinants that affect individual patients’ health. The general idea has been proposed and endorsed by the Institute of Medicine, and the idea (...)
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  41. The Normative Significance of Identifiability.Tomasz Żuradzki - 2019 - Ethics and Information Technology 21 (4):295-305.
    According to psychological research, people are more eager to help identified individuals than unidentified ones. This phenomenon significantly influences many important decisions, both individual and public, regarding, for example, vaccinations or the distribution of healthcare resources. This paper aims at presenting definitions of various levels of identifiability as well as a critical analysis of the main philosophical arguments regarding the normative significance of the identifiability effect, which refer to: (1) ex ante contractualism; (2) fair distribution of chances and risks; (3) (...)
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  42. Spiritual Themes and Challenges in Global Health.David G. Addiss - 2018 - Journal of Medical Humanities 39 (3):337-348.
    Although the importance of spirituality is increasingly recognized in clinical medicine, spirituality is rarely mentioned in the practice, literature, or training programs of global health. To understand the role of spirituality in global health practice and identify factors that influence and limit its expression, I initiated conversations and informal interviews with more than 300 global health leaders, students, and practitioners during 2010-2014. Four spiritual themes or challenges emerged: compassion at a distance; dichotomous thinking; conspiracy of silence; and compulsion to save (...)
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  43. Influenza Vaccination Strategies Should Target Children.Ben Bambery, Thomas Douglas, Michael J. Selgelid, Hannah Maslen, Alberto Giubilini, Andrew J. Pollard & Julian Savulescu - 2018 - Public Health Ethics 11 (2):221-234.
    Strategies to increase influenza vaccination rates have typically targeted healthcare professionals and individuals in various high-risk groups such as the elderly. We argue that they should focus on increasing vaccination rates in children. Because children suffer higher influenza incidence rates than any other demographic group, and are major drivers of seasonal influenza epidemics, we argue that influenza vaccination strategies that serve to increase uptake rates in children are likely to be more effective in reducing influenza-related morbidity and mortality than those (...)
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  44. Harms and Wrongs in Epistemic Practice.Simon Barker, Charlie Crerar & Trystan S. Goetze - 2018 - Royal Institute of Philosophy Supplement 84:1-21.
    This volume has its roots in two recent developments within mainstream analytic epistemology: a growing recognition over the past two or three decades of the active and social nature of our epistemic lives; and, more recently still, the increasing appreciation of the various ways in which the epistemic practices of individuals and societies can, and often do, go wrong. The theoretical analysis of these breakdowns in epistemic practice, along with the various harms and wrongs that follow as a consequence, constitutes (...)
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  45. Blameless Guilt: The Case of Carer Guilt and Chronic and Terminal Illness.Matthew Bennett - 2018 - International Journal of Philosophical Studies 26 (1):72-89.
    My ambition in this paper is to provide an account of an unacknowledged example of blameless guilt that, I argue, merits further examination. The example is what I call carer guilt: guilt felt by nurses and family members caring for patients with palliative-care needs. Nurses and carers involved in palliative care often feel guilty about what they perceive as their failure to provide sufficient care for a patient. However, in some cases the guilty carer does not think that he has (...)
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  46. Capabilities, Health and Systems: Rethinking Health as Part of Distributive Justice.José Rubén Palafox Cabral - 2018 - Revista Iberoamericana de Bioética 7:1-9.
    This paper endeavors to provide an explanation of health and the make-up of healthcare through distributive justice theories and access to the development of capabilities as the basis of a just healthcare structure. It also looks at matters around first level attention in healthcare as fundamental in the development of capabilities and access to functional diversity. It amounts, therefore, to a redefinition of bioethical contractualism, applied at the structure as basis of justice and the capability development.
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  47. Dismissal Policies for Vaccine Refusal -- A Reply.Michael J. Deem, Mark Christopher Navin & John D. Lantos - 2018 - JAMA Pediatrics 172 (11):1101-1102.
    Marshall and O’Leary’s thoughtful response to our article suggests that dismissal policies are ethically justifiable because they might induce parents to immunize their children. This outcome is conceivable, but we have only anecdotes about how often it occurs. Such evidence became the thin reed on which the American Academy of Pediatrics rested its new policy of tolerating the practice of dismissing vaccine-hesitant parents. It seems likely that relatively few parents would agree to vaccinate because they were threatened with dismissal. Other (...)
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  48. Reconceptualizing Autonomy for Bioethics.Lisa Dive & Ainsley J. Newson - 2018 - Kennedy Institute of Ethics Journal 28 (2):171-203.
    The concept of autonomy plays a central role in bioethics,1 but there is no consensus as to how we should understand it beyond a general notion of self-determination. The conception of autonomy deployed in applied ethics2 can have crucial ramifications when it is applied in real-world scenarios, so it is important to be clear. However, this clarity is often lacking when autonomy is discussed in the bioethics literature. In this paper we outline three different conceptions of autonomy, and argue that (...)
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  49. Population Health.Marvin J. H. Lee - 2018 - In Sally Kuykendall (ed.), Encyclopedia of Public Health: Principles, People, and Programs. Santa Barbara, CA, USA:
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  50. Health Care Disparities.Marvin J. H. Lee & Sally Kuykendall - 2018 - In Encyclopedia of Public Health: Principles, People, and Programs. Santa Barbara, CA, USA:
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