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  1.  3
    On the Disenchantment of Medicine: Abraham Joshua Heschel’s 1964 Address to the American Medical Association.Alan B. Astrow - 2018 - Theoretical Medicine and Bioethics 39 (6):483-497.
    In 1964, the American Medical Association invited liberal theologian Abraham Joshua Heschel to address its annual meeting in a program entitled “The Patient as a Person” [1]. Unsurprisingly, in light of Heschel’s reputation for outspokenness, he launched a jeremiad against physicians, claiming: “The admiration for medical science is increasing, the respect for its practitioners is decreasing. The depreciation of the image of the doctor is bound to disseminate disenchantment and to affect the state of medicine itself” [1, p. 35]. Heschel’s (...)
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  2.  1
    “Just Do Your Job”: Technology, Bureaucracy, and the Eclipse of Conscience in Contemporary Medicine.Jacob A. Blythe & Farr A. Curlin - 2018 - Theoretical Medicine and Bioethics 39 (6):431-452.
    Market metaphors have come to dominate discourse on medical practice. In this essay, we revisit Peter Berger and colleagues’ analysis of modernization in their book The Homeless Mind and place that analysis in conversation with Max Weber’s 1917 lecture “Science as a Vocation” to argue that the rise of market metaphors betokens the carry-over to medical practice of various features from the institutions of technological production and bureaucratic administration. We refer to this carry-over as the product presumption. The product presumption (...)
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  3.  3
    Enchanted Nature, Dissected Nature: The Case of Galen’s Anatomical Theology.Kimbell Kornu - 2018 - Theoretical Medicine and Bioethics 39 (6):453-471.
    Through the historical portrait of Galen, I argue that even an enchanted nature does not prevent the performance of violence against nature. Galen, the great physician-philosopher of antiquity, is best known for his systematization and innovation of the Hippocratic medical tradition, whose thought was the reigning medical orthodoxy from the medieval period into the Renaissance. His works on anatomy were the standard that Vesalius’ works on anatomy overturned. What is less known about Galen’s study of anatomy, however, is its philosophical (...)
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  4.  2
    The Worthless Remains of a Physician’s Calling: Max Weber, William Osler, and the Last Virtue of Physicians.Abraham M. Nussbaum - 2018 - Theoretical Medicine and Bioethics 39 (6):419-429.
    On the centenary of Max Weber’s “Science as a Vocation,” his essay still performs interpretative work. In it, Weber argues that the vocation of a scientist is to produce specialized, rationalized knowledge that will be superseded. Weber says this vocation is a rationalized version of the Protestant conception of calling or vocation, tragically disenchanting the world and leaving the idea of calling as a worthless remains. A similar trajectory can be seen in the physician William Osler’s writings, especially his essay (...)
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  5.  1
    Re-Enchanting the Body: Overcoming the Melancholy of Anatomy.Joel James Shuman - 2018 - Theoretical Medicine and Bioethics 39 (6):473-481.
    I argue here that Weberian disenchantment is manifest in the triumph of instrumental reason and the expansion of analytic enquiry, which now dominates not simply those sciences upon which medicine depends, but medical practice itself. I suggest ways that analytic enquiry, also referred to here as anatomical reasoning, are part of a particular ideology—a way of seeing, speaking about, and inhabiting the world—that often fails to serve the health of patients because it is incapable of “seeing” them in the moral (...)
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  6.  1
    Patient Reflections on the Disenchantment of Techno-Medicine.Devan Stahl - 2018 - Theoretical Medicine and Bioethics 39 (6):499-513.
    Over one hundred years after Max Weber delivered his lecture “Science as a Vocation,” his description of the work of the physician in a disenchanted world still resonates. As a chronically ill patient who interacts with physicians frequently, I struggle with reconciling my understanding of my ill body with how my physician makes sense of my illness. My diagnosis created an existential crisis that caused me to search for meaning in my embodied experience, but I soon learned there is little (...)
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  7.  2
    Understanding Modern, Technological Medicine: Enchanted, Disenchanted, or Other?Matthew Vest & Ashley Moyse - 2018 - Theoretical Medicine and Bioethics 39 (6):407-417.
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  8.  3
    Deborah Lynn Steinberg: Genes and the Bioimaginary: Science, Spectacle, Culture.Ana Borovečki - 2018 - Theoretical Medicine and Bioethics 39 (5):393-395.
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  9.  1
    Birth with Dignity From the Confucian Perspective.Jianhui Li & Yaming Li - 2018 - Theoretical Medicine and Bioethics 39 (5):375-388.
    The development of biotechnologies has broadly interfered with a number of life processes, including human birth. An important moral question arises from the application of such medical technologies to birth: do biotechnological advancements violate human dignity? Many valid arguments have been raised. Yet bioethicists are still far from reaching a consensus on how best to protect the dignity of human birth. Confucianism is an influential ethical theory in China and presents a distinctive understanding of human dignity. In this paper, we (...)
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  10.  7
    Nicholas Agar: Truly Human Enhancement: A Philosophical Defense of Limits.Loredana Persampieri - 2018 - Theoretical Medicine and Bioethics 39 (5):389-392.
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  11.  4
    Should Physicians Be Empathetic? Rethinking Clinical Empathy.David Schwan - 2018 - Theoretical Medicine and Bioethics 39 (5):347-360.
    The role and importance of empathy in clinical practice has been widely discussed. This paper focuses on the ideal of clinical empathy, as involving both cognitive understanding and affective resonance. I argue that this account is subject to a number of objections. Affective resonance may serve more as a liability than as a benefit in clinical settings, and utilizing this capacity is not clearly supported by the relevant empirical literature. Instead, I argue that the ideal account of empathy in medicine (...)
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  12.  7
    Luciana Caenazzo, Lucia Mariani, and Renzo Pegoraro : Convergence of New Emerging Technologies: Ethical Challenges and New Responsibilities.Pamela Tozzo - 2018 - Theoretical Medicine and Bioethics 39 (5):403-405.
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  13.  1
    The Dramatic Essence of the Narrative Approach.Oscar Vergara - 2018 - Theoretical Medicine and Bioethics 39 (5):361-374.
    Even though it is not a methodology on the level of principlism or casuistry, narrative bioethics nonetheless contributes to and guides decision-making in the field of biomedical ethics. However, unlike other methodologies, the narrative approach lacks a set of specific patterns and formal rules for doing so. This deficiency leaves this approach more vulnerable to the influence of historical factors; in fact, the vital history of a person is made up of thousands of scenes, which one must select and group (...)
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  14.  9
    Steve Clarke, Julian Savulescu, C.A.J. Coady, Alberto Giubilini, and Sagar Sanyal : The Ethics of Human Enhancement: Understanding the Debate. [REVIEW]Hilary Yancey - 2018 - Theoretical Medicine and Bioethics 39 (5):397-401.
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  15.  2
    Violence, Research, and Non-Identity in the Psychiatric Clinic.Michelle Bach - 2018 - Theoretical Medicine and Bioethics 39 (4):283-299.
    Violence in psychiatric clinics has been a consistent problem since the birth of modern psychiatry. In this paper, I examine current efforts to understand and reduce both violence and coercive responses to violence in psychiatry, arguing that these efforts are destined to fall short. By and large, scholarship on psychiatric violence reduction has focused on identifying discrete factors that are statistically associated with violence, such as patient demographics and clinical qualities, in an effort to quantify risk and predict violent acts (...)
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  16.  1
    Sarah Ferber: Bioethics in Historical Perspective.Massimiliano Colucci - 2018 - Theoretical Medicine and Bioethics 39 (4):337-339.
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  17.  2
    Letter to the Editor.Michael Gross - 2018 - Theoretical Medicine and Bioethics 39 (4):335-336.
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  18.  3
    Twin Inc.Rose Hershenov & Derek Doroski - 2018 - Theoretical Medicine and Bioethics 39 (4):301-319.
    This paper presents an account of how human spontaneous embryonic chimeras are formed. On the prevalent view in the philosophical literature, it is said that chimeras are the product of two embryos that fuse to form a new third embryo. We call this version of fusion synthesis. In contrast to synthesis, we present an alternative mechanism for chimera formation called incorporation, wherein one embryo incorporates the cells of a second embryo into its body. We argue that the incorporation thesis explains (...)
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  19.  7
    Prisoners’ Competence to Die: Hunger Strike and Cognitive Competence.Zohar Lederman - 2018 - Theoretical Medicine and Bioethics 39 (4):321-334.
    Several bioethicists have recently advocated the force-feeding of prisoners, based on the assumption that prisoners have reduced or no autonomy. This assumed lack of autonomy follows from a decrease in cognitive competence, which, in turn, supposedly derives from imprisonment and/or being on hunger strike. In brief, causal links are made between imprisonment or voluntary total fasting and mental disorders and between mental disorders and lack of cognitive competence. I engage the bioethicists that support force-feeding by severing both of these causal (...)
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  20.  3
    The Discourse on Faith and Medicine: A Tale of Two Literatures.Jeff Levin - 2018 - Theoretical Medicine and Bioethics 39 (4):265-282.
    Research and writing at the intersection of faith and medicine by now include thousands of published studies, review articles, books, chapters, and essays. Yet this emerging field has been described, from within, as disheveled on account of imprecision and lack of careful attention to conceptual and theoretical concerns. An important source of confusion is the fact that scholarship in this field constitutes two distinct literatures, or rather meta-literatures, which can be termed faith as a problematic for medicine and medicine as (...)
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  21.  2
    James Tabery: Beyond Versus: The Struggle to Understand the Interaction of Nature and Nurture.Leonardo Nepi - 2018 - Theoretical Medicine and Bioethics 39 (4):341-342.
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  22.  6
    Benjamin Smart: Concepts and Causes in the Philosophy of Disease.Jeremy Simon - 2018 - Theoretical Medicine and Bioethics 39 (4):343-346.
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  23.  5
    Proportionate Palliative Sedation and the Giving of a Deadly Drug: The Conundrum.Thomas Cavanaugh - 2018 - Theoretical Medicine and Bioethics 39 (3):221-231.
    Among the oldest extant medical ethics, the Hippocratic Oath prohibits the giving of a deadly drug, regarding this act as an egregious violation of a medical ethic that is exclusively therapeutic. Proportionate palliative sedation involves the administration of a deadly drug. Hence it seems to violate the venerable Hippocratic promise associated with the dawn of Western medicine not to give a deadly drug. Relying on distinctions commonly employed in the analysis and evaluation of human actions, this article distinguishes physician-assisted suicide (...)
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  24.  5
    Palliative Sedation: Clinical Context and Ethical Questions.Farr Curlin - 2018 - Theoretical Medicine and Bioethics 39 (3):197-209.
    Practitioners of palliative medicine frequently encounter patients suffering distress caused by uncontrolled pain or other symptoms. To relieve such distress, palliative medicine clinicians often use measures that result in sedation of the patient. Often such sedation is experienced as a loss by patients and their family members, but sometimes such sedation is sought as the desired outcome. Peace is wanted. Comfort is needed. Sedation appears to bring both. Yet to be sedated is to be cut off existentially from human experience, (...)
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  25.  2
    Reckoning with the Last Enemy.Douglas Farrow - 2018 - Theoretical Medicine and Bioethics 39 (3):181-195.
    Developing the ethics of palliative sedation, particularly in contrast to terminal sedation, requires consideration of the relation between body and soul and of the nature of death and dying. Christianly considered, it also requires attention to the human vocation to immortality and hence to the relation between medicine and discipline. Leaning on Augustine’s rendering of the latter, this paper provides a larger anthropological and soteriological frame of reference for the ethics of palliative sedation, organized by way of nine briefly expounded (...)
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  26.  8
    Comforting When We Cannot Heal: The Ethics of Palliative Sedation.Gilbert Meilaender - 2018 - Theoretical Medicine and Bioethics 39 (3):211-220.
    This essay considers whether palliative sedation is or is not appropriate medical care. This requires one to consider whether, in addition to the good of health, relief of suffering is also a proper end of medicine; whether unconsciousness can ever be a good for a human being; and how double-effect reasoning can help us think about difficult cases. The author concludes that palliative sedation may be proper medical care, but only in a limited range of cases.
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  27.  4
    Sedation and Care at the End of Life.Daniel Sulmasy - 2018 - Theoretical Medicine and Bioethics 39 (3):171-180.
    This special issue of Theoretical Medicine and Bioethics takes up the question of palliative sedation as a source of potential concern or controversy among Christian clinicians and thinkers. Christianity affirms a duty to relieve unnecessary suffering yet also proscribes euthanasia. Accordingly, the question arises as to whether it is ever morally permissible to render dying patients unconscious in order to relieve their suffering. If so, under what conditions? Is this practice genuinely morally distinguishable from euthanasia? Can one ever aim directly (...)
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  28.  4
    The Last Low Whispers of Our Dead: When is It Ethically Justifiable to Render a Patient Unconscious Until Death?Daniel Sulmasy - 2018 - Theoretical Medicine and Bioethics 39 (3):233-263.
    A number of practices at the end of life can causally contribute to diminished consciousness in dying patients. Despite overlapping meanings and a confusing plethora of names in the published literature, this article distinguishes three types of clinically and ethically distinct practices: double-effect sedation, parsimonious direct sedation, and sedation to unconsciousness and death. After exploring the concept of suffering, the value of consciousness, the philosophy of therapy, the ethical importance of intention, and the rule of double effect, these three practices (...)
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  29.  4
    Physician-Assisted Dying: Thoughts Drawn From Albert Camus’ Writing.Claudia Bozzaro - 2018 - Theoretical Medicine and Bioethics 39 (2):111-122.
    Physician-assisted dying is currently an intensely discussed topic in several countries. Despite differences in legislation and application, countries with end-of-life laws have similar eligibility criteria for assistance in dying: individuals must be in a hopeless situation and experience unbearable suffering. Hopelessness, as a basic aspect of the human condition, is a central topic in Albert Camus’ philosophical work The Myth of Sisyphus, which addresses the question of suicide. Suffering in the face of a hopeless situation, and the way doctors approach (...)
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  30.  8
    Conscientious Objection and Person-Centered Care.Stephen Buetow & Natalie Gauld - 2018 - Theoretical Medicine and Bioethics 39 (2):143-155.
    Person-centered care offers a promising way to manage clinicians’ conscientious objection to providing services they consider morally wrong. Health care centered on persons, rather than patients, recognizes clinicians and patients on the same stratum. The moral interests of clinicians, as persons, thus warrant as much consideration as those of other persons, including patients. Interconnected moral interests of clinicians, patients, and society construct the clinician as a socially embedded and integrated self, transcending the simplistic duality of private conscience versus public role (...)
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  31.  13
    Against the iDoctor: Why Artificial Intelligence Should Not Replace Physician Judgment.Kyle E. Karches - 2018 - Theoretical Medicine and Bioethics 39 (2):91-110.
    Experts in medical informatics have argued for the incorporation of ever more machine-learning algorithms into medical care. As artificial intelligence research advances, such technologies raise the possibility of an “iDoctor,” a machine theoretically capable of replacing the judgment of primary care physicians. In this article, I draw on Martin Heidegger’s critique of technology to show how an algorithmic approach to medicine distorts the physician–patient relationship. Among other problems, AI cannot adapt guidelines according to the individual patient’s needs. In response to (...)
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  32.  1
    Against the iDoctor: Why Artificial Intelligence Should Not Replace Physician Judgment.Kyle Karches - 2018 - Theoretical Medicine and Bioethics 39 (2):91-110.
    Experts in medical informatics have argued for the incorporation of ever more machine-learning algorithms into medical care. As artificial intelligence research advances, such technologies raise the possibility of an “iDoctor,” a machine theoretically capable of replacing the judgment of primary care physicians. In this article, I draw on Martin Heidegger’s critique of technology to show how an algorithmic approach to medicine distorts the physician–patient relationship. Among other problems, AI cannot adapt guidelines according to the individual patient’s needs. In response to (...)
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  33.  3
    Taking Responsibility for Health in an Epistemically Polluted Environment.Neil Levy - 2018 - Theoretical Medicine and Bioethics 39 (2):123-141.
    Proposals for regulating or nudging healthy choices are controversial. Opponents often argue that individuals should take responsibility for their own health, rather than be paternalistically manipulated for their own good. In this paper, I argue that people can take responsibility for their own health only if they satisfy certain epistemic conditions, but we live in an epistemic environment in which these conditions are not satisfied. Satisfying the epistemic conditions for taking responsibility, I argue, requires regulation of this environment. I describe (...)
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  34.  6
    Fredrik Svenaeus: Phenomenological Bioethics: Medical Technologies, Human Suffering, and the Meaning of Being Alive.James Marcum - 2018 - Theoretical Medicine and Bioethics 39 (2):165-169.
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  35.  16
    The Composite Redesign of Humanity’s Nature: A Work in Process.Lantz Miller - 2018 - Theoretical Medicine and Bioethics 39 (2):157-164.
    One of the most salient contemporary concerns in academic debates and pop culture alike is the extent to which new technologies may re-cast Homo sapiens. Species members may find themselves encased in a type of existence they deem to be wanting in comparison with their present form, even if the promised form was assured to be better. Plausibly, the concern is not merely fear of change or of the unknown, but rather it arises out of individuals’ general identification with what (...)
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  36.  9
    Inmaculada de Melo-Martín: Rethinking Reprogenetics: Enhancing Ethical Analyses of Reprogenetic Technologies. Oxford University Press, New York, 2017, 288 Pp, ISBN 9780190460204. [REVIEW]Natalia Fernández-Jimeno - 2018 - Theoretical Medicine and Bioethics 39 (1):85-90.
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  37.  20
    A New Path for Humanistic Medicine.Juliette Ferry-Danini - 2018 - Theoretical Medicine and Bioethics 39 (1):57-77.
    According to recent approaches in the philosophy of medicine, biomedicine should be replaced or complemented by a humanistic medical model. Two humanistic approaches, narrative medicine and the phenomenology of medicine, have grown particularly popular in recent decades. This paper first suggests that these humanistic criticisms of biomedicine are insufficient. A central problem is that both approaches seem to offer a straw man definition of biomedicine. It then argues that the subsequent definition of humanism found in these approaches is problematically reduced (...)
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  38.  8
    The Ethics of Separating Conjoined Twins: Two Arguments Against.Luke Kallberg - 2018 - Theoretical Medicine and Bioethics 39 (1):27-56.
    I argue that the separation of conjoined twins in infancy or early childhood is unethical. Cases may be divided into three types: both twins suffer from lethal abnormalities, only one twin has a lethal abnormality, or neither twin does. In the first kind of case, there is no reason to separate, since both twins will die regardless of treatment. In the third kind of case, I argue that separation at an early age is unethical because the twins are likely to (...)
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  39. How (Not) to Think of the ‘Dead-Donor’ Rule.Adam Omelianchuk - 2018 - Theoretical Medicine and Bioethics 39 (1):1-25.
    Although much has been written on the dead-donor rule in the last twenty-five years, scant attention has been paid to how it should be formulated, what its rationale is, and why it was accepted. The DDR can be formulated in terms of either a Don’t Kill rule or a Death Requirement, the former being historically rooted in absolutist ethics and the latter in a prudential policy aimed at securing trust in the transplant enterprise. I contend that the moral core of (...)
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  40.  12
    Antoine Suarez, Joachim Huarte : Is This Cell a Human Being? Exploring the Status of Embryos, Stem Cells and Human - Animal Hybrids.Susanna Maria Taraschi - 2018 - Theoretical Medicine and Bioethics 39 (1):79-83.
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