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  1.  1
    Could Moral Enhancement Interventions Be Medically Indicated?Sarah Carter - 2017 - Health Care Analysis 25 (4):338-353.
    This paper explores the position that moral enhancement interventions could be medically indicated in cases where they provide a remedy for a lack of empathy, when such a deficit is considered pathological. In order to argue this claim, the question as to whether a deficit of empathy could be considered to be pathological is examined, taking into account the difficulty of defining illness and disorder generally, and especially in the case of mental health. Following this, Psychopathy and a fictionalised mental (...)
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  2.  7
    “I Am Your Mother and Your Father!” In Vitro Derived Gametes and the Ethics of Solo Reproduction.Cutas Daniela & Smajdor Anna - 2017 - Health Care Analysis 25 (4):354-369.
    In this paper, we will discuss the prospect of human reproduction achieved with gametes originating from only one person. According to statements by a minority of scientists working on the generation of gametes in vitro, it may become possible to create eggs from men’s non-reproductive cells and sperm from women’s. This would enable, at least in principle, the creation of an embryo from cells obtained from only one individual: ‘solo reproduction’. We will consider what might motivate people to reproduce in (...)
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  3.  3
    Speaking Out and Being Heard Residents’ Committees in Quebec’s Residential Long-Term Care Centre.Éric Gagnon, Michèle Clément & Lilianne Bordeleau - 2017 - Health Care Analysis 25 (4):308-322.
    Residents’ councils in Quebec’s residential and long-term care centres have the mandate to promote the improvement of living conditions for residents, to assess their level of satisfaction, and to defend their rights. Based on two studies on the autonomy of councils, we examined how committees can express themselves on topics other than those the management is already aware of, to reveal various previously unknown aspects of the services, and to voice unexpressed concerns. We are especially interested in what makes management (...)
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  4.  2
    Doctors on Values and Advocacy: A Qualitative and Evaluative Study.Siun Gallagher & Miles Little - 2017 - Health Care Analysis 25 (4):370-385.
    Doctors are increasingly enjoined by their professional organisations to involve themselves in supraclinical advocacy, which embraces activities focused on changing practice and the system in order to address the social determinants of health. The moral basis for doctors’ decisions on whether or not to do so has been the subject of little empirical research. This opportunistic qualitative study of the values of medical graduates associated with the Sydney Medical School explores the processes that contribute to doctors’ decisions about taking up (...)
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  5.  16
    Ethical Frameworks in Public Health Decision-Making: Defending a Value-Based and Pluralist Approach.Kalle Grill & Angus Dawson - 2017 - Health Care Analysis 25 (4):291-307.
    A number of ethical frameworks have been proposed to support decision-making in public health and the evaluation of public health policy and practice. This is encouraging, since ethical considerations are of paramount importance in health policy. However, these frameworks have various deficiencies, in part because they incorporate substantial ethical positions. In this article, we discuss and criticise a framework developed by James Childress and Ruth Bernheim, which we consider to be the state of the art in the field. Their framework (...)
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  6.  4
    Addressing Deficits and Injustices: The Potential Epistemic Contributions of Patients to Research.Hutchison Katrina, Rogers Wendy & A. Entwistle Vikki - 2017 - Health Care Analysis 25 (4):386-403.
    Patient or public involvement in health research is increasingly expected as a matter of policy. In theory, PPI can contribute both to the epistemic aims intrinsic to research, and to extrinsically valued features of research such as social inclusion and transparency. In practice, the aims of PPI have not always been clear, although there has been a tendency to encourage the involvement of so-called ordinary people who are regarded as representative of an assumed patient perspective. In this paper we focus (...)
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  7.  4
    Am I My Brother’s Keeper? Moral Dimensions of Informal Caregiving in a Neoliberal Society.Ellen Meijer, Gert Schout & Tineke Abma - 2017 - Health Care Analysis 25 (4):323-337.
    Within the current Dutch policy context the role of informal care is revalued. Formal care activities are reduced and family and friends are expected to fill this gap. Yet, there is little research on the moral ambivalences that informal care for loved ones who have severe and ongoing mental health problems entails, especially against the backdrop of neoliberal policies. Giving priority to one’s own life project or caring for a loved one with severe problems is not reconciled easily. Using a (...)
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  8.  15
    Emerging Technologies in the Treatment of Anorexia Nervosa and Ethics: Sufferers’ Accounts of Treatment Strategies and Authenticity.Alina Coman - 2017 - Health Care Analysis 25 (3):212-224.
    New neural models for anorexia nervosa are emerging as a result of increased research on the neurobiology of AN, and these offer a rationale for the development of new treatment technologies such as neuromodulation. The emergence of such treatment technologies raises new ethical questions; however these have been little discussed for AN. In this article, I take an empirical approach and explore how young women who suffer from AN perceive treatment technologies in light of the concept of authenticity. Interview data (...)
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  9.  9
    Making Markets in Long-Term Care: Or How a Market Can Work by Being Invisible.Kor Grit & Teun Zuiderent-Jerak - 2017 - Health Care Analysis 25 (3):242-259.
    Many Western countries have introduced market principles in healthcare. The newly introduced financial instrument of “care-intensity packages” in the Dutch long-term care sector fit this development since they have some characteristics of a market device. However, policy makers and care providers positioned these instruments as explicitly not belonging to the general trend of marketisation in healthcare. Using a qualitative case study approach, we study the work that the two providers have done to fit these instruments to their organisations and how (...)
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  10.  6
    Trust and Its Role in the Medical Encounter.Stephen Holland & David Stocks - 2017 - Health Care Analysis 25 (3):260-274.
    This paper addresses two research questions. The first is theoretical: What is trust? In the first half of this paper we present a distinctive tripartite analysis. We describe three attitudes, here called reliance, specific trust and general trust, each of which is characterised and illustrated. We argue that these attitudes are related, but not reducible, to one another. We suggest that the current impasse in the analysis of trust is in part due to the fact that some writers allude to (...)
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  11.  12
    Critical Realism and Empirical Bioethics: A Methodological Exposition.Alex McKeown - 2017 - Health Care Analysis 25 (3):191-211.
    This paper shows how critical realism can be used to integrate empirical data and philosophical analysis within ‘empirical bioethics’. The term empirical bioethics, whilst appearing oxymoronic, simply refers to an interdisciplinary approach to the resolution of practical ethical issues within the biological and life sciences, integrating social scientific, empirical data with philosophical analysis. It seeks to achieve a balanced form of ethical deliberation that is both logically rigorous and sensitive to context, to generate normative conclusions that are practically applicable to (...)
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  12.  11
    The Principle-Based Method of Practical Ethics.Georg Spielthenner - 2017 - Health Care Analysis 25 (3):275-289.
    This paper is about the methodology of doing practical ethics. There is a variety of methods employed in ethics. One of them is the principle-based approach, which has an established place in ethical reasoning. In everyday life, we often judge the rightness and wrongness of actions by their conformity to principles, and the appeal to principles plays a significant role in practical ethics, too. In this paper, I try to provide a better understanding of the nature of principle-based reasoning. To (...)
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  13.  5
    The Benefits of Patient Involvement for Translational Research.Lieke van der Scheer, Elisa Garcia, Anna Laura van der Laan, Simone van der Burg & Marianne Boenink - 2017 - Health Care Analysis 25 (3):225-241.
    The question we raise in this paper is, whether patient involvement might be a beneficial way to help determine and achieve the aims of translational research and, if so, how to proceed. TR is said to ensure a more effective movement of basic scientific findings to relevant and useful clinical applications. In view of the fact that patients are supposed to be the primary beneficiaries of such translation and also have relevant knowledge based on their experience, listening to their voice (...)
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  14.  1
    No Longer Home Alone? Home Care and the Canada Health Act.Monique Lanoix - 2017 - Health Care Analysis 25 (2):168-189.
    In this paper, I argue that addressing the medical needs of older persons warrants expanding the array of insured services as described by the Canada Health Act to include home care. The growing importance of chronic care supports my call for federally regulated home care services as the nature of disease management has changed significantly in the last decades. In addition, if the values of equity, fairness and solidarity, which are the keystone values of the CHA, are to be upheld (...)
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  15.  6
    Concierge, Wellness, and Block Fee Models of Primary Care: Ethical and Regulatory Concerns at the Public–Private Boundary.Lynette Reid - 2017 - Health Care Analysis 25 (2):151-167.
    In bioethics and health policy, we often discuss the appropriate boundaries of public funding; how the interface of public and private purchasers and providers should be organized and regulated receives less attention. In this paper, I discuss ethical and regulatory issues raised at this interface by three medical practice models in which physicians provide insured services while requiring or requesting that patients pay for services or for the non-insured services of the physicians themselves or their associates. This choice for such (...)
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  16.  7
    Medical Need: Evaluating a Conceptual Critique of Universal Health Coverage.Lynette Reid - 2017 - Health Care Analysis 25 (2):114-137.
    Some argue that the concept of medical need is inadequate to inform the design of a universal health care system—particularly an institutional rather than a residual system. They argue that the concept contradicts the idea of comprehensiveness; leads to unsustainable expenditures; is too indeterminate for policy; and supports only a prioritarian distribution. I argue that ‘comprehensive’ understood as ‘including the full continuum of care’ and ‘medically necessary’ understood as ‘prioritized by medical criteria’ are not contradictory, and that UHC is a (...)
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  17. Introduction to the Special Issue: Precarious Solidarity—Preferential Access in Canadian Health Care.Lynette Reid - 2017 - Health Care Analysis 25 (2):107-113.
    Systems of universal health coverage may aspire to provide care based on need and not ability to pay; the complexities of this aspiration call for normative analysis. This special issue arises in the wake of a judicial inquiry into preferential access in the Canadian province of Alberta, the Vertes Commission. I describe this inquiry and set out a taxonomy of forms of differential and preferential access. Papers in this special issue focus on the conceptual specification of health system boundaries and (...)
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  18.  5
    How Medical Tourism Enables Preferential Access to Care: Four Patterns From the Canadian Context.Jeremy Snyder, Rory Johnston, Valorie A. Crooks, Jeff Morgan & Krystyna Adams - 2017 - Health Care Analysis 25 (2):138-150.
    Medical tourism is the practice of traveling across international borders with the intention of accessing medical care, paid for out-of-pocket. This practice has implications for preferential access to medical care for Canadians both through inbound and outbound medical tourism. In this paper, we identify four patterns of medical tourism with implications for preferential access to care by Canadians: Inbound medical tourism to Canada’s public hospitals; Inbound medical tourism to a First Nations reserve; Canadian patients opting to go abroad for medical (...)
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  19.  9
    How Does Organisational Literacy Impact Access to Health Care for Homeless Individuals?Naomi Rebecca Hughes - 2017 - Health Care Analysis 25 (1):90-106.
    This article describes a study that examined the experiences of 27 individuals who frequented an Open Access homeless shelter in Toronto, Canada. The overarching aim of this study was to map the social organisation of health care in Toronto, with particular regards to the ways in which literacy, or the lack of literacy, mediates the experiences of homeless individuals attempting to gain access to health care. While terms such as “literate” or “illiterate” might be seen to reflect an individual’s level (...)
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  20.  15
    For the Sake of Justice: Should We Prioritize Rare Diseases?Niklas Juth - 2017 - Health Care Analysis 25 (1):1-20.
    This article is about the justifiability of accepting worse cost effectiveness for orphan drugs, that is, treatments for rare diseases, in a publicly financed health care system. Recently, three arguments have been presented that may be used in favour of exceptionally advantageous economic terms for orphan drugs. These arguments share the common feature of all referring to considerations of justice or fairness: the argument of the irrelevance of group size, the argument from the principle of need, and the argument of (...)
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  21.  12
    Intimacy and Sexuality in Institutionalized Dementia Care: Clinical-Ethical Considerations.Lieslot Mahieu, Luc Anckaert & Chris Gastmans - 2017 - Health Care Analysis 25 (1):52-71.
    Intimacy and sexuality expressed by nursing home residents with dementia remains an ethically sensitive issue for care facilities, nursing staff and family members. Dealing with residents’ sexual longings and behaviour is extremely difficult, putting a burden on the caregivers as well as on the residents themselves and their relatives. The parties in question often do not know how to react when residents express themselves sexually. The overall aim of this article is to provide a number of clinical-ethical considerations addressing the (...)
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  22.  15
    Ageism and Autonomy in Health Care: Explorations Through a Relational Lens.Laura Pritchard-Jones - 2017 - Health Care Analysis 25 (1):72-89.
    Ageism within the context of care has attracted increasing attention in recent years. Similarly, autonomy has developed into a prominent concept within health care law and ethics. This paper explores the way that ageism, understood as a set of negative attitudes about old age or older people, may impact on an older person’s ability to make maximally autonomous decisions within health care. In particular, by appealing to feminist constructions of autonomy as relational, I will argue that the key to establishing (...)
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  23.  8
    The Absent Interpreter in Administrative Detention Center Medical Units.Murielle Rondeau-Lutz & Jean-Christophe Weber - 2017 - Health Care Analysis 25 (1):34-51.
    The particular situation of the French administrative detention center medical units appears to be an exemplary case to study the difficulties facing medical practice. Indeed, the starting point of our inquiry was an amazing observation that needed to be addressed and understood: why are professional interpreters so seldom requested in ADC medical units, where one would expect that they would be “naturally” present? Aiming to fully explore the meanings of the “absent interpreter”, this article takes into account the possible meanings (...)
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  24.  3
    The Relevance of Group Size in Health Care Priority Setting: A Reply to Juth.Lars Sandman & Erik Gustavsson - 2017 - Health Care Analysis 25 (1):21-33.
    How to handle orphan drugs for rare diseases is a pressing problem in current health-care. Due to the group size of patients affecting the cost of treatment, they risk being disadvantaged in relation to existing cost-effectiveness thresholds. In an article by Niklas Juth it has been argued that it is irrelevant to take indirectly operative factors like group size into account since such a compensation would risk discounting the use of cost, a relevant factor, altogether. In this article we analyze (...)
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  25.  2
    Http://Trimcoloncleanse.Dk/Junivive-Cream/.Junivivedk9 Junivivedk9 & Healthcare Healthcare - 2017 - Health Care Analysis 19 (19):100.
    Junivive Cream is an anti aging option to raise your aging skin for better beauty benefits. Females have to look after their facial beauty to look stunning and also eternal. The struggle of aging results are limitless as it is among the natural struggle which everybody needs to go.
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  26.  3
    Health Without Care? Vulnerability, Medical Brain Drain, and Health Worker Responsibilities in Underserved Contexts.Yusuf Yuksekdag - 2017 - Health Care Analysis:1-16.
    There is a consensus that the effects of medical brain drain, especially in the Sub-Saharan African countries, ought to be perceived as more than a simple misfortune. Temporary restrictions on the emigration of health workers from the region is one of the already existing policy measures to tackle the issue—while such a restrictive measure brings about the need for quite a justificatory work. A recent normative contribution to the debate by Gillian Brock provides a fruitful starting point. In the first (...)
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