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  1.  6
    Research Translation and Emerging Health Technologies: Synthetic Biology and Beyond.Sarah Chan - 2018 - Health Care Analysis 26 (4):310-325.
    New health technologies are rapidly emerging from various areas of bioscience research, such as gene editing, regenerative medicine and synthetic biology. These technologies raise promising medical possibilities but also a range of ethical considerations. Apart from the issues involved in considering whether novel health technologies can or should become part of mainstream medical treatment once established, the process of research translation to develop such therapies itself entails particular ethical concerns. In this paper I use synthetic biology as an example of (...)
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  2.  1
    New Horizons for Health Care Analysis.John Coggon - 2018 - Health Care Analysis 26 (4):285-286.
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  3.  6
    Exacerbating Inequalities? Health Policy and the Behavioural Sciences.Kathryn MacKay & Muireann Quigley - 2018 - Health Care Analysis 26 (4):380-397.
    There have been calls for some time for a new approach to public health in the United Kingdom and beyond. This is consequent on the recognition and acceptance that health problems often have a complex and multi-faceted aetiology. At the same time, policies which utilise insights from research in behavioural economics and psychology have gained prominence on the political agenda. The relationship between the social determinants of health and behavioural science in health policy has not hitherto been explored. Given the (...)
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  4.  1
    Ethics, Evidence Based Sports Medicine, and the Use of Platelet Rich Plasma in the English Premier League.M. J. McNamee, C. M. Coveney, A. Faulkner & J. Gabe - 2018 - Health Care Analysis 26 (4):344-361.
    The use of platelet rich plasma as a novel treatment is discussed in the context of a qualitative research study comprising 38 interviews with sports medicine practitioners and other stakeholders working within the English Premier League during the 2013–16 seasons. Analysis of the data produced several overarching themes: conservatism versus experimentalism in medical attitudes; therapy perspectives divergence; conflicting versions of appropriate evidence; subcultures; community beliefs/practices; and negotiation of medical decision-making. The contested evidence base for the efficacy of PRP is presented (...)
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  5.  3
    In Defence of Moral Pluralism and Compromise in Health Care Networks.Kasper Raus, Eric Mortier & Kristof Eeckloo - 2018 - Health Care Analysis 26 (4):362-379.
    The organisation of health care is rapidly changing. There is a trend to move away from individual health care institutions towards transmural integrated care and interorganizational collaboration in networks. However, within such collaboration and network there is often likely to be a pluralism of values as different health care institutions often have very different values. For this paper, we examine three different models of how we believe institutions can come to collaborate in networks, and thus reap the potential benefits of (...)
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  6.  23
    Are Concerns About Irremediableness, Vulnerability, or Competence Sufficient to Justify Excluding All Psychiatric Patients From Medical Aid in Dying?William Rooney, Udo Schuklenk & Suzanne van de Vathorst - 2018 - Health Care Analysis 26 (4):326-343.
    Some jurisdictions that have decriminalized assisted dying exclude psychiatric patients on the grounds that their condition cannot be determined to be irremediable, that they are vulnerable and in need of protection, or that they cannot be determined to be competent. We review each of these claims and find that none have been sufficiently well-supported to justify the differential treatment psychiatric patients experience with respect to assisted dying. We find bans on psychiatric patients’ access to this service amount to arbitrary discrimination. (...)
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  7.  18
    Cost-Equivalence and Pluralism in Publicly-Funded Health-Care Systems.Dominic Wilkinson & Julian Savulescu - 2018 - Health Care Analysis 26 (4):287-309.
    Clinical guidelines summarise available evidence on medical treatment, and provide recommendations about the most effective and cost-effective options for patients with a given condition. However, sometimes patients do not desire the best available treatment. Should doctors in a publicly-funded healthcare system ever provide sub-optimal medical treatment? On one view, it would be wrong to do so, since this would violate the ethical principle of beneficence, and predictably lead to harm for patients. It would also, potentially, be a misuse of finite (...)
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  8.  2
    The Athletic Body.Andrew Edgar - 2018 - Health Care Analysis 26 (3):269-283.
    This paper seeks to explore the attraction and the beauty of the contemporary athletic body. It will be suggested that a body shaped through muscular bulk and definition has come to be seen as aesthetically normative. This body differs from the body of athletes from the early and mid-twentieth century. It will be argued that the contemporary body is not merely the result of advances in sports science, but rather that it is expressive of certain meanings and values. The visual (...)
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  9.  13
    Cosmetic Surgery: Regulatory Challenges in a Global Beauty Market.Danielle Griffiths & Alex Mullock - 2018 - Health Care Analysis 26 (3):220-234.
    The market for cosmetic surgery tourism is growing with an increase in people travelling abroad for cosmetic surgery. While the reasons for seeking cosmetic surgery abroad may vary the most common reason is financial, but does cheaper surgery abroad carry greater risks? We explore the risks of poorly regulated cosmetic surgery to society generally before discussing how harm might be magnified in the context of cosmetic tourism, where the demand for cheaper surgery drives the market and makes surgery accessible for (...)
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  10.  5
    Altered Images: Understanding the Influence of Unrealistic Images and Beauty Aspirations.Fiona MacCallum & Heather Widdows - 2018 - Health Care Analysis 26 (3):235-245.
    In this paper we consider the impact of digitally altered images on individuals’ body satisfaction and beauty aspirations. Drawing on current psychological literature we consider interventions designed to increase knowledge about the ubiquity and unreality of digital images and, in the form of labelling, provide information to the consumer. Such interventions are intended to address the negative consequences of unrealistic beauty ideals. However, contrary to expectations, such initiatives may not be effective, especially in the long-term, and may even be counter-productive. (...)
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  11.  12
    Should We Genetically Select for the Beauty Norm of Fair Skin?Herjeet Marway - 2018 - Health Care Analysis 26 (3):246-268.
    Fair skin is often regarded as a beauty ideal in many parts of the world. Genetic selection for non-disease traits may allow reproducers to select fair skin for the purposes of beauty, and may be justified under various procreative principles. In this paper I assess the ethics of genetic selection for fair skin as a beauty feature. In particular, I explore the discriminatory aspects and demands of such selection. Using race and colour hierarchies that many would find objectionable, I argue (...)
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  12.  2
    The Demands of Beauty: Editors’ Introduction.Heather Widdows & Fiona MacCallum - 2018 - Health Care Analysis 26 (3):207-219.
    This article introduces a Special Issue comprising four papers emerging from the Beauty Demands Network project, and maps key issues in the beauty debate. The introduction first discusses the purpose of the Network; to consider the changing demands of beauty across disciplines and beyond academia. It then summarises the findings of the Network workshops, emphasising the complex place of notions of normality, and the different meanings and functions attached to ‘normal’ in the beauty context. Concerns are raised here about the (...)
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  13.  6
    Valuing Healthcare Improvement: Implicit Norms, Explicit Normativity, and Human Agency.Stacy M. Carter - 2018 - Health Care Analysis 26 (2):189-205.
    I argue that greater attention to human agency and normativity in both researching and practicing service improvement may be one strategy for enhancing improvement science, illustrating with examples from cancer screening. Improvement science tends to deliberately avoid explicit normativity, for paradigmatically coherent reasons. But there are good reasons to consider including explicit normativity in thinking about improvement. Values and moral judgements are central to social life, so an adequate account of social life must include these elements. And improvement itself is (...)
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  14.  4
    Improvement Science Meets Improvement Scholarship: Reframing Research for Better Healthcare.Alan Cribb - 2018 - Health Care Analysis 26 (2):109-123.
    In this editorial essay I explore the possibilities of ‘improvement scholarship’ in order to set the scene for the theme of, and the other papers in, this issue. I contrast a narrow conception of quality improvement research with a much broader and more inclusive conception, arguing that we should greatly extend the existing dialogue between ‘problem-solving’ and ‘critical’ currents in improvement research. I have in mind the potential for building a much larger conversation between those people in ‘improvement science’ who (...)
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  15.  6
    “ Don’T Mind the Gap!” Reflections on Improvement Science as a Paradigm.Trenholme Junghans - 2018 - Health Care Analysis 26 (2):124-139.
    Responding to this issue’s invitation to bring new disciplinary insights to the field of improvement science, this article takes as its starting point one of the field’s guiding metaphors: the imperative to “mind the gap”. Drawing on insights from anthropology, history, and philosophy, the article reflects on the origins and implications of this metaphoric imperative, and suggests some ways in which it might be in tension with the means and ends of improvement. If the industrial origins of improvement science in (...)
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  16.  6
    Showing the Unsayable: Participatory Visual Approaches and the Constitution of ‘Patient Experience’ in Healthcare Quality Improvement.Constantina Papoulias - 2018 - Health Care Analysis 26 (2):171-188.
    This article considers the strengths and potential contributions of participatory visual methods for healthcare quality improvement research. It argues that such approaches may enable us to expand our understanding of ‘patient experience’ and of its potential for generating new knowledge for health systems. In particular, they may open up dimensions of people’s engagement with services and treatments which exceed both the declarative nature of responses to questionnaires and the narrative sequencing of self reports gathered through qualitative interviewing. I will suggest (...)
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  17.  13
    Scientism in Medical Education and the Improvement of Medical Care: Opioids, Competencies, and Social Accountability.Lynette Reid - 2018 - Health Care Analysis 26 (2):155-170.
    Scientism in medical education distracts educators from focusing on the content of learning; it focuses attention instead on individual achievement and validity in its measurement. I analyze the specific form that scientism takes in medicine and in medical education. The competencies movement attempts to challenge old “scientistic” views of the role of physicians, but in the end it has invited medical educators to focus on validity in the measurement of individual performance for attitudes and skills that medicine resists conceptualizing as (...)
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  18.  18
    History Matters: The Critical Contribution of Historical Analysis to Contemporary Health Policy and Health Care.Sally Sheard - 2018 - Health Care Analysis 26 (2):140-154.
    History is popular with health policymakers, if the regularity with which they invoke historical anecdotes to support policy change is used as an indicator. Yet the ways in which they ‘use’ history vary enormously, as does its impact. This paper explores, from the perspective of a UK academic historian, the development of ‘applied’ history in health policy. It draws on personal experience of different types and levels of engagement with policymakers, and highlights mechanisms through which this dialogue and partnership can (...)
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  19.  16
    If You’Re a Rawlsian, How Come You’Re So Close to Utilitarianism and Intuitionism? A Critique of Daniels’s Accountability for Reasonableness.Gabriele Badano - 2018 - Health Care Analysis 26 (1):1-16.
    Norman Daniels’s theory of ‘accountability for reasonableness’ is an influential conception of fairness in healthcare resource allocation. Although it is widely thought that this theory provides a consistent extension of John Rawls’s general conception of justice, this paper shows that accountability for reasonableness has important points of contact with both utilitarianism and intuitionism, the main targets of Rawls’s argument. My aim is to demonstrate that its overlap with utilitarianism and intuitionism leaves accountability for reasonableness open to damaging critiques. The important (...)
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  20.  12
    Why Health and Social Care Support for People with Long-Term Conditions Should Be Oriented Towards Enabling Them to Live Well.Vikki A. Entwistle, Alan Cribb & John Owens - 2018 - Health Care Analysis 26 (1):48-65.
    There are various reasons why efforts to promote “support for self-management” have rarely delivered the kinds of sustainable improvements in healthcare experiences, health and wellbeing that policy leaders internationally have hoped for. This paper explains how the basis of failure is in some respects built into the ideas that underpin many of these efforts. When support for self-management is narrowly oriented towards educating and motivating patients to adopt the behaviours recommended for disease control, it implicitly reflects and perpetuates limited and (...)
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  21.  4
    How Much Care is Enough? Carer’s Guilt and Bergsonian Time.Will Johncock - 2018 - Health Care Analysis 26 (1):94-107.
    Despite devoting their time to another person’s needs, many carers paradoxically experience guilt during their caregiving tenure concerning whether they are providing enough care. When discussing the “enough” of anything, what is at stake is that thing’s quantification. Given that there are seemingly no quantifiable units of care by which to measure the role, concerns regarding whether enough care is being provided often focus on what constitutes enough time as a carer. In exploring this aspect of the carer’s experience, two (...)
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  22.  13
    Beyond Fair Benefits: Reconsidering Exploitation Arguments Against Organ Markets.Julian J. Koplin - 2018 - Health Care Analysis 26 (1):33-47.
    One common objection to establishing regulated live donor organ markets is that such markets would be exploitative. Perhaps surprisingly, exploitation arguments against organ markets have been widely rejected in the philosophical literature on the subject. It is often argued that concerns about exploitation should be addressed by increasing the price paid to organ sellers, not by banning the trade outright. I argue that this analysis rests on a particular conception of exploitation, and outline two additional ways that the charge of (...)
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  23.  7
    Examining the Social Benefits Principle in Research with Human Participants.David B. Resnik - 2018 - Health Care Analysis 26 (1):66-80.
    The idea that research with human participants should benefit society has become firmly entrenched in various regulations, policies, and guidelines, but there has been little in-depth analysis of this ethical principle in the bioethics literature. In this paper, I distinguish between strong and weak versions and the social benefits principle and examine six arguments for it. I argue that while it is always ethically desirable for research with human subjects to offer important benefits to society, the reasonable expectation of substantial (...)
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  24.  4
    Individualised Claims of Conscience, Clinical Judgement and Best Interests.Stephen W. Smith - 2018 - Health Care Analysis 26 (1):81-93.
    Conscience and conscientious objections are important issues in medical law and ethics. However, discussions tend to focus on a particular type of conscience-based claim. These types of claims are based upon predictable, generalizable rules in which an individual practitioner objects to what is otherwise standard medical treatment. However, not all conscience based claims are of this type. There are other claims which are based not on an objection to a treatment in general but in individual cases. In other words, these (...)
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  25.  12
    Health Without Care? Vulnerability, Medical Brain Drain, and Health Worker Responsibilities in Underserved Contexts.Yusuf Yuksekdag - 2018 - Health Care Analysis 26 (1):17-32.
    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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