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  1.  5
    Reference-Class Problems Are Real: Health-Adjusted Reference Classes and Low Bone Mineral Density.Nicholas Binney - 2024 - Journal of Medicine and Philosophy 49 (2):jhae005.
    Elselijn Kingma argues that Christopher Boorse’s biostatistical theory (the BST) does not show how the reference classes it uses are objective and naturalistic. Recently, philosophers of medicine have attempted to rebut Kingma’s concerns. I argue that these rebuttals are theoretically unconvincing, and that there are clear examples of physicians adjusting their reference classes according to their prior knowledge of health and disease. I focus on the use of age-adjusted reference classes to diagnose low bone mineral density in children. In addition (...)
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  2.  21
    Beyond Conceptual Analysis: Social Objectivity and Conceptual Engineering to Define Disease.Anne-Marie Gagné-Julien - 2024 - Journal of Medicine and Philosophy 49 (2):jhae002.
    In this article, I side with those who argue that the debate about the definition of “disease” should be reoriented from the question “what is disease” to the question of what it should be. However, I ground my argument on the rejection of the naturalist approach to define disease and the adoption of a normativist approach, according to which the concept of disease is normative and value-laden. Based on this normativist approach, I defend two main theses: (1) that conceptual analysis (...)
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  3.  16
    Interventionism and Intelligibility: Why Depression is not (Always) a Brain Disease.Quinn Hiroshi Gibson - 2024 - Journal of Medicine and Philosophy 49 (2):160-177.
    Major Depressive Disorder (MDD) is a serious condition with a large disease burden. It is often claimed that MDD is a “brain disease.” What would it mean for MDD to be a brain disease? I argue that the best interpretation of this claim is as offering a substantive empirical hypothesis about the causes of the syndrome of depression. This syndrome-causal conception of disease, combined with the idea that MDD is a disease of the brain, commits the brain disease conception of (...)
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  4.  8
    Persons and their Brains: Life, Death, and Lessened Humanity.Caitlin Maples - 2024 - Journal of Medicine and Philosophy 49 (2):117-127.
    The authors of the articles in this issue of The Journal of Medicine and Philosophy address a wide variety of topics, from definitions of disease to bioenhancement. Each author, however, draws out the importance of careful use of language. Over the years, philosophers of medicine and bioethicists have debated questions such as what qualifies something as a disease, whether disease language is evaluative, whether the term “person” encompasses more than just human beings, and what language ought to be used to (...)
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  5.  23
    Phenomenological Interview and Gender Dysphoria: A Third Pathway for Diagnosis and Treatment.Geoffrey Dierckxsens & Teresa R. Baron - 2024 - Journal of Medicine and Philosophy 49 (1):28-42.
    Gender dysphoria (GD) is marked by an incongruence between a person’s biological sex at birth, and their felt gender (or gender identity). There is continuing debate regarding the benefits and drawbacks of physiological treatment of GD in children, a pathway, beginning with endocrine treatment to suppress puberty. Currently, the main alternative to physiological treatment consists of the so-called “wait-and-see” approach, which often includes counseling or other psychotherapeutic treatment. In this paper, we argue in favor of a “third pathway” for the (...)
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  6.  16
    Intentions at the End of Life: Continuous Deep Sedation and France’s Claeys-Leonetti law.Steven Farrelly-Jackson - 2024 - Journal of Medicine and Philosophy 49 (1):43-57.
    In 2016, France passed a major law that is unique in giving terminally ill and suffering patients the right to the controversial procedure of continuous deep sedation until death (CDS). In so doing, the law identifies CDS as a sui generis clinical practice, distinct from other forms of palliative sedation therapy, as well as from euthanasia. As such, it reconfigures the ethical debate over CDS in interesting ways. This paper addresses one aspect of this reconfiguration and its implications for the (...)
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  7.  15
    Moral Distress, Conscientious Practice, and the Endurance of Ethics in Health Care through Times of Crisis and Calm.Lauris Christopher Kaldjian - 2024 - Journal of Medicine and Philosophy 49 (1):11-27.
    When health professionals experience moral distress during routine clinical practice, they are challenged to maintain integrity through conscientious practice guided by ethical principles and virtues that promote the dignity of all human beings who need care. Their integrity also needs preservation during a crisis like the COVID-19 pandemic, especially when faced with triage protocols that allocate scarce resources. Although a crisis may change our ability to provide life-saving treatment to all who need it, a crisis should not change the ethical (...)
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  8.  11
    The “Risks of Routine Tests” and Analogical Reasoning in Assessments of Minimal Risk.Adrian Kwek - 2024 - Journal of Medicine and Philosophy 49 (1):102-115.
    Research risks have to meet minimal risk requirements in order for the research to qualify for expedited ethics review, to be exempted from ethics review, or to be granted consent waivers. The definition of “minimal risk” in the Common Rule (45 CFR 46) relies on the risks-of-daily-life and risks-of-routine-tests as comparators against which research activities are assessed to meet minimal risk requirements. While either or both comparators have been adopted by major ethics codes, they have also been criticized. In response (...)
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  9.  3
    Society, Social Structures, and Community in Clinical Ethics.J. Clint Parker - 2024 - Journal of Medicine and Philosophy 49 (1):1-10.
    Society and social structures play an important role in the formation and evaluation of concepts and practices in clinical ethics. This is evident in the ways the authors in this issue explore a wide range of arguments and concepts in clinical ethics including moral distress and conscience based practice, phenomenological interview techniques and gender dysphoria, continuous deep sedation (CDS) at the end of life, the notion of patient expertise, ethically permissible medical billing practices, the notion of selfhood and patient centered (...)
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  10.  20
    Patient Expertise and Medical Authority: Epistemic Implications for the Provider–Patient Relationship.Jamie Carlin Watson - 2024 - Journal of Medicine and Philosophy 49 (1):58-71.
    The provider–patient relationship is typically regarded as an expert-to-novice relationship, and with good reason. Providers have extensive education and experience that have developed in them the competence to treat conditions better and with fewer harms than anyone else. However, some researchers argue that many patients with long-term conditions (LTCs), such as arthritis and chronic pain, have become “experts” at managing their LTC. Unfortunately, there is no generally agreed-upon conception of “patient expertise” or what it implies for the provider–patient relationship. I (...)
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