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Polly Mitchell
King's College London
  1. Well-being and Pluralism.Polly Mitchell & Anna Alexandrova - forthcoming - Journal of Happiness Studies.
    It is a commonly expressed sentiment that the science and philosophy of well-being would do well to learn from each other. Typically such calls identify mistakes and bad practices on both sides that would be remedied if scientists picked the right bit of philosophy and philosophers picked the right bit of science. We argue that the differences between philosophers and scientists thinking about well-being are more difficult to reconcile than such calls suggest, and that pluralism is central to this task. (...)
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  2. Adaptive Preferences, Adapted Preferences.Polly Mitchell - 2018 - Mind 127 (508):1003-1025.
    People who have not experienced diseases and health conditions tend to judge them to be worse than they are reported to be by people who have experienced them. This phenomenon, known as the disability paradox, presents a challenge for health policy, and in particular, healthcare resource distribution. This divergence between patient and public preferences is most plausibly explained as a result of hedonic adaptation, a widespread phenomenon in which people tend to adapt fairly quickly to the state they are in, (...)
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  3.  24
    What does ‘quality’ add? Towards an ethics of healthcare improvement.Alan Cribb, Vikki Entwistle & Polly Mitchell - 2020 - Journal of Medical Ethics 46 (2):118-122.
    In this paper, we argue that there are important ethical questions about healthcare improvement which are underexplored. We start by drawing on two existing literatures: first, the prevailing, primarily governance-oriented, application of ethics to healthcare ‘quality improvement’ (QI), and second, the application of QI to healthcare ethics. We show that these are insufficient for ethical analysis of healthcare improvement. In pursuit of a broader agenda for an ethics of healthcare improvement, we note that QI and ethics can, in some respects, (...)
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  4.  32
    Patient Safety and the Question of Dignitary Harms.Polly Mitchell, Alan Cribb & Vikki Entwistle - 2023 - Journal of Medicine and Philosophy 48 (1):33-49.
    Patient safety is a central aspect of healthcare quality, focusing on preventable, iatrogenic harm. Harm, in this context, is typically assumed to mean physical injury to patients, often caused by technical error. However, some contributions to the patient safety literature have argued that disrespectful behavior towards patients can cause harm, even when it does not lead to physical injury. This paper investigates the nature of such dignitary harms and explores whether they should be included within the scope of patient safety (...)
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  5. Tackling disrespect.Vikki Entwistle, Alan Cribb & Polly Mitchell - forthcoming - Journal of Health Services Research and Policy.
    Disrespect in health care often persists despite firm commitments to respectful service provision. This conceptual paper highlights how the ways in which respect and disrespect are characterised can have practical implications for how well disrespect can be tackled. We stress the need to focus explicitly on disrespect (not only respect) and propose that disrespect can usefully be understood as a failure to relate to people as equals. This characterisation is consonant with some accounts of respect but sometimes obscured by a (...)
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  6.  22
    Defining What is Good: Pluralism and Healthcare Quality.Polly Mitchell, Alan Cribb & Vikki A. Entwistle - 2019 - Kennedy Institute of Ethics Journal 29 (4):367-388.
    'Quality' is a widely invoked concept in healthcare, and 'quality improvement' is now a central part of healthcare service delivery. However, these concepts and their associated practices represent relatively uncharted territory for applied philosophy and bioethics. In this paper, we explore some of the conceptual complexity of quality in healthcare and argue that quality is best understood to be conceptually plural. Quality is widely agreed to be multidimensional and as such constitutively plural. However, we argue that quality is plural in (...)
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  7.  45
    Affordability and Non-Perfectionism in Moral Action.Benedict Rumbold, Victoria Charlton, Annette Rid, Polly Mitchell, James Wilson, Peter Littlejohns, Catherine Max & Albert Weale - 2019 - Ethical Theory and Moral Practice 22 (4):973-991.
    One rationale policy-makers sometimes give for declining to fund a service or intervention is on the grounds that it would be ‘unaffordable’, which is to say, that the total cost of providing the service or intervention for all eligible recipients would exceed the budget limit. But does the mere fact that a service or intervention is unaffordable present a reason not to fund it? Thus far, the philosophical literature has remained largely silent on this issue. However, in this article, we (...)
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  8. Talking it better: conversations and normative complexity in healthcare improvement.Alan Cribb, Vikki Entwistle & Polly Mitchell - 2022 - Medical Humanities 48:85-93.
    In this paper, we consider the role of conversations in contributing to healthcare quality improvement. More specifically, we suggest that conversations can be important in responding to what we call ’normative complexity’. As well as reflecting on the value of conversations, the aim is to introduce the dimension of normative complexity as something that requires theoretical and practical attention alongside the more recognised challenges of complex systems, which we label, for short, as ’explanatory complexity’. In brief, normative complexity relates to (...)
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  9.  22
    Truth and consequences.Polly Mitchell, Alan Cribb & Vikki Entwistle - 2023 - Metaphilosophy 54 (4):523-538.
    In his 1987 paper “Truth or Consequences,” Dan Brock describes a deep conflict between the goals and virtues of philosophical scholarship and public policymaking: whereas the former is concerned with the search for truth, the latter must primarily be concerned with promoting good consequences. When philosophers are engaged in policymaking, he argues, they must shift their primary goal from truth to consequences—but this has both moral and methodological costs. Brock’s argument exemplifies a pessimistic, but not uncommon, view of the possible (...)
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  10.  20
    Vagueness and variety in person-centred care.Polly Mitchell, Alan Cribb & Vikki Entwistle - 2022 - Wellcome Open Research.
    Person-centred care is a cornerstone of contemporary health policy, research and practice. However, many researchers and practitioners worry that it lacks a 'clear definition and method of measurement,' and that this creates problems for the implementation of person-centred care and limits understanding of its benefits. In this paper we urge caution about this concern and resist calls for a clear, settled definition and measurement approach. We develop a philosophical and conceptual analysis which is grounded in the body of literature concerning (...)
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  11.  35
    Made to Measure: The Ethics of Routine Measurement for Healthcare Improvement.Polly Mitchell, Alan Cribb & Vikki Entwistle - 2020 - Health Care Analysis 29 (1):39-58.
    This paper analyses the ethics of routine measurement for healthcare improvement. Routine measurement is an increasingly central part of healthcare system design and is taken to be necessary for successful healthcare improvement efforts. It is widely recognised that the effectiveness of routine measurement in bringing about improvement is limited—it often produces only modest effects or fails to generate anticipated improvements at all. We seek to show that these concerns do not exhaust the ethics of routine measurement. Even if routine measurement (...)
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  12.  27
    Pushing poverty off limits: quality improvement and the architecture of healthcare values.Guddi Singh, Vikki Entwistle, Alan Cribb & Polly Mitchell - 2021 - BMC Medical Ethics 22 (1):1-13.
    Background: Poverty and social deprivation have adverse effects on health outcomes and place a significant burden on healthcare systems. There are some actions that can be taken to tackle them from within healthcare institutions, but clinicians who seek to make frontline services more responsive to the social determinants of health and the social context of people’s lives can face a range of ethical challenges. We summarise and consider a case in which clinicians introduced a poverty screening initiative into paediatric practice (...)
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  13.  37
    Well-Being as Value Fulfillment: How We Can Help Each Other to Live Well By Valerie Tiberius. [REVIEW]Polly Mitchell - 2020 - Analysis 80 (1):196-198.
    Well-Being as Value Fulfillment: How We Can Help Each Other to Live Well By TiberiusValerieOxford University Press, 2018. xii + 214 pp.
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  14.  21
    What Is Enough? Sufficiency, Justice, and Health: Carina Fourie and Annette Rid, eds, 2017, Oxford University Press. [REVIEW]Polly Mitchell - 2019 - Journal of Bioethical Inquiry 16 (3):473-475.
    Carina Fourie and Annette Rid’s edited volume What Is Enough? Sufficiency, Justice, and Health comprises fifteen original contributions which explore the possibility of a sufficientarian approach to healthcare priority setting and resource allocation. Sufficientarianism is a well-established theory of distributive justice, which tells us that justice requires that each person has “enough,” and assigns particular importance to a threshold level of goods under which no person must fall. Sufficiency is under-explored as a distributive principle in the healthcare context, and this (...)
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