Results for 'medical epistemology'

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  1. Recognizing tacit knowledge in medical epistemology.Stephen G. Henry - 2006 - Theoretical Medicine and Bioethics 27 (3):187--213.
    The evidence-based medicine movement advocates basing all medical decisions on certain types of quantitative research data and has stimulated protracted controversy and debate since its inception. Evidence-based medicine presupposes an inaccurate and deficient view of medical knowledge. Michael Polanyi’s theory of tacit knowledge both explains this deficiency and suggests remedies for it. Polanyi shows how all explicit human knowledge depends on a wealth of tacit knowledge which accrues from experience and is essential for problem solving. Edmund Pellegrino’s classic (...)
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  2.  69
    Quotidian Medical Epistemology.Robert Bass - manuscript
    My title may suggest that I will address the activities of medical professionals as they go about their daily business of diagnosis, prescription and treatment. Certainly, that deserves attention, but it is not my target here. My concern is, on the one hand, with typical consumers of health and medical information, and, on the other, with the problems such consumers face in understanding, interpreting and applying the information available to them.
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  3.  30
    Medical epistemology.Henk ten Have & Bert Gordijn - 2017 - Medicine, Health Care and Philosophy 20 (4):451-452.
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  4.  41
    A Framework for Understanding Medical Epistemologies.George Khushf - 2013 - Journal of Medicine and Philosophy 38 (5):461-486.
    What clinicians, biomedical scientists, and other health care professionals know as individuals or as groups and how they come to know and use knowledge are central concerns of medical epistemology. Activities associated with knowledge production and use are called epistemic practices. Such practices are considered in biomedical and clinical literatures, social sciences of medicine, philosophy of science and philosophy of medicine, and also in other nonmedical literatures. A host of different kinds of knowledge claims have been identified, each (...)
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  5.  20
    The future for medical epistemology? Commentary on Tonelli (2006), Integrating evidence into clinical practice: an alternative to evidence-based approaches. Journal of Evaluation in Clinical Practice 12, 248-256.Michael Loughlin - 2006 - Journal of Evaluation in Clinical Practice 12 (3):289-291.
  6.  19
    Recognizing tacit knowledge in medical epistemology.Stephen G. Henry - 2006 - Theoretical Medicine and Bioethics 27 (4):395-395.
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  7.  68
    An introduction to the medical epistemology of Georges Canguilhem: Moving beyond Michel Foucault.Stuart F. Spicker - 1987 - Journal of Medicine and Philosophy 12 (4):397-411.
    Although American philosophers and physicians are generally familiar with the writings of Claude Bernard (1813–1878), especially his Introduction to the Study of Experimental Medicine (1865), the medicial epistemology of Georges Canguilhem, born in 1904, is virtually unknown in English speaking nations. Although indebted to Bernard for his conception of the methods to be employed in the acquisition of medical knowledge, Canguilhem radically reformulates Bernard's concepts of ‘disease’, ‘health’, ‘illness’, and ‘pathology’. Contemporary exhortations to medical professionals and (...) students that they “pay more attention to the whole patient” take on significance in working through the writings of Canguilhem; of crucial importance is the relation that obtains between a patient's unique symptomatology and the proper drug regiment that is required. (shrink)
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  8.  3
    Current issues in medical epistemology and statistics: a view from the frontline of medicine.John H. Park - 2022 - Synthese 200 (5):1-25.
    Clinical trials play a prominent role today in medicine, but are not without controversy. These issues start from the day physicians begin their specialization process in medical school and continues onto their day-to-day practice as attendings with referral patterns and resulting financial incentives. This combined with the lack of training in basic issues of epistemology and statistics, allows poor interpretations of clinical trials to reign free. A proposal to integrate the notion of severity to help remedy these issues (...)
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  9. The legitimacy of clinical knowledge: Towards a medical epistemology embracing the art of medicine.Kirsti Malterud - 1995 - Theoretical Medicine and Bioethics 16 (2).
    The traditional medical epistemology, resting on a biomedical paradigmatic monopoly, fails to display an adequate representation of medical knowledge. Clinical knowledge, including the complexities of human interaction, is not available for inquiry by means of biomedical approaches, and consequently is denied legitimacy within a scientific context. A gap results between medical research and clinical practice. Theories of knowledge, especially the concept of tacit knowing, seem suitable for description and discussion of clinical knowledge, commonly denoted the art (...)
     
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  10.  57
    The tacit–explicit connection: Polanyian integrative philosophy and a neo-polanyian medical epistemology.S. R. Jha - 1998 - Theoretical Medicine and Bioethics 19 (6):547-568.
    The purpose of this paper is to introduce an approach to clinical practice aiming to resolve the dilemma of choosing between a mechanistic and a phenomenological model. The approach is an extension of Polanyi's epistemology. Michael Polanyi, devised an epistemology of science which overcomes the problem of detachment, inherent in the mechanistic approach, and resolves the problem of subjectivity troubling phenomenologists. His epistemology is known as Personal Knowledge. An extension of this epistemology, a Neo-Polanyian proposal, is (...)
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  11.  13
    Beyond the Paradigm of Explanation In Contemporary Medicine. Alternative and/or complementary medicine as possible source of a medical »epistemological cut«.Karel Turza - 2007 - Filozofska Istrazivanja 27 (1):163-169.
  12.  37
    The Epistemology of Medical Error in an Intersectional World.Devora Shapiro - 2019 - In Fritz Allhoff & Sandra L. Borden (eds.), Ethics and Error in Medicine.
    In this chapter I explicate and evaluate the concept of medical error. Unlike standard philosophical approaches to analyzing medical phenom- ena in the abstract, I instead address medical error specifi cally within the context of an embodied social world. I illustrate how, as a deeply contex- tual concept, medical error is inextricably tied to the social conditions— and concrete, powerful interests—of the particulars in which it is found. -/- I begin with an analysis that demonstrates the (...)
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  13.  5
    Medical Cannabis” as a Contested Medicine: Fighting Over Epistemology and Morality.Sharon R. Sznitman, Simon Vulfsons, Maya Negev & Dana Zarhin - 2020 - Science, Technology, and Human Values 45 (3):488-514.
    Few empirical studies have explored how different types of knowledge are associated with diverse objectivities and moral economies. Here, we examine these associations through an empirical investigation of the public policy debate in Israel around medical cannabis, which may be termed a contested medicine because its therapeutic effects, while subjectively felt by users, are not generally recognized by the medical profession. Our findings indicate that beneath the MC debate lie deep-seated issues of epistemology, which are entwined with (...)
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  14. The Ontology-Epistemology Divide: A Case Study in Medical Terminology.OIivier Bodenreider, Barry Smith & Anita Burgun - 2004 - In Achille Varzi & Laure Vieu (eds.), Formal Ontology in Information Systems. Proceedings of the Third International Conference (FOIS 2004). IOS Press.
    Medical terminology collects and organizes the many different kinds of terms employed in the biomedical domain both by practitioners and also in the course of biomedical research. In addition to serving as labels for biomedical classes, these names reflect the organizational principles of biomedical vocabularies and ontologies. Some names represent invariant features (classes, universals) of biomedical reality (i.e., they are a matter for ontology). Other names, however, convey also how this reality is perceived, measured, and understood by health professionals (...)
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  15. Medical diagnostic reasoning: Epistemological modeling as a strategy for design of computer-based consultation programs.Giovanni Barosi, Lorenzo Magnani & Mario Stefanelli - 1993 - Theoretical Medicine and Bioethics 14 (1).
    The complexity of cognitive emulation of human diagnostic reasoning is the major challenge in the implementation of computer-based programs for diagnostic advice in medicine. We here present an epistemological model of diagnosis with the ultimate goal of defining a high-level language for cognitive and computational primitives. The diagnostic task proceeds through three different phases: hypotheses generation, hypotheses testing and hypotheses closure. Hypotheses generation has the inferential form of abduction (from findings to hypotheses) constrained under the criterion of plausibility. Hypotheses testing (...)
     
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  16.  18
    Medical and nursing clinical decision making: a comparative epistemological analysis.Judy Rashotte & F. A. Carnevale - 2004 - Nursing Philosophy 5 (2):160-174.
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  17.  3
    Epistemologies of evidence-based medicine: a plea for corpus-based conceptual research in the medical humanities.Jan Buts, Mona Baker, Saturnino Luz & Eivind Engebretsen - 2021 - Medicine, Health Care and Philosophy 24 (4):621-632.
    Evidence-based medicine has been the subject of much controversy within and outside the field of medicine, with its detractors characterizing it as reductionist and authoritarian, and its proponents rejecting such characterization as a caricature of the actual practice. At the heart of this controversy is a complex linguistic and social process that cannot be illuminated by appealing to the semantics of the modifier evidence-based. The complexity lies in the nature of evidence as a basic concept that circulates in both expert (...)
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  18.  13
    Medical and nursing clinical decision making: A comparative epistemological analysis.Judy Rashotte RN MScN & F. A. Carnevale RN PhD - 2004 - Nursing Philosophy 5 (2):160–174.
  19.  14
    Epistemology and semiotics of medical systems: A comparative analysis.Martien Brands, Dorothea Franck & Evert van Leeuwen - 2000 - Semiotica 132 (1-2):1-24.
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  20.  35
    Divergent Discourses: The Epistemology of Healing in an American Medical Clinic and a Kwara‘ae Village.Karen Ann Watson-Gegeo & David Welchman Gegeo - 2011 - Anthropology of Consciousness 22 (2):209-233.
    Using the theoretical constructs “biographical disruption” and “limit experience” and also methodological frameworks from autoethnography and discourse analysis, we discuss the divergent ways in which language and healing are conceptualized and performed, first in an American medical clinic and then by traditional healers in Kwara‘ae (Solomon Islands). Discourses at the Dallas clinic draw on allopathic and complementary medicine and in emphasizing a scientific approach to talk about illness and treatment, were found to create ambiguity in patients’ sense of their (...)
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  21.  29
    The lived body as a medical topic: an argument for an ethically informed epistemology.Anna Luise Kirkengen & Eline Thornquist - 2012 - Journal of Evaluation in Clinical Practice 18 (5):1095-1101.
  22.  20
    Introduction to Establishing Medical Reality: Essays in the Metaphysics and Epistemology of Biomedical Science.Harold Kincaid & Jennifer McKitrick - 2007 - In Harold Kincaid & Jennifer McKitrick (eds.), Establishing Medical Reality. Springer. pp. 1-11.
    Medicine has been a very fruitful source of significant issues for philosophy over the last 30 years. The vast majority of the issues discussed have been normative—they have been problems in morality and political philosophy that now make up the field called bioethics. However, biomedical science presents many other philosophical questions that have gotten relatively little attention, particularly topics in metaphysics, epistemology and philosophy of science. This volume focuses on problems in these areas as they surface in biomedical science. (...)
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  23.  65
    Who is afraid of black box algorithms? On the epistemological and ethical basis of trust in medical AI.Juan Manuel Durán & Karin Rolanda Jongsma - 2021 - Journal of Medical Ethics 47 (5).
    The use of black box algorithms in medicine has raised scholarly concerns due to their opaqueness and lack of trustworthiness. Concerns about potential bias, accountability and responsibility, patient autonomy and compromised trust transpire with black box algorithms. These worries connect epistemic concerns with normative issues. In this paper, we outline that black box algorithms are less problematic for epistemic reasons than many scholars seem to believe. By outlining that more transparency in algorithms is not always necessary, and by explaining that (...)
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  24.  27
    Authority and epistemology in islamic medical ethics of women’s reproductive health.Zahra Ayubi - 2021 - Journal of Religious Ethics 49 (2):245-269.
    Journal of Religious Ethics, Volume 49, Issue 2, Page 245-269, June 2021.
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  25.  21
    What’s Knowledge Got to Do with It? Ethics, Epistemology, and Intractable Conflicts in the Medical Setting.Bryan Kibbe & Paul Ford - 2016 - Journal of Clinical Ethics 27 (4):352-358.
    This article utilizes the case of Ms H. to examine the contrasting ways that surrogate decision makers move from simply hearing information about the patient to actually knowing and understanding the patient’s medical condition. The focus of the case is on a family’s request to actually see the patient’s wounds instead of being told about the wounds, and the role of clinical ethicists in facilitating this request. We argue that clinical ethicists have an important role to play in the (...)
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  26.  22
    Rethinking the doctor–patient relationship: toward a hermeneutically-informed epistemology of medical practice.Paul Healy - 2019 - Medicine, Health Care and Philosophy 22 (2):287-295.
    Although typically implicit, clinicians face an inherent conflict between their roles as medical healers and as providers of technical biomedicine (Scott et al. in Philos Ethics Humanit Med 4:11, 2009). This conflict arises from the tension between the physicalist model which still predominates in medical training and practice and the extra-physicalist dimensions of medical practice as epitomised in the concept of patient-centred care. More specifically, the problem is that, as grounded in a "borrowed" physicalist philosophy, the dominant (...)
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  27.  27
    Arguments at cross-purposes: moral epistemology and medical ethics.M. Loughlin - 2002 - Journal of Medical Ethics 28 (1):28-32.
    Different beliefs about the nature and justification of bioethics may reflect different assumptions in moral epistemology. Two alternative views (put forward by David Seedhouse and Michael H Kottow) are analysed and some speculative conclusions formed. The foundational questions raised here are by no means settled and deserve further attention.
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  28. The Epistemology of Cognitive Enhancement.J. Adam Carter & Duncan Pritchard - 2016 - Journal of Medicine and Philosophy (2):220-242.
    A common epistemological assumption in contemporary bioethics held b y both proponents and critics of non-traditional forms of cognitive enhancement is that cognitive enhancement aims at the facilitation of the accumulation of human knowledge. This paper does three central things. First, drawing from recent work in epistemology, a rival account of cognitive enhancement, framed in terms of the notion of cognitive achievement rather than knowledge, is proposed. Second, we outline and respond to an axiological objection to our proposal that (...)
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  29.  48
    Identification and Classification of Diseases: Fundamental Problems in Medical Ontology and Epistemology.Lennart Nordenfelt - 2013 - Studia Philosophica Estonica 6 (2):6-21.
  30.  60
    The 'medical body' as philosophy's arena.Martyn Evans - 2001 - Theoretical Medicine and Bioethics 22 (1):17-32.
    Medicine, as Byron Good argues, reconstitutes thehuman body of our daily experience as a medical body,unfamiliar outside medicine. This reconstitution can be seen intwo ways: as a salutary reminder of the extent to which thereality even of the human body is constructed; and as anarena for what Stephen Toulmin distinguishes as theintersection of natural science and history, in which many ofphilosophy''s traditional questionsare given concrete and urgent form.This paper begins by examining a number of dualities between themedical body and (...)
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  31. Harold Kincaid and Jennifer McKitrick (eds): Establishing medical reality: Essays in the metaphysics and epistemology of biomedical science.Kirstin Borgerson - 2010 - Theoretical Medicine and Bioethics 31 (2):171-174.
  32. At the borders of medical reasoning: aetiological and ontological challenges of medically unexplained symptoms.Thor Eirik Eriksen, Roger Kerry, Stephen Mumford, Svein Anders Noer Lie & Rani Lill Anjum - 2013 - Philosophy, Ethics, and Humanities in Medicine 8:11.
    Medically unexplained symptoms (MUS) remain recalcitrant to the medical profession, proving less suitable for homogenic treatment with respect to their aetiology, taxonomy and diagnosis. While the majority of existing medical research methods are designed for large scale population data and sufficiently homogenous groups, MUS are characterised by their heterogenic and complex nature. As a result, MUS seem to resist medical scrutiny in a way that other conditions do not. This paper approaches the problem of MUS from a (...)
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  33.  42
    Conceptual Engineering of Medical Concepts.Elisabetta Lalumera - forthcoming - In Manuel Gustavo Isaac & Kevin Scharp (eds.), New Perspectives on Conceptual Engineering.
    There is a lot of conceptual engineering going on in medical research. I substantiate this claim with two examples, the medical debate about cancer classification and about obesity as a disease I also argue that the proper target of conceptual engineering in medical research are experts’ conceptions. These are explicitly written down in documents and guidelines, and they bear on research and policies. In the second part of the chapter, I propose an externalist framework in which conceptions (...)
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  34.  5
    Making Medical Science More Scientific: Embracing Uncertainty and Complexity.Mona Gupta - 2022 - Philosophy, Psychiatry, and Psychology 29 (2):125-126.
    Scott Waterman's reflection on his experience with chronic pain and alternative treatments raises a fundamental question in medical epistemology: How can we know that an intervention will help people who are suffering?Waterman's details his trial of an alternative therapy with a dubious pathophysiological rationale. Despite the lack of research demonstrating its efficacy, and a lack of therapeutic benefit for him in particular, he acknowledges its benefit to others who were more attitudinally predisposed to it. This leads him to (...)
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  35.  31
    Medicalization in psychiatry: the medical model, descriptive diagnosis, and lost knowledge.Mark J. Sedler - 2016 - Medicine, Health Care and Philosophy 19 (2):247-252.
    Medicalization was the theme of the 29th European Conference on Philosophy of Medicine and Health Care that included a panel session on the DSM and mental health. Philosophical critiques of the medical model in psychiatry suffer from endemic assumptions that fail to acknowledge the real world challenges of psychiatric nosology. The descriptive model of classification of the DSM 3-5 serves a valid purpose in the absence of known etiologies for the majority of psychiatric conditions. However, a consequence of the (...)
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  36. Virtue epistemology and the acquisition of knowledge.Duncan Pritchard - 2005 - Philosophical Explorations 8 (3):229 – 243.
    The recent literature on the theory of knowledge has taken a distinctive turn by focusing on the role of the cognitive and intellectual virtues in the acquisition of knowledge. The main contours and motivations for such virtue-theoretic accounts of knowledge are here sketched and it is argued that virtue epistemology in its most plausible form can be regarded as a refined form of reliabilism, and thus a variety of epistemic externalism. Moreover, it is claimed that there is strong empirical (...)
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  37.  10
    Discovering a Pluralistic Medicine While Overcoming Art and Science Analyses: Solomon's Social Epistemology Reveals the Contemporary Untidy Making of Medical Knowledge1.Luciana Sarmento Garbayo - 2017 - American Journal of Bioethics 17 (1):7-9.
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  38.  50
    In Quest of 'Good' Medical Classification Systems.Lara K. Kutschenko - 2011 - Medicine Studies 3 (1):53-70.
    Medical classification systems aim to provide a manageable taxonomy for sorting diagnoses into their proper classes. The question, this paper wants to critically examine, is how to correctly systematise diseases within classification systems that are applied in a variety of different settings. ICD and DSM , the two major classification systems in medicine and psychiatry, will be the main subjects of this paper; however, the arguments are not restricted to these classification systems but point out general methodological and epistemological (...)
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  39. The Harm of Ableism: Medical Error and Epistemic Injustice.David M. Peña-Guzmán & Joel Michael Reynolds - 2019 - Kennedy Institute of Ethics Journal 29 (3):205-242.
    This paper argues that epistemic errors rooted in group- or identity- based biases, especially those pertaining to disability, are undertheorized in the literature on medical error. After sketching dominant taxonomies of medical error, we turn to the field of social epistemology to understand the role that epistemic schemas play in contributing to medical errors that disproportionately affect patients from marginalized social groups. We examine the effects of this unequal distribution through a detailed case study of ableism. (...)
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  40.  35
    Trustworthy medical AI systems need to know when they don’t know.Thomas Grote - forthcoming - Journal of Medical Ethics.
    There is much to learn from Durán and Jongsma’s paper.1 One particularly important insight concerns the relationship between epistemology and ethics in medical artificial intelligence. In clinical environments, the task of AI systems is to provide risk estimates or diagnostic decisions, which then need to be weighed by physicians. Hence, while the implementation of AI systems might give rise to ethical issues—for example, overtreatment, defensive medicine or paternalism2—the issue that lies at the heart is an epistemic problem: how (...)
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  41.  98
    Against medical ethics: opening the can of worms.J. Cassell - 1998 - Journal of Medical Ethics 24 (1):8-17.
    In a controversial paper, David Seedhouse argues that medical ethics is not and cannot be a distinct discipline with it own field of study. He derives this claim from a characterization of ethics, which he states but does not defend. He claims further that the project of medical ethics as it exists and of moral philosophy do not overlap. I show that Seedhouse's views on ethics have wide implications which he does not declare, and in the light of (...)
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  42.  31
    Evidence‐based medicine and epistemological imperialism: narrowing the divide between evidence and illness.Helen Crowther, Wendy Lipworth & Ian Kerridge - 2011 - Journal of Evaluation in Clinical Practice 17 (5):868-872.
    Evidence-based medicine has been rapidly and widely adopted because it claims to provide a method for determining the safety and efficacy of medical therapies and public health interventions more generally. However, as others have noted, EBM may be riven through with cultural bias, both in the generation of evidence and in its translation. We suggest that technological and scientific advances in medicine accentuate and entrench these cultural biases, to the extent that they may invalidate the evidence we have about (...)
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  43.  80
    Current epistemological problems in evidence based medicine.R. E. Ashcroft - 2004 - Journal of Medical Ethics 30 (2):131-135.
    Evidence based medicine has been a topic of considerable controversy in medical and health care circles over its short lifetime, because of the claims made by its exponents about the criteria used to assess the evidence for or against the effectiveness of medical interventions. The central epistemological debates underpinning the debates about evidence based medicine are reviewed by this paper, and some areas are suggested where further work remains to be done. In particular, further work is needed on (...)
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  44.  99
    Non-Epistemological Values in Collaborative Research in Neuroscience: The Case of Alleged Differences Between Human Populations.Joanna K. Malinowska & Tomasz Żuradzki - 2020 - American Journal of Bioethics Neuroscience 11 (3):203-206.
    The goals and tasks of neuroethics formulated by Farahany and Ramos (2020) link epistemological and methodological issues with ethical and social values. The authors refer simultaneously to the social significance and scientific reliability of the BRAIN Initiative. They openly argue that neuroethics should not only examine neuroscientific research in terms of “a rigorous, reproducible, and representative neuroscience research process” as well as “explore the unique nature of the study of the human brain through accurate and representative models of its function (...)
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  45.  15
    Medical Error and Moral Luck.Fritz Allhoff - 2019 - Kennedy Institute of Ethics Journal 29 (3):187-203.
    This special issue on ethics and error in medicine reinvigorates a conversation that has been substantially dormant for twenty years. The papers in this issue elaborate and update that conversation in significant ways, particularly with regard to vulnerable populations and the epistemology of medical error. But this first paper is largely conceptual, laying out the motivation for caring about medical error in the first place, exploring what medical error is, and proposing a moral framework to help (...)
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  46.  49
    Seven characteristics of medical evidence.Ross E. G. Upshur - 2000 - Journal of Evaluation in Clinical Practice 6 (2):93-97.
  47.  40
    Medically Inappropriate or Futile Treatment: Deliberation and Justification.Cheryl J. Misak, Douglas B. White & Robert D. Truog - 2016 - Journal of Medicine and Philosophy 41 (1):90-114.
    This paper reframes the futility debate, moving away from the question “Who decides when to end what is considered to be a medically inappropriate or futile treatment?” and toward the question “How can society make policy that will best account for the multitude of values and conflicts involved in such decision-making?” It offers a pragmatist moral epistemology that provides us with a clear justification of why it is important to take best standards, norms, and physician judgment seriously and a (...)
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  48.  90
    The epistemology and ethics of chronic disease research: Further lessons from ecmo.Robyn Bluhm - 2010 - Theoretical Medicine and Bioethics 31 (2):107-122.
    Robert Truog describes the controversial randomized controlled trials (RCTs) of extracorporeal membrane oxygenation (ECMO) therapy in newborns. Because early results with ECMO indicated that it might be a great advance, saving many lives, Truog argues that ECMO should not have been tested using RCTs, but that a long-term, large-scale observational study of actual clinical practice should have been conducted instead. Central to Truog’s argument, however, is the idea that ECMO is an unusual case. Thus, it is an open question whether (...)
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  49.  77
    Epistemology and ethics of evidence-based medicine: putting goal-setting in the right place.Piersante Sestini - 2010 - Journal of Evaluation in Clinical Practice 16 (2):301-305.
    While evidence-based medicine (EBM) is often accused on relying on a paradigm of 'absolute truth', it is in fact highly consistent with Karl Popper's criterion of demarcation through falsification. Even more relevant, the first three steps of the EBM process are closely patterned on Popper's evolutionary approach of objective knowledge: (1) recognition of a problem; (2) generation of solutions; and (3) selection of the best solution. This places the step 1 of the EBM process (building an answerable question) in a (...)
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  50.  29
    The basis of medical knowledge: judgement, objectivity and the history of ideas.Michael Loughlin - 2009 - Journal of Evaluation in Clinical Practice 15 (6):935-940.
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