Please help us test our new pre-print finding feature by giving the pre-print link a rating. A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Please help us test our new pre-print finding feature by giving the pre-print link a rating. A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Please help us test our new pre-print finding feature by giving the pre-print link a rating. A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Please help us test our new pre-print finding feature by giving the pre-print link a rating. A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Abstract: Abstract This article demonstrates the value of French philosophy of science for medical practice through an exposition of Michel Serres’s philosophy of the body. It explores how Serres’s examination of the similarity between scientific models and works of art can provide insight into different conceptions of the human body. What makes Serres’s method of unique is that it does not see art and literature as subordinate to the natural sciences: they are both involved in mapping the communication lines of the body. Since early modernity, we can roughly speak of three successive communication models of the body: mechanical, thermodynamic and informational. This article finally discusses the relationship between those different conceptions and explains how they help to articulate different aspects of the body, health, and medical ethics. PubDate: 2025-03-01 DOI: 10.1007/s11019-024-10244-5
Please help us test our new pre-print finding feature by giving the pre-print link a rating. A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Abstract: Abstract Saving as many lives as possible while ensuring equity for vulnerable groups through access to triage resources has been the dominant position since the onset of the COVID-19 pandemic in 2020. However, the exact relationship between the principles of social justice and efficiency remains a controversial and unresolved issue. In this paper, we aim to systematically distinguish between different models of this relationship and show that conceptualizing social justice as a ‘moral side-constraint’ or adopting a ‘balancing approach’ that attempt to reconcile social justice with efficiency inevitably lead to significant moral costs that require further justification. Based on this discussion, we propose a novel “threshold model” for trading-off moral costs. According to this model, the structural impact of triage must be considered in order to determine whether one opts for triage with the primary aim of efficiency or social justice. This contextualization further explains why, in some societies and circumstances, social justice can rightly be seen as the primary concern, while in other societies and circumstances, efficiency can be defended as the primary concern. PubDate: 2025-03-01 DOI: 10.1007/s11019-024-10232-9
Please help us test our new pre-print finding feature by giving the pre-print link a rating. A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Abstract: Abstract The principle of trust has been placed at the centre as an attitude for engaging with clinical machine learning systems. However, the notions of trust and distrust remain fiercely debated in the philosophical and ethical literature. In this article, we proceed on a structural level ex negativo as we aim to analyse the concept of “institutional distrustworthiness” to achieve a proper diagnosis of how we should not engage with medical machine learning. First, we begin with several examples that hint at the emergence of a climate of distrust in the context of medical machine learning. Second, we introduce the concept of institutional trustworthiness based on an expansion of Hawley’s commitment account. Third, we argue that institutional opacity can undermine the trustworthiness of medical institutions and can lead to new forms of testimonial injustices. Finally, we focus on possible building blocks for repairing institutional distrustworthiness. PubDate: 2025-03-01 DOI: 10.1007/s11019-024-10235-6
Please help us test our new pre-print finding feature by giving the pre-print link a rating. A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Abstract: Abstract Recent publications on digital health technologies highlight the importance of ‘responsible’ use. References to the concept of responsibility are, however, frequently made without providing clear definitions of responsibility, thus leaving room for ambiguities. Addressing these uncertainties is critical since they might lead to misunderstandings, impacting the quality and safety of healthcare delivery. Therefore, this study investigates how responsibility is interpreted in the context of using digital health technologies, including artificial intelligence (AI), telemonitoring, wearables and mobile apps. We conducted a scoping review with a systematic search in PubMed, Web of Science, Embase, CINAHL and Philosopher’s Index. A total of 34 articles were included and categorized using a theoretical framework of responsibility aspects, and revealed two main findings. First, we found that digital health technologies can expand and shift existing ‘role responsibilities’ among caregivers, patients and technology. Second, moral responsibility is often equated with liability or accountability, without clear justification. Articles describe new ways in which physicians can be held accountable, particularly in the context of AI, and discuss the emergence of a ‘responsibility gap’ where no-one can be fully responsible for AI-generated outcomes. The literature also shows that m-Health technologies can increase patients’ accountability for their own health. However, there was limited discussion in the reviewed literature on whether these attributions of accountability are appropriate. We conclude with implications for practice and suggestions for expanding the theoretical framework of moral responsibility, recommending further study on responsibility of collectives and artificial entities, and on the role of virtue in digital health. PubDate: 2025-03-01 DOI: 10.1007/s11019-024-10238-3
Please help us test our new pre-print finding feature by giving the pre-print link a rating. A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Abstract: Abstract In recent years, data-driven approaches to chronic pain care have increased dramatically. However, people living with chronic pain are ambivalent about datafication practices. Drawing on in-depth interviews with individuals living with chronic pain, I discuss and analyze this ambivalence. On the one hand, participants imbibe the promissory rhetoric of data as that which may organize and control the body in pain. On the other hand, they dismiss and critique the type of data collected. This micro-level analysis of the pain tracking experience illuminates a tension between datafication and chronic pain. Datafication demands that the patient relay information about their body that is free of ambiguity. However, chronic pain is ambiguous and full of paradox. This article illuminates the emotional chasm between datafication enthusiasts and chronic pain patients who track their pain and suggests that such enthusiasm may lead to bad faith. PubDate: 2025-03-01 DOI: 10.1007/s11019-024-10226-7
Please help us test our new pre-print finding feature by giving the pre-print link a rating. A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Abstract: Abstract Endometriosis, a chronic inflammatory condition affecting 10% of biological women, is widely understudied and particularly overlooked in later life. Discussions surrounding endometriosis predominantly centre on medical gender bias during reproductive years, with limited attention to intersecting factors of discrimination and the impact of ageism on affected individuals. As endometriosis is framed as a disease of reproductive age, research is lacking when it comes to the effects of the illness on the older population. Symptoms in (post)menopausal individuals are frequently misattributed to other ailments due to ageist and sexist preconceptions, leading to prolonged diagnoses and mistreatment. This is a social justice issue in which age and sex contribute to the discrimination of a certain population – namely older biological women living with endometriosis. In this paper, we approach this issue from the perspective of epistemic justice. The experiences of the affected persons are shaped by a lack of knowledge about endometriosis among both the healthcare personal and the affected person, as well as a lack of acknowledgement and consideration of the persons experiences. Using the lens of epistemic justice, we develop an analytical model to understand the intersection of age and gender in the experiences of endometriosis patients. This article contributes to ongoing debates on epistemic injustice and intersectionality within medicine and healthcare, offering an analytical model that connects the critical approaches of epistemic injustice and intersectionality to address health injustice. Ultimately, this work advocates for a comprehensive, lifespan approach to endometriosis that acknowledges and addresses intersecting forms of discrimination. PubDate: 2025-03-01 DOI: 10.1007/s11019-024-10245-4
Please help us test our new pre-print finding feature by giving the pre-print link a rating. A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Abstract: Abstract In addressing the question of what mental health is we might proceed as if there is a single phenomenon—mental health—denoted by a single overarching concept. The task, then, is to provide an informative analysis of this concept which applies to all and only instances of mental health, and which illuminates what it is to be mentally healthy. In contrast, mental health pluralism is the idea that there are multiple mental health phenomena denoted by multiple concepts of mental health. Analysis and illumination of mental health may still be possible, but there isn’t a single phenomenon or concept to be analysed in addressing the question of what mental health is. The question of pluralism has been overlooked in the philosophy of mental health. The discussion to follow is an attempt to get us to take mental health pluralism seriously. To that end, in this essay I have three primary goals: (1) to give a precise account of what mental health pluralism is, (2) to show that the question of pluralism should not be neglected in debate about what mental health is, and (3) to argue for mental health pluralism. I also draw out some implications of this discussion for philosophy, science, and psychotherapy. PubDate: 2025-03-01 DOI: 10.1007/s11019-024-10233-8
Please help us test our new pre-print finding feature by giving the pre-print link a rating. A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Abstract: Abstract The present paper highlights the urgency for a revitalization of the field of bioethics. The authors have identified the “malaise” present in contemporary bioethics, and they claim that it has become a boring way to approach medicine and life sciences instead of challenging them. Starting from a brief explanation of the origin of bioethics, this paper analyzes the main issues at the core of its malaise, i.e., its depersonalization and extreme specialization which exclude of a holistic view of the patient. Clinical ethics, an applied branch of bioethics, provides a prime example of a bioethical discipline that operates in real-world contexts, and it contrasts with the more theoretical nature of traditional bioethical frameworks. Thus, the inherent multidisciplinary nature of clinical ethics offers an opportunity to a way of connecting the hard and soft sciences, and, ultimately, of transcending this distinction in the medical humanities. The cure of the malaise of bioethics proposed in this article comes from the medical humanities, specifically from the applied humanities perspective, which offers a comprehensive approach to current world issues, including the fast evolution of technologies with applications to the health field. PubDate: 2025-03-01 DOI: 10.1007/s11019-024-10240-9
Please help us test our new pre-print finding feature by giving the pre-print link a rating. A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Abstract: Abstract This paper consists of two parts. In the first part, I will introduce a philosophical toolbox that I call ‘conceptual scaffolding,’ which helps to reflect holistically on phenomena and concepts. I situate this framework within the landscape of conceptual analysis and conceptual engineering, exemplified by the debate about the concept of disease. Within the framework of conceptual scaffolding, I develop the main idea of the paper, which is ‘the binocular model of plural medicine’, a holistic framework for analyzing medical concepts and phenomena. In the second part, I demonstrate the use and value of the binocular model by analyzing, through the lenses of the model, the phenomenon of health wearable devices and their effects on the concept of diagnosis. PubDate: 2025-03-01 DOI: 10.1007/s11019-024-10231-w
Please help us test our new pre-print finding feature by giving the pre-print link a rating. A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Abstract: Abstract False hope is costly for individuals, their loved ones, and society. Scholars have defined false hope as one that involves an epistemically unjustified belief. In this paper, I argue that this account of false hope is incomplete and that false hope should be conceptualized in terms of the way in which the agent attends to or focuses on a highly desired but unlikely outcome. I explain how this account better captures the distinctiveness of false hope. PubDate: 2025-03-01 DOI: 10.1007/s11019-024-10236-5
Please help us test our new pre-print finding feature by giving the pre-print link a rating. A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Abstract: Abstract This paper seeks to determine the extent to which individuals with borderline personality disorders can be held morally responsible for a particular subset of their actions: disproportionate anger, aggressions and displays of temper. The rationale for focusing on these aspects lies in their widespread acknowledgment in the literature and their plausible primary association with blame directed at BPD patients. BPD individuals are indeed typically perceived as “difficult patients” (Sulzer 2015:82; Bodner et al. 2011), significantly more so than schizophrenic or depressive patients (Markam 2003). The “responsibility question” for patients with BPD has already been raised (Martin 2010; Zachar and Potter 2009; Bray 2003), but this paper tackles it from a novel perspective. First, I narrow down the category of things for which the responsibility question is specific to individual with BPD. After that, I argue that some of the diagnosis criteria of BPD such as emotional instability or impulsivity might serve as excusing factors targeting the “control condition” on moral responsibility. Second, this paper also considers another widely accepted condition on moral responsibility: the epistemic condition. The view defended in the paper is that the answer to the responsibility question for individuals with BPD, concerning both the control condition and the epistemic condition, hinges on an understanding of their epistemic profile. PubDate: 2025-03-01 DOI: 10.1007/s11019-024-10243-6
Please help us test our new pre-print finding feature by giving the pre-print link a rating. A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Abstract: Abstract Some philosophical and metaethical theories have tried to provide a fundamental background for bioethics but miss the fundamental question about what medicine is, its nature and its end. We argue that the philosophy of medicine, through the development that Edmund Pellegrino and David Thomasma gave to this field of study, allied with Aristotle’s practical and teleological ethics, can provide an ontological background for bioethics beyond the tradition of principles and deontology, with particular emphasis on the uniqueness of the doctor-patient encounter. Some difficulties and criticisms of this ontological model are also examined. PubDate: 2025-03-01 DOI: 10.1007/s11019-024-10239-2
Please help us test our new pre-print finding feature by giving the pre-print link a rating. A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Abstract: Abstract Artificial intelligence-based clinical decision support systems have a potential to improve clinical practice, but they may have a negative impact on the physician-patient dialogue, because of the control problem. Physician-patient dialogue depends on human qualities such as compassion, trust, and empathy, which are shared by both parties. These qualities are necessary for the parties to reach a shared understanding -the merging of horizons- about clinical decisions. The patient attends the clinical encounter not only with a malfunctioning body, but also with an ‘unhomelike’ experience of illness that is related to a world of values and meanings, a life-world. Making wise individual decisions in accordance with the patient’s life-world requires not only scientific analysis of causal relationships, but also listening with empathy to the patient’s concerns. For a decision to be made, clinical information should be interpreted considering the patient’s life-world. This side of clinical practice is not a job for computers, and they cannot be final decision-makers. On the other hand, in the control problem users blindly accept system output because of over-reliance, rather than evaluating it with their own judgement. This means over-reliant parties leave their place in the dialogue to the system. In this case, the dialogue may be disrupted and mutual trust may be lost. Therefore, it is necessary to design decision support systems to avoid the control problem and to limit their use when this is not possible, in order to protect the physician-patient dialogue. PubDate: 2025-03-01 DOI: 10.1007/s11019-024-10241-8
Please help us test our new pre-print finding feature by giving the pre-print link a rating. A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Abstract: Abstract Empirical research on moral injury (MI) has rapidly evolved since 2009. Originally developed to address the moral dimensions of traumatic experiences among US veterans, MI has also found application in the context of traumatized refugees. This paper delves into the ethical and epistemological questions that arise when applying a concept originally rooted in a qualitatively distinct experience and a demographically different population to refugees. It is argued that the prevailing clinical and psychological conceptualization of MI may not adequately accommodate the unique needs and experiences of refugee populations. This examination underscores the imperative of conceptualizing to better serve the ethical and epistemic demands of refugee communities. PubDate: 2025-03-01 DOI: 10.1007/s11019-024-10237-4
Please help us test our new pre-print finding feature by giving the pre-print link a rating. A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Abstract: Abstract Research on understanding the self of persons with dementia (PWD) has increased significantly in the past decades across various fields of research. This has led to a profusion of novel conceptualizations of self. Meanwhile, the rise in dementia diagnoses worldwide presents us with complex global societal and individual challenges. Since the understanding of the self of PWD is vital for improving their well-being, autonomy and care needs, this article argues that there is a need to integrate and systematize these conceptualizations of self. The current state of conceptual unclarity undermines the wellbeing of PWD, since it impedes the exchange and development of (empirical) research results and ideas. With the aim of uniting and systematizing the conceptualizations of self in research on PWD, in order to develop a pragmatic, clustered approach based on the research of the field itself which can be applied in an empirical setting with PWD, this article departs from the literature reviews from the various fields involved in the research on the self of PWD. By focusing on the theoretical overlap between the conceptualizations of self employed in these reviews, four overarching clusters of self-aspects can be formulated: minimal, embodied-embedded, reflective and socially-embedded self-aspects. These clusters jointly provide the ground for self-continuity in PWD. This clustered approach provides a framework which unites the current field of research, within which new findings can be integrated and which can be applied in an empirical setting. PubDate: 2025-02-14 DOI: 10.1007/s11019-025-10253-y
Please help us test our new pre-print finding feature by giving the pre-print link a rating. A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Abstract: Abstract In an interesting article, Dr Zuzana Parusniková claimed: (i) that Semmelweis’ colleagues did not recognise the importance of his animal experiments, (ii) that the resistance to Semmelweis’ hypothesis and results was due mainly to applying mono-causality and (iii) Semmelweis inability to communicate, (iv) that the New Vienna Medical School applied evidence-based medicine, and (v) that the philosophy of Karl Popper is the best interpretation of Semmelweis’ scientific approach. Here, we present some factual aspects of Semmelweis’ text from 1861 and discuss Dr Parusniková’s claims against this backdrop. We conclude that Semmelweis might intentionally have abstained from communicating his hypothesis and results between 1847 and 1849 – including the results from his animal experiments – as he thought that they would eventually be understood and accepted. Semmelweis’ hypothesis was that cadaveric matters and decaying particles were the cause of childbed fever and increased maternal mortality. This hypothesis might have been controversial, but we claim that the major reason for the resistance was eminence-based and induced by the publication of preliminary and suboptimal results, based on a premature version of his hypothesis. If the New Vienna Medical School had been influenced by evidence-based medicine, we believe that Semmelweis’ empirical results would have been accepted - as they were based on an almost randomised controlled trial - and if the results had not been associated with his hypothesis but instead had focused on a black box procedure. We agree that the philosophy of Popper might be appropriate when analysing Semmelweis’ scientific approach when abandoning low-level theories. However, to understand the resistance against Semmelweis’ hypothesis and results, it is not sufficient to refer to a Pickwickian discussion; a Kuhnian framework is more adequate. PubDate: 2025-02-13 DOI: 10.1007/s11019-025-10257-8
Please help us test our new pre-print finding feature by giving the pre-print link a rating. A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Abstract: Abstract In 2023, thousands of young Norwegian physicians joined an online movement called #legermåleve (#doctorsmustlive) and shared stories of their own mental and somatic health issues, which they considered to be caused by unacceptable working conditions. This paper discusses this case as an extreme example of physicians’ and healthcare workers’ suffering in late modern societies, using Vosman and Niemeijer’s approach of rethinking care imaginaries by a structured process of thinking along, counter-thinking and rethinking, bringing to bear suffering as a heuristic device. Thinking along, taking the physicians’ stories and arguments literally, reveals an image of an unbearable workload. Counter-thinking resituates their suffering within the broader conditions of late modernity, suggesting that the root cause may lie not in the quantity of the workload itself but in its qualities and in its perceived threat to their integrity as caregivers through epistemic and moral injury and an inability to respond to this threat. In rethinking, the ambiguity of suffering– its dual potential as both a constraint and an opening– becomes central. Following the physicians’ own interpretations and the solutions emerging from this framing, both their suffering and that of their patients could paradoxically be exacerbated by further decentering physicians and reinforcing utilitarian, data-driven approaches. However, staying with their suffering and reinterpreting its causes opens possibilities to leverage critiques of medicalization at large and of their own suffering in particular, challenging the assumption that the weight of care must always grow heavier. From this reframing, I argue, it is possible to reclaim and reimagine care and the clinical space as a nexus of epistemic and moral privilege, recentering response-ability both relationally and socially. PubDate: 2025-02-05 DOI: 10.1007/s11019-025-10258-7
Hybrid journal (It can contain Open Access articles)
