首页 > 最新文献

Theoretical Medicine and Bioethics最新文献

英文 中文
An ageless body does not imply transhumanism: A reply to Levin 不老的身体并不意味着超人类主义:答复列文
IF 1.4 3区 哲学 Q3 ETHICS Pub Date : 2024-09-14 DOI: 10.1007/s11017-024-09685-z
Pablo García-Barranquero, Joan Llorca Albareda

Susan B. Levin argues that the human confidence that an ageless body would be better is irrational. She offers a Kantian-inspired argument to show that human understanding cannot rationally access the experiences of a post-human and ageless existence. We challenge this rationale with a three-step argument: first, an ageless body does not have to be post-human. One should distinguish between the transhumanist projects of life extension and accounts focused on enhancing well-being and quality of life. An existence without aging does not require a radical change in one's temporal intuitions, which makes rational discussion possible. Second, we defend that biological aging does not entail any valuable goods. These goods refer to the chronological dimension of aging. Finally, we argue that biological aging is indeed negative and one may need biotechnological interventions in aging to achieve internal transcendence. Thus, we rationally argue that an ageless body would be better.

苏珊-莱文(Susan B. Levin)认为,人类认为不老的身体会更好的信心是非理性的。她提出了一个受康德启发的论点,说明人类的理解力无法理性地获取后人类和无老存在的经验。我们通过三步论证对这一理由提出质疑:首先,无龄身体不一定是后人类的。我们应该区分超人类主义的生命延续计划和以提高福祉和生活质量为重点的论述。没有衰老的存在并不需要彻底改变人的时间直觉,这使得理性讨论成为可能。其次,我们认为生物衰老不会带来任何有价值的物品。这些物品指的是衰老的时间维度。最后,我们认为生物衰老确实是负面的,人们可能需要对衰老进行生物技术干预,以实现内在超越。因此,我们理性地认为,不老的身体会更好。
{"title":"An ageless body does not imply transhumanism: A reply to Levin","authors":"Pablo García-Barranquero, Joan Llorca Albareda","doi":"10.1007/s11017-024-09685-z","DOIUrl":"https://doi.org/10.1007/s11017-024-09685-z","url":null,"abstract":"<p>Susan B. Levin argues that the human confidence that an ageless body would be better is irrational. She offers a Kantian-inspired argument to show that human understanding cannot rationally access the experiences of a post-human and ageless existence. We challenge this rationale with a three-step argument: first, an ageless body does not have to be post-human. One should distinguish between the transhumanist projects of life extension and accounts focused on enhancing well-being and quality of life. An existence without aging does not require a radical change in one's temporal intuitions, which makes rational discussion possible. Second, we defend that biological aging does not entail any valuable goods. These goods refer to the chronological dimension of aging. Finally, we argue that biological aging is indeed negative and one may need biotechnological interventions in aging to achieve internal transcendence. Thus, we rationally argue that <i>an ageless body would be better</i>.</p>","PeriodicalId":46703,"journal":{"name":"Theoretical Medicine and Bioethics","volume":"214 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142259457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Risky first-in-human clinical trials on medically fragile persons: owning the moral cost 对病情脆弱者进行首次人体临床试验的风险:承担道德成本
IF 1.4 3区 哲学 Q3 ETHICS Pub Date : 2024-09-11 DOI: 10.1007/s11017-024-09682-2
Christopher Bobier

The purpose of a first-in-human (FIH) clinical trial is to gather information about how the drug or device affects and interacts with the human body: its safety, side effects, and (potential) dosage. As such, the primary goal of a FIH trial is not participant benefit but to gain knowledge of drug or device efficacy, i.e., baseline human safety knowledge. Some FIH clinical trials carry significant foreseeable risk to participants with little to no foreseeable participant benefit. Participation in such trials would be a bad deal for participants, and the research is considered justifiable because of the promise of significant potential social benefit. I argue that there is an ethical tension inherent in risky FIH research and that researchers should fairly compensate risky FIH trial participants. This does not make the risk–benefit outcome more favorable for participants; rather, it amounts to a collective reckoning with the ethical tension inherent in the research.

首次人体(FIH)临床试验的目的是收集有关药物或器械如何影响人体并与人体相互作用的信息:其安全性、副作用和(潜在)剂量。因此,FIH 试验的主要目的不是让参与者受益,而是了解药物或器械的疗效,即人体安全性基线知识。有些 FIH 临床试验会给参与者带来巨大的可预见风险,而几乎没有可预见的参与者获益。参与此类试验对参与者来说是一笔不划算的交易,而研究被认为是合理的,因为有望带来巨大的潜在社会效益。我认为,有风险的 FIH 研究本身就存在伦理矛盾,研究人员应该公平地补偿有风险的 FIH 试验参与者。这并不会使风险-收益结果对参与者更有利;相反,这相当于对研究中固有的伦理紧张关系进行集体清算。
{"title":"Risky first-in-human clinical trials on medically fragile persons: owning the moral cost","authors":"Christopher Bobier","doi":"10.1007/s11017-024-09682-2","DOIUrl":"https://doi.org/10.1007/s11017-024-09682-2","url":null,"abstract":"<p>The purpose of a first-in-human (FIH) clinical trial is to gather information about how the drug or device affects and interacts with the human body: its safety, side effects, and (potential) dosage. As such, the primary goal of a FIH trial is not participant benefit but to gain knowledge of drug or device efficacy, i.e., baseline human safety knowledge. Some FIH clinical trials carry <i>significant</i> foreseeable risk to participants with little to no foreseeable participant benefit. Participation in such trials would be a bad deal for participants, and the research is considered justifiable because of the promise of significant potential social benefit. I argue that there is an ethical tension inherent in risky FIH research and that researchers should fairly compensate risky FIH trial participants. This does not make the risk–benefit outcome more favorable for participants; rather, it amounts to a collective reckoning with the ethical tension inherent in the research.</p>","PeriodicalId":46703,"journal":{"name":"Theoretical Medicine and Bioethics","volume":"202 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142193984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Values, decision-making and empirical bioethics: a conceptual model for empirically identifying and analyzing value judgements. 价值观、决策和经验生命伦理学:一个经验识别和分析价值判断的概念模型。
IF 1.4 3区 哲学 Q3 ETHICS Pub Date : 2023-12-01 Epub Date: 2023-08-17 DOI: 10.1007/s11017-023-09640-4
Marcel Mertz, Ilvie Prince, Ines Pietschmann

It can be assumed that value judgements, which are needed to judge what is 'good' or 'better' and what is 'bad' or 'worse', are involved in every decision-making process. The theoretical understanding and analysis of value judgements is, therefore, important in the context of bioethics, for example, to be able to ethically assess real decision-making processes in biomedical practice and make recommendations for improvements. However, real decision-making processes and the value judgements inherent in them must first be investigated empirically ('empirical bioethics'). For this to succeed, what exactly a 'value judgement' is and of what components it might consist must initially be theoretically clarified. A corresponding conceptual model can then support or even enable empirical data collection and analysis and, above all, subsequent ethical analysis and evaluation. This paper, therefore, presents a value judgement model with its theoretical derivation. It also illustrates its application in an interview study of decision-making between animal experimentation and alternative methods in the context of biomedical research. Though the model itself can be theoretically deepened and extended, the application of the model works in general and helps to uncover what value judgements can enter into decision-making. However, the empirical methods, for example, qualitative interviews, can also be better oriented towards eliciting value judgements (as understood according to the model). Further applications of the model to other topics or by means of other empirical methods are conceivable.

我们可以假设,每一个决策过程都涉及到价值判断,即判断什么是“好”或“更好”,什么是“坏”或“更糟”。因此,在生物伦理学的背景下,对价值判断的理论理解和分析很重要,例如,能够从道德上评估生物医学实践中的实际决策过程,并提出改进建议。然而,真正的决策过程及其内在的价值判断必须首先进行实证研究(“实证生物伦理学”)。要做到这一点,“价值判断”究竟是什么,以及它可能由哪些组成部分组成,首先必须从理论上加以澄清。相应的概念模型可以支持甚至实现经验数据的收集和分析,最重要的是,随后的伦理分析和评估。因此,本文提出了一个价值判断模型及其理论推导。它还说明了其在生物医学研究背景下动物实验和替代方法之间决策的访谈研究中的应用。虽然模型本身在理论上可以深化和扩展,但模型的应用总体上是有效的,并有助于揭示哪些价值判断可以进入决策。然而,经验方法,例如,定性访谈,也可以更好地导向引出价值判断(根据模型理解)。该模型进一步应用于其他主题或通过其他经验方法是可以想象的。
{"title":"Values, decision-making and empirical bioethics: a conceptual model for empirically identifying and analyzing value judgements.","authors":"Marcel Mertz, Ilvie Prince, Ines Pietschmann","doi":"10.1007/s11017-023-09640-4","DOIUrl":"10.1007/s11017-023-09640-4","url":null,"abstract":"<p><p>It can be assumed that value judgements, which are needed to judge what is 'good' or 'better' and what is 'bad' or 'worse', are involved in every decision-making process. The theoretical understanding and analysis of value judgements is, therefore, important in the context of bioethics, for example, to be able to ethically assess real decision-making processes in biomedical practice and make recommendations for improvements. However, real decision-making processes and the value judgements inherent in them must first be investigated empirically ('empirical bioethics'). For this to succeed, what exactly a 'value judgement' is and of what components it might consist must initially be theoretically clarified. A corresponding conceptual model can then support or even enable empirical data collection and analysis and, above all, subsequent ethical analysis and evaluation. This paper, therefore, presents a value judgement model with its theoretical derivation. It also illustrates its application in an interview study of decision-making between animal experimentation and alternative methods in the context of biomedical research. Though the model itself can be theoretically deepened and extended, the application of the model works in general and helps to uncover what value judgements can enter into decision-making. However, the empirical methods, for example, qualitative interviews, can also be better oriented towards eliciting value judgements (as understood according to the model). Further applications of the model to other topics or by means of other empirical methods are conceivable.</p>","PeriodicalId":46703,"journal":{"name":"Theoretical Medicine and Bioethics","volume":" ","pages":"567-587"},"PeriodicalIF":1.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10643456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10012283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Probability and informed consent. 概率和知情同意。
IF 1.4 3区 哲学 Q3 ETHICS Pub Date : 2023-12-01 Epub Date: 2023-08-08 DOI: 10.1007/s11017-023-09636-0
Nir Ben-Moshe, Benjamin A Levinstein, Jonathan Livengood

In this paper, we illustrate some serious difficulties involved in conveying information about uncertain risks and securing informed consent for risky interventions in a clinical setting. We argue that in order to secure informed consent for a medical intervention, physicians often need to do more than report a bare, numerical probability value. When probabilities are given, securing informed consent generally requires communicating how probability expressions are to be interpreted and communicating something about the quality and quantity of the evidence for the probabilities reported. Patients may also require guidance on how probability claims may or may not be relevant to their decisions, and physicians should be ready to help patients understand these issues.

在本文中,我们说明了一些严重的困难,涉及传达有关不确定风险的信息,并确保知情同意的风险干预在临床设置。我们认为,为了确保医疗干预的知情同意,医生通常需要做的不仅仅是报告一个简单的数字概率值。在给出概率的情况下,确保知情同意通常需要沟通如何解释概率表达式,并就所报告概率的证据的质量和数量进行沟通。患者可能还需要关于概率声明是否与他们的决定相关的指导,医生应该准备好帮助患者理解这些问题。
{"title":"Probability and informed consent.","authors":"Nir Ben-Moshe, Benjamin A Levinstein, Jonathan Livengood","doi":"10.1007/s11017-023-09636-0","DOIUrl":"10.1007/s11017-023-09636-0","url":null,"abstract":"<p><p>In this paper, we illustrate some serious difficulties involved in conveying information about uncertain risks and securing informed consent for risky interventions in a clinical setting. We argue that in order to secure informed consent for a medical intervention, physicians often need to do more than report a bare, numerical probability value. When probabilities are given, securing informed consent generally requires communicating how probability expressions are to be interpreted and communicating something about the quality and quantity of the evidence for the probabilities reported. Patients may also require guidance on how probability claims may or may not be relevant to their decisions, and physicians should be ready to help patients understand these issues.</p>","PeriodicalId":46703,"journal":{"name":"Theoretical Medicine and Bioethics","volume":" ","pages":"545-566"},"PeriodicalIF":1.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9954671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
An account of medical treatment, with a preliminary account of medical conditions. 对医疗状况的初步描述。
IF 1.4 3区 哲学 Q3 ETHICS Pub Date : 2023-12-01 Epub Date: 2023-08-24 DOI: 10.1007/s11017-023-09641-3
Steven Tresker

In this article, I present a philosophical account of medical treatment. In support of this account, I offer a suggestive account of medical conditions. The account of medical treatment uses three desiderata to demarcate treatment from non-treatment. Namely, a treatment should: (1) be describable by features that enable it to be standardized and characterized as a discrete intervention, (2) target a specific medical condition, and (3) have the possibility of being effective. The account of medical conditions underlies the second desideratum and attempts to tie medical conditions closely to biological dysfunction, while also including some conditions for which biological dysfunction is absent or its presence uncertain. I offer a simple typology of treatments and show how the accounts are relevant to treatment effectiveness, disease, placebos, contested treatments, and treatment standardization.

在这篇文章中,我提出了一个关于医疗的哲学观点。为了支持这一说法,我提供了一个关于医疗状况的提示性说明。医疗的叙述用三个方面来划分治疗与非治疗。也就是说,治疗应该:(1)通过使其标准化并被描述为离散干预的特征来描述,(2)针对特定的医疗状况,以及(3)具有有效的可能性。对医疗条件的描述是第二个需求的基础,并试图将医疗条件与生物功能障碍紧密联系起来,同时也包括一些不存在或不确定是否存在生物功能障碍的条件。我提供了一个简单的治疗类型,并展示了这些账户如何与治疗效果、疾病、安慰剂、有争议的治疗和治疗标准化相关。
{"title":"An account of medical treatment, with a preliminary account of medical conditions.","authors":"Steven Tresker","doi":"10.1007/s11017-023-09641-3","DOIUrl":"10.1007/s11017-023-09641-3","url":null,"abstract":"<p><p>In this article, I present a philosophical account of medical treatment. In support of this account, I offer a suggestive account of medical conditions. The account of medical treatment uses three desiderata to demarcate treatment from non-treatment. Namely, a treatment should: (1) be describable by features that enable it to be standardized and characterized as a discrete intervention, (2) target a specific medical condition, and (3) have the possibility of being effective. The account of medical conditions underlies the second desideratum and attempts to tie medical conditions closely to biological dysfunction, while also including some conditions for which biological dysfunction is absent or its presence uncertain. I offer a simple typology of treatments and show how the accounts are relevant to treatment effectiveness, disease, placebos, contested treatments, and treatment standardization.</p>","PeriodicalId":46703,"journal":{"name":"Theoretical Medicine and Bioethics","volume":" ","pages":"607-633"},"PeriodicalIF":1.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10064946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Johnson, L. Syd M. The ethics of uncertainty: entangled ethical and epistemic risks in disorders of consciousness. Oxford: Oxford University Press, 2021. 304 pp. $55 (hardcover). ISBN: 9780190943646 Johnson, L. Syd M. The ethics of uncertainty: entangled ethical and epistemic risks in disorders of consciousness.Oxford:牛津大学出版社,2021 年。304 pp.55 美元(精装)。ISBN: 9780190943646
3区 哲学 Q3 ETHICS Pub Date : 2023-10-11 DOI: 10.1007/s11017-023-09644-0
Austin McCoy
{"title":"Johnson, L. Syd M. The ethics of uncertainty: entangled ethical and epistemic risks in disorders of consciousness. Oxford: Oxford University Press, 2021. 304 pp. $55 (hardcover). ISBN: 9780190943646","authors":"Austin McCoy","doi":"10.1007/s11017-023-09644-0","DOIUrl":"https://doi.org/10.1007/s11017-023-09644-0","url":null,"abstract":"","PeriodicalId":46703,"journal":{"name":"Theoretical Medicine and Bioethics","volume":"162 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136211156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Why we have duties of autonomy towards marginal agents. 为什么我们对边缘代理人有自主权的义务。
IF 1.4 3区 哲学 Q3 ETHICS Pub Date : 2023-10-01 Epub Date: 2023-05-12 DOI: 10.1007/s11017-023-09623-5
Anna Hirsch

Patients are usually granted autonomy rights, including the right to consent to or refuse treatment. These rights are commonly attributed to patients if they fulfil certain conditions. For example, a patient must sufficiently understand the information given to them before making a treatment decision. On the one hand, there is a large group of patients who meet these conditions. On the other hand, there is a group that clearly does not meet these conditions, including comatose patients or patients in the late stages of Alzheimer's disease. Then there is a group of patients who fall into the range in between. At the lower end of this range are so-called 'marginal agents,' which include young children and patients in the middle stages of Alzheimer's disease. They also do not meet the typical requirements for autonomy, which is why they are usually granted fewer autonomy rights. However, some of them are capable of 'pre-forms' of autonomy that express what is important to them. These pre-forms differ from mere desires and reflect the identification/authenticity condition of autonomy. They have something in common with autonomous attitudes, choices, and actions - namely, they express the value of autonomy. As I will argue, autonomy is a value worthy of protection and promotion - even in its non-reflexive forms. Against this background, it becomes clear why we have autonomy duties, more precisely positive, autonomy-enabling duties, towards marginal agents and why we should give them as much attention as autonomy duties towards competent patients.

患者通常被授予自主权,包括同意或拒绝治疗的权利。如果患者满足某些条件,这些权利通常归属于患者。例如,在做出治疗决定之前,患者必须充分了解提供给他们的信息。一方面,有一大群患者符合这些条件。另一方面,有一组人显然不符合这些条件,包括昏迷患者或阿尔茨海默病晚期患者。然后有一组患者属于介于两者之间的范围。这个范围的低端是所谓的“边缘因素”,包括幼儿和阿尔茨海默病中期患者。他们也不符合自治的典型要求,这就是为什么他们通常被授予较少的自治权。然而,他们中的一些人能够表达对他们来说重要的“预先形式”的自治。这些前提形式不同于单纯的欲望,反映了自主的身份/真实性条件。它们与自主的态度、选择和行动有一些共同点,即它们表达了自主的价值。正如我将要说的那样,自治是一种值得保护和促进的价值观,即使是以非反射形式。在这种背景下,我们为什么对边缘代理人负有自治义务,更确切地说,是积极的、赋予自治权的义务,以及为什么我们应该像对有能力的患者负有自治义务一样重视他们,这一点就变得很清楚了。
{"title":"Why we have duties of autonomy towards marginal agents.","authors":"Anna Hirsch","doi":"10.1007/s11017-023-09623-5","DOIUrl":"10.1007/s11017-023-09623-5","url":null,"abstract":"<p><p>Patients are usually granted autonomy rights, including the right to consent to or refuse treatment. These rights are commonly attributed to patients if they fulfil certain conditions. For example, a patient must sufficiently understand the information given to them before making a treatment decision. On the one hand, there is a large group of patients who meet these conditions. On the other hand, there is a group that clearly does not meet these conditions, including comatose patients or patients in the late stages of Alzheimer's disease. Then there is a group of patients who fall into the range in between. At the lower end of this range are so-called 'marginal agents,' which include young children and patients in the middle stages of Alzheimer's disease. They also do not meet the typical requirements for autonomy, which is why they are usually granted fewer autonomy rights. However, some of them are capable of 'pre-forms' of autonomy that express what is important to them. These pre-forms differ from mere desires and reflect the identification/authenticity condition of autonomy. They have something in common with autonomous attitudes, choices, and actions - namely, they express the value of autonomy. As I will argue, autonomy is a value worthy of protection and promotion - even in its non-reflexive forms. Against this background, it becomes clear why we have autonomy duties, more precisely positive, autonomy-enabling duties, towards marginal agents and why we should give them as much attention as autonomy duties towards competent patients.</p>","PeriodicalId":46703,"journal":{"name":"Theoretical Medicine and Bioethics","volume":" ","pages":"453-475"},"PeriodicalIF":1.4,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10564671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9501901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Epistemic injustice in the therapeutic relationship in psychiatry. 精神病学治疗关系中的认识不公。
IF 1.4 3区 哲学 Q3 ETHICS Pub Date : 2023-10-01 Epub Date: 2023-05-24 DOI: 10.1007/s11017-023-09627-1
Eisuke Sakakibara

The notion of epistemic injustice was first applied to cases of discrimination against women and people of color but has since come to refer to wider issues related to social justice. This paper applies the concept of epistemic injustice to problems in the therapeutic relationship between psychiatrists and psychiatric patients. To this end, it is necessary to acknowledge psychiatrists as professionals with expertise in treating mental disorders, which impair the patient's rationality, sometimes leading to false beliefs, such as delusions. This paper classifies the characteristic features of the therapeutic relationship in psychiatry into three stages: those of a professional-client relationship, those of a doctor-patient relationship, and those of a psychiatrist-psychiatric patient relationship. Epistemic injustice is prevalent in psychiatric care owing to prejudice against patients with mental disorders. However, it is also predisposed by the roles that psychiatrists play in relation to psychiatric patients. This paper suggests some ameliorative measures based on the analysis.

认识不公正的概念最初适用于歧视妇女和有色人种的案件,但后来又涉及与社会正义有关的更广泛的问题。本文将认识不公正的概念应用于精神科医生和精神病患者之间治疗关系中的问题。为此,有必要承认精神科医生是具有治疗精神障碍专业知识的专业人员,这种精神障碍会损害患者的理性,有时会导致错误的信念,如妄想。本文将精神病学治疗关系的特征分为三个阶段:专业客户关系、医患关系和精神病学家-精神病患者关系。由于对精神障碍患者的偏见,认知不公正在精神病护理中普遍存在。然而,精神科医生在与精神病患者的关系中所扮演的角色也使其倾向。本文在分析的基础上提出了一些改进措施。
{"title":"Epistemic injustice in the therapeutic relationship in psychiatry.","authors":"Eisuke Sakakibara","doi":"10.1007/s11017-023-09627-1","DOIUrl":"10.1007/s11017-023-09627-1","url":null,"abstract":"<p><p>The notion of epistemic injustice was first applied to cases of discrimination against women and people of color but has since come to refer to wider issues related to social justice. This paper applies the concept of epistemic injustice to problems in the therapeutic relationship between psychiatrists and psychiatric patients. To this end, it is necessary to acknowledge psychiatrists as professionals with expertise in treating mental disorders, which impair the patient's rationality, sometimes leading to false beliefs, such as delusions. This paper classifies the characteristic features of the therapeutic relationship in psychiatry into three stages: those of a professional-client relationship, those of a doctor-patient relationship, and those of a psychiatrist-psychiatric patient relationship. Epistemic injustice is prevalent in psychiatric care owing to prejudice against patients with mental disorders. However, it is also predisposed by the roles that psychiatrists play in relation to psychiatric patients. This paper suggests some ameliorative measures based on the analysis.</p>","PeriodicalId":46703,"journal":{"name":"Theoretical Medicine and Bioethics","volume":" ","pages":"477-502"},"PeriodicalIF":1.4,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10564806/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10074404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Saving unwanted children: a proposal for a National Rearing Institute. 拯救不想要的孩子:国家养育研究所的提案。
IF 1.4 3区 哲学 Q3 ETHICS Pub Date : 2023-10-01 Epub Date: 2023-05-03 DOI: 10.1007/s11017-023-09621-7
Ming-Jui Yeh

Unwanted children are carried, born, and reluctantly raised each year; they are prone to abortion, abandonment, neglect, and abuse. Meanwhile, many developed societies are suffering from depopulation. To address these two issues concurrently, I propose that governments should grant pregnant women and mothers an irreversible and unconditional one-time chance to relinquish all their legal rights and obligations associated with each of their children under a specific age to a National Rearing Institute that adopts the children and rears them to the age when they can fully exercise their rights as adult citizens. I call this set of policy arrangements "Project New Republicans." This project aims to (1) protect and support the best interests of unwanted children, (2) maximize the health outcomes of the mothers who gave birth to these children and help the mothers to achieve self-realization, and (3) preserve an influx to the population from procreation against depopulation. The project is primarily grounded on both the utilitarian and intra- / inter-generational accounts of justice. It also ameliorates the oppression and domination of women by unjust social structures in alignment with the human rights-based approach.

每年都有不想要的孩子被抱、出生和勉强抚养;他们容易堕胎、被遗弃、被忽视和被虐待。与此同时,许多发达社会正遭受人口减少的痛苦。为了同时解决这两个问题,我建议,各国政府应给予孕妇和母亲一个不可逆转的、无条件的一次性机会,让她们将与特定年龄以下的每个孩子相关的所有法律权利和义务交给国家养育研究所,该研究所收养这些孩子,并将他们抚养到能够充分行使成年公民权利的年龄。我把这套政策安排称为“新共和党人项目”。该项目旨在(1)保护和支持不想要的孩子的最大利益,(2)最大限度地提高生下这些孩子的母亲的健康结果,帮助母亲实现自我实现,以及(3)防止人口减少,防止人口因生育而涌入。该项目主要基于对正义的功利性和代际/代际描述。它还改善了不公正的社会结构对妇女的压迫和统治,符合基于人权的做法。
{"title":"Saving unwanted children: a proposal for a National Rearing Institute.","authors":"Ming-Jui Yeh","doi":"10.1007/s11017-023-09621-7","DOIUrl":"10.1007/s11017-023-09621-7","url":null,"abstract":"<p><p>Unwanted children are carried, born, and reluctantly raised each year; they are prone to abortion, abandonment, neglect, and abuse. Meanwhile, many developed societies are suffering from depopulation. To address these two issues concurrently, I propose that governments should grant pregnant women and mothers an irreversible and unconditional one-time chance to relinquish all their legal rights and obligations associated with each of their children under a specific age to a National Rearing Institute that adopts the children and rears them to the age when they can fully exercise their rights as adult citizens. I call this set of policy arrangements \"Project New Republicans.\" This project aims to (1) protect and support the best interests of unwanted children, (2) maximize the health outcomes of the mothers who gave birth to these children and help the mothers to achieve self-realization, and (3) preserve an influx to the population from procreation against depopulation. The project is primarily grounded on both the utilitarian and intra- / inter-generational accounts of justice. It also ameliorates the oppression and domination of women by unjust social structures in alignment with the human rights-based approach.</p>","PeriodicalId":46703,"journal":{"name":"Theoretical Medicine and Bioethics","volume":" ","pages":"435-452"},"PeriodicalIF":1.4,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9768982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Somatics and phenomenological psychopathology: a mental health proposal. 躯体主义和现象学精神病理学:心理健康建议。
IF 1.4 3区 哲学 Q3 ETHICS Pub Date : 2023-10-01 Epub Date: 2023-05-25 DOI: 10.1007/s11017-023-09618-2
Camilo Sánchez Sánchez

This work begins with a brief review - from the physical education movement that began in ancient Greece and is deeply rooted in 19th century Europe, to the somatics movement alive today. The review captures primary historical and conceptual references, relevant to the therapeutic-embodied exploratory work. Then, G. Stanghellini's mental health care model [2] is reviewed. This model is considered within reflexive self-awareness and spoken dialogue: the main vehicles in relation with alterity and its consequences in the realm of psychotherapeutic encounter and intervention. This will highlight the individual's bodily movement and inter-corporeal 'proto-dialogue' as a prior realm of therapeutic intervention. Next, a brief consideration of E. Strauss work [31] is presented. This paper's hypothesis is that bodily qualitative dynamics highlighted by phenomenology are essential for an effective mental health therapeutic intervention. A 'seed' of a framework is proposed in this paper; this seed assesses some phenomenological assets of a positive conception of mental health, for which self-awareness education is key to develop skills such as kinaesthetic intelligence and attunement and to educate healthy persons who can promote edifying social relations and environments.

这项工作以一个简短的回顾开始——从始于古希腊并深深植根于19世纪欧洲的体育运动,到今天活跃的躯体运动。该综述捕获了与治疗性探索工作相关的主要历史和概念参考文献。然后,对G.Stanghellini的心理健康护理模型[2]进行了回顾。这种模式被认为是在反射性自我意识和口语对话中:在心理治疗遭遇和干预领域中,与交替及其后果有关的主要载体。这将突出个人的身体运动和身体间的“原型对话”,作为治疗干预的先决领域。接下来,简要介绍了E.Strauss的工作[31]。本文的假设是,现象学所强调的身体质量动力学对于有效的心理健康治疗干预至关重要。本文提出了一个框架的“种子”;该种子评估了积极心理健康概念的一些现象学资产,其中自我意识教育是发展动觉智能和协调等技能的关键,也是教育能够促进有益社会关系和环境的健康人的关键。
{"title":"Somatics and phenomenological psychopathology: a mental health proposal.","authors":"Camilo Sánchez Sánchez","doi":"10.1007/s11017-023-09618-2","DOIUrl":"10.1007/s11017-023-09618-2","url":null,"abstract":"<p><p>This work begins with a brief review - from the physical education movement that began in ancient Greece and is deeply rooted in 19th century Europe, to the somatics movement alive today. The review captures primary historical and conceptual references, relevant to the therapeutic-embodied exploratory work. Then, G. Stanghellini's mental health care model [2] is reviewed. This model is considered within reflexive self-awareness and spoken dialogue: the main vehicles in relation with alterity and its consequences in the realm of psychotherapeutic encounter and intervention. This will highlight the individual's bodily movement and inter-corporeal 'proto-dialogue' as a prior realm of therapeutic intervention. Next, a brief consideration of E. Strauss work [31] is presented. This paper's hypothesis is that bodily qualitative dynamics highlighted by phenomenology are essential for an effective mental health therapeutic intervention. A 'seed' of a framework is proposed in this paper; this seed assesses some phenomenological assets of a positive conception of mental health, for which self-awareness education is key to develop skills such as kinaesthetic intelligence and attunement and to educate healthy persons who can promote edifying social relations and environments.</p>","PeriodicalId":46703,"journal":{"name":"Theoretical Medicine and Bioethics","volume":" ","pages":"503-532"},"PeriodicalIF":1.4,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10564660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9575088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Theoretical Medicine and Bioethics
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1