Theoretical Medicine and Bioethics最新文献

This article discusses the use of Bayes' Theorem in medical diagnosis with a view to examining the epistemological problems of interpreting the concept of pre-test probability value. It is generally maintained that pre-test probability values are determined subjectively. Accordingly, this paper investigates three main philosophical interpretations of probability (the "classic" one, based on the principle of non-sufficient reason, the frequentist one, and the personalistic one). This study argues that using Bayes' Theorem in medical diagnosis does not require accepting the radical personalistic interpretation. It will be shown that what distinguishes radical and moderate personalist interpretations is the criterion of conditional inter-subjectivity which applies only to the moderate account of personalist interpretation.

In a thought-provoking article - or how she herself named it, 'a thought experiment' - the philosopher-medical ethicist Anna Smajdor analyzed in this journal the idea of whole-body gestational donation (WBGD) in brain-dead female patients, as an alternative means of gestation for prospective women who cannot or prefer not to become pregnant themselves. We have serious legal, economical, medical and ethical concerns about this proposal. First, consent for eight months of ICU treatment can never be assumed to be derived from consent for post-mortem organ donation; these two are of an incomparable and entirely different medical and ethical order. Moreover, the brain-dead woman is very likely to be medically unfit for high-tech surrogacy and the brain-dead state poses a high risk for deficient embryo/fetal development. Second, from a scarcity perspective, occupying an ICU bed for eight months appears to be unjust. The costs for eight months of ICU treatment are far too high compared to the costs of surrogacy for a living, selected, and healthy woman. Neither insurance companies nor prospective parents will want to pay these exceptionally high costs for a dead woman if a living surrogate mother can be hired for a considerably lower amount. Third, there is an increased risk for harm of the child to be in WBGD. And finally, WBGD risks violating the brain-dead woman's dignity and harming the interests of her loved ones. In short, there is simply no need for brain-dead women as surrogates.

Transhumanism aims to bring about radical human enhancement. In 'Truly Human Enhancement' Agar (2014) provides a strong argument against producing radically enhancing effects in agents. This leaves the transhumanist in a quandary-how to achieve radical enhancement whilst avoiding the problem of radically enhancing effects? This paper aims to show that transhumanism can overcome the worries of radically enhancing effects by instead pursuing radical human enhancement via incremental moderate human enhancements (Weak Transhumanism). In this sense, weak transhumanism is much like traditional transhumanism in its aims, but starkly different in its execution. This version of transhumanism is weaker given the limitations brought about by having to avoid radically enhancing effects. I consider numerous objections to weak transhumanism and conclude that the account survives each one. This paper's proposal of 'weak transhumanism' has the upshot of providing a way out of the 'problem of radically enhancing effects' for the transhumanist, but this comes at a cost-the restrictive process involved in applying multiple moderate enhancements in order to achieve radical enhancement will most likely be dissatisfying for the transhumanist, however, it is, I contend, the best option available.

With its rise in popularity, work in the phenomenology of medicine has also attracted its fair share of criticism. One such criticism maintains that, since the phenomenology of medicine does nothing but describe the experience of illness, it offers nothing one cannot obtain more easily by deploying simpler qualitative research methods. Fredrik Svenaeus has pushed back against this charge, insisting that the phenomenology of medicine not only describes but also defines illness. Although I agree with Svenaeus's claim that the phenomenology of medicine does more than merely describe what it is like to be ill, once one acknowledges its more far-reaching theoretical aspirations, one sees that it faces an even more difficult set of objections. Taking a cue from recent work by Rebecca Kukla, Russell Powell, and Eric Scarffe, I argue that the phenomenology of medicine could answer these objections by developing an institutional definition of illness. This not only allows the phenomenology of medicine to answer its critics, but it does so in a way that preserves its major achievements and extends its reach within the philosophy of medicine.

Is moral or other regret for abortion an indicator that abortion may not be morally or prudentially choice worthy? This paper examines the work of Kate Greasley in this area, who offers an explanation of any asymmetry in openness to regret between women who have abortions and women who give birth. The latter, not unlike Derek Parfit's 14-year-old who conceives deliberately, may feel duty-bound not to regret their decision (in their case, to continue their pregnancy) and to affirm the life of their child. In response to Greasley, testimonial evidence of one group cannot be dismissed simply because regret may be less available to another group of decision-makers. Moreover, if moral regret for childbearing is uncommon, this is not because mothers have a moral duty, as Greasley argues, not to regret even a morally mistaken choice to conceive. On the contrary, one must separate the evaluation of choices and of the results of these choices, whether positive or negative. Regret, while not infallible, can elucidate values at stake in choices, and testimonial evidence in the form of regret should be taken more seriously in regard to certain kinds of choice.