Philosophy Ethics and Humanities in Medicine最新文献

Genetic data, which contains human life codes, is the most fundamental privacy of individuals and is therefore protected by the right to privacy. However, given the diverse subjects involved in genetic data, traditional individualistic privacy regulations face challenges in practise, posing a global dilemma on effective gene privacy protection. Over the past three decades, China has seen rapid development in the concepts of privacy and gene privacy. Genetic data is inherently classified as private data, entitled to protection under CCC and CPIPL. China adopts an informed consent model rooted in individualism for gene privacy protection, yet faces triple dilemmas in practice, including inadequate protection for individuals, insufficient safeguards for societal interests, and benefit-sharing imbalances. Going forward, China should first shift its governance philosophy from individualism to group dimension; second, further restrict individuals' self-determination over genetic data; and finally, give full play to its existing organizational structure, public interest litigation system, and the role of groups in safeguarding benefit-sharing.

Medical expertise is traditionally understood through two main epistemic perspectives: propositional-cognitive knowledge, which emphasizes scientific and theoretical understanding, and practical-experiential knowledge, which is rooted in experience and tacit skills. Existing models often focus on one of these dimensions, failing to capture the full complexity of medical expertise. This study proposes a hybrid expertise (HE) framework that integrates both forms of knowledge, offering a more comprehensive characterization of how expertise is acquired and applied in medical practice. This study employs a theoretical-analytical approach, drawing from established distinctions in epistemology, such as know-how vs. know-that, tacit vs. explicit knowledge, and declarative vs. procedural knowledge. This perspective aligns with related concepts such as adaptive expertise (AE) and interdisciplinary expertise (IE). Additionally, we challenge the assumption that all medical students can become experts with proper training, arguing that expertise requires exceptional performance beyond mere competence. This perspective has important implications for medical education, emphasizing the need for curricula that balance theoretical instruction with experiential learning. These insights contribute to a more nuanced understanding of expertise, with potential applications in medical training, policy-making, and healthcare practice.

Background: Studies on the tuberculosis pathogen Mycobacterium tuberculosis bacillus require a biosafety level 3 laboratory. This study aims to investigate the gender distribution of researchers working in the most hazardous tuberculosis laboratory.

Methods: In this study, the original articles indexed in Web of Science between 1970 and 2021, which include phenotypic testing methods in which the susceptibility results of drugs used in the treatment of tuberculosis are determined, were reviewed.

Results: As a result of our analysis, it was found that female researchers were included as first name in the publications at a rate of 49%, unlike other fields of science, and 51% came from lower-middle-income and upper-middle-income countries. According to the incidence rates announced by the World Health Organization in the years when the articles were published, it was seen that female researchers participated in more studies in regions with a high incidence of tuberculosis to ('x̄' = 89.94).

Conclusion: According to our data, it was found that the proportion of female researchers was high in the laboratory with a high risk of contamination of biosafety level 3. The high proportion of female researchers in hazardous areas is striking.

Background: Postpartum depression has a rising global prevalence. Although it receives respectable attention in research, it is not adequately considered in practice. Perceived social support is among the most influential protective factors of PPD; however, the role of sources of social support in the development of PPD is not yet fully discovered. Therefore, this research aims to identify the differential effects of the sources of social support on symptoms of PPD while also investigating the mediating role of resilience.

Methods: The data analysed In this study were collected from 197 women with parturition within six weeks to a year, aged 25 to 41 (M = 30.36, SD = 3.703). Participants were recruited from public and private hospitals and clinics specializing in paediatric and obstetrics/gynaecology care in Cairo, Egypt, and through social media support groups for pregnant and postpartum women. Data were collected using the Arabic multidimensional scale of perceived social support (MSPSS), the Edinburgh Postnatal Depression Scale (EPDS), and the Psychological Capital Questionnaire (PCQ) 'Resilience' subscale. Multiple linear regression and mediation analyses by structural equation model (SEM) were performed to test the study's hypotheses.

Results: Friends' social support was the only significant source in the regression model (β = -.242, t = -3.297, p < .001). However, the overall model was also significant (F (3, 193) = 11.692, p < .001). Resilience significantly and partially mediated the relationship between support from significant others (SO) and PPD symptoms (β = -.042, 95% CI [-0.080, -0.004], z = -2.159, p < .031). However, resilience did not indirectly influence the relationship between family support and PPD symptoms (β = -.025, 95% CI [-0.058, 0.008], z = -1.494, p < .135) and family support and PPD symptoms (β = -.027, 95% CI [-0.056, -0.002], z = -1.830, p < .067) were not significant.

Conclusions: Perceived social support from friends significantly predicts PPD symptoms. The support from significant others impacts symptoms of postpartum depression directly and indirectly through resilience. These findings emphasize social support as protective against PPD risk and enhancing for resilience.

Background: In the translation of traditional Chinese medicine (TCM), it is crucial to preserve the authenticity of its philosophical, historical, and linguistic characteristics. This study aims to conduct a comprehensive analysis of translation strategies for adapting TCM terminology to foreign cultural contexts, based on the classical text The Emperor"s Canon of Eighty-One Difficult Issues.

Methods: A comparative analysis was performed to evaluate the effectiveness of foreignization and domestication strategies in translating TCM terminology into Russian, using an experimental study involving 84 respondents (42 in each group). The Student's t-test was employed to assess medical accuracy, equivalence, pragmatic value, terminological precision, and cultural specificity.

Results: The results revealed a statistically significant advantage of the domestication strategy across most metrics, particularly in equivalence (p = 0.001) and pragmatic value (p = 0.008), where domestication achieved higher mean scores (4.12 and 4.03) compared to foreignization (3.48 and 3.55). Thus, it was established that domestication facilitates better adaptation of complex Chinese medical concepts for target audiences while maintaining sufficient medical accuracy. This is supported by higher scores in overcoming cultural barriers (48.8% versus 22.0%) and ensuring terminological precision (3.88 versus 3.41), making it a more effective strategy for translating medical terminology from Chinese into Russian.

Conclusions: The practical significance of this study lies in determining the effectiveness of translation approaches for TCM terminology into Russian through experimental research. These findings can be applied in the work of medical translators, the development of educational materials on Chinese medicine, and the creation of methodological guidelines for medical text translation. Consequently, the results hold the potential to improve the quality of educational materials on TCM and enhance intercultural medical communication.

Background: In the context of medically futile treatment, clinical decision-making often becomes ethically and existentially fraught, especially when physicians and patients navigate the space between prolonging life and preserving its meaning. Existing shared decision-making (SDM) models often rely heavily on empirical rationality, yet overlook the ontological depth of patient experience.

Methods: Drawing on Heidegger's concept of being-in-the-world and Gadamer's fusion of horizons, we conducted an interpretative phenomenological analysis (IPA) of in-depth interviews with a terminal cervical cancer patient and three attending physicians (specialists in cardiology, cardiac surgery, and gynecologic oncology). These philosophical frameworks guided both the analytic lens and the ethical interpretation of SDM practices in contexts of medical futility.

Results: Our findings reveal that decisions to continue aggressive treatment, even when medically futile, are not mere irrationalities. Rather, they emerge from divergent value orientations and temporal understandings between patients and physicians. A clinically "correct" decision may be ethically inadequate if it fails to integrate the patient's lived horizon.

Conclusions: We propose a hermeneutic framework for SDM that supplements the evidence-based model with three core steps: attunement to the patient's existential situation, fusion of horizons between patient and physician, and respect for irreducible differences. This approach allows for ethically grounded decisions that honor both medical expertise and the patient's being-in-the-world.

Trial registration: Not applicable.

This commentary is a reflection, through a health policy and systems lens, on the medically pluralistic workforce, particularly in low- and middle-income countries that have and utilise numerous systems of medicine, indigenous and adopted. It analyses and distinguishes integration and pluralism, and examines the interaction, and the more frequently observed lack thereof, among different systems of medicine. It highlights the implicit and express hierarchies among the different systems of medicine; the epistemic injustices, wrongs, and resultant harms to different systems of medicine, their practitioners, and the populations that could benefit from them; concomitant inequities in the administration and functioning of the workforce; and the gaps in coordination among diverse disciplines in health care. The commentary underscores the imperative for thoughtful and equitable administration of pluralistic health systems, including emic and etic enquiry, sensitisation, and participatory action, to accomplish the diverse goals of health systems, the health workforce, and the population.

Times of pandemics usually witness a remarkable surge of interest among various poets who, in response to the impending threats and anxiety brought about by the uninvited guest, provide multiple ways of portraying the crisis and its inevitable impact. Pandemic poetry provides a fertile source of data for relating language to its poetic artistic function in general and for studying some linguistic and stylistic features that characterize language in pandemic poems in particular. This study seeks to depict and analyze the stylistic features employed in four Covid-19 pandemic poems with the objective of linking poetic style to the specific representations of experience associated with the pandemic. The samples of the study are four English-language pandemic poems selected from online sources on Covid-19. The qualitative approach is employed to collect, classify and analyze the selected samples of poems inductively in order to find out the distinctive stylistic features of the selected Covid-19 pandemic poems. The framework of analysis employs Leech and Short's (2007) method of stylistic analysis in which four categories are tackled: lexical categories, grammatical categories, figures of speech and context and cohesion. The foregrounding theory also serves as a strategy employed for analyzing the selected poems in order to highlight the prominent features in the text, thereby directing focus towards the thematic concerns linked to the pandemic. The stylistic analysis serves as a tool for readers to comprehend the themes of the selected poems in relation to linguistic choices while revealing deeper layers of interpretation and appreciation of language use in pandemic poems. The selected Covid-19 pandemic poems masterfully communicate medical themes through various stylistic elements, bringing together the fields of medicine, poetry and stylistics. The scientific examination of the virus and its physical and psychological consequences together with the representation of the healthcare system during the pandemic formed the subject matter of the four selected poems. Repetition, figures of speech, paradox, hyperbole and parallelism, are among the most frequently used stylistic devices that managed to underscore the ideas of uncertainty, confusion, anxiety, and pain associated with the Covid-19 pandemic.

Background: Intensive care provision to very old patients is rapidly growing owing to demographic changes and increasing treatment intensity. However, intensive care carries only questionable benefit for the oldest patients, and many of them die after prolonged organ support. Departing from a clinical perspective, this study aims to explore the drivers for the expansion of critical care in advanced age, despite widespread awareness of its potential harms to patients, their families, healthcare professionals, and society.

Methods: Theoretical study into the possible consequences of the medicalization of ageing and dying on intensive care provision for very old patients, applying Ian Hacking's concepts of human, interactive and natural, indifferent kinds as a philosophical framework.

Results: The physiological consequences of ageing are a risk factor for falling critically ill, and for dying from critical illness, while age itself is not regarded as a disease, despite having recently been classified as such. Understanding old age as a human, interactive kind explains the medicalization of ageing and dying as a self-perpetuating process. Defining the natural processes of ageing and dying as disease results in a morally strong call for clinical efforts to provide life-saving care to very old patients despite its questionable overall benefit. As a consequence, adhering to this narrow, medically defined relationship between illness severity and treatment intensity results in vastly increased decisional uncertainty in advanced age compared to younger patient populations in intensive care units.

Conclusion: Delivering the right level of care to very old patients with critical illness requires a more comprehensive clinical approach with philosophical concepts and social theories complementing medical scientific knowledge.

Scientific authorship is undergoing a subtle but profound transformation. With the rise of generative artificial intelligence (AI), the boundary between human contribution and machine assistance is increasingly blurred. This article explores how AI-assisted scientific writing challenges traditional definitions of authorship, accountability, and intellectual ownership. Drawing on both identity debates and contribution-based accounts, it argues that the growing role of AI in manuscript production demands a reconsideration of contributor roles, transparency, and recognition. Using the Ship of Theseus as a guiding metaphor, the argument shows how authorship can be reconceived when human-authored components are progressively replaced with AI-generated content. The central concern is not whether AI should be credited, but how the human contribution, control, and accountability should be tracked and attributed when AI mediates linguistic or argumentative content. A set of policy measures is proposed-linking existing authorship standards to disclosure thresholds, contributor roles, and an empirical programme for monitoring AI use-to preserve credibility and accountability.