Philosophy Ethics and Humanities in Medicine最新文献

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.

Indra Sinha's Animal's People (2007) narrates the story of nineteen-year-old Animal, a severely disabled survivor of a gas leak in Khaufpur, a fictionalized version of post-1984 Bhopal. The novel explores disability as a medical, physical, and social construct, with Animal's disfigurement shaping both his identity and Sinha's critique of power, marginalization, and industrial negligence in a poverty-stricken 'third-world' society. Rejecting victimhood and resisting neoliberal, Eurocentric models of disability tied to individuality and consumerism, Animal asserts a radical self-definition that negotiates intersections of class, embodiment, sexuality, and local cultural norms, undoing simplistic disabled/nondisabled; human/animal binaries. However, this paper argues that his desire for a consensual sexual relationship complicates his claimed animal identity. His interactions with the American doctor, Elli, exemplify this tension-despite his defiance, he yearns for her 'cure' to enhance his sexual desirability. The novel thus raises critical questions about the intersections of desirability, impairment, disability, and cure. Through a critical disability studies lens, this paper examines how Animal's People challenges dominant representations of disability, reconfigures macro-developmental discourses, and calls for the indigenization of disability frameworks. In doing so, it expands understandings of disability, disease, and human experience.

Background: This paper explores how writing and publishing can contribute to recovery after psychosis, focusing on lived experience. Collaborating with DW, whose creative work engages existential and philosophical questions, we examine how narrative expression may help respond to experiences of loss and destabilization.

Methods: Using a co-constructive single-case study design, we analyzed DW's published and unpublished writings in dialogue with psychoanalytic and recovery-oriented frameworks. The data was analyzed using Interpretative Phenomenological Analysis.

Results: Writing emerged as a vital tool for DW to navigate and stabilize his experience. Identified themes include: (1) Grasping the past; (2) Existing in the present; and (3) Hoping for the future. Publishing initiated a second movement: (4) Coming to closure for oneself and others; (5) Reframing psychosis and psychiatry; and (6) Guiding only one other a step forward.

Conclusion: The case study shows how writing can support recovery by restoring narrative coherence, stabilizing self-experience, legitimizing spiritual meaning, and sustaining life-engagement. Publishing, in its turn, helps reaching others, creating possibilities for recognition and reconnection. Rather than opposing forces, loss and transformation appear as interwoven dynamics in recovery. Narrative practices like writing and publishing can be valuable existential tools for individuals reconstructing meaning after psychosis.

This paper aims to analyze the representation of Post-traumatic Stress Disorder (PTSD) in Zoulfa Katouh's novel, As Long as the Lemon Trees Grow (2022). Katouh, a Canadian-Syrian author who specializes in drug sciences, sets her debut novel against the backdrop of the war in Syria in the aftermath of the Arab Spring. The protagonist, Salama, a teenage girl pursuing an undergraduate degree in pharmacy, faces the harrowing realities of war and volunteers as a surgical assistant amidst the chaos of bombings and sniper attacks. As a result of the war, Salama tragically loses almost all her family members, and in response to her fear and anxiety, creates a hallucinatory male figure named Khawf. Khawf, which is the Arabic word for fear, serves as a manifestation of Salama's PTSD and a symbolic representation of her traumatic experience, blurring the lines between reality and imagination and highlighting the psychological toll of living in a war-torn zone. Hence, this paper explores the nature of PTSD, as depicted in the novel, and examines how Salama's sense of responsibility toward injured civilians and her feelings of guilt toward those she could not save influence her psyche, leading her to avoid and repress memories, unleashing her hallucinations and defense mechanisms. The theoretical framework of this study is primarily shaped by Anke Ehlers's research on mental defeat and alienation in victims of political trauma, Horowitz's stress response theory, and Stanley Lyndon and Philip Corlett's exploration of hallucinations as perceptual disturbances in cases of PTSD. Finally, this paper aims to present a deeper understanding of the psychological trauma inflicted by war and the complexities of human defense mechanisms in the face of adversity by analyzing Katouh's portrayal of PTSD symptoms that Salama, the protagonist, suffers immensely.