首页 > 最新文献

Philosophy Ethics and Humanities in Medicine最新文献

英文 中文
Patients' perception of medical care in the hospital environment: the reasons of non-hospitality. 患者在医院环境中对医疗服务的感知:不好客的原因。
IF 1.7 4区 哲学 Q2 ETHICS Pub Date : 2025-07-16 DOI: 10.1186/s13010-025-00176-0
Laura Marques Castelhano, Gilberto de Araujo Guimarães, Isabel Baptista

Background: The medical care provided by the physician is an important part of the hospital scene and the action of caring. Assessments of the physician-patient meeting are based on welcome and the physician's ability to be perceived as hospitable by the patient. By definition, to be hospitable is to have the ability to welcome, care for, reassure, and be courteous, respectful, and trustworthy. This article aims to understand patients' perceptions of medical care perceived as not hospitable, characterized by a lack of care and welcome, in a hospital environment, based on a complaint's website.

Method: The research method used was qualitative analysis and the research strategy was documentary research. The data were collected on a complaints registration platform. The theoretical framework used was the theory of Hospitality. The study selected, coded, and categorized the complaints of 127 patients at the 09 most renowned private hospitals in Brazil. The Voyant tools assisted in the textual analysis of complaints while coding classified them into categories.

Results: After evaluating the reasons and elements of the complaint, the following was analyzed the encounter characterized as hostile and inhospitable and the attitudes perceived by the patients were grouped into what was defined as "the 4 D's of non-hospitality": dehumanization, disregard, dereliction of duty, and disability. Each of the attitudes was characterized by the physician's behavior and the sensations, emotions, and feelings triggered in the patient.

Conclusions: Patients' perception of the not hospitable encounter may be hostile or inhospitable. The physician's attitude is an important criterion for evaluating the encounter. The physician's attitude and the form of care are key factors in a culture focused on hospitality in the hospital environment. Hostile and inhospitable attitudes affect the physician-patient relationship and may compromise the patient's well-being.

背景:医生提供的医疗护理是医院场景的重要组成部分,是护理的行动。对医患会面的评估是基于对病人的欢迎程度和医生被病人认为热情好客的能力。根据定义,好客就是有能力欢迎、关心、安慰、礼貌、尊重和值得信赖。本文旨在了解患者对医院环境中不好客的医疗护理的看法,其特征是缺乏护理和欢迎,基于投诉网站。方法:研究方法为定性分析,研究策略为文献研究。这些数据是在一个投诉登记平台上收集的。使用的理论框架是待客之道理论。该研究对巴西09家最知名私立医院的127名患者的投诉进行了选择、编码和分类。Voyant工具协助对投诉进行文本分析,同时对其进行编码分类。结果:在评估了投诉的原因和要素后,分析了以下以敌意和不好客为特征的遭遇,并将患者感知到的态度归类为定义为“不好客的4d”:非人化、漠视、失职和残疾。每一种态度都以医生的行为和病人的感觉、情绪和感觉为特征。结论:患者对不友好遭遇的感知可能是敌对的或不友好的。医师的态度是评价偶遇的重要标准。医生的态度和护理形式是医院环境中注重热情好客文化的关键因素。敌对和不友好的态度影响医患关系,并可能损害患者的福祉。
{"title":"Patients' perception of medical care in the hospital environment: the reasons of non-hospitality.","authors":"Laura Marques Castelhano, Gilberto de Araujo Guimarães, Isabel Baptista","doi":"10.1186/s13010-025-00176-0","DOIUrl":"10.1186/s13010-025-00176-0","url":null,"abstract":"<p><strong>Background: </strong>The medical care provided by the physician is an important part of the hospital scene and the action of caring. Assessments of the physician-patient meeting are based on welcome and the physician's ability to be perceived as hospitable by the patient. By definition, to be hospitable is to have the ability to welcome, care for, reassure, and be courteous, respectful, and trustworthy. This article aims to understand patients' perceptions of medical care perceived as not hospitable, characterized by a lack of care and welcome, in a hospital environment, based on a complaint's website.</p><p><strong>Method: </strong>The research method used was qualitative analysis and the research strategy was documentary research. The data were collected on a complaints registration platform. The theoretical framework used was the theory of Hospitality. The study selected, coded, and categorized the complaints of 127 patients at the 09 most renowned private hospitals in Brazil. The Voyant tools assisted in the textual analysis of complaints while coding classified them into categories.</p><p><strong>Results: </strong>After evaluating the reasons and elements of the complaint, the following was analyzed the encounter characterized as hostile and inhospitable and the attitudes perceived by the patients were grouped into what was defined as \"the 4 D's of non-hospitality\": dehumanization, disregard, dereliction of duty, and disability. Each of the attitudes was characterized by the physician's behavior and the sensations, emotions, and feelings triggered in the patient.</p><p><strong>Conclusions: </strong>Patients' perception of the not hospitable encounter may be hostile or inhospitable. The physician's attitude is an important criterion for evaluating the encounter. The physician's attitude and the form of care are key factors in a culture focused on hospitality in the hospital environment. Hostile and inhospitable attitudes affect the physician-patient relationship and may compromise the patient's well-being.</p>","PeriodicalId":56062,"journal":{"name":"Philosophy Ethics and Humanities in Medicine","volume":"20 1","pages":"9"},"PeriodicalIF":1.7,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12265275/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144644162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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
The linguocultural concept of /pandemic/пaндeмия in Chinese, English, and Russian linguistic consciousness. /pandemic/пaндeмия在中、英、俄语言意识中的语言文化概念。
IF 1.7 4区 哲学 Q2 ETHICS Pub Date : 2025-07-09 DOI: 10.1186/s13010-025-00168-0
Yanlei Ge

Background: As a major public health event, the pandemic has been widely discussed across various academic disciplines. In the field of humanities, most pandemic-related studies use introspective methods such as description and interpretation, indicating to some extent subjective and one-sided conclusions. In this paper, pandemic-related linguistic information and linguistic big data serve as research materials. Based on the theory of linguocultural concepts, the study employed natural language processing methods such as the analysis of word frequency and collocation co-occurrence to conduct an in-depth empirical study of /pandemic/пaндeмия as a linguocultural concept in Chinese, English, and Russian linguistic consciousness from diachronic and synchronic perspectives.

Methods: Based on the basic linguocultural theories, this study provides a comprehensive interpretation of the etymological data on the conceptual words /pandemic/пaндeмия, its lexical interpretation, and high-frequency words and co-occurring collocations related to the pandemic in Chinese, English, and Russian text corpora in Sketch Engine. The paper also analyzes reports from the mainstream media (People's Daily Online, BBC, and TASS) to depict and explain in detail the aspects of linguocultural concepts. The historical trends of the pandemic-related concepts in the three languages were examined by observing word frequency changes through Google Book Viewer. This hybrid empirical research framework, which combines cultural concepts with linguistic big data technology, made it possible to explore the content of linguocultural concepts in a more objective, comprehensive, and profound way.

Results: The study revealed that: 1) In terms of etymology, the Chinese character (yi, pandemic) implies a belief that pandemics were created by ghosts and gods to render people immobile. The character (yi, pandemic) is also related to the concept of a fight. The English and Russian analogues (pandemic/пaндeмия) denote the same phenomenon: a disease that spreads widely among the whole population. 2) For more than 100 years since the twentieth century, pandemics have been a more significant part of Chinese consciousness than they have been in English and Russian cultures. 3) During the COVID-19 Pandemic of 2020-2023, the total number of news reports on (yi, pandemic) in Chinese was higher than the total number of news reports in English and Russian. This indicates that Chinese media tend to pay much more attention to the COVID-19 pandemic than media in the United Kingdom and Russia in all aspects. 4) China emphasizes the containment of domestic outbreaks through stringent, proactive, and comprehensive measures, including quarantine protocols, extensive testing campaigns, and evidence-based treatment strategies. On the contrary, the United Kingdom and Russia are more concerned with the global outcomes of the pandemic.

Co

背景:作为一项重大公共卫生事件,大流行已在各学科得到广泛讨论。在人文学科领域,与大流行相关的研究大多采用描述和解释等内省方法,得出的结论在一定程度上是主观和片面的。本文以流行病相关的语言信息和语言大数据为研究材料。本研究以语言文化概念理论为基础,采用词频分析、搭配共现分析等自然语言处理方法,从历时和共时的角度对/pandemic/пaндeмия这一语言文化概念在中、英、俄语言意识中的表现进行了深入的实证研究。方法:基于基本的语言文化理论,对Sketch Engine中、英、俄文本语料库中与大流行相关的概念词/pandemic/пaндeмия、词汇解释、高频词和共现搭配的词源数据进行综合解读。本文还分析了主流媒体(人民网、BBC、塔斯社)的报道,对语言文化概念的各个方面进行了详细的描述和解释。通过谷歌Book Viewer观察词频变化,考察了三种语言中与大流行相关概念的历史趋势。这种将文化概念与语言大数据技术相结合的混合实证研究框架,使我们能够更加客观、全面、深入地探索语言文化概念的内容。结果:研究表明:1)从词源上看,汉字“大流行”暗示了一种信仰,认为大流行是鬼神创造的,使人无法移动。字符(yi, pandemic)也与战斗的概念有关。英语和俄语的类似词(pandemic/пaндeмия)表示同样的现象:在全体人口中广泛传播的疾病。自20世纪以来的100多年里,流行病在中国人的意识中比在英国和俄罗斯文化中更为重要。3) 2020-2023年新冠肺炎大流行期间,中文新闻报道总数高于英文和俄文新闻报道总数。这表明,中国媒体在各方面对新冠肺炎疫情的关注度都远高于英国和俄罗斯媒体。4)中国强调通过严格、积极和全面的措施控制国内疫情,包括隔离协议、广泛的检测活动和循证治疗策略。相反,联合王国和俄罗斯更关心这一大流行病的全球后果。结论:本研究客观、全面地考察了汉语、英语和俄语语言意识中对大流行作为重大卫生事件的感知和反应的异同。本文对人文学科的研究体系做出了巨大贡献,拓宽了公共卫生事件的研究范围。本文提出的研究结果在理论和方法层面上都具有相关性。本研究为跨文化公共卫生交流提供了语言基础,对促进国际卫生合作具有现实意义。
{"title":"The linguocultural concept of /pandemic/пaндeмия in Chinese, English, and Russian linguistic consciousness.","authors":"Yanlei Ge","doi":"10.1186/s13010-025-00168-0","DOIUrl":"10.1186/s13010-025-00168-0","url":null,"abstract":"<p><strong>Background: </strong>As a major public health event, the pandemic has been widely discussed across various academic disciplines. In the field of humanities, most pandemic-related studies use introspective methods such as description and interpretation, indicating to some extent subjective and one-sided conclusions. In this paper, pandemic-related linguistic information and linguistic big data serve as research materials. Based on the theory of linguocultural concepts, the study employed natural language processing methods such as the analysis of word frequency and collocation co-occurrence to conduct an in-depth empirical study of /pandemic/пaндeмия as a linguocultural concept in Chinese, English, and Russian linguistic consciousness from diachronic and synchronic perspectives.</p><p><strong>Methods: </strong>Based on the basic linguocultural theories, this study provides a comprehensive interpretation of the etymological data on the conceptual words /pandemic/пaндeмия, its lexical interpretation, and high-frequency words and co-occurring collocations related to the pandemic in Chinese, English, and Russian text corpora in Sketch Engine. The paper also analyzes reports from the mainstream media (People's Daily Online, BBC, and TASS) to depict and explain in detail the aspects of linguocultural concepts. The historical trends of the pandemic-related concepts in the three languages were examined by observing word frequency changes through Google Book Viewer. This hybrid empirical research framework, which combines cultural concepts with linguistic big data technology, made it possible to explore the content of linguocultural concepts in a more objective, comprehensive, and profound way.</p><p><strong>Results: </strong>The study revealed that: 1) In terms of etymology, the Chinese character (yi, pandemic) implies a belief that pandemics were created by ghosts and gods to render people immobile. The character (yi, pandemic) is also related to the concept of a fight. The English and Russian analogues (pandemic/пaндeмия) denote the same phenomenon: a disease that spreads widely among the whole population. 2) For more than 100 years since the twentieth century, pandemics have been a more significant part of Chinese consciousness than they have been in English and Russian cultures. 3) During the COVID-19 Pandemic of 2020-2023, the total number of news reports on (yi, pandemic) in Chinese was higher than the total number of news reports in English and Russian. This indicates that Chinese media tend to pay much more attention to the COVID-19 pandemic than media in the United Kingdom and Russia in all aspects. 4) China emphasizes the containment of domestic outbreaks through stringent, proactive, and comprehensive measures, including quarantine protocols, extensive testing campaigns, and evidence-based treatment strategies. On the contrary, the United Kingdom and Russia are more concerned with the global outcomes of the pandemic.</p><p><strong>Co","PeriodicalId":56062,"journal":{"name":"Philosophy Ethics and Humanities in Medicine","volume":"20 1","pages":"13"},"PeriodicalIF":1.7,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12239291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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
Empathy in technologically mediated patient-provider communication: a phenomenological and postphenomenological exploration. 同理心在技术介导的医患沟通:现象学和后现象学的探索。
IF 1.7 4区 哲学 Q2 ETHICS Pub Date : 2025-06-18 DOI: 10.1186/s13010-025-00172-4
Elisabeth Assing Hvidt, Finn Olesen

Background: This theoretical paper aims to explore empathy in the context of technologically mediated patient-provider communication, specifically within the context of video- and telehealth consultations. Over the past few decades, empathy has been recognized as a vital component of high-quality patient care, often prioritizing the cognitive over the emotional dimensions of empathy. As healthcare increasingly embraces digital communication technologies, including video consultations, the dynamics of empathy in clinical encounters are altered. With this paper we explore the pertinent question: how do new digital communication modalities impact on empathy and its different dimensions?

Methods: To address the above question, we move beyond clinical and applied empathy frameworks instead integrating insights from two related philosophical traditions. First, the classical phenomenological understanding of empathy (represented primarily by Edith Stein) as embodied intuition. Second, the postphenomenological philosophy of technology, represented by Don Ihde and not least inspired by Maurice Merleau-Ponty's phenomenology of embodiment. We apply these theoretical frameworks to empirical analyses of video consultations in general practice and telemedical encounters between chronic obstructive pulmonary disease (COPD) patients and specialist telenurses.

Results: Our analysis demonstrates that even though video consultations do not allow for the same level of "fine-tuned" body-mediated sensory input, a whole-body empathetic experience can nevertheless be established through (1) the audio-visual sensory impressions that are being mediated by the technology, (2) our whole-body interpretations of this information and (3) our shared experiences of a lifeworld that we actively orient ourselves towards. These experiences may lead to empathetic communication and helping actions that draw on both emotional, intuitive and cognitive dimensions in a holistic manner.

Conclusion: Combining theoretical insights from phenomenology and postphenomenology with empirical telehealth analyses, we demonstrate how empathy is both reconfigured through technological mediation and sustained as an embodied, intersubjective practice. We thus conclude that empathetic care practices can be established in technologically mediated encounters through bodily intentionality where our bodies and minds are unified in understanding and connecting with other persons, even though we are not in the same physical space. We propose a theoretical bridge, connecting classical phenomenology and postphenomenology in the context of empathy in technologically mediated patient-provider communication. This bridge is grounded in Merleau-Ponty's conception of whole-body perception and the lifeworld whether through physical proximity or digital interaction.

背景:本理论论文旨在探讨移情在技术介导的患者-提供者沟通的背景下,特别是在视频和远程医疗咨询的背景下。在过去的几十年里,共情被认为是高质量患者护理的重要组成部分,通常优先考虑共情的认知维度而不是情感维度。随着医疗保健越来越多地采用数字通信技术,包括视频咨询,临床遭遇中的移情动态发生了变化。在本文中,我们探讨了相关问题:新的数字通信模式如何影响移情及其不同维度?方法:为了解决上述问题,我们超越临床和应用共情框架,而是整合两种相关哲学传统的见解。首先,经典现象学对共情(主要以伊迪丝·斯坦为代表)的理解是具身直觉。第二,后现象学的技术哲学,以唐·伊德为代表,并受到莫里斯·梅洛-庞蒂体现现象学的启发。我们将这些理论框架应用于一般实践中的视频咨询和慢性阻塞性肺疾病(COPD)患者与专科远程护士之间的远程医疗遭遇的实证分析。结果:我们的分析表明,尽管视频咨询不允许同样水平的“微调”身体介导的感官输入,但通过(1)由技术介导的视听感官印象,(2)我们对该信息的全身解释,(3)我们积极定位自己的生活世界的共享体验,仍然可以建立一个全身的移情体验。这些经历可能会导致移情沟通和帮助行动,以一种整体的方式利用情感、直觉和认知维度。结论:将现象学和后现象学的理论见解与远程医疗的实证分析相结合,我们展示了共情如何通过技术调解重新配置,并作为一种具体化的、主体间的实践持续存在。因此,我们得出结论,移情护理实践可以通过身体意向性在技术介导的接触中建立起来,在这种接触中,我们的身体和思想在理解和与他人联系方面是统一的,即使我们不在同一个物理空间中。我们提出了一个理论桥梁,连接古典现象学和后现象学在共情的背景下,在技术介导的病人-提供者沟通。这座桥是基于梅洛-庞蒂的全身感知和生活世界的概念,无论是通过物理接近还是数字互动。
{"title":"Empathy in technologically mediated patient-provider communication: a phenomenological and postphenomenological exploration.","authors":"Elisabeth Assing Hvidt, Finn Olesen","doi":"10.1186/s13010-025-00172-4","DOIUrl":"10.1186/s13010-025-00172-4","url":null,"abstract":"<p><strong>Background: </strong>This theoretical paper aims to explore empathy in the context of technologically mediated patient-provider communication, specifically within the context of video- and telehealth consultations. Over the past few decades, empathy has been recognized as a vital component of high-quality patient care, often prioritizing the cognitive over the emotional dimensions of empathy. As healthcare increasingly embraces digital communication technologies, including video consultations, the dynamics of empathy in clinical encounters are altered. With this paper we explore the pertinent question: how do new digital communication modalities impact on empathy and its different dimensions?</p><p><strong>Methods: </strong>To address the above question, we move beyond clinical and applied empathy frameworks instead integrating insights from two related philosophical traditions. First, the classical phenomenological understanding of empathy (represented primarily by Edith Stein) as embodied intuition. Second, the postphenomenological philosophy of technology, represented by Don Ihde and not least inspired by Maurice Merleau-Ponty's phenomenology of embodiment. We apply these theoretical frameworks to empirical analyses of video consultations in general practice and telemedical encounters between chronic obstructive pulmonary disease (COPD) patients and specialist telenurses.</p><p><strong>Results: </strong>Our analysis demonstrates that even though video consultations do not allow for the same level of \"fine-tuned\" body-mediated sensory input, a whole-body empathetic experience can nevertheless be established through (1) the audio-visual sensory impressions that are being mediated by the technology, (2) our whole-body interpretations of this information and (3) our shared experiences of a lifeworld that we actively orient ourselves towards. These experiences may lead to empathetic communication and helping actions that draw on both emotional, intuitive and cognitive dimensions in a holistic manner.</p><p><strong>Conclusion: </strong>Combining theoretical insights from phenomenology and postphenomenology with empirical telehealth analyses, we demonstrate how empathy is both reconfigured through technological mediation and sustained as an embodied, intersubjective practice. We thus conclude that empathetic care practices can be established in technologically mediated encounters through bodily intentionality where our bodies and minds are unified in understanding and connecting with other persons, even though we are not in the same physical space. We propose a theoretical bridge, connecting classical phenomenology and postphenomenology in the context of empathy in technologically mediated patient-provider communication. This bridge is grounded in Merleau-Ponty's conception of whole-body perception and the lifeworld whether through physical proximity or digital interaction.</p>","PeriodicalId":56062,"journal":{"name":"Philosophy Ethics and Humanities in Medicine","volume":"20 1","pages":"11"},"PeriodicalIF":1.7,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12175303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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
Moral distress among healthcare professionals in long-term care settings: a scoping review. 长期护理环境中卫生保健专业人员的道德困扰:范围审查。
IF 1.7 4区 哲学 Q2 ETHICS Pub Date : 2025-06-12 DOI: 10.1186/s13010-025-00171-5
Floor Vinckers, Elleke Landeweer

Aim: To explore the body of knowledge available regarding the moral distress of healthcare professionals in long-term care settings, focusing on influencing factors and strategies to cope with moral distress.

Design: Scoping review.

Methods: This scoping review follows the guidelines of the PRISMA-ScR protocol (Tricco et al. 2018) Searches were done using a strategy that included MeSH terms and free text terms.

Data sources: Data sources were PubMed, CINAHL, Psychinfo and Embase. Searches were done in October 2023 without any date restrictions.

Results: Eight articles were included in this review. Moral distress can impact the wellbeing of healthcare professionals. Influencing factors of moral distress of health care professionals appeared to be lack of resources, lack of communication and incongruence with colleagues. Strategies to cope with moral distress were talking about ethical issues with others, receiving support from colleagues and managers, and seeking support from outside the team or organization. Individual healthcare professionals relied on their personal characteristics or their professional identity and used rationalization, distancing themselves or acceptance of the situation to cope with their moral distress.

Conclusion: Moral distress of healthcare professionals in long-term care settings appears not differently experienced than moral distress among healthcare professionals in other healthcare settings. This can be beneficial in learning from each other, but also raises the question whether moral distress is too broadly defined.

Impact: This review addressed the scope and experiences of moral distress in long-term care settings. Future research can contribute to further insight into if and how specific features of long-term care are of influence on moral distress and formulate tailored strategies to lessen moral distress.

Reporting method: PRISMA-ScR.

目的:探讨长期护理医护人员道德困扰的相关知识体系,重点探讨道德困扰的影响因素和应对策略。设计:范围审查。方法:本次范围审查遵循PRISMA-ScR协议(Tricco等人,2018)的指导方针。使用包含MeSH术语和自由文本术语的策略进行搜索。数据来源:PubMed、CINAHL、Psychinfo和Embase。搜索是在2023年10月进行的,没有任何日期限制。结果:本综述纳入了8篇文章。道德困境会影响医疗保健专业人员的健康。医护人员道德困扰的影响因素为资源缺乏、缺乏沟通和与同事不一致。应对道德困境的策略是与他人谈论道德问题,接受同事和经理的支持,以及寻求团队或组织外部的支持。个体医疗保健专业人员依靠他们的个人特征或他们的职业身份,并使用合理化,保持距离或接受这种情况来应对他们的道德困境。结论:长期护理环境中的医疗保健专业人员的道德困扰与其他医疗保健环境中的医疗保健专业人员的道德困扰没有什么不同。这有利于相互学习,但也提出了一个问题,即道德困境的定义是否过于宽泛。影响:本综述探讨了长期护理环境中道德困扰的范围和经历。未来的研究可以有助于进一步了解长期护理的具体特征是否以及如何影响道德困境,并制定有针对性的策略来减轻道德困境。报告方法:PRISMA-ScR。
{"title":"Moral distress among healthcare professionals in long-term care settings: a scoping review.","authors":"Floor Vinckers, Elleke Landeweer","doi":"10.1186/s13010-025-00171-5","DOIUrl":"10.1186/s13010-025-00171-5","url":null,"abstract":"<p><strong>Aim: </strong>To explore the body of knowledge available regarding the moral distress of healthcare professionals in long-term care settings, focusing on influencing factors and strategies to cope with moral distress.</p><p><strong>Design: </strong>Scoping review.</p><p><strong>Methods: </strong>This scoping review follows the guidelines of the PRISMA-ScR protocol (Tricco et al. 2018) Searches were done using a strategy that included MeSH terms and free text terms.</p><p><strong>Data sources: </strong>Data sources were PubMed, CINAHL, Psychinfo and Embase. Searches were done in October 2023 without any date restrictions.</p><p><strong>Results: </strong>Eight articles were included in this review. Moral distress can impact the wellbeing of healthcare professionals. Influencing factors of moral distress of health care professionals appeared to be lack of resources, lack of communication and incongruence with colleagues. Strategies to cope with moral distress were talking about ethical issues with others, receiving support from colleagues and managers, and seeking support from outside the team or organization. Individual healthcare professionals relied on their personal characteristics or their professional identity and used rationalization, distancing themselves or acceptance of the situation to cope with their moral distress.</p><p><strong>Conclusion: </strong>Moral distress of healthcare professionals in long-term care settings appears not differently experienced than moral distress among healthcare professionals in other healthcare settings. This can be beneficial in learning from each other, but also raises the question whether moral distress is too broadly defined.</p><p><strong>Impact: </strong>This review addressed the scope and experiences of moral distress in long-term care settings. Future research can contribute to further insight into if and how specific features of long-term care are of influence on moral distress and formulate tailored strategies to lessen moral distress.</p><p><strong>Reporting method: </strong>PRISMA-ScR.</p>","PeriodicalId":56062,"journal":{"name":"Philosophy Ethics and Humanities in Medicine","volume":"20 1","pages":"8"},"PeriodicalIF":1.7,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12160104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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
Ethics in aesthetic practice: results from a survey of medical doctors attending aesthetic medicine programs in Italy. 美学实践中的伦理:对意大利参加美学医学项目的医生的调查结果。
IF 1.7 4区 哲学 Q2 ETHICS Pub Date : 2025-05-21 DOI: 10.1186/s13010-025-00169-z
Andrea Margara, Francesca Arrigoni, Emanuele Bartoletti, Loredana Cavalieri, Nadia Fraone, Mario Mariotti, Nadia Tamburlin, Laura Tanzini, Gloria Trocchi, Franco Grimolizzi, Antonio Gioacchino Spagnolo

Background: Within a rapidly evolving digital age in which social media plays a key role, the number of aesthetic medicine procedures performed globally is increasing.

Methods: Physicians who participated in training courses in aesthetic medicine in Italy run by two different medical societies SIME (International School of Aesthetic Medicine Carlo Alberto Bartoletti Foundation) and Agorà (Post-Graduate School of Aesthetic Medicine Agorà), completed a survey (November 2023 - January 2024) to assess their viewpoints on ethics in aesthetic medicine and findings combined.

Results: Of 452 physicians, 72.6% - 88.2% strongly agreed about the importance of maintaining up-to-date aesthetic medicine knowledge, protecting patient confidentiality, appropriate patient communication, prioritizing patient care and safety, respecting patient dignity and privacy, and obtaining informed consent. Around half of the respondents strongly agreed with correlations between social media (including the use of filters, idealized photos, and the constant sharing of content for personalized feedback) and psychological dysfunctions/body dissatisfaction, and that physicians should examine patients with highly filtered photographs for warning signs and unrealistic expectations. Approximately 15.4% - 55.0% strongly agreed with the importance of focusing on the patient's best interest, not performing procedures on those with unrealistic expectations, letting patients decide who to involve in consultations, education in key ethical principles in aesthetic medicine (including patient autonomy and self-determination), submitting experimental aesthetic procedures to a territorial ethics committee, and obtaining informed consent from adolescents for their procedures (as well as their parents/caregivers). 43.0% - 52.0% strongly disagreed that it was unnecessary to communicate all treatment information to patients, hear and respect patient opinions, or involve patients in decisions. One-third of respondents reported previously encountering ethical issues for treatment.

Conclusion: In a survey of physicians focused on ethics in aesthetic medicine, most strongly agreed with key ethical principles in aesthetic medicine; however, more formal education/training was required to highlight the importance of patient autonomy and self-determination principles, involving patients in decisions, focusing on the patient's best interest, hearing/respecting patient opinion, avoiding procedures on those with unrealistic expectations, communicating all treatment aspects to patients, letting patients decide who to involve in consultations, and understanding the negative impact of social media on patients.

背景:在快速发展的数字时代,社交媒体发挥着关键作用,全球范围内进行的美容医学手术数量正在增加。方法:在意大利参加由两个不同的医学协会SIME(国际美容医学学院Carlo Alberto Bartoletti基金会)和agor(美容医学研究生院)举办的美容医学培训课程的医生完成了一项调查(2023年11月至2024年1月),评估他们对美容医学伦理学的看法和调查结果。结果:452名医生中,72.6% ~ 88.2%强烈认同保持最新美容医学知识、保护患者隐私、适当的患者沟通、优先考虑患者护理和安全、尊重患者尊严和隐私以及获得知情同意的重要性。大约一半的受访者强烈同意社交媒体(包括使用过滤器、理想化的照片和不断分享内容以获得个性化反馈)与心理功能障碍/身体不满之间的相关性,并且医生应该用高度过滤的照片检查患者,以寻找警告信号和不切实际的期望。大约15.4% - 55.0%的人强烈同意以下观点的重要性:关注患者的最大利益,不为那些有不切实际期望的人实施手术,让患者决定谁参与咨询,对美容医学的关键伦理原则进行教育(包括患者自主和自决),将实验性美容手术提交给地区伦理委员会。获得青少年(以及他们的父母/照顾者)对手术的知情同意。43.0% - 52.0%强烈反对与患者沟通所有治疗信息、听取和尊重患者意见、让患者参与决策的必要性。三分之一的受访者报告说,他们以前在治疗过程中遇到过道德问题。结论:在一项关注美容医学伦理的医生调查中,大多数医生强烈同意美容医学的关键伦理原则;然而,需要更多的正规教育/培训来强调患者自主和自决原则的重要性,让患者参与决策,关注患者的最大利益,倾听/尊重患者的意见,避免对那些不切实际的期望进行手术,与患者沟通所有治疗方面,让患者决定谁参与咨询,以及了解社交媒体对患者的负面影响。
{"title":"Ethics in aesthetic practice: results from a survey of medical doctors attending aesthetic medicine programs in Italy.","authors":"Andrea Margara, Francesca Arrigoni, Emanuele Bartoletti, Loredana Cavalieri, Nadia Fraone, Mario Mariotti, Nadia Tamburlin, Laura Tanzini, Gloria Trocchi, Franco Grimolizzi, Antonio Gioacchino Spagnolo","doi":"10.1186/s13010-025-00169-z","DOIUrl":"10.1186/s13010-025-00169-z","url":null,"abstract":"<p><strong>Background: </strong>Within a rapidly evolving digital age in which social media plays a key role, the number of aesthetic medicine procedures performed globally is increasing.</p><p><strong>Methods: </strong>Physicians who participated in training courses in aesthetic medicine in Italy run by two different medical societies SIME (International School of Aesthetic Medicine Carlo Alberto Bartoletti Foundation) and Agorà (Post-Graduate School of Aesthetic Medicine Agorà), completed a survey (November 2023 - January 2024) to assess their viewpoints on ethics in aesthetic medicine and findings combined.</p><p><strong>Results: </strong>Of 452 physicians, 72.6% - 88.2% strongly agreed about the importance of maintaining up-to-date aesthetic medicine knowledge, protecting patient confidentiality, appropriate patient communication, prioritizing patient care and safety, respecting patient dignity and privacy, and obtaining informed consent. Around half of the respondents strongly agreed with correlations between social media (including the use of filters, idealized photos, and the constant sharing of content for personalized feedback) and psychological dysfunctions/body dissatisfaction, and that physicians should examine patients with highly filtered photographs for warning signs and unrealistic expectations. Approximately 15.4% - 55.0% strongly agreed with the importance of focusing on the patient's best interest, not performing procedures on those with unrealistic expectations, letting patients decide who to involve in consultations, education in key ethical principles in aesthetic medicine (including patient autonomy and self-determination), submitting experimental aesthetic procedures to a territorial ethics committee, and obtaining informed consent from adolescents for their procedures (as well as their parents/caregivers). 43.0% - 52.0% strongly disagreed that it was unnecessary to communicate all treatment information to patients, hear and respect patient opinions, or involve patients in decisions. One-third of respondents reported previously encountering ethical issues for treatment.</p><p><strong>Conclusion: </strong>In a survey of physicians focused on ethics in aesthetic medicine, most strongly agreed with key ethical principles in aesthetic medicine; however, more formal education/training was required to highlight the importance of patient autonomy and self-determination principles, involving patients in decisions, focusing on the patient's best interest, hearing/respecting patient opinion, avoiding procedures on those with unrealistic expectations, communicating all treatment aspects to patients, letting patients decide who to involve in consultations, and understanding the negative impact of social media on patients.</p>","PeriodicalId":56062,"journal":{"name":"Philosophy Ethics and Humanities in Medicine","volume":"20 1","pages":"12"},"PeriodicalIF":1.7,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12093754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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
An investigation into mental illness and its comorbidities from the perspective of supervenience physicalism. 监督物理主义视角下的精神疾病及其合并症研究。
IF 1.7 4区 哲学 Q2 ETHICS Pub Date : 2025-05-08 DOI: 10.1186/s13010-025-00174-2
Ping Yang, Xinyue Zhang, Hongwen Song, Xiaochu Zhang

The exploration into the origin of human spirituality has always been a hot spot with many unsolved questions in the philosophy of mind, and issues concerning mental illness and its comorbidities are still unclear. In the 1970s, Donald Davidson first proposed anomalous monism with the supervenience concept, a theory that both insists on physicalism and transcends traditional reductionism. This theory provides solid and accessible proof for perceiving the mind-body relationship of spiritual origin in a non-reductionist approach. This paper develops arguments in two aspects. First, three principles of anomalous monism are employed to explore the origin of mental illness. Second, the comorbidity of mental illness is explained with the help of the supervenience theory.

人类精神起源的探索一直是心灵哲学的热点,有许多未解之谜,精神疾病及其合并症的问题仍不清楚。20世纪70年代,唐纳德·戴维森首先提出了反常一元论与监督概念,这是一种既坚持物理主义又超越传统还原论的理论。这一理论为以非还原论的方法来感知精神起源的身心关系提供了坚实和可接近的证据。本文从两个方面展开论述。首先,运用反常一元论的三个原则来探讨精神疾病的起源。其次,借助监督理论解释了精神疾病的共病性。
{"title":"An investigation into mental illness and its comorbidities from the perspective of supervenience physicalism.","authors":"Ping Yang, Xinyue Zhang, Hongwen Song, Xiaochu Zhang","doi":"10.1186/s13010-025-00174-2","DOIUrl":"https://doi.org/10.1186/s13010-025-00174-2","url":null,"abstract":"<p><p>The exploration into the origin of human spirituality has always been a hot spot with many unsolved questions in the philosophy of mind, and issues concerning mental illness and its comorbidities are still unclear. In the 1970s, Donald Davidson first proposed anomalous monism with the supervenience concept, a theory that both insists on physicalism and transcends traditional reductionism. This theory provides solid and accessible proof for perceiving the mind-body relationship of spiritual origin in a non-reductionist approach. This paper develops arguments in two aspects. First, three principles of anomalous monism are employed to explore the origin of mental illness. Second, the comorbidity of mental illness is explained with the help of the supervenience theory.</p>","PeriodicalId":56062,"journal":{"name":"Philosophy Ethics and Humanities in Medicine","volume":"20 1","pages":"10"},"PeriodicalIF":1.7,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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
Conceptualizing resilience in public health: a philosophical approach. 公共卫生中的复原力概念化:一种哲学方法。
IF 1.7 4区 哲学 Q2 ETHICS Pub Date : 2025-04-24 DOI: 10.1186/s13010-025-00173-3
Jishnu Pawan K, Mala Ramanathan

Background: The initial inquiry into the concept revealed its usage as a boundary object and how this facilitated its interdisciplinary utilization. The same feature enabled the shift to literature within other disciplines and then identify its conceptualization in them. This led to the understanding that though many disciplines have used the term resilience to describe a phenomenon with a general understanding of "bouncing back to original position", its multi-disciplinary usage has added a lexical ambiguity to the term. The purpose of the study is to utilize this broad and overlapping nature of resilience to identify those elements, models or pathways that might enable conceptualizing resilience in the context of public health. In this process we uncover the underlying philosophical elements that converge or diverge with the whole conceptualization process of resilience in the discipline of public health.

Methods: We used a modified integrated review of the body of literature while also reflecting on how the concept of resilience has evolved from a narrow, "Substance Metaphysics," "Reductionist" phenomenon to a more expansive, "Multi-Dimensional," "Intersectional," and "Dynamic phenomenon." Afterwards, existing philosophical theories that converged or diverged with the conceptualization process were used to further validate the entire process that resulted in the definition of resilience in the context of public health emergencies.

Results: The critical evaluation of existing literature led to the identification of two patterns by which resilience has been conceptualized across disciplines. One on the basis of engagement with acute or enduring crisis resulting in trajectories that enables stability or growth and transformation. Another on the basis of the levels at which it was conceptualized by various authors from multiple disciplines. The two approaches were later critically evaluated so as to conceptualize resilience in the context of public health.

Conclusion: An integrated response to the crisis may be necessary to preserve people's health and the health of communities in order for them to be resilient. Resilience in public health is a result of the successful engagement of relevant stakeholders responsible for health preservation to current and emerging health inequalities that places them in enabling trajectories of sustenance or growth leading to the development of potential capabilities that are sensitive to diverse health disparities.

背景:对这一概念的初步研究揭示了它作为边界对象的用途,以及这如何促进了它的跨学科应用。同样的特征使得文学在其他学科中转移,然后在这些学科中确定其概念化。这导致了这样一种理解,即尽管许多学科都使用弹性一词来描述一种现象,并普遍理解为“反弹到原来的位置”,但它的多学科使用给这个词增加了词汇上的歧义。这项研究的目的是利用复原力的这种广泛和重叠的性质来确定那些可能在公共卫生背景下概念化复原力的要素、模型或途径。在这个过程中,我们揭示了与公共卫生学科中弹性的整个概念化过程一致或不同的潜在哲学元素。方法:我们对文献进行了修改后的综合回顾,同时也反思了弹性的概念是如何从狭义的“物质形而上学”、“还原论”现象演变为更广泛的“多维”、“交叉”和“动态现象”的。随后,利用与概念化过程趋同或分歧的现有哲学理论,进一步验证突发公共卫生事件背景下韧性定义的整个过程。结果:对现有文献的批判性评估导致了两种模式的识别,通过这种模式,弹性已经被跨学科的概念化。一个是基于与严重的或持久的危机接触,从而产生能够实现稳定或增长和转型的轨迹。另一种是基于不同的层次,来自不同学科的不同作者对其进行了概念化。后来对这两种方法进行了严格评估,以便在公共卫生的背景下将复原力概念化。结论:可能需要对危机采取综合应对措施,以保护人民健康和社区健康,使其具有复原力。公共卫生的复原力是负责健康保护的相关利益攸关方成功参与当前和新出现的健康不平等现象的结果,这种不平等使他们处于维持或增长的有利轨道,从而发展对各种健康差异敏感的潜在能力。
{"title":"Conceptualizing resilience in public health: a philosophical approach.","authors":"Jishnu Pawan K, Mala Ramanathan","doi":"10.1186/s13010-025-00173-3","DOIUrl":"https://doi.org/10.1186/s13010-025-00173-3","url":null,"abstract":"<p><strong>Background: </strong>The initial inquiry into the concept revealed its usage as a boundary object and how this facilitated its interdisciplinary utilization. The same feature enabled the shift to literature within other disciplines and then identify its conceptualization in them. This led to the understanding that though many disciplines have used the term resilience to describe a phenomenon with a general understanding of \"bouncing back to original position\", its multi-disciplinary usage has added a lexical ambiguity to the term. The purpose of the study is to utilize this broad and overlapping nature of resilience to identify those elements, models or pathways that might enable conceptualizing resilience in the context of public health. In this process we uncover the underlying philosophical elements that converge or diverge with the whole conceptualization process of resilience in the discipline of public health.</p><p><strong>Methods: </strong>We used a modified integrated review of the body of literature while also reflecting on how the concept of resilience has evolved from a narrow, \"Substance Metaphysics,\" \"Reductionist\" phenomenon to a more expansive, \"Multi-Dimensional,\" \"Intersectional,\" and \"Dynamic phenomenon.\" Afterwards, existing philosophical theories that converged or diverged with the conceptualization process were used to further validate the entire process that resulted in the definition of resilience in the context of public health emergencies.</p><p><strong>Results: </strong>The critical evaluation of existing literature led to the identification of two patterns by which resilience has been conceptualized across disciplines. One on the basis of engagement with acute or enduring crisis resulting in trajectories that enables stability or growth and transformation. Another on the basis of the levels at which it was conceptualized by various authors from multiple disciplines. The two approaches were later critically evaluated so as to conceptualize resilience in the context of public health.</p><p><strong>Conclusion: </strong>An integrated response to the crisis may be necessary to preserve people's health and the health of communities in order for them to be resilient. Resilience in public health is a result of the successful engagement of relevant stakeholders responsible for health preservation to current and emerging health inequalities that places them in enabling trajectories of sustenance or growth leading to the development of potential capabilities that are sensitive to diverse health disparities.</p>","PeriodicalId":56062,"journal":{"name":"Philosophy Ethics and Humanities in Medicine","volume":"20 1","pages":"7"},"PeriodicalIF":1.7,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12020116/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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
Unveiling the shadows: obstacles, consequences, and challenges of information opacity in healthcare systems. 揭开阴影:医疗保健系统中信息不透明的障碍、后果和挑战。
IF 1.7 4区 哲学 Q2 ETHICS Pub Date : 2025-04-14 DOI: 10.1186/s13010-025-00170-6
Majid Alizadeh, Nazila Azizi, Samireh Mahdavi, Fouad Baghlani

Introduction: Information transparency in healthcare systems is critical for ensuring public trust, enhancing service quality, and reducing costs. However, many countries face significant challenges concerning information opacity, which leads to inequality, discrimination, and increased risks for patients and healthcare providers. This study aims to explore the obstacles, consequences, and challenges of information opacity in healthcare systems, along with proposing solutions for improvement.

Method: This review synthesized findings from scientific literature, including articles, reports, and governmental sources, to investigate how the lack of information transparency affects healthcare performance and public trust. A comprehensive search was conducted across major databases such as PubMed, Scopus, and Google Scholar, utilizing relevant keywords. Selection criteria focused on the relevance, quality, and timeliness of the sources, leading to a critical analysis of the extracted data through thematic synthesis.

Findings: The study identifies several key consequences of information opacity, including a decrease in public trust, reduced service quality, increased corruption, and heightened healthcare costs. The findings align with existing literature that highlights the importance of transparency for effective decision-making and accountability in healthcare systems. Furthermore, obstacles to achieving transparency were identified, such as difficulties in accessing necessary information, privacy concerns, commercial interests, and the need for systemic reforms in healthcare financing.

Discussion: The implications of this study underscore the necessity for clear policies and procedures regarding information dissemination in healthcare. The proposed framework for improving transparency includes establishing robust communication channels, enhancing public access to information, fostering a culture of accountability, and leveraging emerging technologies like blockchain and artificial intelligence. Addressing these challenges is essential for building trust and improving healthcare outcomes.

Conclusion: Enhancing information transparency within healthcare systems is vital for improving public trust and service quality. This study provides a foundational framework for policymakers to implement necessary changes, promoting a more equitable and efficient healthcare environment. Future research should focus on evaluating the effectiveness of these proposed measures in diverse healthcare contexts, particularly by integrating theoretical frameworks such as stakeholder theory and institutional theory.

简介:医疗保健系统的信息透明对于确保公众信任、提高服务质量和降低成本至关重要。然而,许多国家面临着信息不透明方面的重大挑战,这导致不平等和歧视,并增加了患者和医疗保健提供者的风险。本研究旨在探讨医疗保健系统中信息不透明的障碍、后果和挑战,并提出改进的解决方案。方法:本综述综合了来自科学文献的发现,包括文章、报告和政府来源,以调查缺乏信息透明度如何影响医疗保健绩效和公众信任。利用相关关键词,在PubMed、Scopus和b谷歌Scholar等主要数据库中进行了全面的搜索。选择标准侧重于来源的相关性、质量和及时性,从而通过专题综合对提取的数据进行批判性分析。研究结果:该研究确定了信息不透明的几个主要后果,包括公众信任度下降、服务质量下降、腐败加剧和医疗成本上升。研究结果与现有文献一致,强调了透明度对医疗保健系统有效决策和问责制的重要性。此外,还确定了实现透明度的障碍,例如获取必要信息的困难、隐私问题、商业利益以及在医疗融资方面进行系统性改革的必要性。讨论:本研究的意义强调了在医疗保健信息传播方面制定明确政策和程序的必要性。拟议的提高透明度的框架包括建立健全的沟通渠道,加强公众获取信息的渠道,培养问责文化,以及利用区块链和人工智能等新兴技术。应对这些挑战对于建立信任和改善医疗保健结果至关重要。结论:提高医疗卫生系统信息透明度对提高公众信任和服务质量至关重要。本研究为决策者提供了一个基础框架,以实施必要的变革,促进更公平和高效的医疗保健环境。未来的研究应侧重于评估这些拟议措施在不同医疗保健背景下的有效性,特别是通过整合理论框架,如利益相关者理论和制度理论。
{"title":"Unveiling the shadows: obstacles, consequences, and challenges of information opacity in healthcare systems.","authors":"Majid Alizadeh, Nazila Azizi, Samireh Mahdavi, Fouad Baghlani","doi":"10.1186/s13010-025-00170-6","DOIUrl":"https://doi.org/10.1186/s13010-025-00170-6","url":null,"abstract":"<p><strong>Introduction: </strong>Information transparency in healthcare systems is critical for ensuring public trust, enhancing service quality, and reducing costs. However, many countries face significant challenges concerning information opacity, which leads to inequality, discrimination, and increased risks for patients and healthcare providers. This study aims to explore the obstacles, consequences, and challenges of information opacity in healthcare systems, along with proposing solutions for improvement.</p><p><strong>Method: </strong>This review synthesized findings from scientific literature, including articles, reports, and governmental sources, to investigate how the lack of information transparency affects healthcare performance and public trust. A comprehensive search was conducted across major databases such as PubMed, Scopus, and Google Scholar, utilizing relevant keywords. Selection criteria focused on the relevance, quality, and timeliness of the sources, leading to a critical analysis of the extracted data through thematic synthesis.</p><p><strong>Findings: </strong>The study identifies several key consequences of information opacity, including a decrease in public trust, reduced service quality, increased corruption, and heightened healthcare costs. The findings align with existing literature that highlights the importance of transparency for effective decision-making and accountability in healthcare systems. Furthermore, obstacles to achieving transparency were identified, such as difficulties in accessing necessary information, privacy concerns, commercial interests, and the need for systemic reforms in healthcare financing.</p><p><strong>Discussion: </strong>The implications of this study underscore the necessity for clear policies and procedures regarding information dissemination in healthcare. The proposed framework for improving transparency includes establishing robust communication channels, enhancing public access to information, fostering a culture of accountability, and leveraging emerging technologies like blockchain and artificial intelligence. Addressing these challenges is essential for building trust and improving healthcare outcomes.</p><p><strong>Conclusion: </strong>Enhancing information transparency within healthcare systems is vital for improving public trust and service quality. This study provides a foundational framework for policymakers to implement necessary changes, promoting a more equitable and efficient healthcare environment. Future research should focus on evaluating the effectiveness of these proposed measures in diverse healthcare contexts, particularly by integrating theoretical frameworks such as stakeholder theory and institutional theory.</p>","PeriodicalId":56062,"journal":{"name":"Philosophy Ethics and Humanities in Medicine","volume":"20 1","pages":"6"},"PeriodicalIF":1.7,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11995619/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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
Bioethical evaluation of methylphenidate and atomoxetine for pediatric ADHD and cognitive enhancement. 哌醋甲酯和托莫西汀对儿童多动症和认知增强的生物伦理学评价。
IF 1.7 4区 哲学 Q2 ETHICS Pub Date : 2025-03-19 DOI: 10.1186/s13010-025-00167-1
Enrique Burguete, Luisa Peydro, Ignacio Ventura

Background: This article presents a bioethical analysis of the use of Methylphenidate and Atomoxetine, exploring their roles as cognitive enhancers and therapeutic agents for Attention Deficit Hyperactivity Disorder (ADHD).

Methods: The analysis centers around the principle of non-maleficence, examining the ethical implications of causing harm in the pursuit of cognitive enhancement and therapeutic benefits. It delves into the blurred boundaries between therapy and enhancement and the challenges of defining "necessary harm" in these contexts.

Results: When used for cognitive enhancement rather than therapeutic purposes, methylphenidate challenges the concept of "necessary harm," raising ethical concerns about seeking improvement at the cost of potential adverse effects. The very notion of neurocognitive enhancement remains controversial in the absence of a clinical pathology. In pediatric ADHD, there is a significant lack of long-term data on both therapeutic benefits and adverse effects beyond 30 weeks of treatment. Clinical trials have highlighted safety concerns, as methylphenidate has been linked to sleep disturbances, anorexia, nervous conditions, and, in rare cases, cardiac events. Additionally, exposure during pregnancy may pose risks of congenital malformations. While atomoxetine generally has minor side effects, occasional reports of suicidal tendencies warrant caution.

Discussion: The article discusses the philosophical and ethical underpinnings of human nature, individual autonomy, and the pursuit of enhancement, drawing on historical perspectives from figures like Julian Huxley and contemporary transhumanist ideals.

Conclusion: The study advocates for a cautious approach to cognitive enhancement, emphasizing the preservation of the individual's well-being over performance gains. In the context of ADHD treatment, it calls for an ethical examination of the long-term effects of Methylphenidate and Atomoxetine use in children and adolescents, recommending a preference for behavioral treatments when possible. Pediatric ADHD: There is a notable scarcity of data regarding the prevalence of therapeutic benefits and/or adverse effects in treatments exceeding 30 weeks. Furthermore, clinical trials concerning its safety and the lack of long-term data compromise the principle of non-maleficence, as we know that the use of Methylphenidate can lead to sleep disorders, anorexic conditions, nervous disorders, and has occasionally been associated with cardiac events. It also has effects on pregnancy that can lead to malformations in offspring. And although the unwanted effects associated with atomoxetine are generally minor, suicidal tendencies have been occasionally reported.

背景:本文对哌醋甲酯和阿托莫西汀的使用进行了生物伦理学分析,探讨了它们作为认知增强剂和治疗注意缺陷多动障碍(ADHD)的作用。方法:分析围绕非恶意原则,检查在追求认知增强和治疗效益的过程中造成伤害的伦理含义。它深入研究了治疗和增强之间模糊的界限,以及在这些情况下定义“必要伤害”的挑战。结果:当用于认知增强而非治疗目的时,哌醋甲酯挑战了“必要伤害”的概念,提出了以潜在副作用为代价寻求改善的伦理问题。在缺乏临床病理学的情况下,神经认知增强的概念仍然存在争议。在小儿多动症中,严重缺乏治疗益处和治疗30周后不良反应的长期数据。临床试验强调了安全性问题,因为哌甲酯与睡眠障碍、厌食症、神经状况有关,在极少数情况下,还与心脏事件有关。此外,在怀孕期间接触可能会造成先天性畸形的风险。虽然托莫西汀通常有轻微的副作用,但偶尔有自杀倾向的报道需要谨慎。讨论:本文从朱利安·赫胥黎(Julian Huxley)等人物和当代超人类主义理想的历史视角出发,讨论了人性、个人自治和追求提升的哲学和伦理基础。结论:该研究提倡对认知增强采取谨慎的方法,强调保持个人的幸福而不是表现的提高。在ADHD治疗的背景下,它呼吁对儿童和青少年使用哌醋甲酯和阿托莫西汀的长期影响进行伦理检查,并建议在可能的情况下优先采用行为治疗。小儿多动症:关于治疗超过30周的疗效和/或不良反应的普遍数据明显缺乏。此外,关于其安全性的临床试验和缺乏长期数据损害了非有害原则,因为我们知道使用哌醋甲酯会导致睡眠障碍、厌食症、神经障碍,偶尔还与心脏事件有关。它对怀孕也有影响,可能导致后代畸形。尽管与托莫西汀相关的不良影响通常很小,但偶尔也有自杀倾向的报道。
{"title":"Bioethical evaluation of methylphenidate and atomoxetine for pediatric ADHD and cognitive enhancement.","authors":"Enrique Burguete, Luisa Peydro, Ignacio Ventura","doi":"10.1186/s13010-025-00167-1","DOIUrl":"10.1186/s13010-025-00167-1","url":null,"abstract":"<p><strong>Background: </strong>This article presents a bioethical analysis of the use of Methylphenidate and Atomoxetine, exploring their roles as cognitive enhancers and therapeutic agents for Attention Deficit Hyperactivity Disorder (ADHD).</p><p><strong>Methods: </strong>The analysis centers around the principle of non-maleficence, examining the ethical implications of causing harm in the pursuit of cognitive enhancement and therapeutic benefits. It delves into the blurred boundaries between therapy and enhancement and the challenges of defining \"necessary harm\" in these contexts.</p><p><strong>Results: </strong>When used for cognitive enhancement rather than therapeutic purposes, methylphenidate challenges the concept of \"necessary harm,\" raising ethical concerns about seeking improvement at the cost of potential adverse effects. The very notion of neurocognitive enhancement remains controversial in the absence of a clinical pathology. In pediatric ADHD, there is a significant lack of long-term data on both therapeutic benefits and adverse effects beyond 30 weeks of treatment. Clinical trials have highlighted safety concerns, as methylphenidate has been linked to sleep disturbances, anorexia, nervous conditions, and, in rare cases, cardiac events. Additionally, exposure during pregnancy may pose risks of congenital malformations. While atomoxetine generally has minor side effects, occasional reports of suicidal tendencies warrant caution.</p><p><strong>Discussion: </strong>The article discusses the philosophical and ethical underpinnings of human nature, individual autonomy, and the pursuit of enhancement, drawing on historical perspectives from figures like Julian Huxley and contemporary transhumanist ideals.</p><p><strong>Conclusion: </strong>The study advocates for a cautious approach to cognitive enhancement, emphasizing the preservation of the individual's well-being over performance gains. In the context of ADHD treatment, it calls for an ethical examination of the long-term effects of Methylphenidate and Atomoxetine use in children and adolescents, recommending a preference for behavioral treatments when possible. Pediatric ADHD: There is a notable scarcity of data regarding the prevalence of therapeutic benefits and/or adverse effects in treatments exceeding 30 weeks. Furthermore, clinical trials concerning its safety and the lack of long-term data compromise the principle of non-maleficence, as we know that the use of Methylphenidate can lead to sleep disorders, anorexic conditions, nervous disorders, and has occasionally been associated with cardiac events. It also has effects on pregnancy that can lead to malformations in offspring. And although the unwanted effects associated with atomoxetine are generally minor, suicidal tendencies have been occasionally reported.</p>","PeriodicalId":56062,"journal":{"name":"Philosophy Ethics and Humanities in Medicine","volume":"20 1","pages":"5"},"PeriodicalIF":1.7,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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
The ethical considerations of primordial pandemic prevention from a one health perspective. 从单一健康角度看原始大流行预防的伦理考虑。
IF 1.7 4区 哲学 Q2 ETHICS Pub Date : 2025-03-12 DOI: 10.1186/s13010-025-00166-2
Rebecca Shalansky, Ross Upshur

Background: The coronavirus disease 2019 (COVID-19) pandemic has left a devastating global toll. As such, there is a strong impetus to prevent future global pandemics. Ethical considerations are an integral element of pandemic preparedness and response plans and should be incorporated into any pandemic prevention plan to explicitly examine the incorporated values from various stakeholders. Our study aims to determine the ethical considerations of primordial pandemic prevention from a One Health perspective.

Methods: This was a prospective Delphi consensus seeking-study. We aimed to recruit a purposive, globally representative sample of experts in the fields of public health ethics, One Health ethics, pandemic ethics and pandemic prevention. Two rounds were completed between November 2021, and January 2022. The first round consisted of open-ended questions to establish ethical considerations for primordial pandemic prevention. Thematic analysis was used to uncover themes. The second-round presented the ethical consideration results of the first round, and asked participants to rate the importance of each of them.

Results: The first-round had 27 participants, and the second-round had 25 participants. Both rounds had global representation from all intended fields of expertise. There were five ethical considerations for which consensus was achieved: Promoting equity, global collective effort, distributive justice, evidence-based efficiency and the interconnectedness of humans, animals and the environment.

Conclusions: Our study identified five ethical considerations for primordial pandemic prevention from a globally representative sample. The findings will contribute to current and future pandemic prevention policy, and expand ethics research in the fields of One Health, pandemic prevention and zoonotic disease control.

背景:2019年冠状病毒病(COVID-19)大流行给全球造成了毁灭性的损失。因此,我们有强大的动力来预防未来的全球流行病。伦理考虑是大流行病防范和应对计划的一个组成部分,应纳入任何大流行病预防计划,以明确审查各利益攸关方所纳入的价值观。我们的研究旨在从“同一个健康”的角度确定原始大流行预防的伦理考虑。方法:前瞻性德尔菲共识寻求研究。我们的目标是在公共卫生伦理、“同一健康”伦理、大流行病伦理和大流行病预防领域招募有目的的、具有全球代表性的专家样本。两轮测试在2021年11月和2022年1月之间完成。第一轮由开放式问题组成,以确定原始大流行病预防的伦理考虑。主题分析是用来揭示主题的。第二轮展示了第一轮的伦理考虑结果,并要求参与者对每一项的重要性进行评分。结果:第一轮27人,第二轮25人。这两轮会议都有来自所有预期专业领域的全球代表。达成共识的五个伦理考虑因素是:促进公平、全球集体努力、分配正义、循证效率以及人类、动物和环境的相互联系。结论:我们的研究从具有全球代表性的样本中确定了预防大流行的五个伦理考虑因素。这些发现将有助于当前和未来的大流行预防政策,并扩大“同一个健康”、大流行预防和人畜共患疾病控制领域的伦理学研究。
{"title":"The ethical considerations of primordial pandemic prevention from a one health perspective.","authors":"Rebecca Shalansky, Ross Upshur","doi":"10.1186/s13010-025-00166-2","DOIUrl":"10.1186/s13010-025-00166-2","url":null,"abstract":"<p><strong>Background: </strong>The coronavirus disease 2019 (COVID-19) pandemic has left a devastating global toll. As such, there is a strong impetus to prevent future global pandemics. Ethical considerations are an integral element of pandemic preparedness and response plans and should be incorporated into any pandemic prevention plan to explicitly examine the incorporated values from various stakeholders. Our study aims to determine the ethical considerations of primordial pandemic prevention from a One Health perspective.</p><p><strong>Methods: </strong>This was a prospective Delphi consensus seeking-study. We aimed to recruit a purposive, globally representative sample of experts in the fields of public health ethics, One Health ethics, pandemic ethics and pandemic prevention. Two rounds were completed between November 2021, and January 2022. The first round consisted of open-ended questions to establish ethical considerations for primordial pandemic prevention. Thematic analysis was used to uncover themes. The second-round presented the ethical consideration results of the first round, and asked participants to rate the importance of each of them.</p><p><strong>Results: </strong>The first-round had 27 participants, and the second-round had 25 participants. Both rounds had global representation from all intended fields of expertise. There were five ethical considerations for which consensus was achieved: Promoting equity, global collective effort, distributive justice, evidence-based efficiency and the interconnectedness of humans, animals and the environment.</p><p><strong>Conclusions: </strong>Our study identified five ethical considerations for primordial pandemic prevention from a globally representative sample. The findings will contribute to current and future pandemic prevention policy, and expand ethics research in the fields of One Health, pandemic prevention and zoonotic disease control.</p>","PeriodicalId":56062,"journal":{"name":"Philosophy Ethics and Humanities in Medicine","volume":"20 1","pages":"4"},"PeriodicalIF":1.7,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11900536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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
Philosophy Ethics and Humanities in Medicine
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
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:604180095
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