Med Health Care Philos [JOURNAL]
Sun
200 papers
Reclaiming human dignity: a critical review of contemporary theories in light of ontological foundations.
Frantz P, Rego F, Barbas S
Med Health Care Philos · 2025 Dec · PMID 40751873 · Full text
Contemporary healthcare ethics often invokes the concept of human dignity as a normative cornerstone. Yet beneath this apparent consensus lies a fragmentation of meaning: dignity is variably interpreted as autonomy, capa...
Contemporary healthcare ethics often invokes the concept of human dignity as a normative cornerstone. Yet beneath this apparent consensus lies a fragmentation of meaning: dignity is variably interpreted as autonomy, capacity, recognition, or social construction-with little agreement on its essential content or justification. This conceptual disarray weakens the ethical coherence of bioethical decision-making and obscures the true nature of the human person. This article offers a critical review of the predominant contemporary theories of human dignity, including recognition-based approaches, capabilities theory, procedural pragmatism, and postmodern critiques. We expose the internal tensions and philosophical fragilities of each, especially when applied to medical practice. In contrast, we defend an ontologically grounded understanding of dignity-one that recognizes the human being as a unified, rational, embodied substance possessing intrinsic worth by virtue of being. By recovering this ontological foundation, we argue for a more coherent, universal, and morally resilient framework for healthcare ethics-one capable of upholding the inviolability of the person beyond shifting cultural, legal, or utilitarian paradigms.
Addressing the overuse-underuse paradox in healthcare.
Hofmann B
Med Health Care Philos · 2025 Dec · PMID 40742671 · Full text
There is a basic contradiction in modern healthcare: while there is an urgent need for more resources to provide documented effective care in many health systems, the same systems provide extensive services that are repo...
There is a basic contradiction in modern healthcare: while there is an urgent need for more resources to provide documented effective care in many health systems, the same systems provide extensive services that are reported to have little or no effect on people's health. This induces long wait times, delayed diagnoses and treatments, poorer prognosis, and worse outcomes. That is, a wide range of studies have demonstrated health care systems to provide large volumes of low-value services while not being able to provide much needed high-value services. This contradiction between simultaneous overuse and underuse can be analysed in a paradox framework. Moreover, identifying the drivers of overuse and underuse can help us develop strategies to curb the problem, its implications, and free resources for reducing underuse. Hence, resolving the overuse-underuse paradox is crucial for the viability of healthcare systems: for the safety, quality, effectiveness, efficiency, and sustainability of care.
Integrating ethics in digital mental healthcare technologies: a principle-based empirically grounded roadmap approach.
Spahl W, Rubeis G
Med Health Care Philos · 2025 Sep · PMID 40736629 · Full text
Digital mental healthcare technologies increasingly incorporate gamification, yet relevant ethical considerations remain underexamined. This paper introduces the Principle-Based Empirically Grounded Roadmap Approach (PER...
Digital mental healthcare technologies increasingly incorporate gamification, yet relevant ethical considerations remain underexamined. This paper introduces the Principle-Based Empirically Grounded Roadmap Approach (PERA), a methodological contribution to empirical bioethics. It has evolved from ethics research within the Horizon Europe project ASPbelong, which designs a collaboratively played augmented reality intervention for adolescents. PERA refines existing integrated empirical bioethics methodologies by responding to three key characteristics of the use case: a largely predetermined technology with a relatively low degree of openness in technological design, embedded co-development practices led by facilitators from within the project team, and planned future iterations beyond the ethics team's involvement. PERA integrates mapping of principles from the ethics literature, a scoping review of the moral intuitions of developers of comparable technologies, and the collection of original empirical data on the use case. Using abductive reasoning, these insights are synthesized into a tangible output: an ethics roadmap designed to guide and be adapted in future use case iterations. By advancing a methodology of combining normative reasoning with empirical insights on a concrete use case, this paper provides both practical tools for ethics researchers in technology projects and a means to generate empirically grounded conceptual contributions. Its outcomes, when brought into dialogue with findings from other integrated empirical bioethics research, can support the critical examination of broader assumptions and implications of gamified mental healthcare, including questions of good care and the broader social implications of such technologies.
Rethinking reversibility.
Gordijn B, Ten Have H
Med Health Care Philos · 2025 Sep · PMID 40728827 · Publisher ↗
Abstract loading — click title to view on PubMed.
Epistemic injustice suffered by patients with rare diseases, poorly understood diseases, and underdiagnosed diseases, and the epistemic advantage granted by these diseases.
Tosas MR
Med Health Care Philos · 2025 Dec · PMID 40728826 · Publisher ↗
Fricker (Epistemic Injustice. Power and the Ethics of Knowing, Oxford University Press, Oxford, 2007) coined the term epistemic injustice to refer to the downgrading of credibility of speakers provoked either by prejudic...
Fricker (Epistemic Injustice. Power and the Ethics of Knowing, Oxford University Press, Oxford, 2007) coined the term epistemic injustice to refer to the downgrading of credibility of speakers provoked either by prejudices-which she labeled testimonial injustice-or by a gap in interpretative resources that account for a given phenomenon-which she referred to as hermeneutical injustice. This paper reviews the existing literature on how patients with rare diseases, poorly understood diseases, and underdiagnosed diseases are questioned by the healthcare practitioners who assist them in order to explore how they suffer from both these types of epistemic injustice. At the same time, the paper argues that the very epistemic marginalization suffered by these patients actually grants them some epistemic advantages over patients with better-known diseases, and even some meta-epistemic advantages-that is, a deeper understanding of how the very taxonomy that marginalizes or excludes them is, to some extent, a sociocultural construction. The paper therefore applies the notion of "epistemic advantage", coined by contemporary standpoint theorists, to the field of healthcare.
Consent and its discontents: the case of UK Biobank.
Barn G
Med Health Care Philos · 2025 Sep · PMID 40676324 · Full text
UK Biobank is a major biomedical database and research resource, holding the genetic, health, and lifestyle information of half a million adult volunteers. Its datasets are accessible to approved researchers from academi...
UK Biobank is a major biomedical database and research resource, holding the genetic, health, and lifestyle information of half a million adult volunteers. Its datasets are accessible to approved researchers from academic, charity, government, and commercial organisations for health-related research in the public interest. Drawing upon a range of approved projects and the downstream applications of this research, I suggest that UK Biobank datasets have been processed towards ends that are inimical to its stated aims, breaking the terms of consent under which its participants entered the study. First, I provide an overview of the broad consent model employed by UK Biobank in recruiting participants and using their data. The consent documents and participant information leaflets used exhibit information failures in their framing of health-research in terms of disease and treatment, obscuring the full range of lawful uses of participants' data. Beyond this, certain approved uses of UK Biobank data, including studies by insurance companies and direct-to-consumer genetic testing companies, arguably fall outside UK Biobank's stated aims altogether. Moreover, UK Biobank has not adequately safeguarded against "dual use" issues. Tracking the trajectory of research outputs that used biobank data, I suggest that approved uses of biobank datasets have gone on to have objectionable further applications that are not in the public interest. Such applications include the development of polygenic scores that seek to predict "intelligence" for use in commercial embryo screening services. Such tools are rife with risk of harm and are being deployed without sufficient public deliberation or oversight.
Burnout as breakdown of one's existence in the world.
IJzerman L, Halsema A
Med Health Care Philos · 2025 Sep · PMID 40622639 · Full text
Burnout is generally conceived as a condition resulting from external stressors in one's work environment, but its precise definition is contested. In line with recent empirical studies, we suggest an existential-phenome...
Burnout is generally conceived as a condition resulting from external stressors in one's work environment, but its precise definition is contested. In line with recent empirical studies, we suggest an existential-phenomenological approach to avoid the dualisms that characterize the present understanding of burnout. Drawing on Merleau-Ponty's phenomenology, we do not consider burnout in terms of a psychological syndrome with physiological aspects, but rather suggest that these syndromes are expressions of the same problem. Burnout is not caused by an individual's inability to cope with external demands, nor by a too demanding work environment, but it is a mismatch between the two. Furthermore, we conceive of 'world' in Arendtian terms and situate burnout within the social context of vita activa. We argue that burnout can be understood in terms of 'world alienation,' and discuss the extent to which Arendt's diagnosis of the shifts in human activity in modernity from 'work' to 'labor' may provide a social context for the existential breakdown that burnout entails. We conclude the paper by outlining some implications for diagnosis and treatment based on our definition of burnout.
Reversibility of neurotechnological interventions: conceptual and ethical issues.
Yang J
Med Health Care Philos · 2025 Sep · PMID 40569339 · Publisher ↗
Currently, we have developed a range of neurotechnologies to intervene in neurological and psychiatric disorders, with some of these interventions considered reversible. However, the term "reversibility," although widely...
Currently, we have developed a range of neurotechnologies to intervene in neurological and psychiatric disorders, with some of these interventions considered reversible. However, the term "reversibility," although widely used in clinical and research contexts, remains ambiguously defined, and is often applied inconsistently in different contexts, which may pose ethical risks for patients. In fact, reversibility can be classified into three categories: ontological reversibility (including structural, functional, and psychological reversibility), methodological reversibility (including current and future methodological reversibility), and ethical reversibility (including autonomy, well-being, and harm reversibility). However, each of these forms of reversibility has inherent problems when applied in clinical settings. To ensure that patients are fully informed about the reversibility of neurotechnological interventions, we should adopt a perspective of practical reversibility to address this issue, improving the informed consent procedures for neurotechnological interventions, and clarifying the actual needs of patients regarding reversibility in terms of individual conditions, technological consequences, and value assessments.
REC review of deceptive studies: diversifying guidance for diverse review needs.
Verbeke K, Baeyens D, Krawczyk T … +2 more , Piasecki J, Borry P
Med Health Care Philos · 2025 Sep · PMID 40569338 · Publisher ↗
Deceiving participants is an ethically complicated research practice which remains an important challenge for research ethics committees (RECs) and researchers, despite the availability of abundant research ethics guidan...
Deceiving participants is an ethically complicated research practice which remains an important challenge for research ethics committees (RECs) and researchers, despite the availability of abundant research ethics guidance. Exploring this persistent policy-practice divide, we develop a framework for assessing the needs of the REC review of deceptive studies in a context-sensitive way. Different guidance formats are evaluated in light of their potential contribution to the frequently recurring REC review need for consistent and representative rules that set a perimeter for precise, coherent and representative discretionary review to take place. Research ethics guidelines and a new format of "descriptive living documents" are argued to respectively provide perimeter-setting rules and support discretionary decision-making about the justifiability of deceptive studies. REC review coordination is argued to benefit from analogous guidance formats to ensure conditions that facilitate successful REC review. As the needs of REC review may differ depending on the context, different mixes of these and possibly other guidance formats may support the REC review of deceptive studies and offer a way out of the policy-practice divide.
The role of clinicians in the looping effect: epistemic injustices and looping breaks.
Gauld C, Nicolle B, Constant A … +1 more , Gagné-Julien AM
Med Health Care Philos · 2025 Sep · PMID 40488946 · Full text
The debate on whether psychiatric disorders can be studied as natural kinds has raised controversy, reviving socio-constructionist arguments about the influence of social factors on psychiatric categories. A key concept...
The debate on whether psychiatric disorders can be studied as natural kinds has raised controversy, reviving socio-constructionist arguments about the influence of social factors on psychiatric categories. A key concept in this discussion is the "looping effect", which describes how individuals change in response to their classifications, necessitating revisions to those classifications. We argue that, until now, the broad discussions around the looping effect have greatly failed to integrate the perspectives surrounding clinicians and patients. We examine more closely the dynamic and unstable nature of psychiatric diagnoses by proposing two key hypotheses: first, that understanding the looping effect requires incorporating both clinician and patient viewpoints, and that when done adequately, such an incorporation can facilitate the work of the clinician by creating feedback loops (i.e., the iterative adjustment of clinical interpretations based on patient responses); and second, that epistemic injustices between clinicians and patients can create disruptions in these feedback loops, which we call "looping breaks", rendering them ineffective. Looping breaks can happen at the clinical level of the relationship between the patient and the clinician or at the nosological level (during the process of revising a classification). We suggest that looping breaks can be caused by a denial or minimization of credibility based on identity prejudice, or due to an epistemic disadvantage, affecting the experiential feedback of patients following the announcement of a diagnosis. To substantiate our claims, we first examine the impact of looping effects in the interaction between patients and clinicians. Second, we investigate the impact of these interactions at the nosological level, on the broader diagnostic framework. We identify epistemic injustices as critical factors that can lead to looping breaks at both levels, thus affecting the stability and validity of psychiatric diagnoses. Our findings underscore the importance of an epistemic approach to the looping effect, emphasizing both knowledge validity and justice in clinician-patient relationships and among clinicians themselves.
On misempowerment & mobile health.
Gray J, Mertes H
Med Health Care Philos · 2025 Sep · PMID 40488945 · Publisher ↗
Mobile health tools often claim to empower their users by giving them the knowledge they need to take control of their health. However, this notion of empowerment, what we refer to as the knowledge-control paradigm, only...
Mobile health tools often claim to empower their users by giving them the knowledge they need to take control of their health. However, this notion of empowerment, what we refer to as the knowledge-control paradigm, only superficially engages with the concept and leaves out the different ways in which people come to be empowered. We first identify two distinct elements of empowerment: psychological empowerment, which pertains to beliefs about one's power and control over their health, and relational empowerment, which is connected with one's actual power to control their health, as well as the ability to hold those in positions of power (the empowered) accountable. The knowledge-control paradigm is incapable of creating empowered individuals in the relational sense, and it is only when knowledge is coupled with both the means and the motivations to control health and/or hold the empowered to account, that one can be considered empowered. Mobile health tools that overemphasize knowledge as the empowering mechanism often misempower their users, that is, they create a belief in users about their power to control their health that does not align with their actual capacity to do so. This mismatch between beliefs and reality can have far reaching consequences as with knowledge, ability, control, and power comes responsibility. We worry not only that the misempowered will be viewed as more responsible for their health than the circumstances permit, but also, that these individuals will lose the ability to hold those in positions of power accountable..
A normativity mapping review on end-of-life care in long-term care institutions by authors from Germany, Austria, and Switzerland.
Metzler I, Mayer H, Rubeis G … +1 more , Eppel-Meichlinger J
Med Health Care Philos · 2025 Sep · PMID 40478398 · Full text
This article presents the findings of a "normativity mapping review" designed to make visible the breadth of normative understandings at work within interdisciplinary scholarship on end-of-life care in long-term care ins...
This article presents the findings of a "normativity mapping review" designed to make visible the breadth of normative understandings at work within interdisciplinary scholarship on end-of-life care in long-term care institutions. The scope of the literature was limited to peer-reviewed articles authored by scholars affiliated with institutions in Austria, Germany, and Switzerland. Terms and slogans associated with the hospice movement were used as keywords to search for literature in both German and English. During data analysis, values, frameworks, and actions were systematically extracted from the articles. Actions were then clustered into four groups: one involving actions aimed at planning future end-of-life decision-making; another focused on transforming cultures of care; a third encompassing end-of-life practices; and a fourth consisting of residual actions. A comparison of two of these groups shows that normative understandings of end-of-life care in long-term care institutions take shape around two poles-a procedural pole, involving standardised tools that can be used in specific practices to address challenges and improve care, and a substantive pole, centred on the embodied competencies and moral sensibilities of caregivers in realising visions of good end-of-life care.
Giving as repaying: towards an embodied ethics of living donor liver transplantation.
Lin YP, Chen HY
Med Health Care Philos · 2025 Sep · PMID 40471532 · Full text
This article explores the lived experiences and ethical complexities of the decision- and meaning-making journey involved in living donor liver transplantation (LDLT) through a case study of a young adult who donated par...
This article explores the lived experiences and ethical complexities of the decision- and meaning-making journey involved in living donor liver transplantation (LDLT) through a case study of a young adult who donated part of his liver to his father. Utilising embodied phenomenology and narrative analysis, we present an in-depth exploration of personal stories and interconnected narratives that reveal the intricate layers and nuances inherent in child-to-parent LDLT within the Taiwanese sociocultural milieu. This study examines the embodied, relational, temporal and normative dimensions through a dynamic, iterative process of careful reading and analysis, from which four plotlines emerged [(1) indebtedness, (2) thrownness, (3) struggle for selfhood and (4) family seniority] along with a postscript. The findings illuminate the complex interplay of body, self, family, intergenerational dynamics and sociocultural norms throughout the decision-making process. The analysis aims to lay the groundwork for a refined framework for understanding concepts such as giving, relationality, agency, temporality and normativity within bioethical discourses on organ transplantation. Furthermore, the study offers insights for healthcare professionals to develop culturally sensitive approaches in LDLT care ethics and practice, with particular attention to vulnerability, relational autonomy and embodied intersubjectivity as normative foundations.
Unresolved ethical questions of mHealth apps for Alzheimer's disease prevention.
Korecky K, Schicktanz S
Med Health Care Philos · 2025 Sep · PMID 40418517 · Full text
In recent years, medical research has sparked hope that up to a third of dementia cases could be prevented. This optimism is driven by a shift in the understanding of dementia and, in particular, Alzheimer's Disease (AD)...
In recent years, medical research has sparked hope that up to a third of dementia cases could be prevented. This optimism is driven by a shift in the understanding of dementia and, in particular, Alzheimer's Disease (AD)-from being a rapid-onset brain disease in later life to a condition strongly linked to lifestyle factors, progressing slowly and gradually through asymptomatic, pre-symptomatic, and symptomatic stages with varying degrees of severity. Accompanying this evolving perception, the use of mobile healthcare applications (mHealth apps) based on dementia prevention research has been on the rise. Health policymakers and companies increasingly advocate for these apps. However, concerns remain about the medical quality of such mHealth apps for dementia prevention. Bioethical research has highlighted significant challenges associated with their use. This paper critically examines dementia prevention strategies through the lenses of mHealth technologies. Exploring four mHealth apps for dementia prevention as case studies, we identify and analyze unsolved ethical issues related to primary, secondary, and tertiary prevention. Hereby we offer a new perspective on familiar ethical dilemmas in dementia prevention, and emphasize the need to examine potentially intensified challenges in the context of digital health in the future in more depth.
Differences in the EU regulations for biomedical research on humans and animals: an ethical analysis.
Żebrowska K
Med Health Care Philos · 2025 Sep · PMID 40338443 · Publisher ↗
The European Union regulations for research on human and nonhuman participants differ significantly. This study aims to present a thorough analysis of these differences in the field of biomedical research. The study cons...
The European Union regulations for research on human and nonhuman participants differ significantly. This study aims to present a thorough analysis of these differences in the field of biomedical research. The study consists of a review of regulations issued by the European Union and Council of Europe institutions, supported by two UNESCO documents. The regulations are compared between three types of research: on humans, on nonhuman animals, and research using human embryos, within five categories: (1) Justification and scope of the regulations; (2) Inclusion criteria; (3) Consent procedures; (4) Participants' welfare; and (5) Values in research. In each category, significant differences between regulations for humans and animals are presented. These differences can be ethically analyzed in terms of values pursued in the protection of participants (intrinsic value of humans vs. value of animal welfare) and hierarchies of values in regulations (priority of participant-centered values in research on humans vs. priority of research-centered values in research on animals). Since the current protection of animals in biomedical research based on the '3Rs' principles seems not adequate, two possible ways forward are analyzed: replacement of all animals in research with other methods and a shift to research on companion animals.
Phenomenology and ethics of terminal pain. Cicely Saunders' proposal.
Malagrinò I
Med Health Care Philos · 2025 Sep · PMID 40317441 · Publisher ↗
Differently from pre-technological societies, the contemporary one, when faced with pain, always thinks it can prepare a therapeutic response using the technique as the most valid form to dominate it. However, medicaliza...
Differently from pre-technological societies, the contemporary one, when faced with pain, always thinks it can prepare a therapeutic response using the technique as the most valid form to dominate it. However, medicalization and pharmacology of pain prevent it from becoming language. Thus, medical progress makes men much more vulnerable to pain. If, on the one hand, the benefits of anesthesia constitute an unparalleled achievement, on the other, they generate a sense of indifference to life. This is precisely why it is important and urgent to return to listening to the cry of pain. In this sense, particularly commendable were the efforts of Cicely Saunders, who dedicated her entire life to listening to pain and made listening to pain the cornerstone of the philosophy of the Hospice Movement. Therefore, this paper aims to propose a reconstruction of the phenomenology of terminal pain that emerges in Cicely's writings, highlighting its particularity and usefulness in designing a better approach to pain management. Terminal pain has a strong ethical dimension that requires not only a therapeutic but, above all, an ethical response. The proposal of care that derives from Saunders' reflections focuses on the direct encounter with the other caught in its aspect of contact and restores importance to the medical art imagined as "pathic," which, based on a complete or comprehensive wisdom, surpasses the classical humanistic vision and dichotomy which separates it from the purely biomedical one.
The use of social media in social care: a systematic review of the argument-based ethics literature.
Vandemeulebroucke T, Bolte L
Med Health Care Philos · 2025 Sep · PMID 40317440 · Full text
Digital technologies, especially social media, have become everyday tools. In care settings, the use of social media is considered a possible guarantee to maintain quality practices. This trend is specifically relevant f...
Digital technologies, especially social media, have become everyday tools. In care settings, the use of social media is considered a possible guarantee to maintain quality practices. This trend is specifically relevant for social care, including social work, psychology, psychiatry, rehabilitation etc., due to their communicative nature. Nevertheless, this use is joined by ethical vulnerabilities. To get insight into these, a systematic review of relevant normative-ethical literature was carried out following a 4-step methodology: developing ethical-conceptual questions; a literature search in four electronic databases (CINAHL, Philosopher's Index, Web of Science, ProQuest Database Psychology); assessment and inclusion of articles based on predefined criteria; extracting, analysing, and synthesizing reported data. Thirty-three articles were included, showing that current ethical debates are governed by nine themes: Benefits of social media; Relations, limits, and boundaries; Searches; Privacy, confidentiality, and trust; Documentation and records; Competency and client suitability; Consultation and referral; Informed consent; and Identity and image. We found that most ethical literature on social media use in social care settings adheres to the principles of biomedical ethics (respect for autonomy, beneficence, non-maleficence, justice) and to an ethics of carefulness, i.e. an ethics which takes social media for granted and considers its impact only on the particular therapeutic relationship. It loses sight of those ethical issues which occur on organizational, societal, and global levels. A full account of the ethics of social media use can only be given by considering these different levels and by informing the ethics of carefulness by an ethics of desirability.
"Big chunks of blank memory": complex trauma and dissociative body memory.
Dorothy J
Med Health Care Philos · 2025 Sep · PMID 40317439 · Full text
Research into traumatic memory has focused heavily upon re-experiencing symptoms (e.g. flashbacks). Features predominantly associated with complex trauma, such as gaps in the recollection of traumatic events, remain comp...
Research into traumatic memory has focused heavily upon re-experiencing symptoms (e.g. flashbacks). Features predominantly associated with complex trauma, such as gaps in the recollection of traumatic events, remain comparatively underexplored. In this article, I draw on the testimonies of survivors of complex trauma who participated in a survey informed by Phenomenologically Grounded Qualitative Research (Køster and Fernandez in Phenomenol Cogn Sci 22:149, 2023). I provide a phenomenological account of how survivors often experience memory blanks as inchoately disturbing, despite being unable to recount 'missing' events. Although challenging and equivocal, the notion of body memory offers one way of articulating this phenomenon. Specifically, I suggest that the troubling feelings accompanying perceived gaps in recollection arise alongside a form of non-conceptual body memory, which, lacking in propositional content, fails to be meaningfully contextualised. Drawing on the literature on body memory, dissociation, and Husserl's (Collected works. Kluwer, Dordrecht, 1991 [1893-1917]) internal time consciousness, I distinguish this as dissociative body memory and describe two central, non-exhaustive, features: (1) habitual dissociation, and (2) protentive salience. What is taken to be a gap in traumatic memory is in fact only a partial gap, involving a kind of pre-reflective remembering that is not recognised as such. Dissociative body memory additionally prevents the narrative integration required for minimising these perceived gaps, leading to an ongoing sense of foreboding concerning one's past. This has significant clinical implications, highlighting that what survivors experience as forgotten must not be disregarded. At the theoretical level, the phenomenon may be a hitherto unrecognised characteristic of complex posttraumatic stress disorder and related conditions.
The obscured face in video consultations. A Levinasian analysis.
Assing Hvidt E, Kofod FG, van den Heuvel J … +1 more , Scheffmann-Petersen M
Med Health Care Philos · 2025 Sep · PMID 40285914 · Full text
Video consultations represent a relatively new way of delivering face-to-face consultation in the context of general practice. The aim of the present analysis is to examine how video consultations influence patients' exp...
Video consultations represent a relatively new way of delivering face-to-face consultation in the context of general practice. The aim of the present analysis is to examine how video consultations influence patients' experiences of their ability to communicate their emotions, needs, and vulnerabilities, as well as their experiences with their general practitioner's ability to respond to these. The empirical base consists of 43 semi-structured interviews with patients (23 women and 20 men), aged between 17 and 81 years old, who have used video consultation as part of their treatment for various health issues in general practice. Emmanuel Levinas' theory of the face was used as an analytical and interpretative tool. The analysis showed that in video consultations, patients experience a digital obscuring of the face, i.e., of their emotions, needs and vulnerabilities. This complicates the GP's ability to perceive their vulnerability, making it challenging to recognize the patients' needs. Moreover, this obscuration hinders the patients' capacity to connect to their own vulnerabilities, which can lead to a diminished awareness of their own suffering. However, this mechanism might help patients who wish to obtain shielding from their face and from difficult emotions. Overall, we argue that significant relational and ethical dimensions of care within the doctor-patient relationship in general practice may be challenged in video consultations. We propose integrating Buber's dialogical principles with the present Levinasian analysis as it may offer a promising approach to enhancing relational and ethical dynamics in video consultations.
Understanding "interests": historical insights for managing conflicts of interest in healthcare and biomedical science.
Wiersma M, Kerridge I, Lipworth W
Med Health Care Philos · 2025 Sep · PMID 40261552 · Full text
Conflicts of interest are widely regarded as being morally, socially, and scientifically problematic in the many sectors, including in the health sector. There has been considerable attention paid to managing conflicts o...
Conflicts of interest are widely regarded as being morally, socially, and scientifically problematic in the many sectors, including in the health sector. There has been considerable attention paid to managing conflicts of interest in clinical practice, medical research and health policy through strategies such as recusal, disinvestment, and disclosure. While these efforts have been important, they are often based on a superficial account of "interests", as few in healthcare and biomedical science have sought to unpack the concept. In this paper, we argue that adopting an historically and philosophically informed account of interests can enrich our thinking about COI in healthcare and biomedical science, and lead to the improvement of COI management strategies. To support this claim, we first provide an overview of contemporary debates about COI in these domains. We then summarise the historical trajectory of the concept of "interest" and show how these insights can be used to inform the management of COI in healthcare and biomedical science using the example of physicians' relationships with the pharmaceutical industry. In particular, we challenge assumed hierarchies of interests and call for increased attention to the multiplicities of interests, both financial and non-financial, that may at times converge and conflict.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe