In this paper, my goal is to use an epistemic injustice framework to extend an existing normative analysis of over-medicalization to psychiatry and thus draw attention to overlooked injustices. Kaczmarek has developed a promising bioethical and pragmatic approach to over-medicalization, which consists of four guiding questions covering issues related to the harms and benefits of medicalization. In a nutshell, if we answer “yes” to all proposed questions, then it is a case of over-medicalization. Building on an epistemic injustice framework, I (...) will argue that Kaczmarek’s proposal lacks guidance concerning the procedures through which we are to answer the four questions, and I will import the conceptual resources of epistemic injustice to guide our thinking on these issues. This will lead me to defend more inclusive decision-making procedures regarding medicalization in the DSM. Kaczmarek’s account complemented with an epistemic injustice framework can help us achieve better forms of medicalization. I will then use a contested case of medicalization, the creation of Premenstrual Dysphoric Disorder in the DSM-5 to illustrate how the epistemic injustice framework can help to shed light on these issues and to show its relevance to distinguish good and bad forms of medicalization. (shrink)

By titling his paper “Slowing the Slide Down the Slippery Slope of Medical Assistance in Dying: Mutual Learnings for Canada and the US,” Daryl Pullman, an esteemed medical ethicist, uses a rhetoric...

Australian law affirms a binary construction of fertility/infertility. This model is based upon the medical categorization of infertility as a disease. Law supports medicine in prioritizing technology, such as in vitro fertilization, as treatment for infertility. This prioritization of a medico-legal model of infertility in turn marginalizes alternative means of family creation such as adoption, fostering, traditional surrogacy, and childlessness. This paper argues that this binary model masks the impact of medicalization upon reproductive choice and limits opportunity for infertile individuals (...) to create families. While medical technology should be available to enhance reproductive opportunity, infertile individuals will benefit from regulatory change which disentangles the medico-legal construct of infertility as a disease from the desire to create a family. This paper suggests that the medico-legal model of infertility should be reframed to support all opportunities for family creation equally, including non-medical opportunities such as adoption, fostering, and childlessness. (shrink)

Artykuł prezentuje krytyczny szkic historyczny i charakterystykę biomedycznego modelu psychopatologii, koncentrując się na drugiej połowie XX w. Wskazuje i opisuje także kluczowe problemy związane z jego dominacją we współczesnej praktyce klinicznej i badawczej. Problemy te dotyczą, m. in., trafności i rzetelności diagnoz psychiatrycznych, metodologii badań, skuteczności leczenia, czy też wpływów koncernów farmaceutycznych na działalność naukową i terapeutyczną. Poważne konceptualne problemy całego modelu stawiają pod znakiem zapytania fundamenty współczesnej psychiatrii oraz opartą na nich wiedzę. Nie udało się stworzyć przekonujących biologicznych wyjaśnień (...) zaburzeń psychicznych ani zidentyfikować mechanizmów odpowiadających za ich powstawanie. Uzasadnione wątpliwości istnieją także w odniesieniu do najczęściej przepisywanych współcześnie leków: przeciwpsychotycznych i antydepresyjnych – pomimo ich coraz szerszego stosowania, przybywa ludzi przewlekle chorych. Rodzi to poważne dylematy etyczne i uzasadnione pytania o nadmierną medykalizację kwestii wiązanych ze zdrowiem psychicznym. Konieczna wydaje się reforma dominującego modelu i wzrost nakładów na badania i praktykę uwzględniającą czynniki psychologiczne, społeczne i kulturowe. (shrink)

Spirituality and healthcare have been dependant on and supported one another from the earliest times. However, this marriage eventually found itself in stormy waters and parted ways, blaming scientific advances in healthcare for the split. But, as in any broken marriage, the story usually has two sides, and the blame for this split cannot be put squarely on science. In fact, scientific research is now trying to bridge the gap, whereas in the field of Christian spirituality, some are even opposing (...) medical practices and the use of medicine as it could portray a belief in the science of healthcare, as opposed to God. These beliefs only serve to widen the gap between spirituality and healthcare, alienating Christianity from healthcare. If we want to restore the marriage between spirituality and healthcare, it is important to reflect on these beliefs.The purpose of this article is therefore to explore and critically reflect on the relationship between spirituality and healthcare from a Christian perspective. The objective is to identify and address beliefs that are alienating Christianity from healthcare, arguing that, rather than opposing medical practices, we could stand in awe of scientific healthcare. (shrink)

Pullman (2023) raises some reasonable worries about the use of MAiD in Canada and outlines a plausible proposal to require patients who request MAiD but who do not meet the “reasonably foreseeable...