Emmanuel Levinas is one of the most elaborately discussed moral philosophers of recent decades, and his philosophy has many adherents. I believe, however, that the scholarly literature on his work...

Health care systems can positively influence our personal decision-making and health-related behavior only if we trust them. I propose a conceptual analysis of the trust relation between the public and a healthcare system, drawing from healthcare studies and philosophical proposals. In my account, the trust relation is based on an epistemic component, epistemic authority, and on a value component, the benevolence of the healthcare system. I argue that it is also modified by the vulnerability of the public on healthcare matters, (...) and by the system’s credibility. I apply my proposed analysis of public trust in health care systems to the phenomenon of vaccine hesitancy, a tendency to question vaccine policies, and to seek alternative vaccine schedules or to refuse vaccination. Understanding the role of trust and its components can be key to understanding the phenomenon. (shrink)

The aim of my paper is to review the discussion concerning various difficulties which surround the definition of depression and the methods of diagnosing and treating the disease against the background of the now dominant reductionist paradigm in psychiatry, as well as to answer the question whether a new approach to psychiatric disorders proposed by philosophers of psychiatry working within the phenomenologically inspired embodied and enactive paradigm indeed offers a solution to these difficulties. I present the issues specific to the (...) subject of depression in light of the more general problems related to biological psychiatry that have recently caused much debate. In the second part of the paper, I consider enactive, phenomenological and embodied theories of depression and the possibilities of new methods of treatment. My goal is to assess whether these theories indeed add anything important to the conceptions that are already present in psychiatry. I conclude that even if the embodied philosophy of psychiatry does not solve many of the problems faced by modern psychiatry, it can, nevertheless, provide a useful theoretical basis for future changes. (shrink)

The 2017 story of Charlie Gard is revisited. Upon the British High Court’s ruling in favor of the physicians that the infant should be allowed to die without the experimental treatment, the view of the public as well as the opinions of bioethicists and Catholic bishops are divided, interestingly along with a cultural line. American bioethicists and Catholic bishops tend to believe that the parents should have the final say while British/European bioethicists and Catholic bishops in general side with the (...) court’s decision. The paper explores the place of culture in bioethical reasoning between the UK/Europe and the US while claiming that cultural differences are more important than geopolitical or religious differences to understand the bioethical positions of a group. In addition, the authors introduce a decision-making program for handicapped neonates which is developed by the American Jesuit Bioethicist, Richard McCormick, and modified further by the contemporary American Jesuit Bioethicist, Peter A. Clark, in an attempt to see if the program’s normatizing categories can contribute to the culture-laden ethical discussions on Charlie’s case. However, it is admitted that the McCormick-Clark device is borne out of the American and Catholic theological context. (shrink)

Although it is intuitively obvious that having health problems makes people vulnerable, neither bioethics nor the philosophy of medicine has paid much attention to the relationship between vulnerability and health or illness. In this paper, I draw on work by Erinn Gilson on the nature of vulnerability in order to address this lack, showing that attending to vulnerability illuminates the relationship between health and illness.

Public funding institutions are able to influence what aspects researchers take into account when they consider the future impacts of their research. On the basis of a description of the evaluation systems that public research funding institutes in the Netherlands (STW and SenterNovem) use to estimate the quality of engineering science, this article shows that researchers are now predominantly required to reflect on the intellectual merit of their research and on the usability and marketability of the technology it contributes to. (...) In addition, SenterNovem also mandates reflection on sustainability. Here it is argued that these requirements do not suffice. Funding institutions should also do more to enhance reflection during the research process on the “soft impacts” of technologies, which refer to the alterations that technologies may bring about in the quality of human life. To do this it is suggested that it is helpful to engage a specifically trained ethicist to monitor the research process and create a feedback loop from the ethicist to the funding institution. (shrink)

Is medicalization always harmful? When does medicine overstep its proper boundaries? The aim of this article is to outline the pragmatic criteria for distinguishing between medicalization and over-medicalization. The consequences of considering a phenomenon to be a medical problem may take radically different forms depending on whether the problem in question is correctly or incorrectly perceived as a medical issue. Neither indiscriminate acceptance of medicalization of subsequent areas of human existence, nor criticizing new medicalization cases just because they are medicalization (...) can be justified. The article: (i) identifies various consequences of both well-founded medicalization and over-medicalization; (ii) demonstrates that the issue of defining appropriate limits of medicine cannot be solved by creating an optimum model of health; (iii) proposes four guiding questions to help distinguish medicalization from over-medicalization. The article should foster a normative analysis of the phenomenon of medicalization and contribute to the bioethical reflection on the boundaries of medicine. (shrink)

"In this book, Gabor Csepregi describes in detail the nature and scope of the body's innate abilities and reflects on their significance in human life."--BOOK JACKET.

The personhood of the physician is a crucial element in accomplishing the goals of medicine. We review claims made on behalf of the humanities in guiding professional identity formation. We explore the dichotomy that has evolved, since the Renaissance, between the humanities and the natural sciences. The result of this evolution is an historic misconstrual, preoccupying educators and diverting them from the moral development of physicians. We propose a curricular framework based on the recovery of Aristotelian concepts that bridge identity (...) and activity. The humanities and the natural sciences, jointly and severally, can fulfill developmental, characterological and instrumental purposes. (shrink)

Intersubjectivity is the proposition that human experience occurs in a world of shared and embodied understandings, mediated by culture and language. Nursing is fundamentally relational, and nursing research stems from an exchange between participants and researchers and indeed around the transaction of the patient and the nurse in the intersubjective space of clinical settings. Through the philosophical standpoints of Husserl, Merleau‐Ponty, Heidegger, and Gadamer we examine these differing philosophical constructs of intersubjectivity and the contribution of these positions to phenomenological nursing (...) inquiry. Particular framings of intersubjectivity should influence the way researchers interact with their participants and data so that the chosen philosophy sits coherently within a research plan and methodology. This exploration of philosophical standpoints is extended through examples of, and reflections upon, the authors' experiences of intersubjectivity in our published phenomenological nursing studies and through dynamic interactions that characterise interpretive activities within a research team. (shrink)

What is the status of empirical contributions to bioethics, especially to clinical bioethics? Where is the empirical approach discussed in bioethics related to the ongoing debate about principlism versus casuistry? Can we consider an integrative model of research in medical ethics and which empirical methodology could then be valuable, the quantitative or the qualitative? These issues will be addressed in the first, theoretical part of the paper. The concept of the “embedded researcher” presented in this article was stimulated by the (...) two questions, (1) how can we safeguard that our research will yield valid and meaningful results to practice? and (2), how can we convince clinical colleagues that medical ethics offers relevant contributions to the analysis and solution of problems? One tentative answer has been our effort to elaborate a coherent methodological research approach in the field of end-of-life issues integrating qualitative and quantitative as well as casuistic methodologies. This development is characterized in the second part describing the ECOPE Study (short title)“Ethical Conditions Of Passive Euthanasia.” The achievements and limitations of the suggested approach of the “embedded researcher” are discussed referring to 3 examples of our joint studies about ethical issues concerning(1) critical decision-making in neonatology(2) limitation of treatment in intensive care(3) problems with doctor-patient conversation at the end of life in oncologyConclusions from our studies are put to discussion in the final part of the paper about how to further develop research in the field of end-of-life care and, maybe,clinical bioethics as a whole. (shrink)

Empowerment is a concept that has been much used and discussed for a number of years. However, it is not always explicitly clarified what its central meaning is. The present paper intends to clarify what empowerment means, and relate it to the goals of health promotion. The paper starts with the claim that health-related quality of life is the ultimate general goal for health promotion, and continues by briefly presenting definitions of some central concepts: “welfare” “health” and “quality of life”. (...) Several suggestions as to what empowerment is are then discussed: autonomy, freedom, knowledge, self-esteem, self-confidence, and control over health or life. One conclusion of this discussion is that empowerment can be seen as a complex goal which includes aspects of the three central concepts welfare, health and quality of life. To the extent that the empowerment goals aimed at are health-related, it is concluded that empowerment is a legitimate goal for health promotion. But empowerment is not only a goal, it can also be described as a process or as an approach. This process, or approach, in a fundamental way involves the participants in problem formulation, decision making and action, which means that the experts have to relinquish some of their control and power. (shrink)

Accounts from the humanities which focus on describing the nature of whole body plastinates are examined. We argue that this literature shows that plastinates do not clearly occupy standard cultural binary categories of interior or exterior, real or fake, dead or alive, bodies or persons, self or other and argue that Noël Carroll’s structural framework for horrific monsters unites the various accounts of the contradictory or ambiguous nature of plastinates while also showing how plastinates differ from horrific fictional monsters. In (...) doing so, it offers an account of the varied reactions of those responding to exhibitions of plastinated whole bodies. (shrink)

Over the past 25 years Healthcare Ethics Committees (HECs) have spread in the U.S. and in Europe (and, more recently, in many non-western countries), since they have been identified as the bodies better suited to tackle the ethical issues which ever more often arise in the clinical setting. While international debate on the pre-conditions to grant them credibility has been ample, little attention has been devoted to two substantial conditions which only can guarantee that they work properly. They are, on (...) one side, the assuming of a genuine ethical perspective and, on the other side, the individuation of a common basis from which to start the ethical debate in a pluralistic society. The present work claims that the notion of human dignity, justified in the framework of a personalistic ethical normative theory of Kantian derivation, can satisfy both the mentioned conditions. Furthermore, the work puts forward a methodology, coherent with the mentioned theory, for the justification of the ethical-clinical judgement. Such methodology, which aims at creatively integrating principles and experience under the constraint of the respect for human dignity, has the ambition to be a useful and flexible tool to support HECs’ deliberative activities. (shrink)