Results for 'Medical Decisions'

997 found
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  1.  42
    Zwischen milieu intérieur und medical decision making – Aspekte einer medizinischen Kybernetik.Johannes W. Dietrich - manuscript
    Seit wenigen Jahren erfreuen sich in den Lebenswissenschaften mehrere Theorien eines immer weitergehenden Einflusses, die unter Etikettierungen wie Systembiologie, Netzwerktheorie oder Signalomics nur scheinbar unabhängige Herangehensweisen an komplexe Zusammenhänge darstellen. Navigation ist der übergreifende Gedanke, der so unterschiedliche Gebiete wie Regelungstheorie, Entscheidungstheorie und Systemwissenschaft verbindet. Navigation als Lage- und Kursbestimmung nebst den zugehörigen Signalverarbeitungsprozessen und Steuerkommandos ist die Grundlage dessen, was lebende Organismen von der blo§en Ansammlung materieller Ingredienzien unterscheidet – von der molekularen Ebene bis zum Sozialverhalten. Denn stets stellen (...)
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  2. Value Theory, Beneficence, and Medical Decision-Making.David DeGrazia - 2020 - American Journal of Bioethics 20 (3):71-73.
    Volume 20, Issue 3, March 2020, Page 71-73.
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  3. Personal Identity and Patient-Centered Medical Decision Making.Lucie White - 2017 - American Journal of Bioethics Neuroscience 8 (3):194-195.
    Nancy Jecker and Andrew Ko (2017) wish to present an account of personal identity which captures what matters to the patient and places the patient at the center of medical decisions. They focus particularly on medical interventions in the brain that can cause drastic changes in personality; under what circumstances should we say the patient has 'survived' these changes? More specifically, how can we best understand the notion of survival in a way that captures what is of (...)
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  4.  48
    Medical AI and Human Dignity: Contrasting Perceptions of Human and Artificially Intelligent (AI) Decision Making in Diagnostic and Medical Resource Allocation Contexts.Paul Formosa, Wendy Rogers, Yannick Griep, Sarah Bankins & Deborah Richards - 2022 - Computers in Human Behaviour 133.
    Forms of Artificial Intelligence (AI) are already being deployed into clinical settings and research into its future healthcare uses is accelerating. Despite this trajectory, more research is needed regarding the impacts on patients of increasing AI decision making. In particular, the impersonal nature of AI means that its deployment in highly sensitive contexts-of-use, such as in healthcare, raises issues associated with patients’ perceptions of (un) dignified treatment. We explore this issue through an experimental vignette study comparing individuals’ perceptions of being (...)
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  5. Are Medical Ethicists Out of Touch? Practitioner Attitudes in the US and UK Towards Decisions at the End of Life.Donna Dickenson - 2000 - Journal of Medical Ethics 26 (4):254-260.
    To assess whether UK and US health care professionals share the views of medical ethicists about medical futility, withdrawing/withholding treatment, ordinary/extraordinary interventions, and the doctrine of double effect. A 138-item attitudinal questionnaire completed by 469 UK nurses studying the Open University course on "Death and Dying" was compared with a similar questionnaire administered to 759 US nurses and 687 US doctors taking the Hastings Center course on "Decisions near the End of Life". Practitioners accept the relevance of (...)
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  6.  29
    Medical Futility as an Action Guide in Neonatal End-of-Life Decisions.Daniel Sidler - 2008 - South African Medical Journal 98:284-286.
    Thesis --University of Stellenbosch, 2004 Acceptance of the concept of medical futility facilitates a paradigm shift from curative to palliative medicine, accommodating a more humane approach and avoiding unnecessary suffering in the course of the dying process. This should not be looked upon as abandoning the patient but rather as providing the patient and family with an opportunity to come to terms with the dying process. It also does not entail withdrawal or passivity on the part of the health (...)
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  7. Clinical-Decision-Making: Turning Medical Ethics On its Head.Cory D. Brewster - manuscript
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  8. Clinical Decision-Making: The Case Against the New Casuistry.Mahesh Ananth - 2017 - Issues in Law and Medicine 32 (2):143-171.
    Albert Jonsen and Stephen Toulmin have argued that the best way to resolve complex “moral” issues in clinical settings is to focus on the details of specific cases. This approach to medical decision-making, labeled ‘casuistry’, has met with much criticism in recent years. In response to this criticism, Carson Strong has attempted to salvage much of Jonsen’s and Toulmin’s version of casuistry. He concludes that much of their analysis, including Jonsen’s further elaboration about the casuistic methodology, is on the (...)
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  9. Supported Decision-Making: Non-Domination Rather Than Mental Prosthesis.Allison McCarthy & Dana Howard - forthcoming - American Journal of Bioethics Neuroscience.
    Recently, bioethicists and the UNCRPD have advocated for supported medical decision-making on behalf of patients with intellectual disabilities. But what does supported decision-making really entail? One compelling framework is Anita Silvers and Leslie Francis’ mental prosthesis account, which envisions supported decision-making as a process in which trustees act as mere appendages for the patient’s will; the trustee provides the cognitive tools the patient requires to realize her conception of her own good. We argue that supported decision-making would be better (...)
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  10. Getting Obligations Right: Autonomy and Shared Decision Making.Jonathan Lewis - 2020 - Journal of Applied Philosophy 37 (1):118-140.
    Shared Decision Making (‘SDM’) is one of the most significant developments in Western health care practices in recent years. Whereas traditional models of care operate on the basis of the physician as the primary medical decision maker, SDM requires patients to be supported to consider options in order to achieve informed preferences by mutually sharing the best available evidence. According to its proponents, SDM is the right way to interpret the clinician-patient relationship because it fulfils the ethical imperative of (...)
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  11. Machine Medical Ethics.Simon Peter van Rysewyk & Matthijs Pontier (eds.) - 2014 - Springer.
    In medical settings, machines are in close proximity with human beings: with patients who are in vulnerable states of health, who have disabilities of various kinds, with the very young or very old, and with medical professionals. Machines in these contexts are undertaking important medical tasks that require emotional sensitivity, knowledge of medical codes, human dignity, and privacy. -/- As machine technology advances, ethical concerns become more urgent: should medical machines be programmed to follow a (...)
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  12. Does Shared Decision Making Respect a Patient's Relational Autonomy?Jonathan Lewis - 2019 - Journal of Evaluation in Clinical Practice 25 (6):1063-1069.
    According to many of its proponents, shared decision making ("SDM") is the right way to interpret the clinician-patient relationship because it respects patient autonomy in decision-making contexts. In particular, medical ethicists have claimed that SDM respects a patient's relational autonomy understood as a capacity that depends upon, and can only be sustained by, interpersonal relationships as well as broader health care and social conditions. This paper challenges that claim. By considering two primary approaches to relational autonomy, this paper argues (...)
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  13.  23
    Medical Ethics Course for Residents: A Preliminary Study.Sukran Sevimli - 2021 - Eubios Journal of Asian and International Bioethics Contents 7 (31):378-384.
    Purpose: The objective of this study is to determine the importance of supplementary medical ethics course for resident physicians. In this study, we assessed the current state of their knowledge of medical ethics and aimed to improve and deepen their understanding of clinical scenarios to increase their awareness of the link between the practice of medicine and ethical issues. Methods: The course was held for groups of 10-12 people for 3 days a week for a total of 6 (...)
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  14. Algorithms for Ethical Decision-Making in the Clinic: A Proof of Concept.Lukas J. Meier, Alice Hein, Klaus Diepold & Alena Buyx - 2022 - American Journal of Bioethics 22 (7):4-20.
    Machine intelligence already helps medical staff with a number of tasks. Ethical decision-making, however, has not been handed over to computers. In this proof-of-concept study, we show how an algorithm based on Beauchamp and Childress’ prima-facie principles could be employed to advise on a range of moral dilemma situations that occur in medical institutions. We explain why we chose fuzzy cognitive maps to set up the advisory system and how we utilized machine learning to train it. We report (...)
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  15. Decision and Discovery in Defining “Disease”.Peter H. Schwartz - 2007 - In Harold Kincaid & Jennifer McKitrick (eds.), Establishing medical reality: Methodological and metaphysical issues in philosophy of medicine. Dordrecht: Springer. pp. 47-63.
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  16. Limits of Trust in Medical AI.Joshua James Hatherley - 2020 - Journal of Medical Ethics 46 (7):478-481.
    Artificial intelligence is expected to revolutionise the practice of medicine. Recent advancements in the field of deep learning have demonstrated success in variety of clinical tasks: detecting diabetic retinopathy from images, predicting hospital readmissions, aiding in the discovery of new drugs, etc. AI’s progress in medicine, however, has led to concerns regarding the potential effects of this technology on relationships of trust in clinical practice. In this paper, I will argue that there is merit to these concerns, since AI systems (...)
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  17. Artificial Intelligence and Patient-Centered Decision-Making.Jens Christian Bjerring & Jacob Busch - 2020 - Philosophy and Technology 34 (2):349-371.
    Advanced AI systems are rapidly making their way into medical research and practice, and, arguably, it is only a matter of time before they will surpass human practitioners in terms of accuracy, reliability, and knowledge. If this is true, practitioners will have a prima facie epistemic and professional obligation to align their medical verdicts with those of advanced AI systems. However, in light of their complexity, these AI systems will often function as black boxes: the details of their (...)
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  18. Patient Autonomy, Clinical Decision Making, and the Phenomenological Reduction.Jonathan Lewis & Søren Holm - 2022 - Medicine, Health Care and Philosophy 25 (4):615-627.
    Phenomenology gives rise to certain ontological considerations that have far-reaching implications for standard conceptions of patient autonomy in medical ethics, and, as a result, the obligations of and to patients in clinical decision-making contexts. One such consideration is the phenomenological reduction in classical phenomenology, a core feature of which is the characterisation of our primary experiences as immediately and inherently meaningful. This paper builds on and extends the analyses of the phenomenological reduction in the works of Husserl, Heidegger, and (...)
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  19. Intuitive Methods of Moral Decision Making, A Philosophical Plea.Emilian Mihailov - 2013 - In Muresan Valentin & Majima Shunzo (eds.), Applied Ethics: Perspectives from Romania. Center for Applied Ethics and Philosophy, Hokkaido University. pp. 62-78.
    The aim of this paper is to argue that intuitive methods of moral decision making are objective tools on the grounds that they are reasons based. First, I will conduct a preliminary analysis in which I highlight the acceptance of methodological pluralism in the practice of medical ethics. Here, the point is to show the possibility of using intuitive methods given the pluralism framework. Second, I will argue that the best starting point of elaborating such methods is a bottom-up (...)
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  20.  93
    On Evidence, Medical and Legal.Donald W. Miller & Clifford Miller - 2005 - Journal of American Physicians and Surgeons 10 (3):70-75.
    Medicine, like law, is a pragmatic, probabilistic activity. Both require that decisions be made on the basis of available evidence, within a limited time. In contrast to law, medicine, particularly evidence-based medicine as it is currently practiced, aspires to a scientific standard of proof, one that is more certain than the standards of proof courts apply in civil and criminal proceedings. But medicine, as Dr. William Osler put it, is an "art of probabilities," or at best, a "science of (...)
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  21.  50
    La délibération comme démarche réflexive accompagnant la décision médicale.Éric Delassus - 2014 - Éthique Publique 16 (2).
    La délibération est souvent perçue comme l’œuvre d’une liberté exami­nant de manière autonome les éléments qui conduisent à la prise de décision, elle-même perçue comme le moment premier de l’action. Cette vision des choses n’est-elle pas la conséquence d’une illusion rétrospective ? Le processus décision­nel dans lequel s’inscrit la délibération ne doit-il pas plutôt être envisagé comme un enchaînement causal par lequel les acteurs sont emportés sans être véritable­ment les auteurs du scénario auquel ils participent ? Une telle approche détermi­niste (...)
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  22. Medical Brain Drain: Free-Riding, Exploitation, and Global Justice.Merten Reglitz - 2016 - Moral Philosophy and Politics 3 (1): 67-81.
    In her debate with Michael Blake, Gillian Brock sets out to justify emigration restrictions on medical workers from poor states on the basis of their free-riding on the public investment that their states have made in them in form of a publicly funded education. For this purpose, Brock aims to isolate the question of emigration restrictions from the larger question of responsibilities for remedying global inequalities. I argue that this approach is misguided because it is blind to decisive factors (...)
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  23. A Life Below the Threshold? Examining Conflict Between Ethical Principles and Parental Values In Neonatal Treatment Decision Making.Thomas V. Cunningham - 2016 - Narrative Inquiry in Bioethics 6 (1).
    Three common ethical principles for establishing the limits of parental authority in pediatric treatment decision making are the harm principle, the principle of best interest, and the threshold view. This paper consider how these principles apply to a case of a premature neonate with multiple significant comorbidities whose mother wanted all possible treatments, and whose health care providers wondered whether it would be ethically permissible to allow him to die comfortably despite her wishes. Whether and how these principles help to (...)
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  24. Medical Maternalism: Beyond Paternalism and Antipaternalism.Laura Specker Sullivan - 2016 - Journal of Medical Ethics 42 (7):439-444.
    This paper argues that the concept of paternalism is currently overextended to include a variety of actions that, while resembling paternalistic actions, are importantly different. I use the example of Japanese physicians’ non-disclosures of cancer diagnoses directly to patients, arguing that the concept of maternalism better captures these actions. To act paternalistically is to substitute one's own judgement for that of another person and decide in place of that person for his/her best interest. By contrast, to act maternalistically is to (...)
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  25.  59
    COVID-19 Vaccine Refusal and Fair Allocation of Scarce Medical Resources.Govind Persad & Emily A. Largent - 2022 - JAMA Health Forum 3 (4):e220356.
    When hospitals face surges of patients with COVID-19, fair allocation of scarce medical resources remains a challenge. Scarcity has at times encompassed not only hospital and intensive care unit beds—often reflecting staffing shortages—but also therapies and intensive treatments. Safe, highly effective COVID-19 vaccines have been free and widely available since mid-2021, yet many Americans remain unvaccinated by choice. Should their decision to forgo vaccination be considered when allocating scarce resources? Some have suggested it should, while others disagree. We offer (...)
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  26. On Algorithmic Fairness in Medical Practice.Thomas Grote & Geoff Keeling - 2022 - Cambridge Quarterly of Healthcare Ethics 31 (1):83-94.
    The application of machine-learning technologies to medical practice promises to enhance the capabilities of healthcare professionals in the assessment, diagnosis, and treatment, of medical conditions. However, there is growing concern that algorithmic bias may perpetuate or exacerbate existing health inequalities. Hence, it matters that we make precise the different respects in which algorithmic bias can arise in medicine, and also make clear the normative relevance of these different kinds of algorithmic bias for broader questions about justice and fairness (...)
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  27. From the Eyeball Test to the Algorithm — Quality of Life, Disability Status, and Clinical Decision Making in Surgery.Charles Binkley, Joel Michael Reynolds & Andrew Shuman - 2022 - New England Journal of Medicine 14 (387):1325-1328.
    Qualitative evidence concerning the relationship between QoL and a wide range of disabilities suggests that subjective judgments regarding other people’s QoL are wrong more often than not and that such judgments by medical practitioners in particular can be biased. Guided by their desire to do good and avoid harm, surgeons often rely on "the eyeball test" to decide whether a patient will or will not benefit from surgery. But the eyeball test can easily harbor a range of implicit judgments (...)
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  28. Belief and Decision Under Uncertainty.Sherrilyn Roush - manuscript
    This is a very short textbook on probabilistic reasoning, expected utility decision-making, cognitive biases, and self-correction, especially in application to medical examples. It also includes a chapter on concepts of health.
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  29.  11
    Multi Criteria Decision Making Using Correlation Coefficient Under Rough Neutrosophic Environment.Surapati Pramanik, Rumi Roy, Tapan Kumar Roy & Florentin Smarandache - 2017 - Neutrosophic Sets and Systems 17:29-38.
    In this paper, we define correlation coefficient measure between any two rough neutrosophic sets. We also prove some of its basic properties.. We develop a new multiple attribute group decision making method based on the proposed correlation coefficient measure. An illustrative example of medical diagnosis is solved to demonstrate the applicability and effecriveness of the proposed method.
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  30. Disclosure and Consent to Medical Research Participation.Danielle Bromwich & Joseph Millum - 2013 - Journal of Moral Philosophy 10 (4):195-219.
    Most regulations and guidelines require that potential research participants be told a great deal of information during the consent process. Many of these documents, and most of the scholars who consider the consent process, assume that all this information must be disclosed because it must all be understood. However, a wide range of studies surveying apparently competent participants in clinical trials around the world show that many do not understand key aspects of what they have been told. The standard view (...)
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  31. Personal Identity and Self-Regarding Choice in Medical Ethics.Lucie White - 2020 - In Michael Kühler & Veselin Mitrović (eds.), Theories of the Self and Autonomy in Medical Ethics. pp. 31-47.
    When talking about personal identity in the context of medical ethics, ethicists tend to borrow haphazardly from different philosophical notions of personal identity, or to abjure these abstract metaphysical concerns as having nothing to do with practical questions in medical ethics. In fact, however, part of the moral authority for respecting a patient’s self-regarding decisions can only be made sense of if we make certain assumptions that are central to a particular, psychological picture of personal identity, namely, (...)
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  32. Conscientious Objection to Medical Assistance in Dying: A Qualitative Study with Quebec Physicians.Jocelyn Maclure - 20019 - Canadian Journal of Bioethics / Revue canadienne de bioéthique 2 (2):110-134.
    Patients in Quebec can legally obtain medical assistance in dying (MAID) if they are able to give informed consent, have a serious and incurable illness, are at the end of their lives and are in a situation of unbearable suffering. Since the Supreme Court of Canada’s 2015 Carter decision, access to MAID, under certain conditions, has become a constitutional right. Quebec physicians are now likely to receive requests for MAID from their patients. The Quebec and Canadian laws recognize a (...)
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  33. Grief and End-of-Life Surrogate Decision Making.Michael Cholbi - 2017 - In John K. Davis (ed.), Ethics at the End of Life: New Issues and Arguments. New York: Routledge. pp. 201-217.
    Because an increasing number of patients have medical conditions that render them incompetent at making their own medical choices, more and more medical choices are now made by surrogates, often patient family members. However, many studies indicate that surrogates often do not discharge their responsibilities adequately, and in particular, do not choose in accordance with what those patients would have chosen for themselves, especially when it comes to end-of-life medical choices. This chapter argues that a significant (...)
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  34. Questioning the Quantitative Imperative: Decision Aids, Prevention, and the Ethics of Disclosure.Peter H. Schwartz - 2011 - Hastings Center Report 41 (2):30-39.
    Patients should not always receive hard data about the risks and benefits of a medical intervention. That information should always be available to patients who expressly ask for it, but it should be part of standard disclosure only sometimes, and only for some patients. And even then, we need to think about how to offer it.
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  35. Epistemic Burdens and the Incentives of Surrogate Decision-Makers.Parker Crutchfield & Scott Scheall - 2019 - Medicine, Health Care and Philosophy 22 (4):613-621.
    We aim to establish the following claim: other factors held constant, the relative weights of the epistemic burdens of competing treatment options serve to determine the options that patient surrogates pursue. Simply put, surrogates confront an incentive, ceteris paribus, to pursue treatment options with respect to which their knowledge is most adequate to the requirements of the case. Regardless of what the patient would choose, options that require more knowledge than the surrogate possesses (or is likely to learn) will either (...)
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  36. Patient Centred Diagnosis: Sharing Diagnostic Decisions with Patients in Clinical Practice.Zackary Berger, J. P. Brito, Ns Ospina, S. Kannan, Js Hinson, Ep Hess, H. Haskell, V. M. Montori & D. Newman-Toker - 2017 - British Medical Journal 359:j4218.
    Patient centred diagnosis is best practised through shared decision making; an iterative dialogue between doctor and patient, whichrespects a patient’s needs, values, preferences, and circumstances. -/- Shared decision making for diagnostic situations differs fundamentally from that for treatment decisions. This has important implications when considering its practical application. -/- The nature of dialogue should be tailored to the specific diagnostic decision; scenarios with higher stakes or uncertainty usually require more detailed conversations.
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  37. Egalitarian Provision of Necessary Medical Treatment.Robert C. Hughes - 2020 - The Journal of Ethics 24 (1):55-78.
    Considerations of autonomy and independence, properly understood, support strictly egalitarian provision of necessary medical treatment. If the financially better-off can purchase access to necessary medical treatments that the financially less well-off cannot purchase without help, then their discretionary power to give or to withhold monetary gifts indirectly gives them the power to make life-and-death or sickness-and-health decisions for others. To prevent private citizens from having this objectionable form of power, government must ensure that citizens’ finances do not (...)
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  38. A Mixed Judgment Standard for Surrogate Decision-Making.Nathan Stout - 2022 - Journal of Medicine and Philosophy 47 (4):540-548.
    The Substituted Judgment Standard for surrogate decision-making dictates that a surrogate, when making medical decisions on behalf of an incapacitated patient, ought to make the decision that the patient would have made if the patient had decisional capacity. Despite its intuitive appeal, however, SJS has been the target of a variety of criticisms. Most objections to SJS appeal to epistemic difficulties involved in determining what a patient would have decided in a given case. In this article, I offer (...)
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  39. SNOMED CT Standard Ontology Based on the Ontology for General Medical Science.Shaker El-Sappagh, Francesco Franda, Ali Farman & Kyung-Sup Kwak - 2018 - BMC Medical Informatics and Decision Making 76 (18):1-19.
    Background: Systematized Nomenclature of Medicine—Clinical Terms (SNOMED CT, hereafter abbreviated SCT) is acomprehensive medical terminology used for standardizing the storage, retrieval, and exchange of electronic healthdata. Some efforts have been made to capture the contents of SCT as Web Ontology Language (OWL), but theseefforts have been hampered by the size and complexity of SCT. Method: Our proposal here is to develop an upper-level ontology and to use it as the basis for defining the termsin SCT in a way that (...)
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  40. A Promenade on the Ethics and Ethical Decision.Kiyoung Kim - 2014 - International Journal of Advanced Research 2 (10):15-23.
    The studies of ethics had long been under-dealt although it is the kind of primary in sustaining a civility. It is hardly deniable that the concept of efficiency and productivity has hailed on the mindedness and interest of academic community. The narrative of ethics or social justice would be ridiculed as the kind of Greek juggle on philosophy or put to be on neglect for its lacking or default on the modern disciplinary frame in the academics. A cure, however, seems (...)
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  41. The Role of Research Ethics Committees in Making Decisions About Risk.Allison Ross & Nafsika Athanassoulis - 2014 - HEC Forum 26 (3):203-224.
    Most medical research and a substantial amount of non-medical research, especially that involving human participants, is governed by some kind of research ethics committee (REC) following the recommendations of the Declaration of Helsinki for the protection of human participants. The role of RECs is usually seen as twofold: firstly, to make some kind of calculation of the risks and benefits of the proposed research, and secondly, to ensure that participants give informed consent. The extent to which the role (...)
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  42. How Can Feminist Theories of Evidence Assist Clinical Reasoning and Decision-Making?Maya J. Goldenberg - 2013 - Social Epistemology (TBA):1-28.
    While most of healthcare research and practice fully endorses evidence-based healthcare, a minority view borrows popular themes from philosophy of science like underdetermination and value-ladenness to question the legitimacy of the evidence-based movement’s philosophical underpinnings. While the feminist origins go unacknowledged, those critics adopt a feminist reading of the “gap argument” to challenge the perceived objectivism of evidence-based practice. From there, the critics seem to despair over the “subjective elements” that values introduce to clinical reasoning, demonstrating that they do not (...)
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  43.  87
    The Role of Evidence in Chronic Care Decision-Making.Fabrizio Macagno & Sarah Bigi - 2021 - Topoi 40 (2):343-358.
    In the domain of medical science, factual evidence is usually considered as the criterion on which to base decisions and construct hypotheses. Evidence-based medicine is the translation of this approach into the field of patient care, and it means providing only the type of care that is based on evidence that proves its effectiveness and appropriateness. However, while the literature has focused on the types and force of evidence used to establish the recommendation and treatment guidelines, the problem (...)
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  44. Exposing the Vanities—and a Qualified Defense—of Mechanistic Reasoning in Health Care Decision Making.Jeremy Howick - 2011 - Philosophy of Science 78 (5):926-940.
    Philosophers of science have insisted that evidence of underlying mechanisms is required to support claims about the effects of medical interventions. Yet evidence about mechanisms does not feature on dominant evidence-based medicine “hierarchies.” After arguing that only inferences from mechanisms (“mechanistic reasoning”)—not mechanisms themselves—count as evidence, I argue for a middle ground. Mechanistic reasoning is not required to establish causation when we have high-quality controlled studies; moreover, mechanistic reasoning is more problematic than has been assumed. Yet where the problems (...)
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  45. Applying Evidence to Support Ethical Decisions: Is the Placebo Really Powerless?Prof Dr Franz Porzsolt, Nicole Scholtz-Gorton, Nikola Biller-Andorno, Anke Thim, Karin Meissner, Irmgard Roeckl-Wiedmann, Barbara Herzberger, Renatus Ziegler, Wilhelm Gaus & Ernst Pöppel - 2004 - Science and Engineering Ethics 10 (1):119-132.
    Using placebos in day-to-day practice is an ethical problem. This paper summarises the available epidemiological evidence to support this difficult decision. Based on these data we propose to differentiate between placebo and “knowledge framing”. While the use of placebo should be confined to experimental settings in clinical trials, knowledge framing — which is only conceptually different from placebo — is a desired, expected and necessary component of any doctor-patient encounter. Examples from daily practice demonstrate both, the need to investigate the (...)
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  46. The Real World Failure of Evidence-Based Medicine.Donald W. Miller & Clifford Miller - 2011 - International Journal of Person Centered Medicine 1 (2):295-300.
    As a way to make medical decisions, Evidence-Based Medicine (EBM) has failed. EBM's failure arises from not being founded on real-world decision-making. EBM aspires to a scientific standard for the best way to treat a disease and determine its cause, but it fails to recognise that the scientific method is inapplicable to medical and other real-world decision-making. EBM also wrongly assumes that evidence can be marshaled and applied according to an hierarchy that is determined in an argument (...)
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  47. Theory Without Theories: Well-Being, Ethics, and Medicine.Jennifer Hawkins - 2021 - Journal of Medicine and Philosophy 46 (6):656-683.
    Medical ethics would be better if people were taught to think more clearly about well-being or the concept of what is good for a person. Yet for a variety of reasons, bioethicists have generally paid little attention to this concept. Here, I argue, first, that focusing on general theories of welfare is not useful for practical medical ethics. I argue, second, for what I call the “theory-without-theories approach” to welfare in practical contexts. The first element of this approach (...)
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  48. The Promise and Perils of AI in Medicine.Robert Sparrow & Joshua James Hatherley - 2019 - International Journal of Chinese and Comparative Philosophy of Medicine 17 (2):79-109.
    What does Artificial Intelligence (AI) have to contribute to health care? And what should we be looking out for if we are worried about its risks? In this paper we offer a survey, and initial evaluation, of hopes and fears about the applications of artificial intelligence in medicine. AI clearly has enormous potential as a research tool, in genomics and public health especially, as well as a diagnostic aid. It’s also highly likely to impact on the organisational and business practices (...)
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  49. Clarifying the Best Interests Standard: The Elaborative and Enumerative Strategies in Public Policy-Making.Chong Ming Lim, Michael C. Dunn & Jacqueline J. Chin - 2016 - Journal of Medical Ethics 42 (8):542-549.
    One recurring criticism of the best interests standard concerns its vagueness, and thus the inadequate guidance it offers to care providers. The lack of an agreed definition of ‘best interests’, together with the fact that several suggested considerations adopted in legislation or professional guidelines for doctors do not obviously apply across different groups of persons, result in decisions being made in murky waters. In response, bioethicists have attempted to specify the best interests standard, to reduce the indeterminacy surrounding (...) decisions. In this paper, we discuss the bioethicists’ response in relation to the state's possible role in clarifying the best interests standard. We identify and characterise two clarificatory strategies employed by bioethicists —elaborative and enumerative—and argue that the state should adopt the latter. Beyond the practical difficulties of the former strategy, a state adoption of it would inevitably be prejudicial in a pluralistic society. Given the gravity of best interests decisions, and the delicate task of respecting citizens with different understandings of best interests, only the enumerative strategy is viable. We argue that this does not commit the state to silence in providing guidance to and supporting healthcare providers, nor does it facilitate the abuse of the vulnerable. Finally, we address two methodological worries about adopting this approach at the state level. The adoption of the enumerative strategy is not defeatist in attitude, nor does it eventually collapse into (a form of) the elaborative strategy. (shrink)
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  50. Evaluating Consequences.Kalle Grill - 2009 - In Kattan (ed.), Encyclopedia of Medical Decision Making. Sage Publications.
    Decisions in medical contexts have immediate and obvious consequences in terms of health and sometimes death or survival. Medical decisions also have less obvious and less immediate consequences, including effects on the long-term physical and mental well-being of patients, their families and of care-givers, as well as on the distribution of scarce medical resources. Some of these consequences are hard to measure and estimate. Even harder, perhaps, is the determination of the relative value of different (...)
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