Introduction. The medical sphere is constantly evolving, requiring improved approaches to its organisation and functioning. Advances in medical technology, observable changes in patient needs and growing competition challenge medical institutions to improve their strategies and approaches. Marketing technologies are becoming one of the key tools for achieving strategic goals. Purpose. This article is aimed at studying the peculiarities of the use of marketing technologies in the medical field. The main purpose of the study is to (...) analyse the impact of marketing tools on the development and success of medical institutions. Method (methodology). The methodological approach involves the use of an analytical approach to studying current trends in marketing and their impact on the healthcare sector. The study uses methods of data analysis and comparative analysis of marketing practices in medical institutions. Results. The study found that the use of targeted marketing strategies allows healthcare facilities to attract more patients, increase customer satisfaction and ensure an excellent reputation. The results of the study show a positive impact of the use of marketing tools on changing the perception of medical services by patients. Conclusions. The scope of application of the results is the practical activities of medical institutions seeking to improve their strategy of promotion and interaction with customers. The findings of the study can be used by marketers and managers of healthcare organisations to develop and implement effective marketing strategies. In summary, this article reveals the importance of using marketing technologies in the healthcare sector and provides practical recommendations for their successful implementation. The study emphasises that marketing in the healthcare industry is necessary to increase competitiveness and ensure quality medical care. (shrink)

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 (...) physician’s right to conscientious objection, but this right is contested both in the medical ethics literature and in the public sphere. This paper presents the results of a qualitative study conducted with twenty Quebec physicians who did not integrate MAID into their medical practice, either because they were opposed to or deeply ambivalent about MAID. The interviews aimed to explore the reasons – religious and secular – for opposition to or ambivalence towards MAID. The secular reasons given by participants were grouped into four main categories: 1) the ends of medicine and professional identity, 2) the philosophy of palliative medicine and resource allocation in palliative care, 3) benevolent paternalism, the “good death”, and the interests of future selves, 4) the risk of a slippery slope and the protection of vulnerable people. (shrink)

In a challenge trial, research subjects are purposefully exposed to some pathogen in a controlled setting, in order to test the efficacy of a vaccine or other experimental treatment. This is an example of medical effective altruism (MEA), where individuals volunteer to risk harms for the public good. Many bioethicists rejected challenge trials in the context of Covid‐19 vaccine research on ethical grounds. After considering various grounds of this objection, I conclude that the crucial question is how much harm (...) research subjects can permissibly risk. But we lack a satisfying way of making this judgment that does not appeal simply to the intuitions of doctors or bioethicists. I consider one recent and structurally plausible approach to critically evaluating the harm question. Alex London defends a social consistency test for research risks: we should compare the risks undertaken by research subjects to relevantly similar risks which are accepted in other spheres of society. I argue there is no good reason not to consider volunteer military service as a relevant social comparison. This implies there is essentially no cap on acceptable risks on the social consistency rationale. In short, if soldiers can be heroes, why can't research volunteers? (shrink)

This article suggests different approaches to the definition of the nature, types, and component elements of safety culture (SC) in the organization; given the possible method of evaluation; formulated the concept of professional safety culture by taking into account the features of the medical industry; suggested innovative ways to implement the SC and strengthen it to improve the efficiency of hospitals. -/- Запропоновано окремі підходи до трактування сутності, видів і складових елементів культури безпеки (КБ) в організації; надано можливий метод (...) оцінки; сформульовано поняття професійної культури безпеки з урахуванням особливостей медичної галузі; запропоновано інноваційні шляхи впровадження КБ і її зміцнення для підвищення ефективності діяльності медичного закладу. (shrink)

Due to the Coronavirus Disease-2019 (COVID-19) lockdown implemented by the government, we had to transform our classes into the online sphere. The most commonly used methods of online teaching in Government Medical College, Thrissur were, live online lectures, PowerPoint presentations with narrations, prerecorded videos and assignments. Aim: To assess the logistical aspects, merit and demerits of different online teaching-learning methods among phase-1 medical student in a tertiary care teaching hospital during COVID-19 lockdown Materials and Methods: This cross-sectional (...) study was conducted from July 2020 to September 2020, among phase-1 MBBS students of Government Medical College, Thrissur, Kerala, India. Data was collected from 161 students through a questionnaire consisting of two parts. The first part dealt with logistical aspects, like net connectivity, gadget, expenditure, financial burden, residence and eye strain with online teaching learning methods. The second part dealt with the merits and demerits of each type of teaching learning methods, according to the students. All statistical data was analysed using the Statistical Package for the Social Sciences (SPSS) software version 16. Qualitative data was expressed as a percentage. Results: A total of 97.5% population of students was able to frequently access the online classes. Online learning strained the eyes of 47.8% of students. Mobile phones were used by 92.5% of students for attending online classes internet connectivity was mainly through 4G (71.4%) followed by Wi-Fi (19.9%) connections. Their most preferred method of online learning was online live lectures (35.4%) followed by PowerPoint presentations with narrations (33.5%). Blended learning (online and traditional together) was best preferred method of learning (46.6%). Conclusion: Live online lectures and blended learning were preferred by the majority of students. Thus, the online classes can be continued along with the traditional teaching in future. (shrink)

This article starts with a brief analysis of the causes of state collapse as states undergo the process of political evolution. Next, I describe and analyze the mechanisms of social-political crises arising in the process of modernization. Such crises are a consequence of the inability of many traditional institutions and ideologies to keep up with changes in technology, communication, system of education, medical sphere, and with the demographic change. This analysis suggests that an accelerated development can cause a (...) system crisis with potentially serious consequences to the society. It is important to take this aspect into consideration because some scholars insist that the economic reconstruction and development are necessary for nation-building. This actually implies a rapid economic advancement (otherwise, the economy could not be reconstructed and developed). However, one should not ignore the possibility that very rapidly developing countries may run the danger of falling into the trap of fast transformation. The present article describes several mechanisms that can contribute to sociopolitical instability, including social tensions arising from rapid urbanization, youth bulges, and ‘resource curses’. (shrink)

Governments standardly deploy a distinction between goods and services in assessing economic health and tracking national income statistics, of which medical goods and services carry significant importance. In what follows we draw on Basic Formal Ontology (BFO) to introduce a third kind of entity called patterns, which help capture the various ways in which goods and services are intertwined and help also to show how many services generate a new kind of non-goods-related products. Patterns are an overlooked yet essential (...) features of many economic sectors including medicine. Studying patterns offers new insights into various components of economic analysis, including outcomes-oriented evaluations of medical services and the value of human capital in the medical sphere. (shrink)

The issue of safety culture is one of the most important in a modern medical facility because any problems during the provision of services may lead to irreversible consequences. Not only the patient may suffer, but the doctor who assisted. Unfortunately, very little attention to this issue is paid in Ukraine. Based on this, we can say that the topic is relevant and requires studying. -/- The purpose of writing this article is the analysis of the ways of forming (...) professional safety culture in clinical medicine. The methods by which we carried out scientific research are observation, analysis, evaluation, comparison, generalization. -/- The work examined interpretation of the term "safety culture", types of innovation in which it belongs and the main methods of its creation in the medical field. -/- Safety culture in the medical field involves the right of all health care workers to use measures to prevent actions that can harm a patient or a colleague. Different approaches were considered in the interpretation of the term "safety culture" and we proposed our own: safety culture is a system of values, objectives, knowledge and skills, rules and procedures, convictions shared by representatives of a certain medical profession and supported by patients, creating a favourable working climate, atmosphere of trust and becoming an efficient tool for achieving the goals of the organization. -/- The main components of the safety culture were defined: responsibilities of managers, communication, performance, resources of safety, trust, the degree of job satisfaction, etc. Based on several studies, it was found that no country has a perfect medical system. Every system should be improved. -/- We proposed measures to fix the situation with the safety culture in health care facilities. The correct management of safety can eliminate or fix many medical errors. That is why the need for a clear program of implementation, execution and control of SC in the medical establishment is necessary. -/- Scientific novelty of this work lies in the interpretation of the term "safety culture" at medical institutions and in determining major steps towards its creation. Practical value of the work is the opportunity to implement these steps in medical institutions for improvement of the safety culture and, therefore, to reduce the risk of bad accidents during treatment. -/- Further research can address safety culture management in medical institutions on the examples from the experience of countries with effective systems of health care. (shrink)

Beauchamp and Childress created the ‘four principle’ approach to help clinicians analyse and resolve ethical dilemmas they may encounter when working. In this project, I will consider whether autonomy ought to have a privileged position within the four principles and if the four principles can apply outside the medical sphere.

Natalia Tomashpolskaia, "Predictive World", pp. 301–308. -/- In the contemporary world, the scientific model of reality has become prognostic and predictive. Scientists make predictions based on facts, re- search, and experiments. These predictions create a new picture of reality and have a great impact on people’s behavior and decision-making. For in- stance, we can observe a vivid manifestation of this phenomenon in mod- ern medicine. Prognosis replaces diagnoses, and diagnoses and vital de- cisions begin to be based on a prognosis. (...) However, not only sciences, but the mass-media news industry also has become prognostic. Nowadays, the prevailing part of all news consists not of facts but of predictions and pro- gnoses (economic, political, societal, environmental, medical, etc.). All types of analysts and prognosticators in all spheres have become in de- mand. To sum up, nowadays we do not live here and now but we are living in constant stress awaiting negative events based on some prognosis we have believed in and these beliefs condition our current behaviour. (shrink)

If bioethical questions cannot be resolved in a widely acceptable manner by rational argument, and if they can be regulated only on the basis of political decision-making, then bioethics belongs to the political sphere. The particular kind of politics practiced in any given society matters greatly: it will determine the kind of bioethical regulation, legislation, and public policy generated there. I propose approaching bioethical questions politically in terms of decisions that cannot be “correct” but that can be “procedurally legitimate.” (...) Two procedures in particular can deliver legitimate bioethical decisions, once combined: expert bioethics committees and deliberative democracy. Bioethics so understood can exceed bioethics as a moral project or as a set of administrative principles to regulate medical practice; it can now aspire to a democratic project that involves ordinary citizens as far as reasonably possible. I advance this argument in four steps: (1) using the example of human germline gene editing, (2) I propose a general understanding of proceduralism, and (3) then combine two types and (4) conclude with a defense of majoritarian proceduralism. I develop this argument in terms of one example: germline gene editing. (shrink)

In the contemporary world, the scientific model of reality has become prognostic and predictive. Scientists make predictions based on facts, re- search, and experiments. These predictions create a new picture of reality and have a great impact on people’s behavior and decision-making. For in- stance, we can observe a vivid manifestation of this phenomenon in mod- ern medicine. Prognosis replaces diagnoses, and diagnoses and vital de- cisions begin to be based on a prognosis. However, not only sciences, but the mass-media (...) news industry also has become prognostic. Nowadays, the prevailing part of all news consists not of facts but of predictions and pro- gnoses (economic, political, societal, environmental, medical, etc.). All types of analysts and prognosticators in all spheres have become in de- mand. To sum up, nowadays we do not live here and now but we are living in constant stress awaiting negative events based on some prognosis we have believed in and these beliefs condition our current behaviour. (shrink)

If each of the subtypes of autism is defined simply as constituted by a set of symptoms, then the criteria for its observation are straightforward, although, of course, some of those symptoms themselves might be hard to observe definitively. Compare with telling whether or not someone is bleeding: while it might be hard to tell if someone is bleeding internally, we know what it takes to find out, and when we have the right access and instruments we can settle the (...) issue. But matters are not so simple for the autism subtypes. For one thing, how do we settle which symptoms to group together under one heading? One key difference between “autism disorder” and “Asperger’s disorder” is that the former exhibit language delays (sometimes extreme), whereas the latter do not. But is that a sign of genuinely distinct conditions or is that an artifact of the distinct groups of subjects that Leo Kanner and Hans Asperger worked with? And in general, although there are certainly types of behavior that are taken to be indicative of autism, none by itself is taken by diagnosticians to be either necessary or sufficient for a definitive diagnosis for any of the autism subtypes. What is the diagnostician to do? This is not merely an academic issue, as many parents can attest. Are we in a situation, then, that each practitioner has his or her own “pet” signs that are the “real keys” to the diagnosis? That would suggest that the term “autistic” might meet the fate of the outdated term “neurotic,” which turned out to be a pseudo-scientific term for an inexact clumping together of unrelated phenomena. The assumption amongst specialists seems to be that we will reach the point with "autism" that we have with "water": there will be a root essence to autism whose presence or absence settles a diagnosis. If that is to be the case, however, we have to settle the level of application of the concept. Does the term apply to people who exhibit particular behaviors? Or is it possible to exhibit “autistic” behaviors without actually being autistic, because autism is instead a particular feature of the mind (as, for example, in Baron-Cohen’s “impaired theory of mind module” theory, discussed below) which usually but not necessarily has behavioral effects? Or is autism located instead in the brain, perhaps in damage to key areas, which in turn would typically have an effect on modules of the mind? Or perhaps autism is located in genetics or biology, so that some people with damage to the brain caused by accidents so that they exhibit autistic symptoms would not actually be autistic. Conversely, supposing one had an “autistic brain” but showed none of (or not a sufficient number of) the symptoms, would one not be autistic? The assumption is that the genotypes and phenotypes will line up neatly, but if they do not, what happens to the concept “autistic?” (There is an analogy in the philosophy of sex and gender: androgen insensitive individuals tend to self-identify as female and have outward female traits, but have XY chromosomes—should we go with chromosomes or self-identity in assigning sex category?) Finally, the implications for these complications for diagnosis and categorization, with the attendant social and medical implications is discussed. The typical assumption of the medical profession is that autism cannot be “cured.” That assumes that autism is not simply the symptoms. However, at the same time, the tests used to diagnose ASDs work simply from the symptoms (for example, Baron-Cohen’s Sally/Anne test, which ASD children of a certain age almost all fail, but which practically no ASD adult fails). This implies an inherent confusion over the status of the concept. I conclude that attempts to make sense of some true or accurate summary of what it is to be autistic (such as one would find in the DSM) are almost certainly misguided and will vanish into history along with “neurotic.” But as with racial terms, which are similarly shifting and perverse, the term has already passed into the public sphere and will have a lasting and dangerous influence beyond its short scientific shelf-life. (shrink)

Despite their shared origins, medicine and dentistry are not always two sides of the same coin. There is a long history in medical philosophy of defining disease and various medical models have come into existence. Hitherto, little philosophical and phenomenological work has been done considering dental caries and periodontitis as examples of disease and illness. A philosophical methodology is employed to explore how we might define dental caries and periodontitis using classical medical models of disease – the (...) naturalistic and normativist. We identify shared threads and highlight how the features of these highly prevalent dental diseases prevent them fitting in either definition. The article describes phenomenology and the current thought around the phenomenology of illness, exploring how and why these dental illnesses might integrate into a phenomenological model. We discover that there are some features particular to dental caries and periodontitis: ubiquity, preventability and hyper-monitorablility. Understanding the differences that these dental diseases have compared to many other classically studied diseases leads us to ethical questions concerning how we might manage those who have symptoms and seek treatment. As dental caries and periodontitis are common, preventable and hyper-monitorable, it is suggested that these features affect the phenomenology of these illnesses. For example, if we experience dental illness when we have consciously made decisions that have led to it, do we experience them differently to those rarer illnesses that we cannot expect? Other diseases share these features are discussed. This paper highlights the central differences between the classical philosophical notion of disease in medicine and the dental examples of caries and periodontitis. It suggests that a philosophical method of conceptualising medical illness - phenomenology - should not be applied to these dental illnesses without thought. A phenomenological analysis of any dental illness is yet to be done and this paper highlights why a separate strand of phenomenology should be explored, instead of employing those that are extant. The article concludes with suggestions for further research into the nascent field of the phenomenology of dental illness and aims to act as a springboard to expose the dental sphere to this philosophical method of analysis. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Affect Attunement in the Caregiver-Infant Relationship and Across SpeciesExpanding the Ethical Scope of ErosCynthia WillettCompelling glimpses into the ethical capacities of our animal kin reveal new possibilities for ethical relationships encompassing humans with other animal species. Consider the remarkable report of a female bonobo in a British zoo who assists a bird found in her cage by retrieving the fallen bird, and spreading its wings so that this fellow (...) creature might fly away to its freedom. Or the report of a cat in a nursing home who curls up around dying elderly patients, and remains steadily by their side as they, unbeknownst to the medical personnel, pass away.1 Or of a sacred moment of silence by a stream for baboons in East Africa.2 Or of the ethics that spontaneously emerges among wolves at play.3 On the basis of extensive studies, biologist Frans de Waal argues that such anecdotes are far from rare, and that some core elements of moral understanding and compassion occur among a significant range of nonhuman as well as the human animal species. Apes, monkeys, and perhaps all nonhuman animals fail to display a distinctly human capacity for abstract moral reasoning. As de Waal (2006) remarks, it is difficult to tell (173–75). But our furry and feathery kin do without a doubt demonstrate rich elements of ethical response, and they often enough extend their moral concern to creatures beyond their own species. Of course, they will also bite each other’s heads off or eat their own young as well. But this is just to say that animals are neither natural [End Page 111] innocents nor savage brutes. Like us, they belong to what post-Nietzschean philosophers might frame, somewhat ironically, as a postlapsarian world of good and evil.What kind of philosophical approach could account for these postlapsarian genealogies of ethics? Biologists, primatologists, and anthropologists are drawing upon investigations of prosocial behavior to remap the boundaries of ethics, as for example in Isabelle Stengers’s call for cosmopolitical ecologies of relationships (2010, 33). Such a cosmopolitics aims to encompass our kin and kind from diverse species within the ethical boundaries of common worlds. Donna Haraway discovers an opening for Stengers’s ecology of relationships in the intimate encounters among co-evolving species, especially those she calls companion species (2008, 83). She argues, following Derrida, that the abstract reasoning processes of Stoic and Kantian cosmopolitan ethics remain closed to the participation of nonhuman animals as anything more than dependents, failing to observe the ways in which they act as companions, if not moral subjects. But then, what normative force might bind together an ethically attuned biosocial sphere that we as humans co-inhabit with other animal species?To explore this question, this essay takes its cues from well-established research on the responsive, preverbal connection of the human infant and adult caregiver (Bateson 1979; Trevarthen 1984; Stern 1985, 2010; Gibbs 2001, 2010; Hansen 2004; Anderson 2006; Papoulias and Callard 2010; Willett 1995, 2001). To this research we can add new animal studies (Smuts 1999, 2001; Fudge 2002; de Waal 2006, 2009; Bekoff 2007; Molnar 2008; Haraway 2008). These animal studies provide a basis for extending an “ethics of eros” with roots in Luce Irigaray, Michel Foucault, Enrique Dussel, Africana feminism, Freudo-Marxist critical theory, and Plato (for discussions of this tradition, see Bergoffen 1997; Huffer 2009; Willett 2001)—but reconfigured in terms of social bonds across multiple animal species. In this tradition of ethics, the lack of a cognitive-based moral subjectivity that can translate into human terms does not consign nonhuman species to a mute moral status. On the contrary, some more primordial basis for relationship and meaning may weave thin but substantial threads of a postmoral ethics across regions of the biosphere.Given the diverse modes of subjectivity among animal species, and even the lack of what we call a moral subject altogether in many species, neither ordinary modes of empathy nor of moral understanding go very far in forging multispecies social bonds. For this reason, we turn to research on “the attunement of affects” in the infant-caregiver relationship (Stern 1985). As we shall see, this... (shrink)

David Tomasi presents new, groundbreaking research on the science and application of Mind-Body Medicine strategies to improve clinical outcomes in inpatient psychiatry settings. Much more than a list of therapeutic recommendations, this book is a thorough description of how Mind-Body Medicine can be successfully applied, from a therapeutic as well as from an organizational, cost-effective analysis viewpoint, to the full spectrum of psychiatric treatments. Furthermore, this study examines the role of multidisciplinary and interdisciplinary treatment teams, with a special focus on (...) the profession and the role of psychotherapists and group therapists, thereby providing solid scientific evidence of the benefits of patient-provider therapeutic alliances. In this sense, this book serves as a guide for professionals and institutions both in the private and the public sphere, to learn effective treatment and management strategies. About the Author Psychotherapist, Researcher, and Philosopher Dr. David Låg Tomasi is the author of Medical Philosophy (ibidem, 2016) and the co-author of Positive Patient Response to a Structured Exercise Program Delivered in Inpatient Psychiatry (Global Advances in Health and Medicine, 2019), the most-read research item from the University of Vermont (Researchgate, 2019). A member of several national and international Academies of Sciences, Dr. Tomasi works in the Inpatient Psychiatry Unit at the UVM Medical Center, and teaches at the University of Vermont and the Community College of Vermont. ---- Ibidem / Columbia University Press. (shrink)

Elite women seized the public health campaign during the 1900 plague outbreak to assert political influence and advocate for sanitation reform grounded in their domestic experiences. These women advocated for their inclusion in the political sphere by valuing their domestic experiences as knowledge relevant for public health initiatives. This reframing of experience positioned them as viable citizens in the imminent Federation. Applying Laura Zanotti's concept of relational ontology, this analysis frames their actions as not simply a battle against institutional (...) authority but as careful and strategic interactions with their era's political context, exploiting aspects of it that were beneficial to them. Their ambivalent involvement in the public health campaign illustrates a complex chapter in Australian medical history. Women used the opportunity of plague to reevaluate their experience of the home as a form of knowledge relevant to public health. At the same time, they leveraged their growing status as political subjects to oppress others. (shrink)

The article examines the participation and assistance of the Orthodox Church in solving problems that allowed to give a scientific justification for the cooperation of health care and Orthodox religious institutions, to determine their role in the historical context and structure of modern healthcare in Russia. The article presents an algorithm for organizing sisters of mercy, their system of upbringing. Particular attention is given to the possibility of teaching the course "Foundations of Orthodox Culture" in secular educational institutions. -/- Research (...) materials can serve as a basis for the formation of morally sound positions of medical workers and the population on the main problems of medical activity. -/- Based on the study, the authors published a series of articles in which the experience of the work of the Orthodox Church in the charitable sphere has been summarized. This experience can be used to create new charitable institutions, including those who provided medical assistance. -/- In preparing the article, the authors used concrete historical, civilizational, formational and social methods of research that allowed us to uncover facts, phenomena and processes in the interconnection and unity of the past, present and future. (shrink)

Mental health challenges can be described via the application of multiple lenses, from clinical-medical perspectives, to social and community-based, to further understandings in the context of public health. While these challenges can represent multiple issues to the scientific community at-large, especially because of the translational issues attached to the application of research and practice to the sphere of community services, it is useful to understand that the triad ethics, evidence, and experience can be instrumental in navigating the complexity (...) of the issue-at-hand. Furthermore, the work of researchers and practitioners is rooted in a solid understanding of the specific needs of psychiatric patients, particularly from the perspective of possible misunderstandings, ostracization, and stigmatization of psychiatric issues and related presentation, affect, and behaviours. Years of research have indicated how a proper interaction between resources at the level of scientific research and the community is a fundamental cornerstone for a practice rooted in both science and true care for individuals affected by mental health disorders. In this presentation we will discuss the case of the Centro Salute Mentale (Mental Health Centre, CSM) of Verona. (shrink)

The possibility that non-biological resources can act as part of the cognitive system is claimed by Andy Clark’s and David Chalmers’s seminal paper, ‘The Extended Mind’ (1998). This hypothesis holds parallels with the history of the book, an area of research that has long been considering the effect on culture and cognition of the technological changes from orality to literacy and from manuscripts to printing. M. T. Clanchy’s From Memory to Written Record describes literacy as a technology that structures the (...) intellect and Walter Ong’s Orality and Literacy argues that the increasing use of texts results in the development of new forms of cognition. More recently a number of scholars have charted how the common Renaissance practices of the annotation and alteration of the books enabled readers to deal with increasing cognitive loads, through reorganising and adding to the textual structures. Furthermore, in the Renaissance the textual was understood as playing a supplementary role to biological memory and historical narratives were understood as supplementing individual experience, with another’s memories or knowledge equivalent to one’s own. In addition, Renaissance accounts of rhetoric explore the notion of language as constitutive of our humanity. These strands form a prevalent notion of language and literacy as a means of extending oneself that is equivalent to the production of biological offspring, and as a means to overcome death and forgetting. This notion infiltrated diverse spheres’ ways of understanding these activities, from literary prefaces, autobiographies, plays and poems, to jest books and medical and scientific texts. These diverse works shape this reading of Shakespeare’s sonnets, which focuses on the exploration in ‘Sonnet 77’ of the benefits and constraints of a biological versus a textual copy of the subject. ‘Sonnet 77’ evidences the co-existence of an uneasy and yet also a celebratory understanding of the human capacity to reproduce and extend itself through biological and linguistic couplings, the latter of which the reader may experience through their own encounter with the sonnets. This chapter thereby demonstrates that the fertile parallels between the extended mind hypothesis, the history of the book, and Renaissance texts invites a re-evaluation of historical, as well as modern, concepts of what constitutes cognition and subjectivity. (shrink)

I am grateful to Philip Reed for his article ‘Expressivism at the Beginning and End of Life’. His piece compellingly demonstrates the import of expanding analyses concerning the expressivist thesis beyond the reproductive sphere to the end-of-life sphere. I hope that his intervention spurns further work on this connection. In what follows, I want to focus on what I take to be moments of slippage in his use of the concept of disability, a slippage to which many disability (...) theorists succumb. In short, I argue that there are crucial moments in his argument where Reed runs together cases of disability that should be kept distinct—at minimum for the context in which he discusses them. Namely, forms of disability the suffering of which justice can eliminate versus those that ‘no amount of accessibility and social justice could eliminate’. (shrink)

In recent years, notable figures within the medical community have expressed concerns about the rate of medical progress, suggesting that the rapid advances of medicine’s ‘golden age’ are now giving way to an ‘age of disappointment’. While these pessimistic pronouncements about medical progress must–implicitly if not explicitly–appeal to some criteria for what medical progress would be, the task of explicitly defining medical progress has been notably neglected. We take up this task, drawing on insights from (...) the philosophy of science concerning both scientific progress and the aims of medicine. Among other things, we differentiate between medical scientific progress and progress in medical practice, and suggest that this distinction helps to evaluate the aforementioned concerns about the current rate of medical progress. While it is not our goal to draw conclusions relating to the state of medicine at the present time, we propose a unifying account of medical scientific progress according to which such progress leads, necessarily, to progress in medical practice, and show how this account both plausibly distinguishes between medical scientific progress and other (non-medical) instances of scientific progress, and does justice to the ‘dual character’ of medicine. (shrink)

The rapid expansion of Big Tech companies into various societal domains (e.g., health, education, and agriculture) over the past decade has led to increasing concerns among governments, regulators, scholars, and civil society. While existing theoretical frameworks—often revolving around privacy and data protection, or market and platform power—have shed light on important aspects of Big Tech expansionism, there are other risks that these frameworks cannot fully capture. In response, this editorial proposes an alternative theoretical framework based on the notion of (...) class='Hi'>sphere transgressions, which draws on political philosopher Michael Walzer's theory of justice. The editorial not only introduces the sphere transgressions framework, but it also highlights its potential to generate novel research questions. Furthermore, this editorial introduces eight articles and one commentary from a group of interdisciplinary scholars that critically examine Big Tech expansionism by reflecting on this expansionism from the perspective of different societal spheres or by engaging with the sphere transgressions framework itself. (shrink)

Pharmaceuticals or other emerging technologies could be used to enhance (or diminish) feelings of lust, attraction, and attachment in adult romantic partnerships. While such interventions could conceivably be used to promote individual (and couple) well-being, their widespread development and/or adoption might lead to “medicalization” of human love and heartache—for some, a source of serious concern. In this essay, we argue that the “medicalization of love” need not necessarily be problematic, on balance, but could plausibly be expected to have either good (...) or bad consequences depending upon how it unfolds. By anticipating some of the specific ways in which these technologies could yield unwanted outcomes, bioethicists and others can help direct the course of love’s “medicalization”—should it happen to occur—more toward the “good” side than the “bad.”. (shrink)

Medicalization occurs when a phenomenon comes to be subject to medical study, diagnosis, treatment, or prevention. Whether a phenomenon ought to be medicalized should be decided on a case-by-case basis. Recent moves to remove “bereavement exclusions” from psychiatric diagnostic manuals and to introduce grief-specific medical disorders have elicited criticisms from skeptics about grief’s medicalization, but these criticisms can largely be blunted. This article first clarifies the nature of disputes about medicalization, highlighting how these disputes do not concern whether (...) a condition such as grief is clinically significant or whether it can generate illness, but whether the condition itself is rightfully categorized as potentially pathological. It then offers a stronger, philosophically grounded case against the medicalization of grief, resting on how medicalizing grief is likely to detrimentally alter the moral and political meanings attached to grief. Specifically, medicalizing grief will “normativize” a medical vocabulary for evaluating grief that may impede authentic engagement with grief, validate a suspect “time slice” model of human well-being that overlooks how grief can benefit a person’s life as a whole, and impede desirable sympathy or solidarity with grieving persons. (shrink)

Medicalisation is a social phenomenon in which conditions that were once under legal, religious, personal or other jurisdictions are brought into the domain of medical authority. Low sexual desire in females has been medicalised, pathologised as a disease, and intervened upon with a range of pharmaceuticals. There are two polarised positions on the medicalisation of low female sexual desire: I call these the mainstream view and the critical view. I assess the central arguments for both positions. Dividing the two (...) positions are opposing models of the aetiology of low female sexual desire. I conclude by suggesting that the balance of arguments supports a modest defence of the critical view regarding the medicalisation of low female sexual desire. (shrink)

I developed a framework regarding an individual’s subjective spheres of influence based on the Mindsponge mechanism and Mindsponge-related studies to illustrate how individuals perceive what they can influence and what can influence them. In fact, this idea has germinated in my mind since I asked the question: “what are beyond Mindsponge?” The framework is expected to help explain how people interact with the world around them, how groups are formed, and how societies operate, which can be valuable for studying political, (...) economic, social-cultural issues across disciplines. (shrink)

The phenomenon of medical overtesting in general, and specifically in the emergency room, is well-known and regarded as harmful to both the patient and the healthcare system. Although the implications of this problem raise myriad ethical concerns, this paper explores the extent to which overtesting might mitigate race-based health inequalities. Given that medical malpractice and error greatly increase when the patients belong to a racial minority, it is no surprise that the mortality rate similarly increases in proportion to (...) white patients. For these populations, an environment that emphasizes medical overtesting may well be the desirable medical environment until care evens out among races and ethnicities; additionally, efforts to lower overtesting in conjunction with a high rate of racist medical mythology may cause harm by lower testing when it is actually warranted. Furthermore, medical overtesting may help to assuage racial distrust. This paper ultimately concludes that an environment of medical overtesting may be less pernicious than the alternative. (shrink)

In this paper, I defend a version of the medical model of disability, which defines disability as an enduring biological dysfunction that causes its bearer a significant degree of impairment. We should accept the medical model, I argue, because it succeeds in capturing our judgments about what conditions do and do not qualify as disabilities, because it offers a compelling explanation for what makes a condition count as a disability, and because it justifies why the federal government should (...) spend hundreds of billions of dollars, annually, on aid and accommodations for disabled people. After responding to a pair of objections Elizabeth Barnes has raised against the medical model, I contrast it with Guy Kahane and Julian Savulescu's welfarist account of disability, and with Barnes's own mere-difference view. Both of these accounts face serious challenges, although elements of Barnes's view can—and, in my opinion, should—be adopted by proponents of the medical model. (shrink)

Many hold that distributing healthcare according to medical need is a requirement of equality. Most egalitarians believe, however, that people ought to be equal on the whole, by some overall measure of well-being or life-prospects; it would be a massive coincidence if distributing healthcare according to medical need turned out to be an effective way of promoting equality overall. I argue that distributing healthcare according to medical need is important for reducing individuals' uncertainty surrounding their future (...) class='Hi'>medical needs. In other words, distributing healthcare according to medical need is a natural feature of healthcare insurance; it is about indemnity, not equality. (shrink)

This paper argues that epistemic errors rooted in group- or identity- based biases, especially those pertaining to disability, are undertheorized in the literature on medical error. After sketching dominant taxonomies of medical error, we turn to the field of social epistemology to understand the role that epistemic schemas play in contributing to medical errors that disproportionately affect patients from marginalized social groups. We examine the effects of this unequal distribution through a detailed case study of ableism. There (...) are four primary mechanisms through which the epistemic schema of ableism distorts communication between nondisabled physicians and disabled patients: testimonial injustice, epistemic overconfidence, epistemic erasure, and epistemic derailing. Measures against epistemic injustices in general and against schema-based medical errors in particular are ultimately issues of justice that must be better addressed at all levels of health care practice. (shrink)

Rationale and objectives: Medical humanities are becoming increasingly recognized as positively impacting medical education and medical practice. However, the extent of medical humanities teaching in medical schools is largely unknown. We reviewed medical school curricula in Canada, the UK and the US. We also explored the relationship between medical school ranking and the inclusion of medical humanities in the curricula. -/- Methods: We searched the curriculum websites of all accredited medical schools (...) in Canada, the UK and the US to check which medical humanities topics were taught, and whether they were mandatory or optional. We then noted rankings both by Times Higher Education and U.S. News and World Report and calculated the average rank. We formally explored whether there was an association between average medical school ranking and medical humanities offerings using Spearman's correlation and inverse variance weighting meta-analysis. -/- Results: We identified 18 accredited medical school programmes in Canada, 41 in the UK, and 154 in the US. Of these, nine (56%) in Canada, 34 (73%) in the UK and 124 (80%) in the US offered at least one medical humanity that was not ethics. The most common medical humanities were medical humanities (unspecified), history, and literature (Canada); sociology and social medicine, medical humanities (unspecified), and art (UK); and medical humanities (unspecified), literature and history (US). Higher ranked medical schools appeared less likely to offer medical humanities. -/- Conclusions: The extent and content of medical humanities offerings at accredited medical schools in Canada, the UK and the US varies, and there appears to be an inverse relationship between medical school quality and medical humanities offerings. Our analysis was limited by the data provided on the Universities' websites. Given the potential for medical humanities to improve medical education and medical practice, opportunities to reduce this variation should be exploited. (shrink)

If medical complicity is understood as compliance with a directive to act against the professional's best medical judgment, the question arises whether it can ever be justified. This paper will trace the contours of what would legitimate a directive to act against a professional's best medical judgment (and in possible contravention of her oath) using Joseph Raz's service conception of authority. The service conception is useful for basing the legitimacy of authoritative directives on the ability of the (...) putative authority to enable subjects to comply better with reasons that already apply to them. Hence, the service conception bases the legitimacy of practical authority on a certain kind of greater knowledge or expertise. This helps to focus the conundrum regarding complicity on the clash of expertise between the medical expert and the governing body tasked with coordinating behaviour and otherwise devising rules for the social good. The ethical dilemma presented by a hypothetically legitimate directive to act against a professional's best medical judgment also serves to highlight the moral dimension of one's duty to obey a legitimate authority. (shrink)

Concerns over medical paternalism are especially salient when there exists a conflict of values between patient and clinician. This is particularly relevant for psychiatry, the field of medicine for which the phenomenon of conflicting values is most present and for which the specter of medical paternalism looms large. Few cases are as glaring as that of anorexia nervosa (AN), a disorder that is considered to be egosyntonic (meaning its symptoms are reflectively endorsed by the patient) and maintained by (...) the presence of pathological values. One might think, given this, that an approach to medicine that foregrounds the role of values in clinical encounters would be particularly well suited to address the problem of medical paternalism in treating AN. As it happens, this is precisely the goal of values-based medicine, an approach to medicine that prioritizes the integration of patients’ unique values into the aims of treatment and that has been touted as being particularly applicable to psychiatric conditions such as AN. Although this strategy may initially appear promising, in this paper I will argue that the directive to incorporate patient values (as dictated by values-based medicine) cannot do the work of mitigating medical paternalism in the treatment of egosyntonic disorders such as AN. Rather than chalking this up as a failure due to AN being a particularly challenging case, I will instead conclude that the failure of values-based medicine in this context cuts to the heart of the limitations of rectifying medical paternalism within psychiatry as it currently exists. (shrink)

I introduce a distinction between health need and medical need, and raise several questions about their interaction. Health needs are needs that relate directly to our health condition. Medical needs are needs which bear some relation to medical institutions or processes. I suggest that the question of whether medical insurance or public care should cover medical needs, health needs, or only needs which fit both categories is a political question that cannot be resolved definitionally. I (...) also argue against an overly strict definition of medical need on the grounds that this presupposes, wrongly, that medical intervention should always be a last resort. (shrink)

Consensus statement by UK teachers of medical ethics and law.

Physicians in Islamic countries might be requested to participate in the Islamic legal code of qiṣāṣ, in which the victim or family has the right to an eye-for-an-eye retaliation. Qiṣāṣ is only used as a punishment in the case of murder or intentional physical injury. In situations such as throwing acid, the national legal system of some Islamic countries asks for assistance from physicians, because the punishment should be identical to the crime. The perpetrator could not be punished without a (...) physician’s participation, because there is no way to guarantee that the sentence would be carried out without inflicting more injury than the initial victim had suffered. By examining two cases of acid throwing, this paper discusses issues related to physicians’ participation in qiṣāṣ from the perspective of medical ethics and Islamic Shari’a law. From the standpoint of medical ethics, physicians’ participation in qiṣāṣ is not appropriate. First, qiṣāṣ is in sharp contrast to the Hippocratic Oath and other codes of medical ethics. Second, by physicians’ participation in qiṣāṣ, medical practices are being used improperly to carry out government mandates. Third, physician participation in activities that cause intentional harm to people destroys the trust between patients and physicians and may adversely affect the patient–physician relationship more generally. From the standpoint of Shari’a, there is no consensus among Muslim scholars whether qiṣāṣ should be performed on every occasion. We argue that disallowing physician involvement in qiṣāṣ is necessary from the perspectives of both medical ethics and Shari’a law. (shrink)

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 (...) at play in the problem of medical brain drain and consequently distorts the different responsibilities this problem generates. Brock’s strategy, if successful, would effectively lead to punishing emigrating workers from poor states for the free-riding and exploitation that is committed by affluent states – which is a counter-intuitive result. (shrink)

From The Cone of Perception, volume one of my collected works, you will remember that one of the main topics in that work was V-Curvature, also called, "phenomenological velocity." In that work, although a solution to the v - curvature variable was provided as well as many graphs that yielded numerous jewels of spiral formulations in exquisite 3D color formations, that method by which the solution was found was not iterated. This chapter begins by showing how it is possible to (...) solve for something that ideally ought cancel out with itself and how, although commutation between square roots is valid, there may be room here for an alternate route of accessing a hidden dimension - that dimension we call V-Curvature, or, "Phenomenological Velocity." Herein is provided the pathway for solving for V-Curvature in terms of Csc, which can be translated into Sin and Cos functionality. Furthermore, the processing these equations through WolframAlpha yielded other insights into limits, roots, and series that logically follow. How did the solutions to the, "velocity," v - variable curvature in the Lorentz coefficient, "manifest," when the Lorentz coefficient ought cancel out with itself? The step - by - step solution below illustrates the algebraic process by which a specific solution for something that ought cancel out with itself can be found. The Sphere of Realization is a groundbreaking work of philosophical and mathematical theory. The first volume of this epic collection examines the concept of V-Curvature, or Phenomenological Velocity, using algebraic equations to explain how this phenomenon can be solved. This book goes on to explore the implications of these equations, such as limits, roots, series, and introspection into infinity, providing an alternate route for accessing a 'hidden dimension' that connects physical laws with abstract philosophical ideas. By utilizing this understanding, the author creates a platform for introspection into life and nature, and considers the philosophical implications of this perception, from the exploration of the infinity of angles to theions of time, velocity, the emergence of real numbers, and the meanings of eternity, forever, infinity, and never ending. This landmark work of mathematical exploration and philosophical discovery will challenge and expand our understanding of the universe, and invite us into a journey of introspection and understanding. An exploration of the esoteric terms therein, and the pathways they provide to access new modes of thought, will give the reader the ability to gain a greater insight into the intricacies of reality. The Sphere of Realization provides a unique and comprehensive approach to a difficult concept. Through a blend of philosophical and mathematical exploration, the author delves into the concept of V-Curvature, or Phenomenological Velocity to unlock the mysteries of "hidden dimensions" within our reality. These equations and theories allow the reader to explore angles, time, velocity, roots, series, and other related concepts. In so doing, the book offers an exciting journey into the esoteric. The author also provides insights into the emergence of real numbers from infinity, introducing concepts such as eternity, forever, and never ending in the process. A comprehensive discussion of the applicable equations and transformations, immune to the construct of time, serves as a powerful tool for unlocking a meaningful understanding of the universe. The Sphere of Realization is an opportunity to gain a deeper appreciation of the reality of our world. (shrink)

: The Islamic jurists utilized the discipline of maqāṣid al-sharīʿah,in its capacity as the philosophy of Islamic law, in their legal and ethicalinterpretations, with added interest in addressing the issues of modern times.Aphoristically subsuming the major themes of the Sharīʿah, maqāṣid play apivotal role in the domain of decision-making and deduction of rulings onunprecedented ethical discourses. Ethics represent the infrastructure of Islamiclaw and the whole science of Islamic jurisprudence operates in the lightof maqāṣid to realize the ethics in people’s lives. (...) Scrutinizing the key themesof maqāṣid-based ijtihād and scope of ethics in maqāṣid, this article delvesinto the discourse on the application of maqāṣid to medical ethics. As a casestudy, this research analyses the extent of medical confidentiality in the light ofmaqāṣid and arrives at the conclusion that limited confidentiality goes more inline with the maxims of maqāṣid. (shrink)

In this paper I examine Axel Honneth’s normative reconstruction of the market as a sphere of social freedom in his 2014 book, Freedom’s Right. Honneth’s position is complex: on the one hand, he acknowledges that modern capitalist societies do not realise social freedom; on the other hand, he insists that the promise of social freedom is implicit in the market sphere. In fact, the latter explains why modern subjects have seen capitalism as legitimate. I will reconstruct Honneth’s conception (...) of social freedom and investigate how it is realised in the sphere in which Honneth sees it most successfully at work, the sphere of interpersonal relations. I then move on to the sphere of the market economy and discuss two related problems of this view that stem from his interpretation of Hegel. Next, I consider Honneth’s method of “normative reconstruction” and his reconstructions of the sphere of consumption and, finally, the labour market. My conclusion will be that market institutions cannot realise social freedom, and that this insight should orient the philosophical direction of critical social theory. (shrink)

Miracle Max, it seems, is the only remaining miracle worker in all of Florin. Among other things, this means that he (unlike anyone else) can resurrect the recently dead, at least in certain circumstances. Max’s peculiar talents come with significant perks (for example, he can basically set his own prices!), but they also raise a number of ethical dilemmas that range from the merely amusing to the truly perplexing: -/- How much about Max’s “methods” does he need to reveal to (...) his patients? Is it really OK for Max to lie about Valerie’s being a witch, even though she really isn’t? Just how much of the “truth” does Max have to tell his patients? -/- Let’s suppose that Humperdinck had offered Max his old job back. Would it have been OK for Max to accept this offer? What about if Humperdinck wanted him to do experiments at “the Zoo”? -/- Is Max obligated to offer his services to everyone who needs them, such as the (mostly) dead Westley and friends? Or is he free to pick and choose? -/- In this chapter, I’ll consider how these questions might be addressed using concepts of medical ethics. As it turns out, Max’s dilemmas are not too different from the sorts of dilemmas that many medical professionals encounter in their daily lives, and exploring how Max could (or should) respond to them can help us figure out what we can do here in the “real” world. (shrink)

The article aims to determine how university professors critically perceive and evaluate information when interacting with the media sphere. The study's relevance is due to the insufficient elaboration of Russian teachers' attitude to the information in the media sphere, which is significant in developing students' critical thinking. The study analyzes theoretical sources and documents on critical thinking in the media sphere and the results of processing empirical data obtained from questioning teachers. The main measuring instrument is a (...) questionnaire survey of university professors with various lengths of service. The study involved 76 teachers from Ural Federal University named after the first President of Russia B.N. Yeltsin. Ural State Pedagogical University (Ekaterinburg, Russia). Linguistics University of Nizhny Novgorod (Nizhny Novgorod, Russia). The data obtained from the study of the teachers' attitude to the information content of the media sphere show a predominant critical attitude in assessing the reliability and availability of information on social networking platforms. This conclusion is important for personality traits that develop students' critical thinking. (shrink)

Abstract: The integration of Artificial Intelligence (AI) into medical imaging represents a transformative shift in healthcare, offering significant improvements in diagnostic accuracy, efficiency, and patient outcomes. This paper explores the application of AI technologies in the analysis of medical images, focusing on techniques such as convolutional neural networks (CNNs) and deep learning models. We discuss how these technologies are applied to various imaging modalities, including X-rays, MRIs, and CT scans, to enhance disease detection, image segmentation, and diagnostic support. (...) Additionally, the paper addresses the challenges faced in AI-driven medical imaging, including data quality, model interpretability, and ethical considerations. By examining recent advancements and real-world case studies, this paper provides insights into the current state of AI in medical imaging and its potential future directions. The findings highlight the ongoing evolution of AI technologies and their crucial role in advancing medical diagnostics and treatment strategies. (shrink)

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 (...) code of medical ethics? What theory or theories should constrain medical machine conduct? What design features are required? Should machines share responsibility with humans for the ethical consequences of medical actions? How ought clinical relationships involving machines to be modeled? Is a capacity for empathy and emotion detection necessary? What about consciousness? -/- The essays in this collection by researchers from both humanities and science describe various theoretical and experimental approaches to adding medical ethics to a machine, what design features are necessary in order to achieve this, philosophical and practical questions concerning justice, rights, decision-making and responsibility, and accurately modeling essential physician-machine-patient relationships. -/- This collection is the first book to address these 21st-century concerns. (shrink)

Assumptions about obesity—e.g., its connection to ill health, its causes, etc.—are still prevalent today, and they make up what I call the medical model of fatness. In this paper, I argue that the medical model was established on the basis of insufficient evidence and has nevertheless continued to be relied upon to justify methodological choices that further entrench the assumptions of the medical model. These choices are illegitimate in so far as they conflict with both the epistemic (...) and social aims of obesity research. I conclude the paper with a partial solution to these epistemic and social shortcomings. (shrink)

Without doctors being able to explain medical decisions to patients, I argue their use of black box AIs would erode the effective and respectful care they provide patients. In addition, I argue that physicians should use AI black boxes only for patients in dire straits, or when physicians use AI as a “co-pilot” (analogous to a spellchecker) but can independently confirm its accuracy. I respond to A.J. London’s objection that physicians already prescribe some drugs without knowing why they work.

Although the question of religion did not feature prominently in Jürgen Habermas’s early political theory, his more recent work has continuously addressed the topic. This later interest in religion is grounded in what one commentator in a volume on The Power of Religion in the Public Sphere, cited as the urgent need to integrate religious voices in the workings of public reason in order to avoid social disharmony and to thwart potential violence. However, the following paper argues that the (...) hermeneutic procedures Habermas develops for the public sphere cannot bear the weight that his later understanding of religion demands of them. Such an insight validates Paul Ricoeur’s earlier argument that Habermas’s “depth hermeneutics,” were themselves utopic in nature. It is from this vantage point that a return to Ricoeur's thought is justified, through which a more productive understanding of the public potential of religious discourse can be understood. (shrink)

When medical assistance in dying (MAiD) was legalized in Canada in June 2016, the question of allowing decisionally capable persons to make advance requests in anticipation of later incapacity was reserved for further consideration during the mandatory parliamentary review originally scheduled to begin in June 2020 (but since delayed by COVID-19). In its current form the legislation does not permit such requests, since it stipulates that at the time at which the procedure is to be administered the patient must (...) give “express consent” to receiving it. Since express consent presupposes decisional capacity, this requirement rules out administering MAiD to a patient who has lost capacity. Amendments to the legislation passed by Parliament in March 2021 open the door slightly by allowing advance requests by patients after they have been approved for MAiD, if they fear losing capacity before the procedure can be administered. But this provision would apply only to patients whose natural death was deemed to be “reasonably foreseeable”, and would continue to exclude (a) requests made after diagnosis of a “grievous and irremediable medical condition” but in advance of approval for MAiD, and (b) requests made before such a diagnosis. My aim in this paper is twofold: to explore the ethical and legal issues concerning advance requests for MAiD, and to argue for expanding provision for such requests to include both of these further scenarios. (shrink)

Most people are completely oblivious to the danger that their medical data undergoes as soon as it goes out into the burgeoning world of big data. Medical data is financially valuable, and your sensitive data may be shared or sold by doctors, hospitals, clinical laboratories, and pharmacies—without your knowledge or consent. Medical data can also be found in your browsing history, the smartphone applications you use, data from wearables, your shopping list, and more. At best, data about (...) your health might end up in the hands of researchers on whose good will we depend to avoid abuses of power.2 Most likely, it will end up with data brokers who might sell it to a future employer, or an insurance company, or the government. At worst, your medical data may end up in the hands of criminals eager to commit extortion or identity theft. In addition to data harms related to exposure and discrimination, the collection of sensitive data by powerful corporations risks the creation of data monopolies that can dominate and condition access to health care. -/- This chapter aims to explore the challenge that big data brings to medical privacy. Section I offers a brief overview of the role of privacy in medical settings. I define privacy as having one’s personal information and one’s personal sensorial space (what I call autotopos) unaccessed. Section II discusses how the challenge of big data differs from other risks to medical privacy. Section III is about what can be done to minimise those risks. I argue that the most effective way of protecting people from suffering unfair medical consequences is by having a public universal healthcare system in which coverage is not influenced by personal data (e.g., genetic predisposition, exercise habits, eating habits, etc.). (shrink)