Articles

How clinicians make (or avoid) moral judgments of patients: implications of the evidence for relationships and research

Physicians, nurses, and other clinicians readily acknowledge being troubled by encounters with patients who trigger moral judgments. For decades social scientists have noted that moral judgment of patients is ...

Authors: Terry E Hill

Pain Control in the African Context: the Ugandan introduction of affordable morphine to relieve suffering at the end of life

Dr Anne Merriman is the founder of Hospice Africa and Hospice Africa Uganda. She is presently Director of Policy and International Programmes. Here she tells the story of how HAU was founded. Dr Richard Hardin...

Authors: Anne Merriman and Richard Harding

The Infectious Diseases Society of America Lyme guidelines: a cautionary tale about the development of clinical practice guidelines

Flawed clinical practice guidelines may compromise patient care. Commercial conflicts of interest on panels that write treatment guidelines are particularly problematic, because panelists may have conflicting ...

Authors: Lorraine Johnson and Raphael B Stricker

Ambient Assistive Technologies (AAT): socio-technology as a powerful tool for facing the inevitable sociodemographic challenges?

Due to the socio-demographic change in most developed western countries, elderly populations have been continuously increasing. Therefore, preventive and assistive systems that allow elderly people to independ...

Authors: Astrid M Schülke, Herbert Plischke and Niko B Kohls

Should the NHS be privatized? Annual varsity medical debate - London, 22 January 2010

The Varsity Medical Debate, between Oxford and Cambridge Universities, brings together practitioners and the public, professors, pupils and members of the polis, to facilitate discussion about ethics and polic...

Authors: Myura Nagendran, Sanjay Budhdeo, Mahiben Maruthappu and Kapil Sugand

The ethics of everyday practice in primary medical care: responding to social health inequities

Social and structural inequities shape health and illness; they are an everyday presence within the doctor-patient encounter yet, there is limited ethical guidance on what individual physicians should do. This...

Authors: John S Furler and Victoria J Palmer

Construct representation and definitions in psychopathology: the case of delusion

Delusion is one of the most intriguing psychopathological phenomena and its conceptualization remains the subject of genuine debate. Claims that it is ill-defined, however, are typically grounded on essentiali...

Authors: Adriano CT Rodrigues and Claudio EM Banzato

A diagnosis of conflict: theoretical barriers to integration in mental health services & their philosophical undercurrents

This paper examines the philosophical substructure to the theoretical conflicts that permeate contemporary mental health care in the UK. Theoretical conflicts are treated here as those that arise among practit...

Authors: Nathan M Gerard

On the ontological assumptions of the medical model of psychiatry: philosophical considerations and pragmatic tasks

A common theme in the contemporary medical model of psychiatry is that pathophysiological processes are centrally involved in the explanation, evaluation, and treatment of mental illnesses. Implied in this per...

Authors: Tejas Patil and James Giordano

Psychosomatic medicine and the philosophy of life

Basing ourselves on the writings of Hans Jonas, we offer to psychosomatic medicine a philosophy of life that surmounts the mind-body dualism which has plagued Western thought since the origins of modern scienc...

Authors: Michael A Schwartz and Osborne P Wiggins

Principlism, medical individualism, and health promotion in resource-poor countries: can autonomy-based bioethics promote social justice and population health?

Through its adoption of the biomedical model of disease which promotes medical individualism and its reliance on the individual-based anthropology, mainstream bioethics has predominantly focused on respect for...

Authors: Jacquineau Azétsop and Stuart Rennie

The clinical investigator-subject relationship: a contextual approach

The nature of the relationship between a clinical investigator and a research subject has generated considerable debate because the investigator occupies two distinct roles: clinician and scientist. As a clini...

Authors: David B Resnik

Presumed consent for organ preservation in uncontrolled donation after cardiac death in the United States: a public policy with serious consequences

Organ donation after cessation of circulation and respiration, both controlled and uncontrolled, has been proposed by the Institute of Medicine as a way to increase opportunities for organ procurement. Despite...

Authors: Joseph L Verheijde, Mohamed Y Rady and Joan McGregor

Paranoid atmospheres: Psychiatric knowledge and delusional realities

In this paper I investigate the topic of paranoid atmospheres. This subject is especially of interest with respect to persons who are deluded, and also, I will demonstrate, sheds light upon the psychiatrist's ...

Authors: Jann E Schlimme

Time for a unified approach to medical ethics

A code of ethics is used by individuals to justify their actions within an environment. Medical professionals require a keen understanding of specific ethical codes due to the potential consequences of their a...

Authors: Shaheen E Lakhan, Elissa Hamlat, Turi McNamee and Cyndi Laird

Quo vadis? Philosophy, Ethics, and Humanities in Medicine - preserving the humanistic character of medicine in a biotechnological future

Authors: James Giordano

Healing relationships and the existential philosophy of Martin Buber

The dominant unspoken philosophical basis of medical care in the United States is a form of Cartesian reductionism that views the body as a machine and medical professionals as technicians whose job is to repa...

Authors: John G Scott, Rebecca G Scott, William L Miller, Kurt C Stange and Benjamin F Crabtree

Nosologomania: DSM & Karl Jaspers' Critique of Kraepelin

Emil Kraepelin's nosology has been reinvented, for better or worse. In the United States, the rise of the neo-Kraepelinian nosology of DSM-III resuscitated Kraepelin's work but also differed from many of his i...

Authors: S Nassir Ghaemi

Conference Report: The Nour Foundation Georgetown University & Blackfriars Hall, Oxford University Symposium Series Technology, Neuroscience & the Nature of Being: Considerations of Meaning, Morality and Transcendence Part I: The Paradox of Neurotechnology 8 May 2009

This reviews the first of a tripartite symposia series dealing with novel neuroscientific technologies, the nature of consciousness and being, and the questions that arise from such interactions. The event too...

Authors: Guillermo Palchik

Determining the status of non-transferred embryos in Ireland: a conspectus of case law and implications for clinical IVF practice

The development of in vitro fertilisation (IVF) as a treatment for human infertilty was among the most controversial medical achievements of the modern era. In Ireland, the fate and status of supranumary (non-tra...

Authors: Eric Scott Sills and Sarah Ellen Murphy

Ethical psychiatry in an uncertain world: conversations and parallel truths

Psychiatric practice is often faced with complex situations that seem to pose serious moral dilemmas for practitioners. Methods for solving these dilemmas have included the development of more objective rules ...

Authors: Alexander M Carson and Peter Lepping

For an indeterministic ethics. The emptiness of the rule in dubio pro vita and life cessation decisions

It is generally claimed that there exist exceptional circumstances when taking human life may be approved and when such actions may be justified on moral grounds. Precise guidelines in the medical field for ma...

Authors: Dragan Pavlovic, Christian Lehmann and Michael Wendt

Reflective thinking and medical students: some thoughtful distillations regarding John Dewey and Hannah Arendt

Reflective thought (critical thinking) is essential to the medical student who hopes to become an effective physician. John Dewey, one of America's foremost educators in the early twentieth century, revolution...

Authors: Thomas J Papadimos

The "spare parts person"? Conceptions of the human body and their implications for public attitudes towards organ donation and organ sale

The increasing debate on financial incentives for organ donation raises concerns about a "commodification of the human body". Philosophical-ethical stances on this development depend on assumptions concerning ...

Authors: Mark Schweda and Silke Schicktanz

Prolonging life and delaying death: The role of physicians in the context of limited intensive care resources

Critical care is in an emerging crisis of conflict between what individuals expect and the economic burden society and government are prepared to provide. The goal of critical care support is to prevent suffer...

Authors: Robert C McDermid and Sean M Bagshaw

Are animal models predictive for humans?

It is one of the central aims of the philosophy of science to elucidate the meanings of scientific terms and also to think critically about their application. The focus of this essay is the scientific term predic...

Authors: Niall Shanks, Ray Greek and Jean Greek

The end of the era of generosity? Global health amid economic crisis

In the past decade donor commitments to health have increased by 200 percent. Correspondingly, there has been a swell of new players in the global health landscape. The unprecedented, global response to a sing...

Authors: Kammerle Schneider and Laurie Garrett

Living apart together: reflections on bioethics, global inequality and social justice

Significant inequalities in health between and within countries have been measured over the past decades. Although these inequalities, as well as attempts to improve sub-standard health, raise profound issues ...

Authors: Stuart Rennie and Bavon Mupenda

The 'Brain Drain' of physicians: historical antecedents to an ethical debate, c. 1960–79

Many western industrialized countries are currently suffering from a crisis in health human resources, one that involves a debate over the recruitment and licensing of foreign-trained doctors and nurses. The i...

Authors: David Wright, Nathan Flis and Mona Gupta

The need to reform our assessment of evidence from clinical trials: A commentary

The ideology of evidence-base medicine (EBM) has dramatically altered the way we think, conceptualize, philosophize and practice medicine. One of its major pillars is the appraisal and classification of eviden...

Authors: Sean M Bagshaw and Rinaldo Bellomo

Human embryonic stem cell research, justice, and the problem of unequal biological access

In 2003, Ruth Faden and eighteen other colleagues argued that a "problem of unequal biological access" is likely to arise in access to therapies resulting from human embryonic stem cell research. They showed t...

Authors: Mark S Moller

"Enhanced" interrogation of detainees: do psychologists and psychiatrists participate?

After revelations of participation by psychiatrists and psychologists in interrogation of prisoners at Guantánamo Bay and Central Intelligence Agency secret detention centers, the American Psychiatric Associat...

Authors: Abraham L Halpern, John H Halpern and Sean B Doherty

Ethical challenges with the left ventricular assist device as a destination therapy

The left ventricular assist device was originally designed to be surgically implanted as a bridge to transplantation for patients with chronic end-stage heart failure. On the basis of the REMATCH trial, the US...

Authors: Aaron G Rizzieri, Joseph L Verheijde, Mohamed Y Rady and Joan L McGregor

Internationalisation of information services for publishers' open access policies: the DINI multilingual integration layer

It is essential for the strategy of open access self-archiving that scientific authors are given comprehensive information on publisher copyright policies. DINI, the German Initiative for Networked Information...

Authors: Frank Scholze

Peter Stastny, Peter Lehmann: Alternatives beyond Psychiatry Peter Lehmann Publishing:431. IBSN-978-0-954428-1

Peter Stastny and Peter Lehmann's Alternatives beyond Psychiatry offers a comprehensive and up to date account of the alternatives to mainstream psychiatry that are being developed by service consumers and sur...

Authors: Paul Hammersley

The anatomy of sorrow: a spiritual, phenomenological, and neurological perspective

There is considerable controversy, both within and outside the field of psychiatry, regarding the boundaries of normal sadness and clinical depression. Furthermore, while there are frequent calls for a "plural...

Authors: Ronald Pies

The beginning of the end for chimpanzee experiments?

The advanced sensory, psychological and social abilities of chimpanzees confer upon them a profound ability to suffer when born into unnatural captive environments, or captured from the wild – as many older re...

Authors: Andrew Knight

Cueto Marcos: Cold War, Deadly Fevers: Malaria Eradication in Mexico, 1955–1975 Washington, D.C., Woodrow Wilson Center Press (Co-published Johns Hopkins University Press); 2007:xv + 264. ISBN – 978-0-8018-8645-4

This review of Professor Marcos Cueto's Cold War Deadly Fevers: Malaria Eradication in Mexico, 1955–1975 discusses some of the historical, sociological, political and parasitological topics included in Dr. Cueto'...

Authors: Filiberto Malagón

Effectiveness of antidepressants: an evidence myth constructed from a thousand randomized trials?

Antidepressants, in particular newer agents, are among the most widely prescribed medications worldwide with annual sales of billions of dollars. The introduction of these agents in the market has passed throu...

Authors: John PA Ioannidis

Doukas David John, Reichel William: Planning for Uncertainty:Living Wills and Other Advance Directives for You and Your Family 2nd edition. Baltimore, MD, The Johns Hopkins University Press; 2007:145. ISBN – 13:978-0-8018-8608-9

Advance directives are useful ways to express one's wishes about end of life care, but even now most people have not completed one of the documents. David Doukas and William Reichel strongly encourage planning...

Authors: Ellen W Bernal

Foucault's "fearless speech" and the transformation and mentoring of medical students

In his six 1983 lectures published under the title, Fearless Speech (2001), Michel Foucault developed the theme of free speech and its relation to frankness, truth-telling, criticism, and duty. Derived from the a...

Authors: Thomas J Papadimos and Stuart J Murray

DuBois JM: Ethics in Mental Health Research, Principles, Guidance and Cases Oxford: Oxford University Press. 256 pages, ISBN13 9780195179934

The burgeoning field of medical ethics raises complicated questions for mental health researchers. The critical issues of risk assessment, beneficence, and the moral duties researchers owe their patients are a...

Authors: Ronald Pies

Walking a mile in their patients' shoes: empathy and othering in medical students' education

One of the major tasks of medical educators is to help maintain and increase trainee empathy for patients. Yet research suggests that during the course of medical training, empathy in medical students and resi...

Authors: Johanna Shapiro

Barr Donald A: Introduction to U.S. Health Policy: The Organization, Financing and Delivery of Health Care in America 2nd edition. Baltimore, MD, The Johns Hopkins University Press; 2007. xiv + 303 pages, ISBN – 13:978-0-8018-8574-7 (hardcover) and 13:978-0-8018-8574-4 (pbk)

Donald A. Barr's Introduction to U.S. Health Policy: The Organization, Financing, and Delivery of Health Care in America (second edition, 2007) offers a lucid and informative overview of the U.S. health system an...

Authors: Audrey R Chapman

Depression in an evolutionary context

Sadness and low levels of depression are adaptive since they lead the individual to try and make up a loss. By contrast, severe or clinical depression is not adaptive, but can be thought of as sadness having b...

Authors: Lewis Wolpert

Decade of the Mind

In the Fall of 2007, ten neuroscientists published a proposal for an interdisciplinary research initiative, the Decade of the Mind, that would focus on four "broad but intertwined areas": mental health, research ...

Authors: Manfred Spitzer

A darwinian perspective: right premises, questionable conclusion. A commentary on Niall Shanks and Rebecca Pyles' "Evolution and medicine: the long reach of "Dr. Darwin""

As Dobzhansky wrote, nothing in biology makes sense outside the context of the evolutionary theory, and this truth has not been sufficiently explored yet by medicine. We comment on Shanks and Pyles' recently p...

Authors: Paolo Vineis and Ronald Melnick

Death, organ transplantation and medical practice

A series of papers in Philosophy, Ethics and Humanities in Medicine (PEHM) have recently disputed whether non-heart beating organ donors are alive and whether non-heart beating organ donation (NHBD) contravenes t...

Authors: Thomas S Huddle, Michael A Schwartz, FAmos Bailey and Michael A Bos

Are human embryos Kantian persons?: Kantian considerations in favor of embryonic stem cell research

One argument used by detractors of human embryonic stem cell research (hESCR) invokes Kant's formula of humanity, which proscribes treating persons solely as a means to an end, rather than as ends in themselve...

Authors: Bertha Alvarez Manninen

The ethics of interrogation and the American Psychological Association: A critique of policy and process

The Psychological Ethics and National Security (PENS) task force was assembled by the American Psychological Association (APA) to guide policy on the role of psychologists in interrogations at foreign detentio...

Authors: Brad Olson, Stephen Soldz and Martha Davis