Theoretical Medicine and Bioethics

In this article, I present a philosophical account of medical treatment. In support of this account, I offer a suggestive account of medical conditions. The account of medical treatment uses three desiderata to demarcate treatment from non-treatment. Namely, a treatment should: (1) be describable by features that enable it to be standardized and characterized as a discrete intervention, (2) target a specific medical condition, and (3) have the possibility of being effective. The account of medical conditions underlies the second desideratum and attempts to tie medical conditions closely to biological dysfunction, while also including some conditions for which biological dysfunction is absent or its presence uncertain...

In a thought-provoking article - or how she herself named it, 'a thought experiment' - the philosopher-medical ethicist Anna Smajdor analyzed in this journal the idea of whole-body gestational donation (WBGD) in brain-dead female patients, as an alternative means of gestation for prospective women who cannot or prefer not to become pregnant themselves. We have serious legal, economical, medical and ethical concerns about this proposal. First, consent for eight months of ICU treatment can never be assumed to be derived from consent for post-mortem organ donation; these two are of an incomparable and entirely different medical and ethical order...

In my paper recently published in a collection of controversial arguments in this journal, I argued that the same principles that are behind ethical veganism also warrant antinatalist conclusions. I thus suggested that to be consistent in their ethical reasoning, moral vegans should not have children. William Bülow has kindly responded to my claims and offered a plausible reply, which, according to him, concludes that at least some moral vegans may resist antinatalism. In this short paper, I reply to Bülow...

No abstract text is available yet for this article.

It can be assumed that value judgements, which are needed to judge what is 'good' or 'better' and what is 'bad' or 'worse', are involved in every decision-making process. The theoretical understanding and analysis of value judgements is, therefore, important in the context of bioethics, for example, to be able to ethically assess real decision-making processes in biomedical practice and make recommendations for improvements. However, real decision-making processes and the value judgements inherent in them must first be investigated empirically ('empirical bioethics')...

In this paper, we illustrate some serious difficulties involved in conveying information about uncertain risks and securing informed consent for risky interventions in a clinical setting. We argue that in order to secure informed consent for a medical intervention, physicians often need to do more than report a bare, numerical probability value. When probabilities are given, securing informed consent generally requires communicating how probability expressions are to be interpreted and communicating something about the quality and quantity of the evidence for the probabilities reported...

'Shared' decision-making is heralded as the gold standard of how medical decisions should be reached, yet how does one 'share' a decision when any attempt to do so will undermine autonomous decision-making? And what exactly is being shared? While some authors have described parallels in literature, philosophical examination of shared agency remains largely uninvestigated as an explanation in bioethics. In the following, shared decision-making will be explained as occurring when a group, generally comprised of a patient and or their family, and the medical team become a genuine intentional subject which acts as a collective agent...

In her controversial paper, Anna Smajdor proposes that brain-dead people could be used as gestation units for prospective parents unable or unwilling to undertake the act themselves-what she terms whole body gestational donation (WBGD). She explores the ethical issues of such an idea and, comparing it with traditional organ donation, asserts that such deceased surrogacy could be a way of outsourcing pregnancy's harms to a populace unable to be affected by them. She argues that if the prospect is unacceptable, this may reveal some underlying problems with traditional cadaveric organ donation...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

Anna Smajdor's proposal of whole body gestational donation (WBGD) states that female patients diagnosed as brain-dead should be considered for use as gestational donors. In this response, Smajdor's proposal is rejected on four different accounts: (a) the debated acceptability of surrogacy despite women's autonomy, (b) the harm to dead women ́s interests, (c) the interests of the descendants, and (d) the symbolic value of the body and interests of relatives. The first part argues that WBGD rests on a particular conception of the instrumentalization of bodies that cannot be circumvented simply by the patient's consent and relinquished autonomy...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

With its rise in popularity, work in the phenomenology of medicine has also attracted its fair share of criticism. One such criticism maintains that, since the phenomenology of medicine does nothing but describe the experience of illness, it offers nothing one cannot obtain more easily by deploying simpler qualitative research methods. Fredrik Svenaeus has pushed back against this charge, insisting that the phenomenology of medicine not only describes but also defines illness. Although I agree with Svenaeus's claim that the phenomenology of medicine does more than merely describe what it is like to be ill, once one acknowledges its more far-reaching theoretical aspirations, one sees that it faces an even more difficult set of objections...

In a recent article, Tyler Tate argues that the suffering of children - especially children with severe cognitive impairments - should be regarded as the antithesis of flourishing, where flourishing is relative to one's individual characteristics and essentially involves receiving care from others. Although initially persuasive, Tate's theory is ambiguous in several ways, leading to significant conceptual problems. By identifying flourishing with receiving care, Tate raises questions about the importance of care that he does not address, giving rise to a bootstrapping problem...

The aim of this paper is to enhance doctors' awareness of implicit understandings between doctors and patients in the context of pre-operative communication of risks. This paper draws on insights from the philosophy of language - in particular pragmatic analysis tools - that make explicit the implicit understandings of the interaction. Mastering not only what is said but also what is unsaid allows doctors to improve their communication with their patients. I suggest that being aware of the implications of the interactions is useful for improving both the doctor's and the patient's experience, further strengthening the therapeutic alliance...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.