The Journal of medicine and philosophy
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How are we to decide where our scarce medical resources are most effectively spent? The notion of a quality-adjusted-life-year has been proposed as a way of doing this. Some economists appear to think that this can be done without making ethical assumptions. We examine the application of this notion to the treatment of premature newborns, and especially to comparisons between the value of medical care for newborns, and the value of medical care for older people. We find that some highly questionable ethical assumptions are involved in such comparisons.
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The ethical implications of the growth of for-profit health care institutions are complex. Two major moral criticisms of for-profit medicine are analyzed. ⋯ The authors conclude that while the continued expansion of for-profit health care may exacerbate in some respects problems of access, trust and conflicts of interest, it is a mistake to consider these problems as unique to for-profit health care; they are problems for not for-profit health care as well. Though these issues justify continuing moral concern, they do not at this time provide decisive grounds for substantially curbing or eliminating for-profit enterprise in health care.
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The fetal human possesses an active central nervous system from at least the eighth week of development. Until mid-gestation the most significant center of activity is the brainstem. By the end of the first trimester, it appears that the brainstem could be acting as a rudimentary modulator of sensory information and motor activity. ⋯ Our thinking about sentience is not advanced a great deal, as we as yet have no good way of talking about it at the brainstem level. As for the neocortex, available evidence indicates that it does not become a functional part of the neuraxis until at least mid-gestation. It is not until then that the thalamus--the major gateway for sensory input to the cerebrum--makes its first afferent contacts with the neocortex.
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Biography Historical Article
A commentary on 'two pathographies: a study in illness and literature'.
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In order to appreciate the role of the phenomenon of shame in the context of the clinic - both as normal self evaluation and as neurotic response - a philosophical anthropological description of shame is offered. Not only are Biblical metaphors recast , but more recent phenomenological psychological descriptions taken from Max Scheler and others are cited. These necessarily require some account of the patient's body in shame, taken from both his perspective and the physician's. In short, the corporeality of shame is constituted as "ce que enveloppe le corps".