Journal of evaluation in clinical practice
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Evidence-based medicine (EBM) calls for medical practitioners to "integrate" our best available evidence into clinical practice. A significant amount of the literature on EBM takes this integration to be unproblematic, focusing on questions like how to interpret evidence and engage with patient values, rather than critically looking at how these features of EBM can be implemented together. ⋯ In particular, I introduce an epistemological issue for this integration problem, which I call the epistemic integration problem. This is essentially the problem of how we can use information that is both general (eg, about a population sample) and descriptive (eg, about what expected outcomes are) to reach clinical judgements that are individualized (applying to a particular patient) and normative (about what is best for their health).
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The aim of this review was to evaluate the implementation of shared decision-making (SDM) in dentistry and the roles of informed consent and patient decision-making aids (PDAs) as part of this process. ⋯ SDM is applied in dentistry and is influenced by many factors. Informed consent is an important part of this process. PDAs in more dental fields need to be further developed, in order to ensure a satisfactory integration of patients in the SDM process.
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In this article, we offer an extended critical review of a new conception of bioethics, presented by Darlei Dall'Agnol, in the book Care and Respect in Bioethics. ⋯ Dall'Agnol offers an insightful and persuasive account of how the single attitude of respectful care can express practical moral knowledge in healthcare. In this paper, we evaluate, criticize, and suggest refinements. One of them concerns Dall'Agnol's interpretation about Stephen Darwall's views on care and respect as two attitudes supported, respectively, by a third- and a second-personal moral point-of-view. Other is about the Dall'Agnol's Wittgensteinian description of the moral language-games of Clinical Bioethics, adding to the approach the "language-game of rights."
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While professional values are seen as a fundamental part of element of shared decision-making, there is little research on how they are learnt within the paramedic profession. ⋯ This study has highlighted that professional values would be worthy of being explored within the paramedic undergraduate curriculum, in an effort to enable students to understand and develop their values during their education and appreciate the importance of values within shared decision-making.
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In this paper, I will consider, from a number of philosophical and real-life perspectives, what happens to us when we fall ill and what the experience of falling ill tells us about the nature of our being. I will take up the oft used Myth of the Cave from Plato's Republic and use this as a means to interpret the experience of falling ill. Plato gave us the allegory to show that what we think we know might not be all there is to know and that what we take for truth may not, at least, be the whole truth. ⋯ To make the argument, I will use examples from my own experience of illness and some of those other which have been recounted to me. I will also refer to the work of Havi Carel on illness and mortality, the conception of illness as leading to a feeling of not-being-at-home with our bodies (unheimlich) discussed by Frederick Svenaeus, and Gadamer's notion of illness as a loss of equilibrium. Underpinning the argument throughout will be Heidegger's existential analysis of dying in which he discusses the experience of anxiety and the way that separates us from the world of involvements.