Medicine, health care, and philosophy
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It is frequently said that pain is incommunicable and even that it "destroys language". This paper offers a phenomenological account of pain and then explores and critiques this view. It suggests not only that pain is communicable to an adequate degree for clinical purposes, but also that it is itself a form of communication through which the person in pain appeals to the empathy and ethical goodness of the clinician. To explain this latter idea and its ethical implications, reference is made to the writings of Emmanuel Levinas.
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Med Health Care Philos · Jan 2002
The internet doctor and medical ethics. Ethical implications of the introduction of the Internet into medical encounters.
In this article, consultation via the Internet and the use of the Internet as a source of medical information is examined from an ethical point of view. It is argued that important ethical aspects of the clinical interaction, such as dialogue and trust will be difficult to realise in an Internet-consultation. Further, it is doubtful whether an Internet doctor will accept responsibility. However, medical information via the Internet can be a valuable resource for patients wanting to know more about their disease and, thus, it is a means to enhancing their autonomy.
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Med Health Care Philos · Jan 2002
(Mis)understanding Singer: replaceability of children or intellectual endeavour?
Should doctors have the possibility to save children from incurable suffering and end their lives?. At first glance, the standpoints in the debate around this question seem translucent and well known and the debate intelligible. ⋯ This demands emotional restraint and intellectual honesty. Trying to understand Singer and his opponents is a challenging way of charting what exactly is at stake in this debate.
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Med Health Care Philos · Jan 2001
Autonomy, authenticity, or best interest: everyday decision-making and persons with dementia.
The question of when we have justification for overriding ordinary, everyday decisions of persons with dementia is considered. It is argued that no single criterion for competent decision-making is able to distinguish reliably between decisions we can legitimately override and decisions we cannot legitimately override.
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Med Health Care Philos · Jan 2001
ReviewPatient decision making competence: outlines of a conceptual analysis.
In order to protect patients against medical paternalism, patients have been granted the right to respect of their autonomy. This right is operationalized first and foremost through the phenomenon of informed consent. If the patient withholds consent, medical treatment, including life-saving treatment, may not be provided. ⋯ In this article, we set out to fill that hiatus by beginning at the very beginning, the literal meaning of the term competence. We suggest a generic definition of competence and derive four necessary conditions of competence. We then transpose this definition to the health care context and discuss patient decision making competence.