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  1. What is morally at stake when using algorithms to make medical diagnoses? Expanding the discussion beyond risks and harms.Bas de Boer & Olya Kudina - 2021 - Theoretical Medicine and Bioethics 42 (5):245-266.
    In this paper, we examine the qualitative moral impact of machine learning-based clinical decision support systems in the process of medical diagnosis. To date, discussions about machine learning in this context have focused on problems that can be measured and assessed quantitatively, such as by estimating the extent of potential harm or calculating incurred risks. We maintain that such discussions neglect the qualitative moral impact of these technologies. Drawing on the philosophical approaches of technomoral change and technological mediation theory, which (...)
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  • On Recovery: Re-Directing the Concept by Differentiation of its Meanings.Yael Friedman - 2021 - Medicine, Health Care and Philosophy 24 (3):389-399.
    Recovery is a commonly used concept in both professional and everyday contexts. Yet despite its extensive use, it has not drawn much philosophical attention. In this paper, I question the common understanding of recovery, show how the concept is inadequate, and introduce new and much needed terminology. I argue that recovery glosses over important distinctions and even misrepresents the process of moving away from malady as "going back" to a former state of health. It does not invite important nuances needed (...)
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  • How to Distinguish Medicalization From Over-Medicalization?Emilia Kaczmarek - 2019 - Medicine, Health Care and Philosophy 22 (1):119-128.
    Is medicalization always harmful? When does medicine overstep its proper boundaries? The aim of this article is to outline the pragmatic criteria for distinguishing between medicalization and over-medicalization. The consequences of considering a phenomenon to be a medical problem may take radically different forms depending on whether the problem in question is correctly or incorrectly perceived as a medical issue. Neither indiscriminate acceptance of medicalization of subsequent areas of human existence, nor criticizing new medicalization cases just because they are medicalization (...)
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  • Towards Precision Medicine; a New Biomedical Cosmology.M. W. Vegter - 2018 - Medicine, Health Care and Philosophy 21 (4):443-456.
    Precision Medicine has become a common label for data-intensive and patient-driven biomedical research. Its intended future is reflected in endeavours such as the Precision Medicine Initiative in the USA. This article addresses the question whether it is possible to discern a new ‘medical cosmology’ in Precision Medicine, a concept that was developed by Nicholas Jewson to describe comprehensive transformations involving various dimensions of biomedical knowledge and practice, such as vocabularies, the roles of patients and physicians and the conceptualisation of disease. (...)
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  • Who’s Afraid of EBM? Medical Professionalism From the Perspective of Evidence-Based Medicine.Sabine Salloch - 2017 - Medicine, Health Care and Philosophy 20 (1):61-66.
    Evidence-based medicine and medical professionalism are two prominent notions in current medical debates. However, proponents of professionalism fear a restriction in doctors’ freedom to make their best decisions for individual patients caused by the influence of EBM and highly standardised decision procedures. The challenge which EBM allegedly poses to physicians’ discretion forms the starting point for an analysis of the relationship between professionalism, as an inherent value system of medical practice, and EBM, as an approach to optimise the decision-making for (...)
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  • Medicalization and Overdiagnosis: Different but Alike.Bjørn Hofmann - 2016 - Medicine, Health Care and Philosophy 19 (2):253-264.
    Medicalization is frequently defined as a process by which some non-medical aspects of human life become to be considered as medical problems. Overdiagnosis, on the other hand, is most often defined as diagnosing a biomedical condition that in the absence of testing would not cause symptoms or death in the person’s lifetime. Medicalization and overdiagnosis are related concepts as both expand the extension of the concept of disease. They are both often used normatively to critique unwarranted or contested expansion of (...)
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  • Precision Medicine in an Imprecise and Complex World: Magic Bullets, Hype, and the Fuzzy Line Between Health and Disease.David Clark Aron - 2020 - Journal of Evaluation in Clinical Practice 26 (5):1534-1538.
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  • Personalized Medicine, Digital Technology and Trust: A Kantian Account.Bjørn K. Myskja & Kristin S. Steinsbekk - 2020 - Medicine, Health Care and Philosophy 23 (4):577-587.
    Trust relations in the health services have changed from asymmetrical paternalism to symmetrical autonomy-based participation, according to a common account. The promises of personalized medicine emphasizing empowerment of the individual through active participation in managing her health, disease and well-being, is characteristic of symmetrical trust. In the influential Kantian account of autonomy, active participation in management of own health is not only an opportunity, but an obligation. Personalized medicine is made possible by the digitalization of medicine with an ensuing increased (...)
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  • How Medical Technologies Shape the Experience of Illness.Bjørn Hofmann & Fredrik Svenaeus - unknown
    In this article we explore how diagnostic and therapeutic technologies shape the lived experiences of illness for patients. By analysing a wide range of examples, we identify six ways that technology can form the experience of illness. First, technology may create awareness of disease by revealing asymptomatic signs or markers. Second, the technology can reveal risk factors for developing diseases. Third, the technology can affect and change an already present illness experience. Fourth, therapeutic technologies may redefine our experiences of a (...)
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  • What Matters in “Multimorbidity”? Arguably Resilience and Personal Health Experience Are Central to Quality of Life and Optimizing Survival.Carmel Mary Martin - 2018 - Journal of Evaluation in Clinical Practice 24 (6):1282-1284.
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  • Multimorbidity, P4 Medicine and Holism.James A. Marcum - 2017 - Journal of Evaluation in Clinical Practice 23 (1):213-215.
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  • Medicine’s Metaphysical Morass: How Confusion About Dualism Threatens Public Health.Diane O’Leary - 2020 - Synthese 2020 (December):1977-2005.
    What position on dualism does medicine require? Our understanding of that ques- tion has been dictated by holism, as defined by the biopsychosocial model, since the late twentieth century. Unfortunately, holism was characterized at the start with con- fused definitions of ‘dualism’ and ‘reductionism’, and that problem has led to a deep, unrecognized conceptual split in the medical professions. Some insist that holism is a nonreductionist approach that aligns with some form of dualism, while others insist it’s a reductionist view (...)
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  • Ethischer Diskurs zu Epigenetik und Genomeditierung: die Gefahr eines (epi-)genetischen Determinismus und naturwissenschaftlich strittiger Grundannahmen.Karla Karoline Sonne Kalinka Alex & Eva C. Winkler - 2021 - In Boris Fehse, Ferdinand Hucho, Sina Bartfeld, Stephan Clemens, Tobias Erb, Heiner Fangerau, Jürgen Hampel, Martin Korte, Lilian Marx-Stölting, Stefan Mundlos, Angela Osterheider, Anja Pichl, Jens Reich, Hannah Schickl, Silke Schicktanz, Jochen Taupitz, Jörn Walter, Eva Winkler & Martin Zenke (eds.), Fünfter Gentechnologiebericht: Sachstand und Perspektiven für Forschung und Anwendung. Baden-Baden, Deutschland.: Nomos. DOI: 10.5771/9783748927242. pp. 299-323.
    Slightly modified excerpt from the section 13.4 Zusammenfassung und Ausblick (translated into englisch): This chapter is based on an analysis of ethical debates on epigenetics and genome editing, debates, in which ethical arguments relating to future generations and justice play a central role. The analysis aims to contextualize new developments in genetic engineering, such as genome and epigenome editing, ethically. At the beginning, the assumptions of "genetic determinism," on which "genetic essentialism" is based, of "epigenetic determinism" as well as "genetic" (...)
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  • Will Big Data and personalized medicine do the gender dimension justice?Antonio Carnevale, Emanuela A. Tangari, Andrea Iannone & Elena Sartini - forthcoming - AI and Society:1-13.
    Over the last decade, humans have produced each year as much data as were produced throughout the entire history of humankind. These data, in quantities that exceed current analytical capabilities, have been described as “the new oil,” an incomparable source of value. This is true for healthcare, as well. Conducting analyses of large, diverse, medical datasets promises the detection of previously unnoticed clinical correlations and new diagnostic or even therapeutic possibilities. However, using Big Data poses several problems, especially in terms (...)
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  • Overuse of Diagnostic Tests in Canada: A Critical Perspective.Julia Borges, Tiffany Lee, Abdullah Saif, Amit Sundly & Fern Brunger - 2019 - Canadian Journal of Bioethics/Revue canadienne de bioéthique 2 (2):39-41.
    In this commentary we describe the interplay between 1) contemporary popular and professional understandings of “risk” and “normality” in health and healthcare, and 2) the promotion by state and market forces of individual self-regulation of health. We draw upon the work of critical theorists who have described the relationship between risk, fear, and the notion of “normal” in health discourse to argue that these factors act, primarily via the popular media, to shape the discourse on, and overuse of, diagnostic tests (...)
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  • Personalizing Medicine: Disease Prevention in Silico and in Socio.Sara Green & Henrik Vogt - 2016 - Humana Mente 9 (30).
    Proponents of the emerging field of P4 medicine argue that computational integration and analysis of patient-specific “big data” will revolutionize our health care systems, in particular primary care-based disease prevention. While many ambitions remain visionary, steps to personalize medicine are already taken via personalized genomics, mobile health technologies and pilot projects. An important aim of P4 medicine is to enable disease prevention among healthy persons through detection of risk factors. In this paper, we examine the current status of P4 medicine (...)
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  • Personalizing Medicine in Silico and in Socio.Sara Green & Henrik Vogt - 2016 - Humana.Mente Journal of Philosophical Studies 30.
    Proponents of the emerging field of P4 medicine argue that computational integration and analysis of patient-specific “big data” will revolutionize our health care systems, in particular primary care-based disease prevention. While many ambitions remain visionary, steps to personalize medicine are already taken via personalized genomics, mobile health technologies and pilot projects. An important aim of P4 medicine is to enable disease prevention among healthy persons through detection of risk factors. In this paper, we examine the current status of P4 medicine (...)
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  • Personalized Medicine: Evidence of Normativity in its Quantitative Definition of Health.Henrik Vogt, Bjørn Hofmann & Linn Getz - 2016 - Theoretical Medicine and Bioethics 37 (5):401-416.
    Systems medicine, which is based on computational modelling of biological systems, is emerging as an increasingly prominent part of the personalized medicine movement. It is often promoted as ‘P4 medicine’. In this article, we test promises made by some of its proponents that systems medicine will be able to develop a scientific, quantitative metric for wellness that will eliminate the purported vagueness, ambiguity, and incompleteness—that is, normativity—of previous health definitions. We do so by examining the most concrete and relevant evidence (...)
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  • Big Data for Biomedical Research and Personalised Medicine: An Epistemological and Ethical Cross-Analysis.Thierry Magnin & Mathieu Guillermin - 2017 - Human and Social Studies. Research and Practice 6 (3):13-36.
    Big data techniques, data-driven science and their technological applications raise many serious ethical questions, notably about privacy protection. In this paper, we highlight an entanglement between epistemology and ethics of big data. Discussing the mobilisation of big data in the fields of biomedical research and health care, we show how an overestimation of big data epistemic power – of their objectivity or rationality understood through the lens of neutrality – can become ethically threatening. Highlighting the irreducible non-neutrality at play in (...)
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  • Represent Me: Please! Towards an Ethics of Digital Twins in Medicine.Matthias Braun - 2021 - Journal of Medical Ethics 47 (6):394-400.
    Simulations are used in very different contexts and for very different purposes. An emerging development is the possibility of using simulations to obtain a more or less representative reproduction of organs or even entire persons. Such simulations are framed and discussed using the term ‘digital twin’. This paper unpacks and scrutinises the current use of such digital twins in medicine and the ideas embedded in this practice. First, the paper maps the different types of digital twins. A special focus is (...)
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  • Aging Biomarkers and the Measurement of Health and Risk.Sara Green & Line Hillersdal - 2021 - History and Philosophy of the Life Sciences 43 (1):1-23.
    Prevention of age-related disorders is increasingly in focus of health policies, and it is hoped that early intervention on processes of deterioration can promote healthier and longer lives. New opportunities to slow down the aging process are emerging with new fields such as personalized nutrition. Data-intensive research has the potential to improve the precision of existing risk factors, e.g., to replace coarse-grained markers such as blood cholesterol with more detailed multivariate biomarkers. In this paper, we follow an attempt to develop (...)
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  • Systems Biology, Systems Medicine, Systems Pharmacology: The What and The Why.Angélique Stéphanou, Eric Fanchon, Pasquale F. Innominato & Annabelle Ballesta - 2018 - Acta Biotheoretica 66 (4):345-365.
    Systems biology is today such a widespread discipline that it becomes difficult to propose a clear definition of what it really is. For some, it remains restricted to the genomic field. For many, it designates the integrated approach or the corpus of computational methods employed to handle the vast amount of biological or medical data and investigate the complexity of the living. Although defining systems biology might be difficult, on the other hand its purpose is clear: systems biology, with its (...)
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  • Patient and interest organizations’ views on personalized medicine: a qualitative study.Isabelle Budin-Ljøsne & Jennifer R. Harris - 2016 - BMC Medical Ethics 17 (1):1.
    Personalized medicine aims to tailor disease prevention, diagnosis, and treatment to individuals on the basis of their genes, lifestyle and environments. Patient and interest organizations may potentially play an important role in the realization of PM. This paper investigates the views and perspectives on PM of a variety of PIOs. Semi-structured telephone interviews were conducted among leading representatives of 13 PIOs located in Europe and North-America. The data collected were analysed using a conventional content analysis approach. The PIO representatives supported (...)
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