1,720,989 research outputs found
Informed consent in artificial nutrition and hydration: Ethical, legal, and clinical considerations
No full textThis article addresses the complex issue of informed consent in the context of Artificial Nutrition and Hydration (ANH). It explores how physicians should act when patients are unable to provide valid consent and whether explicit, legally prescribed consent is necessary or if presumed consent can be inferred from the patient’s lifestyle, values, and beliefs. The necessity of detailed patient information and the evolution of the doctor-patient relationship from a paternalistic model to one recognizing patient autonomy are discussed. The article emphasizes that ANH should be administered based on informed consent, except in exceptional urgent cases where presumed consent is applicable. Ethical and legal responsibilities of physicians in ensuring clear and comprehensible information for informed decision-making are highlighted. The article concludes that adherence to guidelines should be carefully considered and contextualized, ensuring that therapeutic choices respect the patient’s dignity and autonomy. This multidisciplinary approach, involving ethicists, legal experts, and family members, is essential for decisions made in the best interest of the patient
Origins and Development of Narrative-Based Medicine
No full textIn the early days of medicine, diagnosis was based on what a patient told the Hippocratic doctor. With the establishment of hospitals and their spread over the 18th century, objective data collection about disease began to be regarded as fundamental, with a patient’s narrative taking second place. Over time, disease increasingly began to coincide with a biological entity that could be objectively observed and quantified, while medicine became a science on a par with physics and chemistry
Philosophy and Medicine: an Aristotelian Reflection
No full textThe debate on the relationship between philosophy and medicine raised by both philosophers and physicians concerns the possibility of elaborating a practical philosophy of medicine as an autonomous discipline distinct from both philosophy and medicine as separate entities. Analysis reveals the close link between philosophy and medicine since its inception in ancient Greece as well as the difficulty of defining the epistemological status of medicine, which presents a dual character of science and practice. The impossibility of defining medicine as pure science, on a par with physics and mathematics, generates tensions between explanatory theories and therapeutic aims and between universal knowledge and understanding of the specific where medical science is confronted with the values that come into play in a clinical encounter. The doctor-patient relationship is the core of clinical medicine. The significant contribution that philosophical reflection (1) can offer to medical science is to be found in the practice of the therapeutic encounter and the analysis of the ethical dimensions involved in it. A practical philosophy, in the Aristotelian sense of the term, is understood as the expression of a form of rationality that differs from the scientific one, which does not seek knowledge as an end in itself but is directed towards an understanding that aims to guide actions. This reference is to that practical logic that allows the physician to deliberate on the most suitable means to achieve his end and the greatest good for the patient
Moral Strangers, Markets and Secular Bioethics according to H. T. Engelhardt
No full textH.T. Engelhardt’s reflections on bioethics show his vision of a correlation between liberalism and biopolitics expressed in the person as a proprietary conception of the body, the result of a link between liberal thought and the free market economic system. Pluralism has taken on a specific social conformity, erasing some of the categorical boundaries caused by manifest obsolescence and rewriting any plots of modernity based on socio-anthropological grammar. This shift in social space is configured within a specific historical-cultural horizon characterized by the pluralism of moral views and prompted by the emergence of new forms of intervention on the human body, posing questions on the categorisation of a person and their body
INFORMED CONSENT Beyond The Person and The Body
No full textIndividual power of choice has overcome the old boundaries which governed only a patient’s existence or body and now takes into account surrogate consent, i.e. that expressed by a third party, as well as the management of cells, tissues and organs that are no longer part of the person, parts that were previously considered surgical waste and that today have become priceless objects of research. Just over a decade ago doctors made the decisions and patients did what they were told. Doctors were not used to asking patients what their wishes and priorities were; they often withheld vital information from them and patients were treated like children: “too fragile and clueless to face the truth, let alone make decisions.” Patients were sometimes attached to machines, forced to take drugs, and subjected to operations without their opinion being sought. The principle of consent constitutes a natural corollary of the broader principle of personal freedom and is substantiated by the exclusivity of one’s body and mind in that the person cannot be subjected to coercion or violation of his or her bodily sphere nor moral freedom; any power or duty of the doctor over the patient finds its sole and exclusive source in the consent of the patient themselves, representing the focal point of all legal authorisation of medical activity
Medicalisation in the Post-Genomic Era: Transformations in Identity, Autonomy, and Ethics
No full textThe advent of the post-genomic society has fundamentally transformed the concept of medicalisation, expanding its scope from disease treatment to reshaping personal identity, autonomy, and societal norms. This paper examines the profound implications of genomic knowledge on individual and collective experiences, exploring its dual roles as a liberating force and a source of new constraints. Key areas of focus include the intersection of genomic data with social structures, the ethical tensions faced by healthcare professionals, and the evolving roles of patients and research subjects in the context of predictive and precision medicine. The discussion highlights the challenges posed by genetic determinism, the ethical complexities of consent, and the societal impact of genomic categorization on equity and justice. By integrating multidisciplinary perspectives, this study offers insights into the promises and perils of genomic innovation, charting pathways for ethical frameworks that balance scientific progress with human dignity and social responsibility
Moral Strangers, Markets and Secular Bioethics according to H. T. Engelhardt
No full textH.T. Engelhardt’s reflections on bioethics show his vision of a correlation between liberalism and biopolitics expressed in the person as a proprietary conception of the body, the result of a link between liberal thought and the free market economic system. Pluralism has taken on a specific social conformity, erasing some of the categorical boundaries caused by manifest obsolescence and rewriting any plots of modernity based on socio-anthropological grammar. This shift in social space is configured within a specific historical-cultural horizon characterized by the pluralism of moral views and prompted by the emergence of new forms of intervention on the human body, posing questions on the categorisation of a person and their body
Comparison of ultra-high frequency US with Contrast Enhanced MR Angiography and conventional US: evaluation of carotid atheromatous plaques and bioethical decision making
No full textBackground and aim. The methods routinely used for the study of atherosclerotic plaque include conventional ultrasound (US) and Magnetic Resonance Imaging (MRI), and Computed Tomography (CT), each one with its own strength and weak points. The aim of this study is to investigate diagnostic capabilities of high frequency ultrasound (HFUS) in order to provide a close and accurate inspection of atherosclerotic plaque, evaluating the characteristics that can categorize it as stable or unstable. Method. a total of 20 subjects (10 male, 10 female) were enrolled in order to assess presence/absence of carotid plaque by the use of Conventional US. All enrolled patients resulting positive for plaques presence at Color Doppler US examination underwent to Ultra High-frequency ultrasound exam, using a linear-array 48 MHz transducer, and Contrast MRI Angiography examination of the carotid arteries using a 1.5 Tesla scanner. Results. HFUS could assess specific size ranges for the plaque and the lipid core. Conventional US and CEMRA failed the measurement of FC Thickness in 75% of cases, while HFUS could assess them precisely, experiencing specific values. Conclusion. HFUS has proved to be reliable in defining the qualitative and quantitative values of plaque, highlighting, in a finer way, the characteristics of vulnerability
Biological existence from medicalisation to biomedicalization
No full text: The process of medicalisation began around the end of the 18th century due to the emergence of the bourgeoisie and its values, which included the right to be healthy and carry out one's everyday skills, actions which in turn entailed the creation of a state's wealth. In this period, biopolitics was established, a new form of power administration. This made use of medicine to create behaviour that was useful for social activity, shifting the focus from the administration of the law to bringing subjects back within norms through therapeutic action. This stemmed from the fact that the key issue in governing a population is to maintain the workforce and to establish, through health, modes of behaviour that are valuable in its preservation. Genetic engineering and new forms of biomedicine have changed the paradigm of medicalisation into biomedicalisation, marking a shift from medical control over external nature to the control and transformation of inner nature. Through this optimisation, man regains a natural mode of expression within social norms
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