1,721,228 research outputs found
Understanding the impact of Artificial Intelligence on physician-patient relationship: a revisitation of conventional relationship models in the light of new technological frontiers
No full textThe physician-patient relationship has undergone a transition throughout the ages. The introduction of Artificial Intelligence (AI) in recent years, however, is redefining this relationship. The four main relationship models described by Emanuel in 1992 are known as paternalistic, informative, interpretive, and deliberative. The aim of this study is to understand how conventional models of doctor-patient relationships are changing when considering the impact AI has on medical practice. The introduction of AI could strengthen the physician’s role resulting in the so-called digital paternalism or even undermining the physician’s role. Also, doctors and patients could experience decision paralysis when AIs’ recommendations are difficult to understand or explain to patients and it may affect the organizational aspects of healthcare contexts. It becomes necessary to define the source of the information presented to the patient. On another hand, AI could increase the patient’s trust in the doctor by knowing that various therapeutic choices are being discussed and fully explained. It’s complicated to understand whether the trust relationship established between doctor and patient remains bi-univocal, by incorporating AI in the clinician’s figure, or whether AI must be introduced as a separate entity implying an asymmetry in this relationship. Shared decision-making, guidelines and training, together with an effort in communication are fundamental to best incorporate AI into clinical practice. It is relevant to educate doctors on the new models of relationships that can be created, in addition to studying patient populations within the context of these models’ framework
Combining genetic and linearized algorithms for a two-step joint inversion of Reyleigh wave dispersion and H/V spectral ratio curves
No full textThe joint inversion of Rayleigh wave dispersion and H/V curves from environmental noise measurements allows the retrieval of S-wave velocity profiles for the shallow subsoil. For this purpose, genetic and linearized algorithm have been combined in a two-step inversion procedure, that allows the principal drawbacks typical of the application of each algorithm separately to be overcome. In the first step, a genetic algorithm procedure is used to constrain the subvolume of the parameter space where the absolute minimum of the misfit function is located. In the second step, a linearized inversion algorithm, having as an initial guess the minimum misfit model deduced from the first step, is applied to force the inversion towards the optimal solution. To evaluate the feasibility and effectiveness of this approach, seismic noise recordings at a test site in the Po river valley (North Italy) have been analysed. Here, detailed geophysical and geological information is available along with earthquake recordings, which allow a well constrained definition of both the local shear wave profile and transfer function. Comparisons between theoretical and experimental S-wave velocity profiles and, above all, between the theoretical and experimental site response functions shows that this combination of inversion procedures can very efficiently to manage the extreme non-linearity of the problem
Legal accountability in Clinical Ethics Consultation
No full textThe aim of this paper is to outline the framework for a critical reflection about legal accountability associated with Clinical Ethics Consultation (CEC). First of all, we will explain why we believe that, at the present time, in Italy, CEC provided by an individual Ethics Consultant shoud be considered the best format to guarantee a quality service to patients and healthcare professionals. We will then analyse whether and when an Ethics Consultant can be held liable for violation of a civil or criminal law. Finally, starting from the analysis of the jurisprudential evolution and the healthcare legislation reforms, we will propose a discipline applicable to the Ethics Consultant's activity in case of damage to a patient. According to this perspective, we will illustrate why the formal and juridical acknowledgement of the Ethics Consultant's activity can define the contents of his actual role in the care process while helping to spread the CEC culture as a dialogic process meant to effectively improve health care through the identification, analysis and resolution of ethical dilemmas in clinical practice
Five autopsy reports of rib fractures in the mental hospital of Reggio Emilia (1874–5): pathogenesis proposal in defence of the ‘non-restraint’ system
No full textAt the end of the nineteenth century, recurrent cases of rib fractures were recorded in psychiatric asylums, opening a long chapter of discussions about the application of the ‘non-restraint’ system. Here we present a brief discussion of an article written by Enrico Morselli about five cases of rib fractures in the mental asylum of Reggio Emilia, in 1874–5. Morselli, a supporter of the ideas of ‘non-restraint’, suggested a common pathological cause. His analysis proposed the osteomalacic condition as the possible cause of fractured ribs, rejecting the accusations of violence by asylum attendants. The discussion also examines similar cases of the same period, making rib fractures the means through which the issue of management of the insane was addressed
Ethical implications of genetic susceptibility testing: NeuroGenEthics and the "Angelina Jolie effect"
No full textAn increasing interest in genetics of aggressive behavior has developed in literature over time and specifically regarding genes involved in dopaminergic and serotonergic systems, sex steroids and glucocorticoids. The same could be said for mood and anxiety disorders, psychosis, schizophrenia syndromes and antisocial and criminal behavior. This has led to the idea that it was possible to make genetic tests applicable in psychiatry with the ability to define a risk profile. However, the results obtained to date are mostly contradictory, un-replicable and lack standardized protocols and the legal frames are not clear. The results found were that there wasn't a simple mendelian transmission or connection of a few genes. Today, we have to overcome the genetic determinism and generalize it in an interdisciplinary perspective without neglecting the ethical, legal and social issues and without slipping into a sort of "Angelina Jolie effect"
The contribution of ethical reflection during the Coronavirus pandemic. A comparative analysis
No full textThe Coronavirus pandemic has deeply marked all ordinary health care activities and has dictated matters usually faced by the medicine of disasters. The most critical and dramatic dilemma has been the triage and the urge to select patients for Intensive Care Unit (ICU) because there was no place for all at the same time. The need to decide in a very short time has made this decision even more complex. The data of the Italian situation and namely of Lombardia reveal it clearly. Worldwide, there have been many different views on triage, sometimes with very peculiar emphasis. In this paper we will illustrate the contributions of the Unites States compared to the European ones. We have critically analyzed different views and we have highlighted that nevertheless there are several shared elements such as clinical criteria, if we consider only them we might underestimate the uniqueness of the patient, including vulnerable ones. There is a huge gap between the US view and the European view when it comes to the appointment of the final decision maker in triage. We propose the criteria of proportionality as a guide line to take decisions in triage because it allows to integrate collective public health objectives and the principle of ensuring protection for the individual patient. Finally, we envisage the potential role of ethics consultation in this pandemic scenario
Enhancing the mind: A neuroethical perspective on diverse brain enhancement techniques
Full text linkAdvances in medical science have expanded our ability to manipulate health, extending beyond treating diseases to enhancing cognitive and emotional functions. This practice, known as cosmetic neurology, involves using neurologic interventions and psychotropic drugs to improve brain performance, resilience to stress, and overall mental well-being, even in healthy individuals. While these interventions raise critical ethical concerns—such as issues of authenticity, beneficence, non-maleficence, and justice—emerging evidence suggests promising alternatives. Non-invasive brain enhancement techniques and experimental biohacking practices, including lifestyle adjustments and technological interventions, offer innovative pathways for cognitive enhancement. However, ethical investigations into these alternatives remain limited. This paper provides a comprehensive neuroethical analysis of invasive and non-invasive enhancement methods, emphasizing the relative advantages of non-drug-based approaches. It argues that non-invasive techniques present a less ethically fraught and more sustainable alternative to psychotropic drugs, positioning them as viable solutions for advancing the field of brain enhancement
Managing brain-hype: Understanding and discriminating overemphasized brain-based allegations
No full textResearch about our brain’s function is today essential for the assessment of the human species and for our self-comprehension. However, since the neuroscientific turn took place in several areas of research such as psychology, philosophy, and AI, the consequential interdisciplinarity this event created gave birth to an important phenomenon that is still in place today: neuro-hype or brain-hype. As a matter of fact, we are increasingly overstimulated by brain-based observations, research, and alleged discoveries. But, how much of this hype around our brains is justified? This is an essential question if we aim to assess and understand neuroscientific research today. Therefore, in this work, we analyze this phenomenon and its outcomes by investigating different topics ranging from newspaper titles to the relationship between brains and research. In addition to that, we discuss several theories such as neuroessentialism that have made an attempt to explain and understand this phenomenon, which has important ethical implications concerning both scientists and society in its entirety
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