Welcome to the Nexus of Ethics, Psychology, Morality, Philosophy and Health Care

Welcome to the nexus of ethics, psychology, morality, technology, health care, and philosophy
Showing posts with label Medicalization. Show all posts
Showing posts with label Medicalization. Show all posts

Monday, October 1, 2018

How Do Medicalization and Rescue Fantasy Prevent Healthy Dying?

Peter T. Hetzler III and Lydia S. Dugdale
AMA Journal of Ethics
2018;20(8):E766-773.

Abstract

Before antibiotics, cardiopulmonary resuscitation (CPR), and life-sustaining technologies, humans had little choice about the timing and manner of their deaths. Today, the medicalization of death has enabled patients to delay death, prolonging their living and dying. New technology, the influence of the media, and medical professionals themselves have together transformed dying from a natural part of the human experience into a medical crisis from which a patient must be rescued, often through the aggressive extension of life or through its premature termination. In this paper, we examine problematic forms of rescue medicine and suggest the need to rethink medicalized dying within the context of medicine’s orientation to health and wholeness.

The info is here.

Wednesday, July 11, 2018

Could Moral Enhancement Interventions be Medically Indicated?

Sarah Carter
Health Care Analysis
December 2017, Volume 25, Issue 4, pp 338–353

Abstract

This paper explores the position that moral enhancement interventions could be medically indicated (and so considered therapeutic) in cases where they provide a remedy for a lack of empathy, when such a deficit is considered pathological. In order to argue this claim, the question as to whether a deficit of empathy could be considered to be pathological is examined, taking into account the difficulty of defining illness and disorder generally, and especially in the case of mental health. Following this, Psychopathy and a fictionalised mental disorder (Moral Deficiency Disorder) are explored with a view to consider moral enhancement techniques as possible treatments for both conditions. At this juncture, having asserted and defended the position that moral enhancement interventions could, under certain circumstances, be considered medically indicated, this paper then goes on to briefly explore some of the consequences of this assertion. First, it is acknowledged that this broadening of diagnostic criteria in light of new interventions could fall foul of claims of medicalisation. It is then briefly noted that considering moral enhancement technologies to be akin to therapies in certain circumstances could lead to ethical and legal consequences and questions, such as those regarding regulation, access, and even consent.

The paper is here.

Saturday, January 30, 2016

Epigenetics in the neoliberal 'regime of truth'

by Charles Dupras and Vardit Ravitsky
Hastings Center Report - 2015

Here is an excerpt:

In this paper, we argue that the impetus to create new biomedical interventions to manipulate and reverse epigenetic variants is likely to garner more attention than effective social and public health interventions and therefore also to garner a greater share of limited public resources. This is likely to happen, we argue, because of the current biopolitical context in  which scientific findings are translated. This contemporary neoliberal “regime of truth,” to use a term from the historian and philosopher Michel Foucault, greatly influences the ways in which knowledge is being interpreted and implemented. Building on sociologist Thomas Lemke’s Foucauldian “analytics of biopolitics” and on literature from the field of science and technology studies,  we present two sociological trends that may impede the policy transla-tion of epigenetics: molecularization and biomedicalization. These trends,  we argue, are likely to favor the clini-cal translation of epigenetics—in other words, the development of new clinical tools fostering what has been called “personalized” or “precision” medicine.

In addition, we argue that an over-emphasized clinical translation of epigenetics may further reinforce this biopolitical landscape through four processes that are closely related to neoliberal pathways of thinking: the internalization and isolation (liberal individualism) of socioenvironmental determinants of health and increased opportunities for commodification and technologicalization  (economic liberalism) of health care interventions. Hence, epigenetics may end up promoting further the mobilization of resources toward technological innovation at the expense of public health and social strategies. Our analysis therefore first presents how the current biopolitical landscape may bias scientific knowledge translation and then circles around to explain how, in return, the outcome of a biased translation of epigenetics may strengthen our contemporary neoliberal “regime of truth.”

The paper is here.

Sunday, February 17, 2013

Mislabeling Medical Illness

By ALLEN FRANCES, MD
The Health Care Blog
Originally published on February 12, 2013


Many readers of my previous blog listing the 10 worst suggestions in DSM 5 were shocked that I failed to mention an 11th dangerous mistake — that DSM-5 will harm people who are medically ill by mislabeling their medical problems as mental disorder. They are absolutely right. I apologize for my previous failure to attend to this danger and hope it is not now too late to influence the process.

Adding to the woes of the medically ill could be one of the biggest problems caused by DSM-5. It will do this in two ways: 1) by encouraging a quick jump to the erroneous conclusion that someone’s physical symptoms are ‘all in the head’; and 2) by mislabeling as mental disorders what are really just the normal emotional reactions that people understandably have in response to a medical illness.

UK health advocate, Suzy Chapman, has closely monitored every step in the development of DSM-5. Her website is the best available resource for finding just about everything you need to know about DSM-5 and ICD-11. Ms Chapman sent me a troubling email that summarizes where DSM-5 has gone wrong and the many harmful consequences that will follow. More details are available at: ‘Somatic Symptom Disorder could capture millions more under mental health diagnosis’ (http://wp.me/pKrrB-29B )

Ms Chapman writes:
…The DSM-5 Somatic Symptom Disorders Work Group is planning to eliminate several little used DSM-IV Somatoform Disorders and replace them instead with an extremely broad new category that is likely to be wildly overused (‘Somatic Symptom Disorder’ — SSD).
A person will meet the criteria for SSD by reporting just one bodily symptom that is distressing and/or disruptive to daily life and having just one of the following three reactions to it that persist for at least six months: 1) ‘disproportionate’ thoughts about the seriousness of their symptom(s); or 2) a high level of anxiety about their health; or, 3) devoting excessive time and energy to symptoms or health concerns.
The entire blog post is here.