Philosophy of Medicine https://philmed.pitt.edu/philmed <p><em>Philosophy of Medicine</em> publishes original philosophical research and perspectives, as well as content for health professionals, health scientists and the general public.</p> en-US <p>Authors who publish with this journal agree to the following terms:</p> <ol> <li class="show">The Author retains copyright in the Work, where the term “Work” shall include all digital objects that may result in subsequent electronic publication or distribution.</li> <li class="show">Upon acceptance of the Work, the author shall grant to the Publisher the right of first publication of the Work.</li> <li class="show">The Author shall grant to the Publisher and its agents the nonexclusive perpetual right and license to publish, archive, and make accessible the Work in whole or in part in all forms of media now or hereafter known under a <a title="CC-BY" href="http://creativecommons.org/licenses/by/4.0/">Creative Commons Attribution 4.0 International License</a>&nbsp;or its equivalent, which, for the avoidance of doubt, allows others to copy, distribute, and transmit the Work under the following conditions: <ol type="a"> <li class="show">Attribution—other users must attribute the Work in the manner specified by the author as indicated on the journal Web site;</li> </ol> with the understanding that the above condition can be waived with permission from the Author and that where the Work or any of its elements is in the public domain under applicable law, that status is in no way affected by the license.</li> <li class="show">The Author is able to enter into separate, additional contractual arrangements for the nonexclusive distribution of the journal's published version of the Work (e.g., post it to an institutional repository or publish it in a book), as long as there is provided in the document an acknowledgement of its initial publication in this journal.</li> <li class="show">Authors are permitted and encouraged to post online a prepublication manuscript (but not the Publisher’s final formatted PDF version of the Work) in institutional repositories or on their Websites prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work. 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However, the concept of </span><span lang="EN-US">vulnerability</span> <span lang="EN-US">is still underexplored in philosophy of psychiatry. This article discusses psychiatric vulnerability to clarify some conceptual issues about the various factors contributing to vulnerability, the notions of </span><span lang="EN-US">risk </span><span lang="EN-US">and </span><span lang="EN-US">protection, and </span><span lang="EN-US">the idea that there are multiple ways of crossing the threshold to clinical relevance. My goal is to lay the groundwork for a finer-grained discussion on psychiatric vulnerability that reflects the complex nature of mental conditions and illustrates the kind of thinking needed in clinical practice.</span></p> </div> Valentina Petrolini Copyright (c) 2021 Valentina Petrolini https://creativecommons.org/licenses/by/4.0 https://philmed.pitt.edu/philmed/article/view/10 Fri, 01 Oct 2021 08:19:57 -0400 Abject Object Relations and Epistemic Engagement in Clinical Practice https://philmed.pitt.edu/philmed/article/view/45 <p>The article engages with medical practice to develop a philosophically informed understanding of epistemic engagement in medicine, and epistemic object relations more broadly. I take point of departure in the clinal encounter and draw on French psychoanalytical theory to develop and expand a taxonomy already proposed by Karin Knorr-Cetina. Doing so, I argue for the addition of an abject type object relation, that is, the encounter with objects that transgress frameworks and disrupt further investigation, hence preventing dynamic engagement and negatively shaping our epistemic pathways. The article is primarily theoretical although partly grounded in qualitative fieldwork.</p> Helene Scott-Fordsmand Copyright (c) 2021 Helene Scott-Fordsmand https://creativecommons.org/licenses/by/4.0 https://philmed.pitt.edu/philmed/article/view/45 Fri, 19 Nov 2021 09:25:53 -0500 Causal Inference, Moral Intuition, and Modeling in a Pandemic https://philmed.pitt.edu/philmed/article/view/70 <p><span lang="EN-US">Throughout the Covid-19 pandemic, people have been eager to learn what factors, and especially what public health policies, cause infection rates to wax and wane. But figuring out conclusively what causes what is difficult in complex systems with nonlinear dynamics, such as pandemics. We review some of the challenges that scientists have faced in answering quantitative causal questions during the Covid-19 pandemic, and suggest that these challenges are a reason to augment the moral dimension of conversations about causal inference. We take a lesson from Martha Nussbaum—who cautions us not to think we have just one question on our hands when we have at least two—and apply it to modeling for causal inference in the context of cost-benefit analysis.</span></p> Stephanie Harvard, Eric Winsberg Copyright (c) 2021 Stephanie Harvard, Eric Winsberg https://creativecommons.org/licenses/by/4.0 https://philmed.pitt.edu/philmed/article/view/70 Fri, 17 Sep 2021 10:06:56 -0400 Interpreting Patient-Reported Outcome Measures https://philmed.pitt.edu/philmed/article/view/66 <p><span lang="EN-US">Patient-reported outcome measures (PROMs) are valued in healthcare evaluation for bringing patient perspectives forward, and enabling patient-centered care. The range of evidence permitted by PROMs to measure patients’ quality of life narrowly denies subjective experience. This neglect is rooted in the epistemic assumptions that ground PROMs, and the tension between the standardization (the task of measurement) and the individual and unique circumstances of patients. To counter the resulting methodological shortcomings, this article proposes a hermeutical approach and interpretive phenomenology instead of generic qualitative research methods.</span></p> Keith Meadows Copyright (c) 2021 Keith Meadows https://creativecommons.org/licenses/by/4.0 https://philmed.pitt.edu/philmed/article/view/66 Fri, 19 Nov 2021 09:26:14 -0500 Vaccine Hesitancy by Maya J. Goldenberg https://philmed.pitt.edu/philmed/article/view/57 Inmaculada de Melo-Martín Copyright (c) 2021 Inmaculada de Melo-Martín https://creativecommons.org/licenses/by/4.0 https://philmed.pitt.edu/philmed/article/view/57 Tue, 27 Jul 2021 08:58:24 -0400