Health and Medicine

The project:

This project addresses conceptual and normative questions relating to health and medicine, broadly construed. These include:

  • Consent: Consent is integral to ethical practice in health care and clinical research. By giving valid consent a competent adult can give permission for acts that would otherwise be rights violations. Under what conditions is consent valid?
  • Disorders of consciousness in psychiatry. The concept of a disorder of consciousness is central to the medical understanding of post-comatose disorders like coma, the persistent vegetative state and the minimally conscious state. It picks out a family of conditions in which one’s state of wakeful consciousness is severely degraded, dysfunctional or absent. Can we use this and related concepts (such as dreaming, and the psychedelic state) to make sense of the changes to conscious experience reported in depression, schizophrenia and other forms of mental illness?
  • Health care allocation: All health care systems are resource-constrained, meaning that not everyone can receive the medical interventions that would benefit them. How can scarce resources for health care be fairly allocated?
  • Health research priority setting: The resources available for health research are also limited. Difficult decisions must be made about how to allocate them across different populations, diseases, and types of intervention. How can the different actors involved in health research ethically set priorities?
  • Psychiatric categories and mental health. Psychiatric kinds play a key role in modern medical practice. The number of diagnoses of mental disorders is also growing rapidly. What , if anything, does this tell us about the nature of the categories utilized in psychiatry? What are our concepts of mental health and mental illness, and what should they be? Are clinicians ‘over-medicalizing’ mental illness, and what, if anything, ought to be done about it?

Project members:

Joseph Millum (St Andrews)

Cecily Whiteley (St Andrews)

Teaching:

PY4666 Bioethics

PY4670 Ethics and the allocation of health resources

PY4671 Philosophy of Dreaming

Recent Publications:

Millum, J. “Should health research funding be proportional to the burden of disease?” Politics, Philosophy & Economics 22.1 (2023): 76-99. https://doi.org/10.1177/1470594X221138

Zionts J., Millum J. “How not to count the health benefits of family planning.” Journal of Medical Ethics 49 (2023): 41-44. https://doi.org/10.1136/medethics-2021-107668

Whiteley, C. “Depression as a Disorder of Consciousness” (forthcoming). The British Journal for the Philosophy of Science. https://doi.org/10.1086/716838