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Target Article

Why Bioethics Should Be Concerned With Medically Unexplained Symptoms

 

Biomedical diagnostic science is a great deal less successful than we've been willing to acknowledge in bioethics, and this fact has far-reaching ethical implications. In this article I consider the surprising prevalence of medically unexplained symptoms, and the term's ambiguous meaning. Then I frame central questions that remain answered in this context with respect to informed consent, autonomy, and truth-telling. Finally, I show that while considerable attention in this area is given to making sure not to provide biological care to patients without a need, comparatively little is given to the competing, ethically central task of making sure never to obstruct access to biological care for those with diagnostically confusing biological conditions. I suggest this problem arises from confusion about the philosophical value of vagueness when it comes to the line between biological and psychosocial needs.

ACKNOWLEDGMENTS

The author is grateful to the Kennedy Institute of Ethics, and in particular to Laura Bishop, whose support made this paper possible. She is also grateful to the resourceful staff at Georgetown's Bioethics Research Library, to Claire Junga Kim, for substantial insights during the revision process, and to Erik Parens, for valuable conversations about mind and body. Finally, the author would like to express gratitude to three anonymous reviewers, whose comments and suggestions greatly improved this article.

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