J Bioethic Inq
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There can be little doubt about the ethical imperative to ensure adequate vaccination uptake against certain infectious diseases. In the face of vaccine refusal, health authorities and providers instinctively appeal to coercive approaches or increased education as methods to ensure adequate vaccine uptake. Recently, some have argued that public fear around Ebola should be used as an opportunity for such approaches, should an Ebola vaccine become available. ⋯ Both coercion and education can cause opposite effects than intended in certain circumstances. The correct area of focus is to address the breakdown in trust within clinical relationships. The author presents suggestions for an approach towards vaccine refusal that may be more promising.
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Truth and knowledge are conceptually related and there is a way of construing both that implies that they cannot be solely derived from a description that restricts itself to a set of scientific facts. In the first section of this essay, I analyse truth as a relation between a praxis, ways of knowing, and the world. ⋯ An analysis drawing on philosophical semantics motivates the needed (anti-scientistic) account of meaning and truth (and therefore knowledge) and underpins the following argument: (i) the formulation and dissemination of knowledge rests on language; (ii) language is selective in what it represents in any given situation; (iii) the praxes of a given (sub)culture are based on this selectivity; but (iv) human health and illness involve whole human beings in a human life-world; therefore, (v) medical knowledge should reflectively transcend, where required, biomedical science towards a more inclusive view. Parts three and four argue that a post-structuralist (Lacanian) account of the human subject can avoid both scientism and idealism or unconstrained relativism.