Adaptive preferences in medicine: a subjectivity-first account

Area of Science:

• Philosophy of Medicine
• Bioethics
• Health Psychology

Background:

• Health-related adaptive preferences (HRAPs) are often evaluated in isolation.
• Existing frameworks may overlook the pre-clinical shaping of these preferences.
• Paternalism and relativism pose challenges in assessing HRAPs.

Purpose of the Study:

• To propose a subjectivity-first account of HRAPs.
• To shift normative attention to the mutual shaping of subject and world.
• To provide a framework for understanding HRAP emergence under non-ideal conditions.

Main Methods:

• Focus on two dimensions of subject formation: ecosystemic and configurational.
• Analysis of how patterned norms, material conditions, and lived orientation interact.
• Examining the intelligibility of HRAPs within a subject's context.

Main Results:

• HRAPs are shaped by the interplay of ecosystemic (environmental) and configurational (interpretive) factors.
• This approach elucidates how HRAPs become intelligible to subjects.
• The framework avoids both paternalistic judgment and uncritical relativism.

Conclusions:

• A subjectivity-first account offers a nuanced understanding of HRAPs.
• Considering the subject's lived orientation and environment is crucial.
• This model provides a robust ethical framework for assessing HRAPs in diverse contexts.