Medical Model Research Articles

The Population-Centered Medical Model: a method of practice for public health physicians

Abstract Background Public Health Physicians (PHPs) in Canada occupy a liminal space between medicine and public health. Current practice frameworks for the care of individual patients by physicians do not account for the complexity of working with communities and populations for health. Similarly, frameworks for public health practice do not account for the roles and responsibilities of physicians in public health. A method of practice that outlines how public health physicians care for populations is vital for training and development of practice for this specialty group within medicine and public health. Methods Constructivist Grounded Theory methods were used in this study. Ethics approval was obtained through The Western University Health Sciences Research Ethics Board. Semi-structured interviews were conducted with eighteen (18) currently practicing PHPs across Canada. Data was analysed iteratively using constant comparison, multi-level coding, and memo writing. Thick description and reflexivity were employed to enhance rigour. Results The key finding is the elucidation of the Population-Centered Medical Model. In this empirically grounded model, PHPs bring values, knowledge and stances to their practice of Public Health Medicine. PHPs consider the population as patient, along with ethical obligations that flow from the physician to the population as a consequence. The process of caring for populations involves both diagnosis and intervention, with a focus on systems and prevention. It relies on knowledge sharing and relationship building between the physician and the population. Conclusions This is the first empirical model to describe the practice of PHPs. The model firmly grounds PHP practice in both medicine (diagnosis and intervention, the construction of a patient) and public health (focus on populations, systems and prevention). It also presents an opportunity to develop a general model of medical practice for n patients, where n can range between 1 and N. Key messages • The Population-Centered Medical Model is an empirically grounded model that describes the work of Public Health Physicians in Canada and grounds practice firmly in medicine and in public health. • Public Health Physicians consider populations as patients. They diagnose and intervene for health, with a focus on systems and prevention, by building relationships and sharing knowledge.

Artificial Intelligence in Head and Neck Cancer Diagnosis: A Comprehensive Review with Emphasis on Radiomics, Histopathological, and Molecular Applications

The present review discusses the transformative role of AI in the diagnosis and management of head and neck cancers (HNCs). Methods: It explores how AI technologies, including ML, DL, and CNNs, are applied in various diagnostic tasks, such as medical imaging, molecular profiling, and predictive modeling. Results: This review highlights AI’s ability to improve diagnostic accuracy and efficiency, particularly in analyzing medical images like CT, MRI, and PET scans, where AI sometimes outperforms human radiologists. This paper also emphasizes AI’s application in histopathology, where algorithms assist in whole-slide image (WSI) analysis, tumor-infiltrating lymphocytes (TILs) quantification, and tumor segmentation. AI shows promise in identifying subtle or rare histopathological patterns and enhancing the precision of tumor grading and treatment planning. Furthermore, the integration of AI with molecular and genomic data aids in mutation analysis, prognosis, and personalized treatment strategies. Conclusions: Despite these advancements, the review identifies challenges in AI adoption, such as data standardization and model interpretability, and calls for further research to fully integrate AI into clinical practice for improved patient outcomes.

Synthetic data for privacy-preserving clinical risk prediction

Synthetic data promise privacy-preserving data sharing for healthcare research and development. Compared with other privacy-enhancing approaches—such as federated learning—analyses performed on synthetic data can be applied downstream without modification, such that synthetic data can act in place of real data for a wide range of use cases. However, the role that synthetic data might play in all aspects of clinical model development remains unknown. In this work, we used state-of-the-art generators explicitly designed for privacy preservation to create a synthetic version of ever-smokers in the UK Biobank before building prognostic models for lung cancer under several data release assumptions. We demonstrate that synthetic data can be effectively used throughout the medical prognostic modeling pipeline even without eventual access to the real data. Furthermore, we show the implications of different data release approaches on how synthetic biobank data could be deployed within the healthcare system.

MCI net: mamba- convolutional lightweight self-attention medical image segmentation network.

With the development of deep learning in the field of medical image segmentation, various network segmentation models have been developed. Currently, the most common network models in medical image segmentation can be roughly categorized into pure convolutional networks, Transformer-based networks, and networks combining convolution and Transformer architectures. However, when dealing with complex variations and irregular shapes in medical images, existing networks face issues such as incomplete information extraction, large model parameter sizes, high computational complexity, and long processing times. In contrast, models with lower parameter counts and complexity can efficiently, quickly, and accurately identify lesion areas, significantly reducing diagnosis time and providing valuable time for subsequent treatments. Therefore, this paper proposes a lightweight network named MCI-Net, with only 5.48M parameters, a computational complexity of 4.41, and a time complexity of just 0.263. By performing linear modeling on sequences, MCI-Net permanently marks effective features and filters out irrelevant information. It efficiently captures local-global information with a small number of channels, reduces the number of parameters, and utilizes attention calculations with exchange value mapping. This achieves model lightweighting and enables thorough interaction of local-global information within the computation, establishing an overall semantic relationship of local-global information. To verify the effectiveness of the MCI-Net network, we conducted comparative experiments with other advanced representative networks on five public datasets: X-ray, Lung, ISIC-2016, ISIC-2018, and capsule endoscopy and gastrointestinal segmentation. We also performed ablation experiments on the first four datasets. The experimental results outperformed the other compared networks, confirming the effectiveness of MCI-Net. This research provides a valuable reference for achieving lightweight, accurate, and high-performance medical image segmentation network models.

Construction and Application of a Private 5G Standalone Medical Network in a Smart Health Environment: Exploratory Practice From China.

To date, the differentiated requirements for network performance in various health care service scenarios-within, outside, and between hospitals-remain a key challenge that restricts the development and implementation of digital medical services. This study aims to construct and implement a private 5G (the 5th generation mobile communication technology) standalone (SA) medical network in a smart health environment to meet the diverse needs of various medical services. Based on an analysis of network differentiation requirements in medical applications, the system architecture and functional positioning of the proposed private 5G SA medical network are designed and implemented. The system architecture includes the development of exclusive and preferential channels for medical use, as well as an ordinary user channel. A 3-layer network function architecture is designed, encompassing resource, control, and intelligent operation layers to facilitate management arrangements and provide network open services. Core technologies, including edge cloud collaboration; service awareness; and slicing of access, bearer, and core networks, are employed in the construction and application of the 5G SA network. The construction of the private 5G SA medical network primarily involves system architecture, standards, and security measures. The system, featuring exclusive, preferential, and common channels, supports a variety of medical applications. Relevant standards are adhered to in order to ensure the interaction and sharing of medical service information. Security is achieved through mechanisms such as authentication, abnormal behavior analysis, and dynamic access control. Three typical medical applications that rely on the 5G network in intrahospital, interhospital, and out-of-hospital scenarios-namely, mobile ward rounds, remote first aid, and remote ultrasound-were conducted. Testing of the 5G-enabled mobile ward rounds showed an average download rate of 790 Mbps and an average upload rate of 91 Mbps. Compared with 4G, the 5G network more effectively meets the diverse requirements of various business applications in prehospital emergency scenarios. For remote ultrasound, the average downlink rate of the 5G network is 4.82 Mbps, and the average uplink rate is 2 Mbps, with an average fluctuation of approximately 8 ms. The bandwidth, performance, and delay of the 5G SA network were also examined and confirmed to be effective. The proposed 5G SA medical network demonstrates strong performance in typical medical applications. Its construction and application could lead to the development of new medical service models and provide valuable references for the further advancement and implementation of 5G networks in other industries, both in China and globally.

Medical large language models are susceptible to targeted misinformation attacks

Large language models (LLMs) have broad medical knowledge and can reason about medical information across many domains, holding promising potential for diverse medical applications in the near future. In this study, we demonstrate a concerning vulnerability of LLMs in medicine. Through targeted manipulation of just 1.1% of the weights of the LLM, we can deliberately inject incorrect biomedical facts. The erroneous information is then propagated in the model’s output while maintaining performance on other biomedical tasks. We validate our findings in a set of 1025 incorrect biomedical facts. This peculiar susceptibility raises serious security and trustworthiness concerns for the application of LLMs in healthcare settings. It accentuates the need for robust protective measures, thorough verification mechanisms, and stringent management of access to these models, ensuring their reliable and safe use in medical practice.

Fuzzy Soft Sets and its Application to Decision Making: A Short Case Study Involving the Health Sector

The health sector faces uncertainty and complex decision-making scenarios, making traditional analytical tools insufficient. The fuzzy soft set theory has emerged as a powerful framework for modeling and reasoning with uncertain information, with promising applications in the health domain. This project explores the application of fuzzy soft sets in various decision-making processes in the health sector, including medical diagnosis, disease classification, treatment planning, risk assessment, patient stratification, and predictive modeling. The study reviews historical development of fuzzy set theory and its extension to soft sets, discussing challenges, limitations, and future research directions. The findings aim to contribute to the growing body of knowledge on the practical relevance and potential of fuzzy soft set theory in addressing healthcare decision-making needs.

Optimization model for mass casualty management system using qos-aware routing protocol and casualty triage prediction

Abstract Purpose Unexpected events, whether man-made or natural, cause significant distress and disorder. The number and magnitude of disasters and catastrophes have been rising globally in recent decades, according to historical data. Continued real-time monitoring of mass casualty along with the arrangement of needed medical resources to handle the mass casualty is required to reduce the mortality and morbidity rates. Methods Electronic tag-based casualty monitoring and machine learning-based Decision Support Systems are emerging as a more effective and proactive solution that provides continuous remote monitoring of patients. A novel framework based on Body-to-Body Network, Prediction model, and Genetic Algorithm-based medical resource optimization is proposed for the continuous monitoring of the mass casualty and medical resource allocation at the incident. The aim of this work is to give priority to the handling of critical casualties. Firstly, a Quality of Service and load-sensitive routing protocol for transmitting mass casualties' physiological parameters across a wireless network is proposed, with the critical casualty being emphasized. Secondly, the clinical seriousness degree of the mass casualty is predicted using Backpropagation Artificial Neural Network. Finally, an optimization model using a Genetic algorithm and queuing theory is proposed to find the required optimal number of medical resources to handle critical and non-critical casualties separately. Also, the proposed optimization model considers the predicted clinical level transition rates of the mass casualty. Results The performance and accuracy of the proposed framework are evaluated using the MIMIC-II dataset. The outcome demonstrates that the framework emphasizes critical casualty management. Furthermore, the framework allocates an adequate number of servers by incorporating the proposed routing protocol in comparison to the AODV protocol. Conclusion The inclusion of a prediction model in the framework aids in allocating an adequate number of servers by considering the predicted clinical deteriorating transition rates of casualties at a mass casualty incident. In terms of the estimated length of the casualty at the incident, the results suggest that incorporating a medical resource optimization model outperforms the non-optimal option.

Efficient labeling of french mammogram reports with MammoBERT

Recent advances in deep learning and natural language processing (NLP) have broadened opportunities for automatic text processing in the medical field. However, the development of models for low-resource languages like French is challenged by limited datasets, often due to legal restrictions. Large-scale training of medical imaging models often requires extracting labels from radiology text reports. Current methods for report labeling primarily rely on sophisticated feature engineering based on medical domain knowledge or manual annotations by radiologists. These methods can be labor-intensive. In this work, we introduce a BERT-based approach for the efficient labeling of French mammogram image reports. Our method leverages both the expansive scale of existing rule-based systems and the precision of radiologist annotations. Our experimental results showcase the superiority of the proposed approach. It was initially fine-tuned on a limited dataset of radiologist annotations. Then, it underwent training on annotations generated by a rule-based labeler. Our findings reveal that our final model, MammoBERT, significantly outperforms the rule-based labeler while simultaneously reducing the necessity for radiologist annotations during training. This research not only advances the state of the art in medical image report labeling but also offers an efficient and effective solution for large-scale medical imaging model development.

Teaching Models of Disability with Katherine Dunn’s Geek Love

Katherine Dunn’s Geek Love , a novel about children with engineered disabilities living and performing in a traveling freak show, has proved a useful vehicle in teaching of disability studies in the college classroom in that it utilizes and complicates the negative depictions of disability often available to students, and even works to advance an opposing and more positive view of disability. From the vast field of disability studies, the article focuses on five paradigms or models of disability to ground and focus students’ learning: the morality model, the charity model, the medical model, the supercrip model, and the social group model. All highlight the problematic ways in which society often views disability, as well as how readers might begin to shift these perceptions in more positive ways.

Necessity and impact of specialization of large foundation model for medical segmentation tasks.

Large foundation models, such as the Segment Anything Model (SAM), have shown remarkable performance in image segmentation tasks. However, the optimal approach to achieve true utility of these models for domain-specific applications, such as medical image segmentation, remains an open question. Recent studies have released a medical version of the foundation model MedSAM by training on vast medical data, who promised SOTA medical segmentation. Independent community inspection and dissection is needed. Foundation models are developed for general purposes. On the other hand, stable delivery of reliable performance is key to clinical utility. This study aims at elucidating the potential advantage and limitations of landing the foundation models in clinical use by assessing the performance of off-the-shelf medical foundation model MedSAM for the segmentation of anatomical structures in pelvic MR images. We also explore the simple remedies by evaluating the dependency on prompting scheme. Finally, we demonstrate the need and performance gain of further specialized fine-tuning. MedSAM and its lightweight version LiteMedSAM were evaluated out-of-the-box on a public MR dataset consisting of 589 pelvic images split 80:20 for training and testing. An nnU-Net model was trained from scratch to serve as a benchmark and to provide bounding box prompts for MedSAM. MedSAM was evaluated using different quality bounding boxes, those derived from ground truth labels, those derived from nnU-Net, and those derived from the former two but with 5-pixel isometric expansion. Lastly, LiteMedSAM was refined on the training set and reevaluated on this task. Out-of-the-box MedSAM and LiteMedSAM both performed poorly across the structure set, especially for disjoint or non-convex structures. Varying prompt with different bounding box inputs had minimal effect. For example, the mean Dice score and mean Hausdorff distances (in mm) for obturator internus using MedSAM and LiteMedSAM were {0.251±0.110, 0.101±0.079} and {34.142±5.196, 33.688±5.306}, respectively. Fine-tuning of LiteMedSAM led to significant performance gain, improving Dice score and Hausdorff distance for the obturator internus to 0.864±0.123 and 5.022±10.684, on par with nnU-Net with no significant difference in evaluation of most structures. All segmentation structures benefited significantly from specialized refinement, at varying improvement margin. While our study alludes to the potential of deep learning models like MedSAM and LiteMedSAM for medical segmentation, it highlights the need for specialized refinement and adjudication. Off-the-shelf use of such large foundation models is highly likely to be suboptimal, and specialized fine-tuning is often necessary to achieve clinical desired accuracy and stability.

Cap2Seg: leveraging caption generation for enhanced segmentation of COVID-19 medical images

Incorporating medical text annotations compensates for the quality deficiencies of image data, effectively overcoming the limitations of medical image segmentation. Many existing approaches achieve high-quality segmentation results by integrating text into the image modality. However, these approaches require matched image-text pairs during inference to maintain their performance, and the absence of corresponding text annotations results in degraded model performance. Additionally, these methods often assume that the input text annotations are ideal, overlooking the impact of poor-quality text on model performance in practical scenarios. To address these issues, we propose a novel generative medical image segmentation model, Cap2Seg (Leveraging Caption Generation for Enhanced Segmentation of COVID-19 Medical Images). Cap2Seg not only segments lesion areas but also generates related medical text descriptions, guiding the segmentation process. This design enables the model to perform optimal segmentation without requiring text input during inference. To mitigate the impact of inaccurate text on model performance, we consider the consistency between generated textual features and visual features and introduce the Scale-aware Textual Attention Module (SATaM), which reduces the model’s dependency on irrelevant or misleading text information. Subsequently, we design a word-pixel fusion decoding mechanism that effectively integrates textual features into visual features, ensuring that the text information effectively supplements and enhances the image segmentation task. Extensive experiments on two public datasets, MosMedData+ and QaTa-COV19, demonstrate that our method outperforms the current state-of-the-art models under the same conditions. Additionally, ablation studies have been conducted to demonstrate the effectiveness of each proposed module. The code is available at https://github.com/AllenZzzzzzzz/Cap2Seg.

Evaluation and mitigation of cognitive biases in medical language models.

Increasing interest in applying large language models (LLMs) to medicine is due in part to their impressive performance on medical exam questions. However, these exams do not capture the complexity of real patient-doctor interactions because of factors like patient compliance, experience, and cognitive bias. We hypothesized that LLMs would produce less accurate responses when faced with clinically biased questions as compared to unbiased ones. To test this, we developed the BiasMedQA dataset, which consists of 1273 USMLE questions modified to replicate common clinically relevant cognitive biases. We assessed six LLMs on BiasMedQA and found that GPT-4 stood out for its resilience to bias, in contrast to Llama 2 70B-chat and PMC Llama 13B, which showed large drops in performance. Additionally, we introduced three bias mitigation strategies, which improved but did not fully restore accuracy. Our findings highlight the need to improve LLMs' robustness to cognitive biases, in order to achieve more reliable applications of LLMs in healthcare.

3D medical model encryption based on five-dimensional hyperchaotic systems with 3D Arnold transform and selectable multiple spiral arrangements

3D medical model encryption based on five-dimensional hyperchaotic systems with 3D Arnold transform and selectable multiple spiral arrangements

3D LVCN: A Lightweight Volumetric ConvNet

ABSTRACTIn recent years, with the significant increase in the volume of three‐dimensional medical image data, three‐dimensional medical models have emerged. However, existing methods often require a large number of model parameters to deal with complex medical datasets, leading to high model complexity and significant consumption of computational resources. In order to address these issues, this paper proposes a 3D Lightweight Volume Convolutional Neural Network (3D LVCN), aiming to achieve efficient and accurate volume segmentation. This network architecture combines the design principles of convolutional neural network modules and hierarchical transformers, using large convolutional kernels as the basic framework for feature extraction, while introducing 1 × 1 × 1 convolutional kernels for deep convolution. This improvement not only enhances the computational efficiency of the model but also improves its generalization ability. The pro‐posed model is tested on three challenging public datasets, namely spleen, liver, and lung, from the medical segmentation decathlon. Experimental results show that the proposed model performance has in‐creased from 0.8315 to 0.8673, with a reduction in parameters of approximately 5%. This indicates that compared to currently advanced model structures, our proposed model architecture exhibits significant advantages in segmentation performance.

Defining Disability in Policy and in Practice in México

In the interest of providing inclusive education for students with disabilities within higher education and vocational formation, it is imperative that we examine how disability is understood by the actors involved. This research examines the definition of disability as it moves from an inclusive policy in México into practice at the macro, meso, and micro levels of implementation. Two key policy documents, one from the United Nations and one from México, were examined for how they define disability. Interviews, in which participants were asked to define disability, were conducted with government workers in key entities, program directors, and students with disabilities. The definitions from both documents and the interviews were categorized by specific constructs used in disability research including the social model, the medical model, the adaptability approach, and the International Classification of Functioning, Disability, and Health. A salient finding is that the construct of disability used within policies does not permeate to the actors involved in practice. To develop a clear understanding of this construct and in the interest of cohesion across implementation, a conversation between all actors would be beneficial.

SwinUNeCCt: bidirectional hash-based agent transformer for cervical cancer MRI image multi-task learning

Cervical cancer is the fourth most common malignant tumor among women globally, posing a significant threat to women’s health. In 2022, approximately 600,000 new cases were reported, and 340,000 deaths occurred due to cervical cancer. Magnetic resonance imaging (MRI) is the preferred imaging method for diagnosing, staging, and evaluating cervical cancer. However, manual segmentation of MRI images is time-consuming and subjective. Therefore, there is an urgent need for automatic segmentation models to identify cervical cancer lesions in MRI scans accurately. All MRIs in our research are from cervical cancer patients diagnosed by pathology at Tongren City People’s Hospital. Strict data selection criteria and clearly defined inclusion and exclusion conditions were established to ensure data consistency and accuracy of research results. The dataset contains imaging data from 122 cervical cancer patients, with each patient having 100 pelvic dynamic contrast-enhanced MRI scans. Annotations were jointly completed by medical professionals from Universiti Putra Malaysia and the Radiology Department of Tongren City People’s Hospital to ensure data accuracy and reliability. Additionally, a novel computer-aided diagnosis model named SwinUNeCCt is proposed. This model incorporates (i) A bidirectional hash-based agent multi-head self-attention mechanism, which optimizes the interaction between local and global features in MRI, aiding in more accurate lesion identification. (ii) Reduced computational complexity of the self-attention mechanism. The effectiveness of the SwinUNeCCt model has been validated through comparisons with state-of-the-art 3D medical models, including nnUnet, TransBTS, nnFormer, UnetR, UnesT, SwinUNetR, and SwinUNeLCsT. In semantic segmentation tasks without a classification module, the SwinUNeCCt model demonstrates excellent performance across multiple key metrics: achieving a 95HD of 6.25, an IoU of 0.669, and a DSC of 0.802, all of which are the best results among the compared models. Simultaneously, SwinUNeCCt strikes a good balance between computational efficiency and model complexity, requiring only 442.7 GFLOPs of computational power and 71.2 M parameters. Furthermore, in semantic segmentation tasks that include a classification module, the SwinUNeCCt model also exhibits powerful recognition capabilities. Although this slightly increases computational overhead and model complexity, its performance surpasses other comparative models. The SwinUNeCCt model demonstrates excellent performance in semantic segmentation tasks, achieving the best results among state-of-the-art 3D medical models across multiple key metrics. It balances computational efficiency and model complexity well, maintaining high performance even with the inclusion of a classification module.

Evaluating Medical Entity Recognition in Health Care: Entity Model Quantitative Study.

Named entity recognition (NER) models are essential for extracting structured information from unstructured medical texts by identifying entities such as diseases, treatments, and conditions, enhancing clinical decision-making and research. Innovations in machine learning, particularly those involving Bidirectional Encoder Representations From Transformers (BERT)-based deep learning and large language models, have significantly advanced NER capabilities. However, their performance varies across medical datasets due to the complexity and diversity of medical terminology. Previous studies have often focused on overall performance, neglecting specific challenges in medical contexts and the impact of macrofactors like lexical composition on prediction accuracy. These gaps hinder the development of optimized NER models for medical applications. This study aims to meticulously evaluate the performance of various NER models in the context of medical text analysis, focusing on how complex medical terminology affects entity recognition accuracy. Additionally, we explored the influence of macrofactors on model performance, seeking to provide insights for refining NER models and enhancing their reliability for medical applications. This study comprehensively evaluated 7 NER models-hidden Markov models, conditional random fields, BERT for Biomedical Text Mining, Big Transformer Models for Efficient Long-Sequence Attention, Decoding-enhanced BERT with Disentangled Attention, Robustly Optimized BERT Pretraining Approach, and Gemma-across 3 medical datasets: Revised Joint Workshop on Natural Language Processing in Biomedicine and its Applications (JNLPBA), BioCreative V CDR, and Anatomical Entity Mention (AnatEM). The evaluation focused on prediction accuracy, resource use (eg, central processing unit and graphics processing unit use), and the impact of fine-tuning hyperparameters. The macrofactors affecting model performance were also screened using the multilevel factor elimination algorithm. The fine-tuned BERT for Biomedical Text Mining, with balanced resource use, generally achieved the highest prediction accuracy across the Revised JNLPBA and AnatEM datasets, with microaverage (AVG_MICRO) scores of 0.932 and 0.8494, respectively, highlighting its superior proficiency in identifying medical entities. Gemma, fine-tuned using the low-rank adaptation technique, achieved the highest accuracy on the BioCreative V CDR dataset with an AVG_MICRO score of 0.9962 but exhibited variability across the other datasets (AVG_MICRO scores of 0.9088 on the Revised JNLPBA and 0.8029 on AnatEM), indicating a need for further optimization. In addition, our analysis revealed that 2 macrofactors, entity phrase length and the number of entity words in each entity phrase, significantly influenced model performance. This study highlights the essential role of NER models in medical informatics, emphasizing the imperative for model optimization via precise data targeting and fine-tuning. The insights from this study will notably improve clinical decision-making and facilitate the creation of more sophisticated and effective medical NER models.

Towards a general computed tomography image segmentation model for anatomical structures and lesions

Numerous deep-learning models have been developed using task-specific data, but they ignore the inherent connections among different tasks. By jointly learning a wide range of segmentation tasks, we prove that a general medical image segmentation model can improve segmentation performance for computerized tomography (CT) volumes. The proposed general CT image segmentation (gCIS) model utilizes a common transformer-based encoder for all tasks and incorporates automatic pathway modules for task prompt-based decoding. It is trained on one of the largest datasets, comprising 36,419 CT scans and 83 tasks. gCIS can automatically perform various segmentation tasks using automatic pathway modules of decoding networks through text prompt inputs, achieving an average Dice coefficient of 82.84%. Furthermore, the proposed automatic pathway routing mechanism allows for parameter pruning of the network during deployment, and gCIS can also be quickly adapted to unseen tasks with minimal training samples while maintaining great performance.

Mental Health Conditions Between Neurodiversity and the Medical Model

Scholarship in neuroethics and related disciplines has long reflected on the value of different conceptual models of disability and impairment. While this theoretical work is valuable, centering the voices of people with mental health conditions in neuroethics research can help us better understand how such models apply in everyday people’s lives. Drawing on qualitative data from a study on mental health peer providers’ lived experiences of recovery, this paper will demonstrate that peers borrow from both a neurodiversity framework and the medical model of disability, though their feelings toward the two models were often complex and ambivalent. These findings advance neuroethics by indicating that future research and clinical practice should take a nuanced approach to responding to the needs of people with mental health conditions and turn to peers as experts, honoring their values and recognizing both the promise and pitfalls of living with a mental health condition.