Philosphical medical ethics forms the basis of the codes of conduct and legal constraints involved in doctors' professional lives. This series of articles presents a British approach to the concepts, assumptions, beliefs, attitudes, and arguments underlying medico-moral decision-making in the context of medical practice. The book serves as an introduction whose aim is to encourage more rigorous analysis of the moral dilemmas confronting all physicians and to contribute to a comprehensive and coherent moral theory for medical practice.
Explores the philosophical and practical ethical implications of a definition of health as a state that allows us to reach our goals. Definitions of health and disease are of more than theoretical interest. Understanding what it means to be healthy has implications for choices in medical treatment, for ethically sound informed consent, and for accurate assessment of policies or programs. This deeper understanding can help us create more effective public policy for health and medicine. It is notable that such contentious legal initiatives as the Americans with Disability Act and the Patients' Bill of Rights fail to define adequately the medical terms on which their effectiveness depends. In Ethics and the Metaphysics of Medicine, Kenneth Richman develops an "embedded instrumentalist" theory of health and applies it to practical problems in health care and medicine, addressing topics that range from the philosophy of science to knee surgery. "Embedded instrumentalist" theories hold that health is a match between one's goals and one's ability to reach those goals, and that the relevant goals may vary from individual to individual. This captures the normative implications of the term health while avoiding problematic relativism. Richman's embedded instrumentalism differs from other theories of health in drawing a distinction between the health of individuals as biological organisms and the health of individuals as moral agents. This distinction illuminates many difficulties in patient-provider communication and helps us understand conflicts between promoting health and promoting ethically permissible behavior. After exploring, expanding, and defending this theory in the first part of the book, Richman examines its ethical implications, discussing such concerns as the connection between medical beneficence and respect for autonomy, patient-provider communication, living wills, and clinical education.
The idea of reviewing the ethical concerns of ancient medicine with an eye as to how they might instruct us about the extremely lively disputes of our own contemporary medicine is such a natural one that it surprises us to real ize how very slow we have been to pursue it in a sustained way_ Ideologues have often seized on the very name of Hippocrates to close off debate about such matters as abortion and euthanasia - as if by appeal to a well-known and sacred authority that no informed person would care or dare to oppose_ And yet, beneath the polite fakery of such reference, we have deprived our selves of a familiarity with the genuinely 'unsimple' variety of Greek and Roman reflections on the great questions of medical ethics. The fascination of recovering those views surely depends on one stunning truism at least: humans sicken and die; they must be cared for by those who are socially endorsed to specialize in the task; and the changes in the rounds of human life are so much the same from ancient times to our own that the disputes and agreements of the past are remarkably similar to those of our own.
In this unique study Fulford combines the disciplines of rigorous philosophy with an intimate knowledge of psychopathology to overturn traditional hegemonies. The patient replaces the doctor at the heart of medicine. Moral theory and the logic of evaluation replace epistemology as the focus of philosophical enquiry. Ever controversial, mental illness is at the interface of philosophy and medicine. Mad or bad? Dissident or diseased? Dr Fulford shows that it is possible to achieve new insights into these traditional dilemmas, insights at once practically relevant and philosophically significant.
Medical ethics draws upon methods from a wide array of disciplines, including anthropology, economics, epidemiology, health services research, history, law, medicine, nursing, philosophy, psychology, sociology, and theology. In this influential book, outstanding scholars in medical ethics bring these many methods together in one place to be systematically described, critiqued, and challenged. Newly revised and updated chapters in this second edition include philosophy, religion and theology, virtue and professionalism, casuistry and clinical ethics, law, history, qualitative research, ethnography, quantitative surveys, experimental methods, and economics and decision science. This second edition also includes new chapters on literature and sociology, as well as a second chapter on philosophy which expands the range of philosophical methods discussed to include gender ethics, communitarianism, and discourse ethics. In each of these chapters, contributors provide descriptions of the methods, critiques, and notes on resources and training. Methods in Medical Ethics is a valuable resource for scholars, teachers, editors, and students in any of the disciplines that have contributed to the field. As a textbook and reference for graduate students and scholars in medical ethics, it offers a rich understanding of the complexities involved in the rigorous investigation of moral questions in medical practice and research.
At all times physicians were bound to pursue not only medical tasks, but to reflect also on the many anthropological and metaphysical aspects of their discipline, such as on the nature of life and death, of health and sickness, and above all on the vital ethical dimensions of their practice. For centuries, almost for two millennia, how ever, those who practiced medicine lived in a relatively clearly defined ethical and implicitly philosophical or religious 'world-order' within which they could safely turn to medical practice, knowing right from wrong, or at least being told what to do and what not to do. Today, however, the situation has radically changed, mainly due to three quite different reasons: First and most obviously, physicians today are faced with a tremendous development of new possibilities and techniques which allow previously unheard of medical interventions (such as cloning, cryo-conservation, ge netic interference, etc. ) which call out for ethical reflection and wise judgment but regarding which there is no legal and medical ethical tradition. Traditional medical education did not prepare physicians for coping with this new brave world of mod em medicine. Secondly, there are the deep philosophical crises and the philosophical diseases of medicine mentioned in the preface that lead to a break-down of firm and formative legal and ethical norms for medical actions.
Edmund D. Pellegrino has played a central role in shaping the fields of bioethics and the philosophy of medicine. His writings encompass original explorations of the healing relationship, the need to place humanism in the medical curriculum, the nature of the patient’s good, and the importance of a virtue-based normative ethics for health care. In this anthology, H. Tristram Engelhardt, Jr., and Fabrice Jotterand have created a rich presentation of Pellegrino’s thought and its development. Pellegrino’s work has been dedicated to showing that bioethics must be understood in the context of medical humanities, and that medical humanities, in turn, must be understood in the context of the philosophy of medicine. Arguing that bioethics should not be restricted to topics such as abortion, third-party-assisted reproduction, physician-assisted suicide, or cloning, Pellegrino has instead stressed that such issues are shaped by foundational views regarding the nature of the physician-patient relationship and the goals of medicine, which are the proper focus of the philosophy of medicine. This volume includes a preface (“Apologia”) by Dr. Pellegrino and a comprehensive Introduction by the editors. Of interest to medical ethicists as well as students, scholars, and physicians, The Philosophy of Medicine Reborn offers fascinating insights into the emergence of a field and the work of one of its pioneers.
The goal of this open access book is to develop an approach to clinical health care ethics that is more accessible to, and usable by, health professionals than the now-dominant approaches that focus, for example, on the application of ethical principles. The book elaborates the view that health professionals have the emotional and intellectual resources to discuss and address ethical issues in clinical health care without needing to rely on the expertise of bioethicists. The early chapters review the history of bioethics and explain how academics from outside health care came to dominate the field of health care ethics, both in professional schools and in clinical health care. The middle chapters elaborate a series of concepts, drawn from philosophy and the social sciences, that set the stage for developing a framework that builds upon the individual moral experience of health professionals, that explains the discontinuities between the demands of bioethics and the experience and perceptions of health professionals, and that enables the articulation of a full theory of clinical ethics with clinicians themselves as the foundation. Against that background, the first of three chapters on professional education presents a general framework for teaching clinical ethics; the second discusses how to integrate ethics into formal health care curricula; and the third addresses the opportunities for teaching available in clinical settings. The final chapter, "Empowering Clinicians", brings together the various dimensions of the argument and anticipates potential questions about the framework developed in earlier chapters.
